Samuel is a 25-year-old male from a religious background that does not believe in health care. He is also from a non-English speaking background and has very limited skills in the English language. Although Samuel has had a severe stomach ache for the past month, he is determined not to seek any medical assistance. He attends an appointment with you, accompanied by his tutor from the local community house learning centre. Samuel is observed to be reluctant to be in the appointment. The tutor is observed to be concerned and worried over Samuel's well-being. The tutor informs you that Samuel is living in extremely overcrowded conditions with 10 other people in a 2-bedroom flat and she feels concerned that Samuel will face eviction shortly. The tutor states to you she will interpret for Samuel and that there "is no need to phone the interpreter services".

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.