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SOCIAL CASE STUDY REPORT
Date: ______________
Family ID No:
I. Identifying Information (Grantee)
Name :
Address :
Birthdate :
Highest Educational Report :
Gender :
Family Circumstances : (category of the HH)
II. Family Composition
Name Age Family
Members
Category
(per
member)
Relationship
to Client
Civil
Status
Highest
Educational
Attainment
Occupation Estimated
Monthly
Income
III. Presenting Problem
• From the Point of View of the Client (presenting problem)
• From the Point of View of the Case Worker (immediate problem to work on and
underlying problem anchored on the SWI results)
IV. Background Information/ History
A. Client – (Clear target who among the family members ,e.g. Grantee it should be grantee
focused) –Biopschosocio-spiritual
Republic of the Philippines
Department of Social Welfare and Development
• Biological (Physical and Health Status)
• Social Context (Role performance, relationship with others)
• Psychological Context (Emotional and Cognitive)
B. Family
• Socio-economic status of the Family
C. Environment/Community
V. Current Family Functioning
a. Role Performance
b. Rules
c. Relationships
d. Rituals
(decision-making, interaction, communication & problem-solving patterns)
VI. Assessment (Based on findings/assessment based on the above and used of tools)
• Strengths, motivations, opportunities for change
• Limitations, weaknesses/constraints or obstacles to be overcome
• Problem prioritization
VII. Rehabilitation/Intervention Plan
INTERVENTION PLAN/S FOR THE FAMILY
Goal:
Objectives:
Need/Problem Interventions Activities Time Frame Responsible Person Remarks
Efforts for economic
sufficiency
Compliance to
Program
conditionalities
INTERVENTION PLAN/S FOR THE CHILD/CHILDREN
Objectives:
Problem Area Intervention/Activities Time Frame Responsible
Person
Remarks
Compliance to health Health grant
Compliance to education Education grant
VIII. Recommendations
• Priority Actions to be taken based on the above
Prepared by: Reviewed by:
___________ ____________________
Case Worker Registered Social Worker
License No._________ License No___________
Approved by:
____________
Head of the Organization

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Sample case study report format

  • 1. SOCIAL CASE STUDY REPORT Date: ______________ Family ID No: I. Identifying Information (Grantee) Name : Address : Birthdate : Highest Educational Report : Gender : Family Circumstances : (category of the HH) II. Family Composition Name Age Family Members Category (per member) Relationship to Client Civil Status Highest Educational Attainment Occupation Estimated Monthly Income III. Presenting Problem • From the Point of View of the Client (presenting problem) • From the Point of View of the Case Worker (immediate problem to work on and underlying problem anchored on the SWI results) IV. Background Information/ History A. Client – (Clear target who among the family members ,e.g. Grantee it should be grantee focused) –Biopschosocio-spiritual Republic of the Philippines Department of Social Welfare and Development
  • 2. • Biological (Physical and Health Status) • Social Context (Role performance, relationship with others) • Psychological Context (Emotional and Cognitive) B. Family • Socio-economic status of the Family C. Environment/Community V. Current Family Functioning a. Role Performance b. Rules c. Relationships d. Rituals (decision-making, interaction, communication & problem-solving patterns) VI. Assessment (Based on findings/assessment based on the above and used of tools) • Strengths, motivations, opportunities for change • Limitations, weaknesses/constraints or obstacles to be overcome • Problem prioritization VII. Rehabilitation/Intervention Plan INTERVENTION PLAN/S FOR THE FAMILY Goal: Objectives: Need/Problem Interventions Activities Time Frame Responsible Person Remarks Efforts for economic sufficiency Compliance to Program conditionalities INTERVENTION PLAN/S FOR THE CHILD/CHILDREN Objectives: Problem Area Intervention/Activities Time Frame Responsible Person Remarks Compliance to health Health grant Compliance to education Education grant
  • 3. VIII. Recommendations • Priority Actions to be taken based on the above Prepared by: Reviewed by: ___________ ____________________ Case Worker Registered Social Worker License No._________ License No___________ Approved by: ____________ Head of the Organization