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USING RESEARCH TO SELECT A THERAPEUTIC MODALITY
Imagine that some of your colleagues mention using cognitive behavior therapy, dialectical behavioral therapy, acceptance and commitment therapy, and reality therapy. Your colleagues continue to say that, based on their experiences, they really like these therapies and they appear to work. Your instincts also tell you that perhaps they might be helpful for your client in your case study. However, from Week 1, you recall that experiences and instincts as sources of knowledge are quite limited because they are biased. Instead, it is important to utilize existing research and data to support your choices of interventions. Theory helps inform the evidence-based practice process that should guide social workers’ practice.
In this Discussion, you examine the research related to a therapy based on cognitive or cognitive behavior theory to determine its effectiveness.
Recall the client from the case study you have been using in this course. You will apply your research for this Discussion to that client.
Select one therapy from the following: cognitive behavior therapy, dialectical behavioral therapy, acceptance and commitment therapy, or reality therapy.
Conduct a search in the Walden University Library for one peer-reviewed research study about the effectiveness of the therapy you selected.
Note: You must select a study that has not already been used by a colleague in the Discussion. Each student is required to identify a unique research study.
Remember when looking for studies to take into account your client’s age and developmental stage and presenting problem.
Post a response to the following:
Provide the reference for the study you found using APA guidelines. Be sure to provide a link to the article.
Identify the therapy that you chose.
Briefly paraphrase, in 2–3 sentences, the methodological context (i.e., research method, how data was collected, and the instruments used) of the study and the findings.
Explain how the findings are applicabile or appropriate for the client in your case study.
Determine whether you would use or not use the therapy you selected for the client in your selected case study (consider how culturally relevant it is, how aligned it is with social work ethics, etc.) and explain why.
Full article: Adapting Dialectical Behavior Therapy for Young Adults Diagnosed with Serious Mental Health Conditions in Residential Care: A Feasibility Study (tandfonline.com)
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
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
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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
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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
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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
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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
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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 Alabama to an African American family system. He reports his time
growing up to have been within a “normal” family system with a large extended family in
his town and nearby towns. He states he was emotionally close to his mother and
worshipped his father. His father was strict but loving, pushing Sam to become fairly
independent from a young age. His dad had previously been in the military and was
raised with the understanding that his duty is to support his country. His family displayed
traditional roles, with his dad supporting the family after he was discharged from military
service. Sam was raised to believe that real men do not show weakness and must be
the head of the household.
Sam’s parents are deceased, and he has three older sisters who live in Atlanta. He is
close to the sister who is close to him in age, and they talk frequently on the phone.
Sam has not, however, shared his current struggles with any of his siblings. He is afraid
to let them down.
Sheri is an only child, and although her mother lives in the area, she offers little support.
Her mother never approved of Sheri marrying Sam, so she thinks Sheri needs to deal
with their problems on her own. Sam reports he has not been engaged with his sons at
all since his return from Iraq, and he keeps to himself when he is at home.
Sam and Sheri met during one of his stateside deployments prior to being deployed to
Iraq. At the time, Sheri was still in college. Sam and Sheri both say they “fell for each
other fast” and kept in touch during Sam’s deployment to Iraq. When Sam’s deployment
was over, Sheri encouraged him to complete a bachelor’s degree while stationed back
in the U.S. After Sam’s graduation, they married and had Miles within a year.
© Walden University, LLC
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Employment History
Sam is employed as a human resources director for the military. Sam works in an office
with civilians and military personnel and mostly gets along with people in the office. Sam
is having difficulty getting up in the morning to go to work, which increases the stress
level with Sheri. Shari is a special education teacher in a local elementary school. Sam
thinks it is his responsibility to provide for his family and is having stress over what is
happening to him at home and work. He thinks he is failing as a provider.
Social History
Sam and Sheri identify as Baptist and attend a local church on major holidays. They do
not otherwise practice, though both were raised with stronger religious community. Sam
used to be quite social in the neighborhood, but he is withdrawn and tends to keep to
himself. He says he sometimes feels pressured to be more communicative and social.
Sam believes he is socially inept and not able to develop friendships. He says he is able
to “fake it” at work but is not sure how long that can last. The couple has some mutual
couple friends, since Sheri gets involved with the parents in their sons’ school.
However, because of Sam’s recent behaviors, their socializing with other couples has
tapered off. He is very worried that Sheri will leave him due to the isolation.
Mental Health History
Sam reports that since retiring from the military 10 months ago, he has difficulty
sleeping, frequent heart palpitations, and moodiness. After his deployment, during his
stateside assignments, he reports he did not experience intense feelings from his
experiences on the battlefield. He would occasionally have intense memories, but he
reports that he was able to “lock them back up pretty quickly.” It is only since his
retirement that these feelings arose.
Sam has seen Dr. Zoe, a psychiatrist at the VA, who diagnosed him with post-traumatic
stress disorder (PTSD). Dr. Zoe prescribed Paxil to help reduce his symptoms of
anxiety and depression, and suggested Sam also begin counseling. Sam says he does
not really understand what PTSD is, but thinks it refers to a person who is “going crazy.”
He admits he thought was happening to him at times.
Sam expresses concern that he will never feel “normal” again and says that when he
drinks alcohol, his symptoms and the intensity of his emotions ease. Sam describes that
he sometimes thinks he is back on the battlefield, which makes him feel uneasy and
watchful. He hates the experience and tries to numb it. He has difficulty sleeping and is
irritable, so he isolates himself and soothes this with drinking. He talks about always
feeling “ready to go.” He says he is exhausted from being always alert and looking for
potential problems around him. Every sound seems to startle him. He shares that he
often thinks about what happened “over there” but tries to push it out of his mind.
Nighttime is the worst, as Sam has terrible recurring nightmares of one particular event.
He says he wakes up shaking and sweating most nights. He adds that drinking is the
one thing that seems to give him a little relief.
© Walden University, LLC
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Despite his close and normally supportive relationship with his sisters, Sam is unwilling
to share his struggles with them. He fears that he will let them down and prove that he is
not able to carry on the strong provider and family patriarch role of their father. He sees
this role as crucial to his self-identity. Sam reports that he never saw his father drunk
and is ashamed that his own children may have a memories of him being drunk.
Educational History
Sheri has a bachelor’s degree in special education from a local college. Sam received a
bachelor’s degree in human resources management upon his return from the military.
Military History
Sam is an Iraqi War veteran. He enlisted in the Marines at 18 years old. Sam was
stationed in several states prior to Sam being deployed to Iraq. Sam left the service 10
months ago but still works in human resources as a civilian.
Medical History
Sam is physically fit but an injury he sustained in combat sometimes limits his ability to
use his left hand. Sam reports sometimes feeling inadequate because of the reduction
in the use of his hand, but he tries to push through because he worries how the injury
will impact his responsibilities as a provider, husband, and father. Sam considers
himself resilient enough to overcome this disadvantage and “be able to do the things I
need to do.” Sheri is in good physical condition and has recently found out that she is
pregnant with their third child.
Legal History
Sam and Sheri deny having criminal histories.
Alcohol and Drug Use History
As teenagers, Sam and Sheri used marijuana and drank. Both deny current use of
marijuana but report they still drink. Sheri drinks socially and has one or two drinks over
the weekend. Sam reports that he has four to five drinks in the evenings during the
week and eight to 10 drinks on Saturdays and Sundays. Sam spends his evenings on
the couch drinking beer and watching TV or playing video games. Shari reports that
Sam drinks more than he realizes, doubling what Sam has reported.
Strengths
Sam is cognizant of his limitations and has worked on overcoming his physical
challenges. Sam is resilient. Sam did not have any disciplinary actions taken against
him in the military. He is dedicated to his wife and family.
Father: Sam Franklin (31 years old)
Mother: Sheri Franklin (28 years old)
Son 1: Miles Franklin (10 years old)
Son 2: Raymond Franklin (8 years old)
© Walden University, LLC
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Helen Petrakis
Identifying Data
Helen Petrakis is a 52-year-old, Caucasian female of Greek descent living in a fourbedroom house in Tarpon Springs, Florida. Her family consists of her husband, John
(60), son, Alec (27), daughter, Dmitra (23), and daughter Althima (18). John and Helen
have been married for 30 years. They married in the Greek Orthodox Church and attend
services weekly.
Presenting Problem
Helen reports feeling overwhelmed and “blue.” She was referred by a close friend who
thought Helen would benefit from having a person who would listen. Although she is
uncomfortable talking about her life with a stranger, Helen says that she decided to
come for therapy because she worries about burdening friends with her troubles. John
has been expressing his displeasure with meals at home, as Helen has been cooking
less often and brings home takeout. Helen thinks she is inadequate as a wife. She
states that she feels defeated; she describes an incident in which her son, Alec,
expressed disappointment in her because she could not provide him with clean laundry.
Helen reports feeling overwhelmed by her responsibilities and believes she can’t handle
being a wife, mother, and caretaker any longer.
Family Dynamics
Helen describes her marriage as typical of a traditional Greek family. John, the
breadwinner in the family, is successful in the souvenir shop in town. Helen voices a
great deal of pride in her children. Dmitra is described as smart, beautiful, and
hardworking. Althima is described as adorable and reliable. Helen shops, cooks, and
cleans for the family, and John sees to yard care and maintaining the family’s cars.
Helen believes the children are too busy to be expected to help around the house,
knowing that is her role as wife and mother. John and Helen choose not to take money
from their children for any room or board. The Petrakis family holds strong family bonds
within a large and supportive Greek community.
Helen is the primary caretaker for Magda (John’s 81-year-old widowed mother), who
lives in an apartment 30 minutes away. Until recently, Magda was self-sufficient, coming
for weekly family dinners and driving herself shopping and to church. Six months ago,
she fell and broke her hip and was also recently diagnosed with early signs of dementia.
Helen and John hired a reliable and trusted woman temporarily to check in on Magda a
couple of days each week. Helen would go and see Magda on the other days,
sometimes twice in one day, depending on Magda’s needs. Helen would go food
shopping for Magda, clean her home, pay her bills, and keep track of Magda’s
medications. Since Helen thought she was unable to continue caretaking for both
Magda and her husband and kids, she wanted the helper to come in more often, but
John said they could not afford it. The money they now pay to the helper is coming out
of the couple’s vacation savings. Caring for Magda makes Helen think she is failing as a
wife and mother because she no longer has time to spend with her husband and
children.
© Walden University, LLC
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Helen spoke to her husband, John (the family decision maker), and they agreed to have
Alec (their son) move in with Magda (his grandmother) to help relieve Helen’s burden
and stress. John decided to pay Alec the money typically given to Magda’s helper. This
has not decreased the burden on Helen, since she had to be at the apartment at least
once daily to intervene with emergencies that Alec is unable to manage independently.
Helen’s anxiety has increased, since she noted some of Magda’s medications were
missing, the cash box was empty, Magda’s checkbook had missing checks, and jewelry
from Greece, which had been in the family for generations, was also gone.
Helen comes from a close-knit Greek Orthodox family, where women are responsible
for maintaining the family system and making life easier for their husbands and children.
She was raised in the community where she currently resides. Both her parents were
born in Greece and came to the United States after their marriage to start a family and
give them a better life. Helen has a younger brother and a younger sister. She was
responsible for raising her siblings, since both her parents worked in a fishery they
owned. Helen feared her parents’ disappointment if she did not help raise her siblings.
Helen was very attached to her parents and still mourns their loss. She idolized her
mother and empathized with the struggles her mother endured raising her own family.
Helen reports having that same fear of disappointment with her husband and children.
Employment History
Helen has worked part time at a hospital in the billing department since graduating from
high school. John Petrakis owns a Greek souvenir shop in town and earns the larger
portion of the family income. Alec is currently unemployed, which Helen attributes to the
poor economy. Dmitra works as a sales consultant for a major department store in the
mall. Althima is an honors student at a local college and earns spending money as a
hostess in a family friend’s restaurant. During town events, Dmitra and Althima help in
the souvenir shop when they can.
Social History
The Petrakis family live in a community centered on the activities of
