Case Vignettes

    INSTRUCTION:

     

    •  Answer each case vignette response must be 1 page in length and you must use one outside scholarly resource for each case 
    • There are 3 Vignette Cases=3 pages

     

    Only Send me a message if you are sure you can finish in time

     

     

     

      

     

    Case vignette 2:

     

    Victoria is a 10-year-old African American female placed in state custody because of a combination of physical abuse on the part of her mother, Anita, and Anita’s inability to control and supervise Victoria. Victoria displays many aggressive behaviors, including refusing to do chores or look after her two younger siblings, refusing to go to school, smoking cigarettes, being out late at night without parent permission, and disobeying school rules, which resulted in several in-school suspensions and detentions. According to Anita, she used physical punishment (hitting with a belt) only as a last resort after all else had failed, including a brief hospitalization in the psychiatric ward of the local hospital. On three occasions, school personnel reported bruises to child welfare authorities, who confirmed abuse on all three occasions. After the first report, intensive in-home family preservation services were initiated to prevent placement, but after the second and third incidents, when Victoria displayed extreme anger at Anita and Anita did not think she herself could control her own anger, it was decided Victoria’s safety could not be assured in the home. After meeting with Victoria, she admits to having nightmares and waking up at night crying and screaming. Although her grooming was appropriate during our first session, Victoria wore long-sleeved shirt even though it was summer. Victoria was also noticeably thin for her age. You have been assigned to this case to assess a variety of issues and to determine the appropriate level of care for Victoria.

     

    A. How does Victoria’s gender, age, race and ethnicity matter to the case? Provide justification for your answer.

     

    B. Erik Erikson (1963) described eight stages of development. What stage of development is Victoria in? What crisis will Victoria need resolve during this stage? What is your intervention strategy? How will your intervention assist Victoria in resolving the crisis of the stage?

     

    C. Given that there have been previous instances of physical abuse, how would you go about detecting current child abuse and neglect?  In Victoria’s case, what signs indicate that she may still be a victim of child abuse? Name and discuss three or more signs.

     

    D. What kind of effects can abuse/trauma have on young children (name and discuss at least four)? Consider short-term and long-term effects. Identify and discuss at least three symptoms of PTSD that Victoria is displaying.

     

    E. List and describe two types of therapy that abused children respond well to. 

     

    F. What two attending skills would be most helpful when working with Victoria’s mother and why? What two attending skills would be most helpful when working with Victoria? and why 

     

    Case vignette 3:

     

    Robert is a 35-year-old Caucasian businessman who was involved in a car accident on his way home after having a couple of drinks at the local bar. He was legally mandated to obtain evaluation and treatment because at the time of the accident, his blood alcohol test showed .09, which was above the legal limit. He is overweight and tends to have high blood pressure. He grew up in the neighborhood where he and his wife now live. They have two children, ages 6 and 4 years. Robert has several childhood friends who come to the bar, almost every day during the week, to have drinks and socialize. His father is also a frequent visitor to the bar, and has been for the past 40 years. Robert’s father drinks 4 to 5 drinks when he is at the bar, but Robert father feels that he does not have any significant problems related to drinking, except for his hypertension. Robert also drinks 4 to 5 beers at the bar, but he does not feel that he has any drinking problems because he does not drink at home except for wine with his evening meal. When asked if Robert drank more than usual on the night of the car accident he stated, “It’s not like I am an alcoholic, I just had a really stressful day at work and maybe had one too many drinks but it’s nothing that I can’t control.”

     

    A. How does Robert’s gender, age, race and ethnicity matter to the case? Provide justification for your answer.

     

    B. Erik Erikson (1963) described eight stages of development. What stage of development is Robert in? What crisis will Robert  need resolve during this stage? What is your intervention strategy? How will your intervention assist Robert in resolving the crisis of the stage?

     

    C. Kanel (2012) cites seven defense mechanisms commonly observed in alcoholics. Name and describe at least three of the defense mechanisms that Robert uses and are relevant to his alcohol use.

     

    D. What three interventions would you recommend for Robert that may assist him in decreasing his dependency on alcohol? Of the three you selected, which one would you make a priority recommendation and why?

     

    E. Are there any codependents in this case? Provide justification for your response.

     

    Case vignette 4:

     

    Sally is an 11-year-old Vietnamese girl who was recently in a terrible car accident while her mother was driving her to school. The driver of the other vehicle ran through a red light and hit the car Sally’s family was driving in. The car was totaled and luckily no one was seriously injured, however, Sally’s mom suffered a concussion and broken ribs and Sally’s brother broke his arm. Sally was knocked unconscious in the crash and when she awoke, she could hear the car sizzling and saw that everyone had bumps and bruises and began to scream. Initially, Sally refused to talk about what happened but was extremely fearful of getting back into the car and would refuse to go to school some days as a result. She often has flashbacks of the scene inside the car and reports that she also frequently suffers from nightmares relating to being in car accidents. Recently, Sally’s mother is feeling very overwhelmed and concerned since Sally’s school wants to hold her back due to her poor attendance. When Sally does come to school, she often has had panic attacks, refusing to leave her mother because she is afraid her mother will get into another accident once she leaves the schoolyard. The school social worker suspects that Sally is suffering from PTSD, however, Sally’s family is reluctant to take her to see a counselor.

     

    1. Explain how Sally’s      gender, age, race and/or ethnicity matter to the case. Provide      justification for your answer.
    2. Erik Erikson described      eight stages of development. What stage of development is Sally in? What      crisis will Sally need resolve during this stage? What is your      intervention strategy? How will your intervention assist Sally in      resolving the crisis of the stage?
    3. Describe at least three      symptoms of PTSD that are present in Sally’s case.
    4. Describe at least two      treatment strategies you might use in working with Sally.
    5. What communication style      should be considered when working with Sally and her mother to respect the      family’s culture?
    6. What are your recommendations      for Sally’s mother who has become overwhelmed with coping with Sally’s      symptoms?

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