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 * __Case Study - Berice__ **

 media type="file" key="Memo-1.m4a" align="center" Berice is a thirty-five-year –old married Jamaican male who sustained a [|closed-head injury] approximately six months ago. He fell off a ladder while painting a friend’s house. He was employed by a painting company at the time of the injury, but the injury did not occur on the job. He was knocked unconscious and was discovered by his friend, who called an ambulance. He was taken to the hospital where he was admitted. He regained consciousness after a few hours. He was diagnosed with a [|moderate head injury], based upon the [|Glasgow Coma Scale]. Residual effects of the head injury included difficulty in concentration, mild memory loss, sudden mood swings from happy to sad, and anger either unprovoked or inconsistent with the circumstances for the situation. Berice entered the US approximately two years ago. His brother, who is a UScitizen, owned the painting company, and this brother had sponsored him.

After the injury, Berice was able to return to work, but he was unsteady on a ladder and the company did not want to risk further injury. His family noted how the residual side effects impacted his relationships with others. Berice would forget what he was talking about, and he was emotionally unpredictable. A relative of Berice informed him that he may be eligible for services at the state vocational offices. He decided to visit an office and apply for services.

Jim, a twenty-five-year-old white male [|vocational rehabilitation counselor], was assigned Berice’s case. Jim had worked at the state vocational rehabilitation office for several years and he had had a few clients with head injuries. Jim found Berice to be pleasant and motivated to become employed again. Berice expressed an interest in employment as an alarm-system installer. He wanted to receive training for this type of occupation and requested that the state vocational rehabilitation program fund the training. Jim did not know whether this was a viable goal given Berice’s head injury and the residual effects. Berice gave permission for Jim to speak to his physician, family, and former employer as part of the initial informational-gathering process.

 A review of job tasks showed that the occupation of alarm-system installer involved:  · Consulting with clients to assess risks and to determine security requirements  · Drilling holes for wiring in wall studs, joists, ceilings, and floors  · Feeding cables through access holes  · Inspecting installation sites  · Studying work orders, building plans, and instillation manuals ([|Occupational Information Network [ONET, 2004]])

Jim questioned whether Berice had the ability and skills to perform such job tasks. He decided to obtain further formal assessment information and determined that a [|neuropsychological assessment] would be helpful. His office typically used a [|psychologist], Dr. Kinney, who was knowledgeable in neuropsychological assessment, but who did not use any assessments that accounted for cultural difference. Counselors in the office knew this was a limitation of Dr. Kinney. Jim decided to use Dr. Kinney despite these limitations because Jim ahead a large caseload and did not have the time to located another neuropsychologist that might provide a more culturally sensitive assessment.

Berice completed the assessment with Dr. Kinney and then met with Jim to discuss the results. Jim explained to Berice that the results indicated that Berice had limitations that prevented him from perusing employment as an alarm-system installer. Berice was upset with the results and stated that he did not believe Dr. Kinney understood him.