Maria is paralyzed from the waist down following an accident three summers ago in a swimming pool. She is hoping to complete her degree in accounting, but she is complaining of depression and an inability to focus on school. When you see her, she looks anxious and tired. Her affect is flat, and she tells you nothing interests her. At the local college, she has had trouble finding appropriate parking and misses many days of class when the weather is bad because of the parking situation. One of the professors she must work with closely has made remarks about the difficulty of “other people getting around that wheelchair.” She believes her boyfriend, who was with her the night the accident happened, has remained with her simply out of pity. When they fight about other things, she throws this up to him, although he vehemently denies it and tells Maria this is a hurtful accusation. 

Interventions on the micro level: 

Interventions on the mezzo level: 

Interventions on the macro level:

Look at the four cases above and decide how you would intervene on three levels: the personal (micro), the contextual or social context immediately surrounding the client (meso/mezzo), and the larger environment (macro).