David was a one-year-old child of Ghanaian heritage

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David was a one-year-old child of Ghanaian heritage. Both of his parents have mental health difficulties and were unable to look after him. His mother had two older children who were being brought up by their grandmother under Special Guardianship Orders (SGOs), but the grandmother was unable to care for David as well. The family put forward some cousins in Ghana as potential carers and they were positively assessed. The local authority began planning David's move to a placement in Ghana, but the children's guardian was concerned about the fact that moving there would mean David growing up away from his immediate family, and in particular losing a direct relationship with his siblings. She approached the foster carer and asked her to consider making an application for an SGO herself. The foster carer was also positively assessed and the court was faced with making a decision between two potential carers. The court heard that the relationship between the foster carer and family in the UK had deteriorated since she put herself forward, but nonetheless accepted her assurances that she would promote ongoing direct contact between David and his birth family. The local authority supported placement with family in Ghana and their intention to visit the UK twice each year to allow David to see his immediate family. The judge at first instance identified the opportunity for David to develop real relationships with his siblings as well as wider family members as the fact which tipped the balance in favour of the foster carer and made an SGO to her. The local authority appealed.

The court acknowledged that there were powerful arguments in favour of the foster carer's claim, but found that the judge had not shown that she had given sufficient weight to the advantages of David growing up embedded in his Ghanaian culture, supported by a maternal family who had aleady shown that they could make very satisfactory arrangements for the care of his siblings. Equally, the judge had not balanced the risks in each placement, i.e. the potential disadvantages of growing up between two families with different cultures, especially if the relationship between the foster carer and family broke down and contact failed, and of Ghana being a considerable distance from his family, particularly if the planned visits to England did not materialise. The judge's welfare evaluation and proportionality evaluation could not stand and the case would be remitted for rehearing.

In this case the local authority and David's family were all agreed that the parents could not look after him and that he should be placed with extended family in Ghana. It was the children's guardian who raised the importance of a closer sibling relationship and prompted the foster carer to put herself forward. This reflects the growing awareness of the importance of sibling relationships as part of the child's lifelong experience, as brothers and/or sisters are likely to be closer in age and experience than other family members and have the potential to be part of the child's support network for his whole life. It was also accepted that David had an existing family relationship with his foster carer which should be respected, despite the fact that this was a professional relationship, but that this needed to be weighed against the prospect of a placement available within his biological family, albeit in another country. The court emphasised that the appeal was being allowed on the basis of inadequate reasoning set out by the court at first instance, and provided no support for one outcome over another once the balancing exercise had been carried out fully at a rehearing

DESCRIPTION OF CLIENT(S):

Write what you observe about the client—age, sex, ethnicity, appearance, behaviors, and impressions.

PRESENTING PROBLEM:

Describe the problem as the client has presented it, including perspective, function impairment, and symptoms.

HISTORY OF PROBLEM:

Describe the course of the problem and specific onset and symptoms.

MENTAL STATUS:

Activity:

Mood and Affect: 

Thought Process, Content, and Perception:

Cognition, Insight, and Judgment:

                     Suicidal and Homicidal Assessment

If a more thorough suicide/homicide evaluation is conducted, it may be documented in a separate section.

SOCIAL HISTORY:

Describe the client's present living situation:

Family:

School:

Health:

Occupational/Work:

Spiritual/Religious:

Legal:

Social History (include history of abuse/trauma):

HEALTH & WELLNESS HISTORY:

           Substance use (including alcohol, drugs, tobacco and caffeine intake):

                   Sleep habits:

           Exercise habits:

          Eating habits and appetite:

PREVIOUS THERAPY / PSYCHIATRIC SERVICES:

Have you ever been in counseling before? ?No ?Yes, ?Inpatient ?Outpatient ?Day Treatment

Name of Provider Clinic Year Diagnosis / Problem

_____________________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

Have you ever seen a Psychiatrist before? ?No ?Yes, ?Inpatient ?Outpatient ?Day Treatment

Name of MD: _______________________________________ Clinic: _____________________________

Was any of your previous therapy related to substance abuse? ?No ?Yes

Have you ever had serious thoughts of suicide or homicide? ?No ?Yes

Have you ever made a suicide / homicide attempt? ?No ?Yes Explain: ____________________________

_____________________________________________________________________________________

Do you presently feel suicidal or homicidal? ?No ?Yes Explain: __________________________________

FAMILY RELATIONSHIP HISTORY:

Describe the client's current and historical family status and relationships, including during childhood/adolescence.

STRENGTHS:

Describe assets that will facilitate progress and change, such as motivation, intelligence, self-discipline, and willingness to utilize resources.

CHALLENGES 

Describe aspects' of the client's life circumstance that may impede progress/change, such as homelessness, major psychiatric disorder, financial hardship, etc.

DIAGNOSIS: 

Using the information gathered thus far, make a diagnosis using DSM 5.

DISCUSSION/CLINICAL FORMULATION:

Provide your rationale for the provided diagnosis. Describe the appropriate theory to consider using with this client. Note the basics of this theory and how it might apply to this client.