Alcoholism as the Reason of Family Ruining - Essay Example

Alcoholism as the Reason of Family Ruining 1 Introduction The case of Shana and her family would be a difficult case for the therapist. In looking at her descriptions, it felt like one needed a score card or something similar to keep track of everything that was needed to help this family. Shana is correct I part of what she is saying, and yet there are aspects of what she is doing that could create the loss of her children. One thing that is very clear is that Shana is not capable at this time of taking care of her children, which is one of the ethical issues that will be discussed later. 2 Analysis of the Case Study 2.1 Shana and Family Shana is a 31 year old recovering alcoholic. It seems that she probably inherited the gene for alcoholism because her mother is also an alcoholic. Currently, Shana is living with her mother attempting to stay sober, while her mother (according to Shana) is drinking and possibly doing drugs. It seems that Shana was doing well (since she has been sober for three and a half years) until her ex-husband brought her children back to live with her. Shana has two sons, Jason 15 and Adam 11, and she has a 13 year old daughter, Maria. Shana and her children currently live with Shana’s mother. Shana is currently working, with a low end job, as she says she does not make much money. 2.2 The Children Shana has three children as mentioned previously. According to Shana, Jason wants to find a job to help keep the family together. Maria spends most of her time with her boyfriend, and Adam is away from the family most of the time. Shana states that he may be hanging out at the mall, and may be doing drugs. She alludes to the idea that Adam has talked of suicide and that he may need some of her Prozac. Shana has given the children what sounds like her prescription of Prozac in order to calm them down and see them through the transition. 2.2.1 The Children and School Not much is known about the children and school. It seems from Shana’s statement that she is trying to do the right thing. The challenge is that she does not know the children enough to know how they are doing in school or whether to expect them to bring homework home. 2.4 Shana’s Ex-husband Shana’s ex-husband was given custody by a judge. According to her statement, it seems that he was given full custody of the children. It is not known when he received custody of the children or how long he has had them. The ex-husband, according to Shana’s statement, has given her the children back so that he can live his own life. The ex-husband has a new wife who has a seven year old, and the couple has a new baby. 3. Ethical Issues There are several ethical issues in this case study. Shana has asked the therapist to contact the father and make him provide child support for her. In this situation, the therapist has no authority to call the children’s father and tell him he must pay child support. Further, there is not a clear understanding of whether Shana is telling the truth or whether she has taken the children. A couple of things she said trigger this response: She says that she cannot afford the children but she also says that Jason wants to work to keep them all together. She also says that the children will tell the therapist they want to stay with her. In reading this, the question of what is going on between her and the ex-husband is very important to the interaction with the children. Another ethical issue is confidentiality. The therapist cannot talk to the children without their guardian present. In this case, the therapist does not know the status of the relationship of the ex-husband to the children. If he is the legal guardian of the children because he has custody, the therapist cannot talk to the children or to the school without his consent. There is also the duty to warn. In this situation, Shana may be a danger to herself and to her children. She does not know where these children are, what they do when they are not at home, and how to work with them. All three children are feeling vulnerable. In this state, if Maria is hanging out with her boyfriend all the time, she could be having sex with him, which is child endangerment. Shana never knows where Adam is and since all three children are minors, this may be a case of neglect and child endangerment. Shana further endangers the children by giving them Prozac. The prescription is hers and she is not a medical doctor. She has no idea how to administer such a powerful drug to the children and she has no way of knowing whether they need it. At the very least, the first two calls should be to the ex-husband and possibly to the police. Depending on the conversation between the therapist and the ex-husband, children may need to be taken into protective custody by social workers. The reason for this is because the children are living with a grandmother that is an active alcoholic and Shana is a recovering alcoholic. This could create an adverse situation with the children. In other words, the behavior the children are exhibiting may increase depending on the circumstances at home between mom and grandmother. 4. Assessments and Administration In this situation, the only person that could legally be tested is Shana, unless the father gives permission for the children to be tested. The first test would be to find whether Shana is using again or not. Her behavior seems erratic and she may be drinking or doing drugs with her mother. An Alcohol Dependence Scale may be a good test to begin with to assess Shana’s current situation. Talking to her sponsor with her permission, may be a good place to start also. This scale could be done by the therapist. However, there may be a need for a full psychological makeup to see whether there is an undetected psychological process. The reason this may be necessary is because Shana is exhibiting erratic behavior. This may be the result of a psychological disorder. A psychiatrist would be the person to administer such a test. An MMPI-2 may be appropriate, again done by a psychiatrist, to also detect any psychological problems. If the father gave permission for the children to be tested, the therapist might start with the Wechsler Intelligence Scale for Children (WISC) because it tests IQ and since Shana says something is wrong, this may be a starting place to find out whether there is a problem. The Beck Youth Inventories would be a series of instruments that the therapist could use with all of the children. Since this checks depression, anxiety, anger, self-concept, and disruptive behavior, the inventories could help the therapist assess what each child was feeling pertinent to their living situation and the sudden displacement from their father’s house. The depression inventory can be a good indication for Adam to assess his level of depression. If he was talking about suicide, this needs to be addressed quickly. Read More