Mary is a mother of four children between the ages of 2 months and 6 years old. She lives in a nice family home in the suburbs of Melbourne; however, she does not leave the house much as she is always looking after her children and their needs. Mary's husband Tony is a builder; Mary states he is a "traditional" man and their European culture states that "women must stay at home and rear the children whilst your husband goes out to work". Mary has had constant back pain for the past few years, which she states has increased in severity since her first pregnancy, and gradually worsened with each pregnancy. She further states her back pain is getting more severe as time progresses. Mary has been referred to you by her GP, referral states stress and anxiety as the main issues. At the initial appointment, Mary states she has not had time to get her back checked out due to lack of time away from her children; Mary is observed to commence crying when speaking of seeking support from her husband and/or their families.

1. Identify the ways in which social and cultural institutions impact this client.

2. Evaluate the consequences that factors such as inequality, long-term unemployment, homelessness and age may have on this client.

3. Identify which of the client's health and well-being needs could impact the work you will undertake with the client.

4. Suggest what relevant services you would like to refer the client to, explaining why.

5. Explain how you will monitor and review the effectiveness of the work and/or services you provide to this client.

6. Explain how you will revise the work and/or services you provide to this client if you find the current treatments do not enhance client outcomes enough or do not address social and cultural factors enough.