Upbringing Children - Essay Example

? Analysis of a Case Study of Analysis of a Case Study Case History Background of the Problem Marceline (M) is a 19 year old woman with a 26-year-old child named Michael Jr. that is nicknamed Junior. M admits that Junior is difficult to handle and she brought a friend with her into the office to try and work with him while she was talking to the therapist. The friend was not successful because the baby is very disruptive. M and Michael live in a one-room studio apartment currently, after moving from a house. They had to move because Leon (her boyfriend) was laid off and M’s hours were cut; they worked at the same grocery store. M and Leon drink heavily, in M’s words, “to calm their nerves.” The living contains peeling paint, a toilet that will not stop running, and a heater that does not work. Although they have complained to the landlord does not fix the problems. The couple is often late on their rent, but the landlord allows it because they pay within the same month and pay a late fee. They have received many calls from creditors, so they changed their phone number in response. Status of Family Members M and Leon are not married. M is still married to Michael senior, a high-school sweetheart. The marriage did not work out. Michael left M for someone else but now wants to come back to her and his child. M states that she is confused about whether she should stay with Leon or go back to Michael. M describes drinking more than she used to calm her nerves, and she takes “some other stuff now and then”. M also states she “is depressed” and “has suicidal thoughts” when she is not drinking. Michael Jr. does not respond to other people, does not talk, cries, and throws tantrums. M would like to leave Leon and move in with Grace, her mother-in-law, who sometimes takes care of Michael Jr. Grace calls during the interview with Michael senior on the other line. People to be Interviewed This is a case where the therapist has to decide several things on an ethical level. The first issue is whether Junior is in a safe environment. According to the interview with M, it seems that he is not in a safe or healthy environment. The challenge is that student services may have to be called because M says she is drinking, does not know what do with Junior, often neglects his care (sits and watches him run around), and she feels Leon is rough with him. A therapist’s first process in this case is duty to warn, so more information would need to be gathered. M’s friend may need to be interviewed, with M’s permission, alone. The therapist needs to understand more about what M is experiencing from an outside source. Michael Senior also needs to be interviewed to understand his relationship with M and his son. There needs to be a determination of whether Junior would be better in a different environment. Michael’s mother may be someone to interview, but it would be a separate interview from Michael because his mother seems a bit controlling, since she called and had Michael on the other phone. It is not known the age of Michael Senior and this may need to be taken into consideration. Paperwork on File The first piece of paper would be a release of information form that allows the therapist to interview the people identified. The therapist would also want to know about hospital visits for Michael Jr. to see whether there is physical cause for concern. Releases for the tests that M will take will also be important to have on file, and the results of these tests. M may need to go to a psychiatrist for a psychological evaluation also, and the release would be important in this situation. Generally, all papers on file would have to do with confidentiality. Ethical Issues M comes to the therapist for help with talking to her boyfriend about his treatment of Junior. This is one of the first ethical issues to deal with. The therapist has to decide whether this home environment is in the best interest of the child. This would be an example of consequential ethics because the consequences of the actions in this situation must be weighed against the breakup of the family. This is a central issue because if the parents are drinking and having problems with Junior, Junior may not get the care he needs. His crying may be due to something medical, which will need to be checked. Confidentiality is another issue here. The therapist cannot talk to the boyfriend as they are not married and the limitation of marriage and family counseling may prevent the therapist from talking to the boyfriend. Also, the therapist cannot talk to the mother-in-law without permission from M. Michael is the husband and legal father of Junior, so, without the mother-in-law, the therapist could talk to him in a couples counseling situation. This is another example of consequential ethics because the protection of the family is most important in this situation, and any decisions made by the therapist will be made to support the family. Assessments and Screenings The first screening would be a toxic screen to see whether she is currently on drugs or drinking. Her behavior seems somewhat erratic and it may be due to substance abuse. The major clients in this situation are three: M, Junior, and her husband. The boyfriend may be involved if she decides to stay with him, but legally, he is not part of her family. M will definitely need counseling and she might be referred to an alcohol facility if she is drinking on a regular basis. A Beck Depression Scale would be used to test her depression and suicidal thoughts. This would create baseline information to treat the depression. If this were found, she would be referred to her family physician to work on the depression. Junior is of particular concern because of his crying all the time. This could mean there is a medical condition and this may also mean a call to Children’s Services. This should be a last resort, but it is important for the therapist to find out why Junior is crying. Asking M to take Junior to a hospital or clinic may show that she would not follow through. Children’s Services may be a temporary place for the baby until the family issues between M and Michael are straightened out. M is only 19 and would need to be referred to parenting classes with Michael, if they are going to stay together. The study does not provide the age of Michael, but if he is similar in age, he probably does not have an understanding of parenting or being in a relationship. Marriage and family counseling is also important in this situation to bring some understanding to these two individuals for their relationship and their problems. Conclusion This family has many problems and the boyfriend, Leon may be complicating the situation. The parents need to understand more fully how to take care of the baby, but it may be too late. There is an ethical consideration to make sure the baby is in a healthy and safe environment, but this does not seem to be the case from the case study. The primary focus should be the family (M, Junior, and Michael) to help them get back on track. Much of the work must be done with M to help her find a better way to deal with Junior. Also, she must find assistance for her problems with substance abuse. Read More