Description
Please provide an answer that is 100% original and do not copy the answer to this question from any other website since I am already well aware of this. I will be sure to check this.
Please be sure that the answer comes up with way less than 18% on Studypool’s internal plagiarism checker since anything above this is not acceptable according to Studypool’s standards. I will not accept answers that are above this standard.
No AI or Chatbot! I will be sure to check this.
Please be sure to carefully follow the instructions.
Ella Schultz is the case we were working on.
It is common for social workers to be presented with a crisis situation brought forth by clients, families, communities, and/or organizations. The ultimate goal is to restore the client to equilibrium. The five stages of the crisis are (1) the hazardous event, (2) the vulnerable stage, (3) the precipitating factor, (4) the state of active crisis, and (5) the reintegration or crisis resolution phase.
We neeed to use these 5 stages. Just pointing it out.
APPLICATION OF CRISIS THEORY AND RESILIENCY THEORY TO A CASE STUDY
It is common for social workers to be presented with a crisis situation brought forth by clients, families, communities, and/or organizations. The ultimate goal is to restore the client to equilibrium. The five stages of the crisis are (1) the hazardous event, (2) the vulnerable stage, (3) the precipitating factor, (4) the state of active crisis, and (5) the reintegration or crisis resolution phase.
There are times when a social worker will use more than one theory to assist in conceptualizing the problem and intervention, particularly if the theories complement each other. For example, resiliency theory can be used alongside crisis theory.
TO PREPARE
Review the same case study you selected in Week 2.
Use the Analysis of a Theory Worksheet to help you dissect the theory. Use this tool to dissect the theory, employ the information in the table to complete your Assignment, and then keep it to add to your Theories Study Guide in Week 11.
SUBMIT A 1 TO 2 full PAGE CASE WRITE-UP THAT ADDRESSES THE FOLLOWING:
Map the client’s crisis using the five stages of the crisis.
Describe the client’s assets and resources (in order to understand the client’s resilience).
Describe how you, the social worker, will intervene to assist the client to reach the reintegration stage of the crisis. Be sure that the intervention promotes resiliency.
Explain how using crisis theory and resiliency theory together help in working with a client.
Submit also, as a separate document, your Week 5 Analysis of a Theory Worksheet.
Be sure to:
Identify and correctly reference the case study you have chosen.
Use literature to support your claims.
Use APA formatting and style.
Remember to double-space your paper.
Life Span and Resiliency Theory: A Critical Review | Advances in Social Work (iupui.edu)
Requirements: 1-2 Full Page Write-Up + Complete Week 3 Analysis of a Theory Worksheet. Times New Roman Size 12 Font Double-Spaced APA Format Excluding the Title and Reference Pages
Please provide an answer that is 100% original and do not copy the answer to this question from any other website since I am already well aware of this. I will be sure to check this.
Please be sure that the answer comes up with way less than 18% on Studypool’s internal plagiarism checker since anything above this is not acceptable according to Studypool’s standards. I will not accept answers that are above this standard.
No AI or Chatbot! I will be sure to check this.
Please be sure to carefully follow the instructions.
Please be sure to include an introduction paragraph with a clear thesis statement in the last sentence of the introduction paragraph and a conclusion paragraph for the write-up.
No plagiarism & No Course Hero & No Chegg. The assignment will be checked for originality via the Turnitin plagiarism tool.
Please be sure to include at least one in-text citation in each body paragraph.
Unformatted Attachment Preview
JOURNAL OF FAMILY SOCIAL WORK
2018, VOL. 21, NO. 2, 81–84
https://doi.org/10.1080/10522158.2018.1424426
PREFACE
Family resilience: Emerging trends in theory and practice
Kristin Hadfielda and Michael Ungarb
a
Department of Biological and Experimental Psychology, Queen Mary, University of London, London, UK;
Resilience Research Centre, Dalhousie University, Halifax, Canada
b
KEYWORDS Family resilience; resilience; family systems; adversity; family functioning
ARTICLE HISTORY Received 28 December 2017; Accepted 03 January 2018
Thinking systemically has always been important to how social workers
approach problems and their solutions. The field of resilience, and in particular
the study of human resilience, however, was initially led largely by psychologists
who focused on individual traits and patterns of invulnerability or coping to
explain better-than-expected developmental outcomes of children living in
stressful environments (e.g., Anthony, 1987; Murphy & Moriarty, 1976). The
systems surrounding the child and the family were mentioned, but the focus
remained largely on an individual child’s capacity to cope rather than the
available strengths in a child’s family, peer, school, or community contexts.
A shift to a more systemic focus to studies of positive functioning and
resilience began in earnest during the 1980s with the important work of
Dr. Froma Walsh (1998, 2003; who appears in this special issue) and her
focus on patterns of adaptation in families. Other researchers, such as
Dr. Hamilton McCubbin and his group, were studying the resilience of
military families and racial minority families (McCubbin et al., 1998;
McCubbin & Patterson, 1983) around the same time, noticing that it takes a
well-functioning family system, not just individuals, to cope in a stressful
environment. Models of family coping (and resilience), along with shifting
discourses in the field of psychology toward a more contextualized science of
human development, began to influence the pioneers of resilience theory,
including Sir Michael Rutter (1985), Dr. Norman Garmezy and his student
Dr. Ann Masten (Garmezy, 1983; Garmezy, Masten, & Tellegen, 1984), and
Drs. Emmy Werner and Ruth Smith (1982). They and many others began to
observe the positive impact of attachments and the opportunities that proximal (family) and distal (community) systems provided vulnerable populations
of children. The result has been the broadening of our understanding of the
mechanisms that create resilience, with the resilience of family processes now
known to improve the resilience of individuals biologically (Sternthal et al.,
2009), psychologically (Cicchetti, 2013), and socially (Ungar, 2015, 2016).
CONTACT Kristin Hadfield
[email protected]
Fogg Building, Department of Biological and
Experimental Psychology, School of Biological and Chemical Sciences, Queen Mary, University of London, E1 4NS.
© 2018 Taylor & Francis
82
K. HADFIELD AND M. UNGAR
Although we know family systems matter when it comes to resilience, there is
still much to learn about how families influence the resilience of their members
and how we (as social workers and other health professionals) can intervene to
improve the resilience of populations who are marginalized by personal
limitations and social and structural barriers.
This special issue of the Journal of Family Social Work on family resilience
explores some emerging trends in a systemic approach to resilience, drawing
attention to new understandings of how family systems impact child and adult
well-being in contexts of adversity. We begin this issue with an interview
between the Editor-in-Chief of the Journal of Family Social Work, Dr. Judith
Siegel, and one of the leading experts on family resilience, Dr. Froma Walsh. In
this fascinating interview, Dr. Walsh describes how her own experiences led
her to a family resilience perspective, how a strengths-based approach can be
useful when working with families, and changes she has seen in this field
throughout her career.
We have then included two articles that are focused on how individuals and
families cope with displacement and adversity resulting from major challenges
outside of the family. In the first, through interviews with Syrian refugees and
social workers in a European country which receives few refugees, Dubus (this
issue) explains what family and societal processes are critical to well-being
among refugees. She contrasts how differences in two families’ predisplacement
lives influence how they deal with the resettlement process. Given the scale of
displacement worldwide, this in-depth exploration into how and which pre- and
postsettlement factors influence family resilience has important practical implications for social workers. The second article is a theoretical and review piece on
how natural disasters impact individuals and families. Osofsky and Osofsky (this
issue) explain how building resilience at the individual, family, and community
level is necessary for reducing the negative effects of major disasters. Using a case
study as an example, they provide specific points to help social workers and
other professionals to work effectively with students in schools after disasters in
ways which promote students’ resilience, as well as emphasizing the lessons they
have learned through doing this work.
Finally, we have included three articles that focus more specifically on family
and couple functioning. These articles take different approaches, with the first
two focusing on building protective processes to improve relationships, and the
final paper discussing how a one-size-fits-all approach to families may be counter-productive. Jensen and Bowen (this issue) use survey data from over 30,000
active-duty Air Force members in the United States to test a model of how
resilience can be bolstered. They aim to understand how maltreatment within
families can be reduced by improving how Air Force members deal with adversity. Their findings suggest the critical importance of safe, stable, and nurturing
families in promoting resilience and reducing family maltreatment perpetration.
Following this, Lucier-Greer, Birney, Gutierrez, and Adler-Baeder’s (this issue)
JOURNAL OF FAMILY SOCIAL WORK
83
article describes the development and testing of a mobile app, Love Every Day,
which enhances relationship quality, skills, and behaviours. The possibility of
using a mobile application to promote daily positive interactions between families
has great potential for improving couple relationships and bolstering the resilience of all couples but may be of particular use for those who are unable to
benefit from in-person interventions because of geographic or social issues.
Finally, Hadfield, Ungar, and Nixon (this issue) examine “family instability,”
which is a concept often used in research and practice to describe when a parent
dissolves or enters into a romantic relationship. In their article, Hadfield and
colleagues use case examples from interviews with mothers and their children in
Ireland to exemplify ways in which these transitions in family structure may be
positive or negative, and provide advice for how parents can manage these
transitions to avoid causing stress to their children.
Together these articles continue a four-decade conversation about family
resilience and the important role social workers play in advancing our
understanding of how the resilience of systems can improve the resilience
of individuals. The articles give a sense of the diversity of research done in
the field of family resilience and its application to social work practice.
References
Anthony, E. J. (1987). Risk, vulnerability, and resilience: An overview. In E. J. Anthony & B.
Cohler (Eds.), The invulnerable child (pp. 3–48). New York, NY: Guilford Press.
Cicchetti, D. (2013). Annual research review: Resilient functioning in maltreated children—Past,
present, and future perspectives. Journal of Child Psychology and Psychiatry, 54, 402–422.
doi:10.111/j.1469-7610.2012.02608.x
Dubus, N. (2018). Family resiliency during resettlement: A comparative study of two Syrian
families resettled in an Arctic nation. Journal of Family Social Work, 21, . doi:10.1080/
10522158.2017.1410269
Garmezy, N. (1983). Stressors of childhood. In N. Garmezy & M. Rutter (Eds.), Stress, coping,
and development in children (pp. 43–84). New York, NY: McGraw-Hill.
Garmezy, N., Masten, A. S., & Tellegen, A. (1984). The study of stress and competence in
children: A building block for developmental psychopathology. Child Development, 55,
97–111. doi:10.2307/1129837
Hadfield, K., Ungar, M., & Nixon, E. (2018). Rethinking discourses of family instability.
Journal of Family Social Work, 21. doi:10.1080/10522158.2017.1410268
Jensen, T. M., & Bowen, G. L. (2018). Informing efforts to prevent family maltreatment
among airmen: A focus on personal resilience. Journal of Family Social Work, 21.
doi:10.1080/10522158.2017.1410270
Lucier-Greer, M., Birney, A. J., Gutierrez, T. M., & Adler-Baeder, F. (2018). Enhancing
relationship skills and couple functioning with mobile technology: An evaluation of the
love every day mobile intervention. Journal of Family Social Work, 21. doi:10.1080/
10522158.2017.1410267
McCubbin, H. I., Fleming, W. M., Thompson, A. I., Neitman, P., Elver, K. M., & Savas, S. A.
(1998). Resiliency and coping in ‘at risk’ African-American youth and their families. In
84
K. HADFIELD AND M. UNGAR
H. I. McCubbin, E. A. Thompson, A. I. Thompson, & J. A. Futrell (Eds.), Resiliency in
African-American families (pp. 287–328). Thousand Oaks, CA: Sage.
McCubbin, H. I., & Patterson, J. M. (1983). The family stress process: The double ABCX
model of adjustment and adaptation. Marriage and Family Review, 6, 7–37. doi:10.1300/
J002v06n01_02
Murphy, L. B., & Moriarty, A. E. (1976). Vulnerability, coping, and growth from infancy to
adolescence. New Haven, CT: Yale University Press.
Osofsky, J., & Osofsky, H. (2018). Challenges in building child and family resilience after
disasters. Journal of Family Social Work. doi:10.1080/10522158.2018.1427644
Rutter, M. (1985). Family and school influences on behavioural development. Child
Psychology and Psychiatry, 26, 349–368. doi:10.1111/j.1469-7610.1985.tb01938.x
Sternthal, M. J., Enlow, M. B., Cohen, S., Canner, M. J., Staudenmayer, J., Tsang, K., & Wright,
R. J. (2009). Maternal interpersonal trauma and cord blood IgE levels in an inner-city cohort:
A life-course perspective. Journal of Allergy and Clinical Immunology, 124, 954–960.
doi:10.1016/j.jaci.2009.07.030
Ungar, M. (2015). Practitioner review: Diagnosing childhood resilience–a systemic approach
to the diagnosis of adaptation in adverse social and physical ecologies. Journal of Child
Psychology and Psychiatry, 56, 4–17. doi:10.1111/jcpp.12306
Ungar, M. (2016). Varied patterns of family resilience in challenging contexts. Journal of
Marital and Family Therapy, 42, 19–31. doi:10.1111/jmft.12124
Walsh, F. (1998). Strengthening family resilience. New York, NY: Guilford.
Walsh, F. (2003). Normal family processes (3rd ed.). New York, NY: Guilford.
Werner, E. E., & Smith, R. S. (1982). Vulnerable but invincible: A longitudinal study of
resilient children and youth. New York, NY: McGraw-Hill.
Copyright of Journal of Family Social Work is the property of Taylor & Francis Ltd and its
content may not be copied or emailed to multiple sites or posted to a listserv without the
copyright holder’s express written permission. However, users may print, download, or email
articles for individual use.
Analysis of Theory Worksheet
Use this worksheet to help you apply a theory as a lens to the case study for your
assignments. Fill in the column on the right with all applicable information, and then
consider it a reference for how to apply the theory. You must submit this worksheet,
where indicated, in applicable assignments. Then you will compile the worksheet for
your Theories Study Guide (that you can use for the licensure exam) at the end of the
course.
Name of theory
Author or founder
Historical origin of
theory
Basic assumptions
Underlying
assumptions
Key concepts
Foci/unit of analysis
Philosophical or
conceptual framework
Strengths of theory
Limitations of theory
Common criticisms
When and with whom it
would be appropriate to
use the theory/model
Consistency of
theory/model with
social work principles
Identification of
goodness of fit with
ethical principles
Ways in which
theory/model informs
research methods
Implications for social
work practice
© Walden University, LLC
1
Theory Into Practice: Four Social Work Case Studies
In this course, you select one of the following four case studies and use it throughout
the entire course. By doing this, you will have the opportunity to see how different
theories guide your view of a client and that client’s presenting problem. Each time you
return to the same case, you will use a different theory, and your perspective of the
problem will change—which then changes how you ask assessment questions and how
you intervene.
Table of Contents
Ella Schultz ……………………………………………………………………………………………………… 2
Paula Cortez ……………………………………………………………………………………………………. 9
Sam Franklin ………………………………………………………………………………………………….. 10
Helen Petrakis ………………………………………………………………………………………………… 13
© Walden University, LLC
1
Ella Schultz
Identifying Data
Ella Schultz is a 16-year-old White female of German decent. She was raised in Ohio.
Ella’s family consists of her father, Robert (44 years old), and her mother, Rose (39
years old). Ella currently resides in a residential group home, where she has been since
she ran away from home. Ella has been provided room and board in the residential
treatment facility for the past 3 months. Ella describes herself as bi-sexual.
Presenting Problem
Ella has been living homeless for 13 months. She has been arrested on two occasions
for shoplifting and once for loitering (as a teen in need of supervision) in the last 7
months. Ella has recently been court ordered to reside in a group home with counseling.
She refuses to return home due to the abuse she experienced. After 3 months at Teens
First, Ella said she is thinking about reinitiating contact with her mother. She has not
seen either parent in 6 months and missed the stability of the way her family “used to
be,” although she is also conflicted due to recognizing the instability of her family. Ella is
confused about the path to follow.
Family Dynamics
Ella indicates that her family worked well until her father began drinking heavily about 3
years ago. She remembers her parents being social and going out or having friends
over for drinks, but she never remembered them becoming drunk. Then, her father lost
his job as an information technology (IT) support professional and was unable to find
meaningful work. He took on part-time jobs at electronics stores, but they left him
demoralized. Her parents stopped socializing, and then her father was fired from his last
job because he arrived drunk. Ella’s father would regularly be drunk by the time she
arrived home from school.
When Ella started having trouble in school, her father would berate her when she came
home if she didn’t study immediately. Then, he would interrupt her studies by following
her around and verbally abusing her. Soon after, he began hitting her or throwing
objects at her. Once she went to the emergency room for stitches on her brow when
she was struck by a drinking glass her father threw. She was able to convince the
emergency room (ER) staff, however, that it was a bike accident, as she was known as
an avid biker around her community, often riding to and from school and elsewhere.
Ella’s mother did not witness these events, as they often occurred before she returned
from work, and her father might be passed out by this time. Ella reports that her mother
was in denial about her father, often pretending there was no issue. When Ella tried to
report the abuse, her mother took her father’s side. Finally, after the stitches, Ella
confronted her mom with her father present. Her father denied it, flew into a rage, and
then physically abused both Ella and her mom.
The next day, Ella’s mom acted as if nothing happened. After the abuse quickly
escalated in the next week, to the point where she could no longer hide it or cover it up,
© Walden University, LLC
2
Ella fled home and has been homeless since. She left a note before leaving for school
one morning and did not return home.
Educational History
Ella attends school at the group home, taking general education classes for her general
education development (GED) credential. Shortly after her father lost his job, Ella began
experiencing learning disabilities. Her difficulties began in math, where she had difficulty
sorting and making sense of numbers. Then she began to fall behind in her reading. Her
grades went from a B average to consistent D’s. Some of Ella’s Instructors began to
raise the issue of a possible learning disability. A counselor made an appointment to
discuss possible causes, but Ella left school and home just prior to that meeting, and did
not attend.
Employment History
Ella reports that her father was employed as an IT support professional at a bank. When
the bank downsized and closed many branches, her father was laid off. He was unable
to secure another IT support position, as many companies had begun outsourcing this
work to contractors or overseas. He began to work part-time retail jobs at consumer
electronics stores but quickly became demoralized and lost a series of those jobs. Her
mother works as a full-time home health aide.
Social History
Ella reports that the homeless encampment (where she wound up for a long stretch)
had a group of teens that stuck together for protection and to shield themselves and
each other from certain bad choices. It was at this time that Ella reports she became
bisexual, seeking out and bonding to a group of women who were able to avoid being
exploited for human trafficking.
The encampment group did still engage in risky behavior, however, including frequent
shoplifting and other theft to secure food, supplies, etc. Likewise, although Ella reports
that she did not engage in prostitution, she did engage in unprotected sex with one
woman whose sexual history may have included prostitution or intravenous drug use.
Thus Ella contracted a sexually transmitted infection (STI) in one instance.
Ella reports she might consider trying to go home if she knew her father was no longer
there, despite feeling betrayed by her mother. She would also be willing to reconcile and
attend therapy with her. However, Ella feels that her mother, who comes from a very
religious family (though does not practice much now), would ultimately reject her due to
her bisexual identification.
Ella also feels a strong bond to the group of teens and women with whom she stayed in
the homeless encampment. She reports that she misses them and wishes she could
see them—especially one teen in particular named Marisol. She says she considers
these women to be as much, if not more, her family as her biological family.
© Walden University, LLC
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Mental Health History
Ella began counseling to address the abuse in her history. In her initial reports, as
detailed above, she cites mostly verbal and psychological abuse with only two instances
of physical abuse. She denies any sexual abuse.
When Ella recounts the physical abuse specifically, however, she shows added signs of
acute distress and trauma. The physical harm caused by the event that triggered her
leaving was reportedly significant—bruising on both arms, a split lip, a bloody nose, and
a bump on the head—all from punches—as well as bruises on her leg from being
kicked. She did not seek medical help and avoided as much social contact as possible
the day she ran away, so as not to encourage inquiries about her home situation.
Ella does have positive memories of what she calls “the before time,” and she shows a
desire to return to that time. She worries for her mom, despite feeling betrayed by her.
The last time she did have contact with her mom, she promised to leave her dad, but
Ella does not know if this ever occurred.
Legal History
Ella has been arrested three times, twice for shoplifting and once for vagrancy. Citing
the abuse she reported at home and the fears she felt, Ella was mandated to services at
the Teens First agency, unlike her prior arrests when she was sent to detention.
Alcohol and Drug Use History
Ella denies any alcohol or drug use while living homeless. She reports the homeless
encampment (where she wound up for a long stretch) had a group of teens that stuck
together and were able to shield themselves from certain bad choices.
Medical History
During intake, it was noted that Ella showed signs of living homeless, including carrying
all her possessions in one bag, signs of malnourishment, feet with heavy callouses, and
clothing in disrepair. She did not show signs of drug use or self-harm. The STI she
contracted was diagnosed upon intake, and she received antibiotics for treatment.
Strengths
Ella is resilient in learning how to survive in a difficult situation. She was able to avoid
the more severe negative outcomes, such as human trafficking and drug use. She is
able to form beneficial bonds for protection and support.
Father: Robert Schultz (44 years old)
Mother: Rose Schultz (39 years old)
Daughter: Ella Schultz (16 years old)
© Walden University, LLC
4
Paula Cortez
Identifying Data
Paula Cortez is a 43-year-old Catholic Hispanic female residing in New York City, New
York. Paula was born in Colombia. When she was 17 years old, Paula left Colombia
and moved to New York where she met David, who later became her husband. Paula
and David have one son, Miguel, 20 years old. They divorced after 5 years of marriage.
Paula has a 5-year-old daughter, Maria, from a different relationship.
Presenting Problem
Paula has multiple medical issues, and there is concern about whether she will be able
to continue to care for her youngest child, Maria. Paula has been overwhelmed,
especially since she again stopped taking her medication. Paula is also concerned
about the wellness of Maria.
Family Dynamics
Paula comes from a moderately well-to-do family. Paula reports suffering physical and
emotional abuse at the hands of both her parents, eventually fleeing to New York to get
away from the abuse. Paula comes from an authoritarian family where her role was to
be “seen and not heard.” Paula states that she did not feel valued by any of her family
members and reports never receiving the attention she needed. As a teenager, she
realized she felt “not good enough” in her family system, which led to her leaving for
New York and looking for “someone to love me.” Her parents still reside in Colombia
with Paula’s two siblings.
Paula met David when she sought to purchase drugs. They married when Paula was 18
years old. The couple divorced after 5 years of marriage. Paula raised Miguel, mostly by
herself, until he was 8 years old, at which time she was forced to relinquish custody due
to her medical condition. Paula maintains a relationship with her son, Miguel, and her
ex-husband, David. Miguel takes part in caring for his half-sister, Maria.
Paula does believe her job as a mother is to take care of Maria but is finding that more
and more challenging with her physical illnesses.
Employment History
Paula worked for a clothing designer, but she realized that her true passion was
painting. She has a collection of more than 100 drawings and paintings, many of which
track the course of her personal and emotional journey. Paula held a full-time job for a
number of years before her health prevented her from working. She is now unemployed
and receives Supplemental Security Disability Insurance (SSD) and Medicaid. Miguel
does his best to help his mom but only works part time at a local supermarket delivering
groceries.
Paula currently uses federal and state services. Paula successfully applied for WIC, the
federal Supplemental Nutrition Program for Women, Infants, and Children. Given
© Walden University, LLC
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Paula’s low income, health, and Medicaid status, Paula is able to receive in-home
childcare assistance through New York’s public assistance program.
Social History
Paula is bilingual, fluent in both Spanish and English. Although Paula identifies as
Catholic, she does not consider religion to be a big part of her life. Paula lives with her
daughter in an apartment in Queens, New York. Paula is socially isolated, as she has
limited contact with her family in Colombia and lacks a peer network of any kind in her
neighborhood.
Five (5) years ago Paula met a man (Jesus) at a flower shop. They spoke several times.
He would visit her at her apartment to have sex. Since they had an active sex life, Paula
thought he was a “stand-up guy” and really liked him. She believed he would take care
of her. Soon everything changed. Paula began to suspect that he was using drugs,
because he had started to become controlling and demanding. He showed up at her
apartment at all times of the night demanding to be let in. He called her relentlessly, and
when she did not pick up the phone, he left her mean and threatening messages. Paula
was fearful for her safety and thought her past behavior with drugs and sex brought on
bad relationships with men and that she did not deserve better. After a couple of
months, Paula realized she was pregnant. Jesus stated he did not want anything to do
with the “kid” and stopped coming over, but he continued to contact and threaten Paula
by phone. Paula has no contact with Jesus at this point in time due to a restraining
order.
Mental Health History
Paula was diagnosed with bipolar disorder. She experiences periods of mania lasting
for a couple of weeks, and then goes into a depressive state for months when not
properly medicated. Paula has a tendency toward paranoia. Paula has a history of not
complying with her psychiatric medication treatment because she does not like the way
it makes her feel. She often discontinues it without telling her psychiatrist. Paula has
had multiple psychiatric hospitalizations but has remained out of the hospital for the past
5 years. Paula accepts her bipolar diagnosis but demonstrates limited insight into the
relationship between her symptoms and her medication.
Paula reports that when she was pregnant, she was fearful for her safety due to the
baby’s father’s anger about the pregnancy. Jesus’ relentless phone calls and voicemails
rattled Paula. She believed she had nowhere to turn. At that time, she became scared,
slept poorly, and her paranoia increased significantly. After completing a suicide
assessment 5 years ago, it was noted that Paula was decompensating quickly and was
at risk of harming herself and/or her baby. Paula was involuntarily admitted to the
psychiatric unit of the hospital. Paula remained on the unit for 2 weeks.
Educational History
Paula completed high school in Colombia. Paula had hoped to attend the Fashion
Institute of Technology (FIT) in New York City, but getting divorced, and then raising
© Walden University, LLC
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Miguel on her own, interfered with her plans. Miguel attends college full time in New
York City.
Medical History
Paula was diagnosed as HIV positive 15 years ago. Paula acquired AIDS 3 years later
when she was diagnosed with a severe brain infection and a T-cell count of less than
200. Paula’s brain infection left her completely paralyzed on the right side. She lost
function in her right arm and hand, as well as her ability to walk. After a long stay in an
acute care hospital in New York City, Paula was transferred to a skilled nursing facility
(SNF) where she thought she would die. After being in the skilled nursing facility for
more than a year, Paula regained the ability to walk, although she does so with a severe
limp. She also regained some function in her right arm. Her right hand (her dominant
hand) remains semi-paralyzed and limp. Over the course of several years, Paula taught
herself to paint with her left hand and was able to return to her beloved art.
Paula began treatment for her HIV/AIDS with highly active antiretroviral therapy
(HAART). Since she ran away from the family home; married and divorced a drug user;
and then was in an abusive relationship, Paula thought she deserved what she got in
life. She responded well to HAART and her HIV/AIDS was well controlled. In addition to
her HIV/AIDS disease, Paula is diagnosed with Hepatitis C (Hep C). While this condition
was controlled, it has reached a point where Paula’s doctor recommends she begin a
new treatment. Paula also has significant circulatory problems, which cause her severe
pain in her lower extremities. She uses prescribed narcotic pain medication to control
her symptoms. Paula’s circulatory problems led also to chronic ulcers on her feet that
will not heal. Treatment for her foot ulcers demands frequent visits to a wound care
clinic. Paula’s pain paired with the foot ulcers make it difficult for her to ambulate and
leave her home. Paula has a tendency for noncompliance with her medical treatment.
She often disregards instructions from her doctors and resorts to holistic treatments like
treating her ulcers with chamomile tea. When she stops her treatment, she deteriorates
quickly.
Maria was born HIV negative and received the appropriate HAART treatment after birth.
She spent a week in the neonatal intensive care unit, as she had to detox from the
effects of the pain medication Paula took throughout her pregnancy.
Legal History
Previously, Paula used the AIDS Law Project, a not-for-profit organization that helps
individuals with HIV address legal issues, such as those related to the child’s father. At
that time, Paula filed a police report in response to Jesus’ escalating threats and was
successful in getting a restraining order. Once the order was served, the phone calls
and visits stopped, and Paula regained a temporary sense of control over her life.
Paula completed the appropriate permanency planning paperwork with the assistance
of The Family Center organization. She named Miguel as her daughter’s guardian
should something happen to her.
© Walden University, LLC
7
Alcohol and Drug Use History
Paula became an intravenous drug user (IVDU), using cocaine and heroin at age 17.
David was one of Paula’s “drug buddies” and suppliers. Paula continued to use drugs in
the United States for several years; however, she stopped when she got pregnant with
Miguel. David continued to use drugs, which led to the failure of their marriage.
Strengths
Paula has shown resilience over the years. She has artistic skills and found a way to
utilize them. Paula has the foresight to seek social services to help her and her children
survive. Paula has no legal involvement. She has the ability to bounce back from her
many physical and health challenges to continue to care for her child and maintain her
household.
Father: David Cortez (46 years old)
Mother: Paula Cortez (43 years old)
Son: Miguel Cortez (20 years old)
Maria’s Father: Jesus (unknown last name, 44 years old)
Daughter: Maria Cortez (5 years old)
© Walden University, LLC
8
Sam Franklin
Identifying Data
Sam Franklin is a 41-year-old, married, African American male. Sam’s wife, Sheri, is 41
years old. They have two sons, Miles (10) and Raymond (8). The family resides in a
three-bedroom home in a middle-class neighborhood in Rockville, Maryland. They have
been married for 11 years.
Presenting Problem
Sam, a war veteran, came to the Veterans Affairs Health Care Center (VA) for services
because his wife threatened to leave him if he does not get help. She is particularly
concerned about his drinking and lack of involvement in their sons’ lives. She told him
his drinking is out of control and is making him mean and distant. Sam reports he and
his wife have been fighting a lot and that he drinks to take the edge off and help him
sleep. Sam expresses fear of losing his job and his family if he does not get help. Sam
identifies as the primary provider for his family and believes this is his responsibility as a
husband and father. Sam realizes he may be putting that in jeopardy because of his
drinking. He says he has never seen Sheri so angry before, and he sees she is at her
limit with him and his behaviors.
Family Dynamics
Sam was born in Alaba
