12 Working With Families: The Case of Carol and Joseph Carol is a 23-year-old, heterosexual, Caucasian female and the mother of a 1-year-old baby girl. She is currently unemployed, having previously worked for a house cleaning company. The baby is healthy and developmentally on target, and she and the parents appear to be well bonded with one another. Carol lives in a rented house with her husband, Joseph. Joseph is a 27-year-old, heterosexual, Hispanic male. He was recently arrested at their home for a drug deal, which he asserts was a setup. Both parents were charged with child endangerment because weapons were found in the child’s crib and drugs were found in the home. The parents assert that the child never sleeps in the crib but in their bed. As a result of the parents’ arrest, social services was notified, and the child was temporarily placed in a kinship care arrangement with the maternal grandmother, who resides nearby. As a result of Joseph’s arrest, he was fired from the cleaning company where he worked, and the family is now experiencing financial difficulties. After initial contact was made with the parents, a number of concerns were noted and the family was recommended for additional case management. Carol’s mother indicated that she had concerns about Carol’s drinking habits and stated that Carol’s father and grandfather were alcoholics. She and the father separated when Carol was a baby, and Carol has had only limited contact with him. There appears to be significant tension between the grandmother and Carol and Joseph. I addressed the alcohol issue with both parents, who denied there was a problem, but shortly after the discussion, Carol was involved in a serious car accident with the baby in the car. She was determined to have been under the influence of alcohol. I advised Carol that she could not have any unsupervised contact with her child until she completed intensive inpatient substance abuse treatment. I made arrangements for her placement, but after a week, she was discharged for noncompliance with the rules. She was then referred to an intensive outpatient program and began therapy there. Initially her attendance was erratic because she had lost her license as a result of the DUI. Eventually, however, she became engaged in the program and began to address her issues. She acknowledged that she had started using drugs at a very young age but said that she had only begun drinking in the previous year or so. We discussed the genetics of her family, and she said that she realized that she had deteriorated rapidly since beginning to drink and knew that she simply could not drink alcohol. Joseph’s mother is deceased, and his father travels extensively in his job and is not available as a support. Joseph was very devoted to his mother and was devastated by her premature death. We discussed the strengths that he and Carol demonstrated in staying together and working out their p.

1. 12
Working With Families:
The Case of Carol and Joseph
Carol is a 23-year-old, heterosexual, Caucasian female and the
mother of a 1-year-old baby girl. She is currently unemployed,
having previously worked for a house cleaning company. The
baby is healthy and developmentally on target, and she and the
parents appear to be well bonded with one another. Carol lives
in
a rented house with her husband, Joseph. Joseph is a 27-year-
old,
heterosexual, Hispanic male. He was recently arrested at their
home for a drug deal, which he asserts was a setup. Both
parents
were charged with child endangerment because weapons were
found in the child’s crib and drugs were found in the home. The
parents assert that the child never sleeps in the crib but in their
bed. As a result of the parents’ arrest, social services was
notified,

2. and the child was temporarily placed in a kinship care
arrangement
with the maternal grandmother, who resides nearby. As a
result of Joseph’s arrest, he was fired from the cleaning
company
where he worked, and the family is now experiencing financial
difficulties.
After initial contact was made with the parents, a number of
concerns were noted and the family was recommended for
additional
case management. Carol’s mother indicated that she had
concerns about Carol’s drinking habits and stated that Carol’s
father and grandfather were alcoholics. She and the father
separated
when Carol was a baby, and Carol has had only limited
contact with him. There appears to be significant tension
between
the grandmother and Carol and Joseph. I addressed the alcohol
issue with both parents, who denied there was a problem, but
shortly after the discussion, Carol was involved in a serious car
accident with the baby in the car. She was determined to have

3. been
under the influence of alcohol. I advised Carol that she could
not
have any unsupervised contact with her child until she
completed
intensive inpatient substance abuse treatment. I made
arrangements
for her placement, but after a week, she was discharged
for noncompliance with the rules. She was then referred to an
intensive outpatient program and began therapy there. Initially
her attendance was erratic because she had lost her license as a
result of the DUI. Eventually, however, she became engaged in
the
program and began to address her issues. She acknowledged that
she had started using drugs at a very young age but said that she
had only begun drinking in the previous year or so. We
discussed
the genetics of her family, and she said that she realized that
she
had deteriorated rapidly since beginning to drink and knew that

4. she simply could not drink alcohol.
Joseph’s mother is deceased, and his father travels extensively
in his job and is not available as a support. Joseph was
very devoted to his mother and was devastated by her premature
death. We discussed the strengths that he and Carol
demonstrated
in staying together and working out their problems. Joseph
indicated
that as a Hispanic man, family is very important to him and
he wants his family to stay together. Although they have been
struggling financially, Joseph has obtained stable employment
landscaping for a large development and said he plans to take
courses at the community college to learn the trade. He stated
that he wants to provide a good life for his child. Carol has a lot
of
unresolved issues to deal with in therapy, not the least of which
is
the accident that could have killed her child and the legal
ramifications
that resulted from this incident. Although angry and hostile
at the beginning, through the implementation of person-centered

5. therapy, we were able to establish agreed-upon goals that
showed
respect for the client and encouraged her to find solutions to
her problems. Although our relationship was tenuous at times,
providing encouragement to her rather than judgment enabled
her to forgive herself and take corrective action.
Reflection questions
the common myth that a traditional therapy office setting is
necessary to do “clinical work.”
Through this case, students can also witness how treatment
goals can shift throughout the course of treatment.
This is evident in the step-by-step growth that Pedro
demonstrated.
Each shift in treatment goals resulted in a change or
deepening of our relationship and gave Pedro the opportunity
to address more difficult issues as time went on.
Working With Families: The Case of Carol and Joseph

6. 1. What specific intervention strategies (skills, knowledge,
etc.) did you use to address this client situation?
This case required extensive use of active and passive listening
and patience to enable the client to become sufficiently
comfortable
with me and to arrive at a point where she could work on
her issues. Initially she was very angry, hostile, resistant, and
very much in denial.
2. Which theory or theories did you use to guide your practice?
I work with people in their homes, which is their territory, not
mine. I think it is very important to be aware of how I would
feel
if I were in their shoes. The person-in-environment perspective
and Carl Rogers’ person-centered approach are crucial here.
3. What were the identified strengths of the client(s)?
She was smart and had a good support system in her husband
and mother, who were very supportive during her treatment.
4. What were the identified challenges faced by the client(s)?
Carol was a severe alcoholic and had a drug problem to a lesser

7. extent. She had psychological issues as well, including low
selfesteem,
depression, and anxiety. She also had transportation and
legal problems as a result of losing her driver’s license after the
DUI.
5. What were the agreed-upon goals to be met to address the
concern?
The primary goal was to protect her child by keeping Carol
sober and finding the intervention method that would be most
appropriate for her to do that. This took time due to the
resistance
6. How would you advocate for social change to positively
affect this case?
Treatment options and access to them need to be improved
in rural areas. There were not many choices for this client,
and losing her license in an area with no public transportation
greatly affected her ability to seek treatment.
7. Is there any additional information that is important to this
case?

8. I subsequently found out that there had been other serious
episodes concerning Carol’s drinking that the family had failed
to disclose to me because they were covering up for her.
Carol’s parents separated when she was very young, so she
was mostly cared for by a family friend and grandparents.
Carol’s
mother seemed to have resented the child’s interference with
her
social life, and clearly the daughter resented her mother’s lack
of
involvement with her. Carol’s mother, who was from a Southern
White Protestant family, seemed uncomfortable with Joseph’s
culturally unfamiliar Hispanic Catholic background. She
reported
to me that she felt the son-in-law was lazy and did not work in
the
early stages of his relationship with her daughter, who she said
worked very hard. During my involvement with this couple, I
found
Joseph to be hard working and doing his best to provide for all
of
them. He was very committed to doing whatever was necessary

9. to keep his family intact, even if his judgment at times was
poor.
Working With Immigrants and Refugees:
The Case of Aaron
1. What specific intervention strategies (skills, knowledge,
etc.) did you use to address this client situation?
I used support, active listening, reflection, reframing, and
validation
with the client, and I recognized the importance of
structure, reliability, and predictability of the social worker in
the therapeutic alliance.
2. Which theory or theories did you use to guide your practice?
I used family systems theory, multicultural family theories, and
attachment theory.to treatment.

10. Working With Survivors of Domestic Violence: The Case of
Charo
Charo is a 34-year-old, heterosexual, Hispanic female. She is
unemployed and currently lives in an apartment with her five
chil-dren, ages 2, 3, 6, 7, and 8. She came to this country 8
years ago from Mexico with her husband, Paulo. During intake,
Charo reported that she suffered severe abuse and neglect in the
home as a child and rape as a young adult. Charo does not speak
English and currently does not have a visa to work.
Charo initially came for services at our domestic violence
agency because Child Protective Services (CPS) and the court
ordered her to attend a domestic violence support group after
allegations of domestic violence were made by one of her
chil-dren to a teacher at their school. Her husband was ordered
to attend a batterer’s intervention program (BIP). Charo
attended the domestic violence support group but seldom said a
word. Although she rarely shared during group, she also rarely
missed a session. While she attended the group, she also met
with me weekly for individual sessions. During these sessions I
informed her of the dynamics of domestic violence and helped
her create a safety plan. She often said that she was only
attending the group because it was mandated and that she just
wanted CPS to close her case. One week, Charo suddenly
stopped attending group. When I called her, she said that she

11. had been busy and unable to attend. That same day her husband
called me to verify that I was who his wife said I was, as he
often accused Charo of having affairs.
Charo showed up to group again one day after a 3-month
absence. Her appearance was disheveled, and she had lost a
significant amount of weight. The next day she called me and
requested an emergency individual session. During the session,
she reported that her husband had an imaginary friend who was
telling him to kill her and that the previous weekend he had
placed a knife on her pillow and threatened to take her life.
Charo stated that her husband would force her to wear short
skirts and bleach
her hair. He would also throw plates of food on the floor and
walls of the house whenever meals were not to his satisfaction.
She said he would spend his days drinking alcohol with friends
and would beat her relentlessly in front of the children. She told
me she had thought he would change after CPS became involved
but that, instead, his abuse became more calculating and
discreet.
I worked on an updated safety plan with the client, and she
agreed to hide herself and the children in the agency’s safe
house. The safety plan included information on obtaining a
restraining order, going into a safe house, identifying safe
people she could talk to, and teaching the children safety
planning strategies as well as tips on important documentation
and the importance of journ-aling all significant details of the
abuse. Charo’s husband showed up outside of the agency that
day while she was there and called her phone repeatedly. Charo
put the call on speaker so I could hear his voice. He ordered her
to go outside and go home with him and made threats toward
her. I called the police, and Charo’s husband was arrested

12. outside of the agency. I went to the court-house with Charo,
helping her file a temporary restraining order and providing her
with emotional support throughout the experi-ence. After
obtaining the restraining order, Charo and her five children
were admitted to the agency’s safe house.
While at the safe house, Charo met with me weekly for
indi-vidual counseling and continued to attend the domestic
violence support groups. She reported feeling damaged, ugly,
and unlov-able. She also reported feeling anxious, depressed,
and hopeless, crying often, and losing weight. Charo’s husband
was eventually deported back to Mexico.
I discussed with Charo the dynamics of domestic violence and
provided her with numerous resources that could serve as
informal and formal supports to her and the children. Charo was
referred to a psychiatrist, who prescribed 50 mg of Zoloft to
help manage the anxiety and depressive symptoms she was
experiencing. Charo began attending a church nearby where she
quickly felt connected and also began attending English as a
second language (ESL) classes twice a week. We met once a
week for 9 months. During the first 3 months, we focused on
stabilization. During the second 3 months, we focused on
decreasing symptoms of anxiety
and depression. During the final 3 months of our time together
we focused on financial empowerment, reintegrating back into
the
community, and renewing connections with family.
While Charo met with me for counseling and case management,

13. her children participated in a 6-month trauma reduction art
therapy program for children within the agency. At the 9-month
mark, we agreed to terminate services. She continued to attend
the group sessions for support and found new friends who had
become a support network for her. She also completed a
financial
empowerment program, which further taught her how to manage
her finances.
Reflection Questions
. How would you advocate for social change to positively
affect this case?
Mary and her family could benefit from help exploring their
assumptions about race, but this was out of the scope of
Mary’s initial therapy.
8. Were there any legal or ethical issues present in the case?
If so, what were they and how were they addressed?
It is difficult but important to respect Mary’s therapeutic
process while remaining nonjudgmental about the assumptions

14. about race Mary and her sisters hold as truth.
9. How can evidence-based practice be integrated into this
situation?
Mary and I identified her PTSD symptoms in her treatment
plan. We were able to measure the successes she had with
specific behavioral interventions in changing the frequency
and severity of her symptoms.
10. Describe any additional personal reflections about this case.
Mary clearly felt that she needed to trust that I would not bring
my own judgments or opinions about racism into therapy.
As with all trauma treatment, building a therapeutic alliance
and trust was essential. We built such an alliance so she could
feel safe enough to tell her traumatic story and work to
assimilate
that story into her own sense of strength and resilience.
Working With Survivors of Domestic Violence:
The Case of Charo
1. What specific intervention strategies (skills, knowledge,

15. etc.) did you use to address this client situation?
I utilized psychoeducational support groups, case management,
and solution-focused interventions.
2. Which theory or theories did you use to guide your practice?
I used learning theory and feminist empowerment and
strengthsbased
perspectives to guide my practice.
3. What were the identified strengths of the client(s)?
Charo’s many strengths included her level of resilience and
being a strong advocate for her children and a support to
other survivors at the shelter. She also shared her resources
with other survivors no matter how little she had. She was
very kind.
4. What were the identified challenges faced by the client(s)?
The barriers for this client are enormous; aside from the
domestic violence, some of the barriers include not speaking
English, the involvement of Child Protective Services, a lack
of affordable housing, obtaining employment without a visa,
discrimination, and needing child care for five children.

16. 5. What were the agreed-upon goals to be met to address the
concern?
The three treatment goals we set were reducing depressive and
anxiety symptoms, connecting to resources in the community
that would help her become more stable, and obtaining therapy
for the children.
6. What local, state, or federal policies could (or did) affect
this situation?
The Violence Against Women Act (VAWA) affected the
situation.
7. How would you advocate for social change to positively
affect this case?
Victims should not be mandated to attend a domestic violence
support group. Participation should be voluntary. These women
have been coerced in their relationships and then they are
coerced by the system and made to feel like they have done
something wrong. Much more education is needed in the courts
and with Child Protective Services.

17. 8. How can evidence-based practice be integrated into this
situation?
Clients are asked to complete client satisfaction surveys at
termination. We also call the clients for follow-ups for up to
a year. Lastly, clients complete a survey on a monthly basis,
which is used statewide and called the Family Violence
Prevention
and Services Act (FVPSA) survey. The surveys mainly
measure whether the client learned additional resources and
additional ways of planning for safety.
Working With Survivors of
Sexual Abuse and Trauma:
The Case of Angela
Angela is a 27-year-old, Caucasian female, who first came to
counseling to address her history of sexual abuse. She graduated
from college with a BS in chemistry and has since been
employed

18. by pharmaceutical companies. After obtaining a new job, she
relocated
to an apartment in an East Coast city where she knew no
one. Both of Angela’s parents live on the West Coast, and she
has
one younger brother who also lives in a different state. Angela
has
limited contact with both her mother and brother and does not
have any contact with her father. Angela is obese and disclosed
a history of struggling with her weight and eating issues. She
has
few friends, and those she does have live far away.
Angela has a long history of trauma in her life. She was
sexually
abused between the ages of 9 and 21 by her father, sexually
assaulted
at the age of 14 by a classmate in school, and mugged as a
young
adult. There was domestic violence in the home, also
perpetrated by
her father. Angela’s father is considered an upstanding member
of

19. the community, and he is well liked and respected by others. No
one
in Angela’s family believes that she was sexually abused, and
her
father joined a “false memory syndrome” group and is
outspoken
about that issue. There has been little discussion in her family
about
what took place in the home while she was growing up.
Angela struggled with daily functioning and exhibited
symptoms
of post-traumatic stress disorder (PTSD). She had a history
of cutting herself and binge eating and displayed some
characteristics
of borderline personality disorder. Angela also mildly
dissociated when under duress. Angela suffered from depression
and anxiety and had trouble establishing new relationships, both
socially and at work. Although Angela has a stable job and was
able to complete her work each day, at times she became
overwhelmed
by her emotions and retreated to the bathroom where
she cried and sometimes cut herself before returning to her

20. workstation.
Angela relied on writing, artwork, and her cat for solace
and comfort. She was also very active outdoors, often hiking,
biking, and going on camping trips by herself. Her goals in life
were to own her own home, lose weight, enjoy relationships
with
others, and find peace with her traumas.
As a result of the abuse she experienced, it was necessary to
begin treatment focusing heavily on establishing trust and a
relationship
with the client. After 1 year of therapy, deeper process
work was being done around her traumas, and she was able to
open up much more. She disclosed more painful experiences to
the therapist and began expressing her feelings, including
intense
anger at her family members.
Angela also joined a group for survivors of sexual violence in
the same program where she was receiving individual therapy.
She was thus able to meet other survivors and engage them in
relationship building and obtain support. Over time, she lost

21. 100 pounds and made new friends, and her level of functioning
increased dramatically. Six months into the group, however, I
noticed boundary issues between the members of the group and
the group facilitator. After speaking with the group facilitator
about these concerns and others regarding her clinical judgment
and boundary crossing, the decision was made to terminate her.
As a new group facilitator began engaging the group, I noticed
that Angela was not sharing as much in her individual sessions
and, overall, seemed guarded. I tried on numerous occasions to
address the shift, and while Angela acknowledged that trust had
become an issue, she would not directly express her concerns or
feelings. After some discussion, I explained to Angela that
while I
could not discuss the issues concerning the group facilitator,
she
should feel free to talk about her feelings and concerns in
general.
However, it became obvious that trust could not be rebuilt,
particularly
in light of the professional boundary issues with the group

22. facilitator. I asked if she wanted to terminate counseling with
me
and find a new therapist, and Angela agreed. I provided Angela
with three referrals so that she could continue her treatment. I
learned that Angela and the former group facilitator had become
friends and remained so after both had left the program in their
respective capacities.
Reflection Questions
activities as Veronica did. She went to school every day and did
not appear very different from other children in her area. It is
important to note that families in poverty-stricken countries like
Guatemala are deceived by traffickers who offer them money
equivalent to a year’s income in exchange for their children. All
the details of this case are not clear as of yet but it is believed
that
the maternal aunt was working in conjunction with someone
else.
9. Describe any additional personal reflections about this case.
This was a hard case to digest. It is one of those cases that you

23. end up taking home with you in your heart. This 13-year-old
girl has been through a lifetime of exploitation. For the first few
weeks she would just look at me as if she were looking right
through me. She needed a lot of coaxing to participate.
Although
she still has a great deal of healing ahead of her, Veronica is in
a
much better place and is making every effort to live a normal
life.
Working With Survivors of Sexual Abuse and Trauma:
The Case of Angela
1. What specific intervention strategies (skills, knowledge,
etc.) did you use to address this client situation?
Knowledge of trauma and child sexual abuse was key as was
active listening, validation, boundary setting, and, at times,
confrontation.
2. Which theory or theories did you use to guide your practice?
I applied relational, cognitive behavioral, empowerment, and
strengths-based theories.
3. What were the identified strengths of the client(s)?

24. Angela’s strengths were her ability to persevere and be
resilient,
as well as her ability to find time for self-reflection and
self-care. Despite everyone around her telling her otherwise,
she was still able to stand firm in the knowledge that she was
sexually abused and therefore needed to have clear boundaries
with those who did not believe her.
4. What were the identified challenges faced by the client(s)?
Angela’s challenges included an occasional inability to function
at work, self-harm, and isolation.
5. What were the agreed-upon goals to be met to address
the concern?
The goals were to increase functioning, enhance ability to
create and sustain relationships with others, reduce isolation,
address and increase self-esteem, refrain from cutting, and
work through early sexual trauma.
6. What local, state, or federal policies could (or did) affect

25. this situation?
The statute of limitations in both civil and criminal cases
affected Angela’s case.
7. How would you advocate for social change to positively
affect this case?
I would advocate with legislators in the state to eliminate the
statute of limitations so that survivors of sexual abuse could
prosecute and/or sue their perpetrator when they were ready.
8. Were there any legal or ethical issues present in the case?
If so, what were they and how were they addressed?
There were ethical issues regarding boundaries and dual
relationships. The group facilitator in this case was
inappropriate
with her clients and became personal friends with this
particular client along with the other women in the group. I
addressed this by trying to work with the group facilitator, as
well as by encouraging her to discuss this in her off-site clinical
supervision. Because no change was occurring, eventually
the group facilitator was terminated.

26. 9. How can evidence-based practice be integrated into this
situation?
The use of a sequenced, titrated approach using relational
theory to address complex PTSD is incredibly helpful,
especially
for those survivors of sexual trauma with multiple
victimizations and difficulty with daily functioning.
10. Describe any additional personal reflections about this case.
As the individual therapist, this case was heartbreaking for
me. The relationship and trust I had built with this client was
destroyed, and I was placed in a very precarious position. The
client did not want to discuss the changing dynamic andclearly
been influenced by the group facilitator, who was incredibly
friendly and outgoing. There was no other choice but
termination,
and the realization that the damage could not be repaired was
disappointing. However, had I disclosed “my side” of what was
happening, I would have been making the same errors as the
group
facilitator and involving myself in a dysfunctional and

27. unhealthy
dynamic, including crossing boundaries—exactly what survivors
do not need. There are times when you must “swallow your
pride”
to do what is right and best for the client, especially given the
different variables and considering the ethical issues at play.
Working With Survivors of Sexual Abuse and Trauma:
The Case of Brenna
1. What specific intervention strategies (skills, knowledge,
etc.) did you use to address this client situation?
I used reflective listening and reframing to assist Brenna in
setting goals and determining her unmet needs. I used
knowledge
of local systems and social service agencies to provide
referrals and to secure needed services.
2. Which theory or theories did you use to guide your practice?
I utilized systems theory.
3. What were the identified strengths of the client(s)?
Brenna’s strengths were her resiliency and self-sufficiency.

28. Brenna viewed her desire to provide a better future for her
child as a strong motivating factor for changing her life.
4. What were the identified challenges faced by the client(s)?
Brenna lacked a familial support system and network of friends,
and she was socially isolated. Upon entry to the shelter, she
lacked
medical care, employment, income, and housing. Brenna also
struggled
with difficulty reading and writing. Brenna had experienced
trauma and violence in her past and would be raising her child
alone.
5. What were the agreed-upon goals to be met to address the
concern?
Brenna and I agreed to secure medical care, a housing plan,
and a source of income. Brenna also set goals to improve her
mental health.
Working With Survivors of
Sexual Abuse and Trauma:

29. The Case of Angela
Angela is a 27-year-old, Caucasian female, who first came to
counseling to address her history of sexual abuse. She graduated
from college with a BS in chemistry and has since been
employed
by pharmaceutical companies. After obtaining a new job, she
relocated
to an apartment in an East Coast city where she knew no
one. Both of Angela’s parents live on the West Coast, and she
has
one younger brother who also lives in a different state. Angela
has
limited contact with both her mother and brother and does not
have any contact with her father. Angela is obese and disclosed
a history of struggling with her weight and eating issues. She
has
few friends, and those she does have live far away.
Angela has a long history of trauma in her life. She was
sexually
abused between the ages of 9 and 21 by her father, sexually
assaulted

30. at the age of 14 by a classmate in school, and mugged as a
young
adult. There was domestic violence in the home, also
perpetrated by
her father. Angela’s father is considered an upstanding member
of
the community, and he is well liked and respected by others. No
one
in Angela’s family believes that she was sexually abused, and
her
father joined a “false memory syndrome” group and is
outspoken
about that issue. There has been little discussion in her family
about
what took place in the home while she was growing up.
Angela struggled with daily functioning and exhibited
symptoms
of post-traumatic stress disorder (PTSD). She had a history
of cutting herself and binge eating and displayed some
characteristics
of borderline personality disorder. Angela also mildly
dissociated when under duress. Angela suffered from depression
and anxiety and had trouble establishing new relationships, both

31. socially and at work. Although Angela has a stable job and was
able to complete her work each day, at times she became
overwhelmed
by her emotions and retreated to the bathroom where
she cried and sometimes cut herself before returning to her
workstation.
Angela relied on writing, artwork, and her cat for solace
SOCIAL WORK CASE STUDIES: FOUNDATION YEAR
30
and comfort. She was also very active outdoors, often hiking,
biking, and going on camping trips by herself. Her goals in life
were to own her own home, lose weight, enjoy relationships
with
others, and find peace with her traumas.
As a result of the abuse she experienced, it was necessary to
begin treatment focusing heavily on establishing trust and a
relationship
with the client. After 1 year of therapy, deeper process
work was being done around her traumas, and she was able to
open up much more. She disclosed more painful experiences to

32. the therapist and began expressing her feelings, including
intense
anger at her family members.
Angela also joined a group for survivors of sexual violence in
the same program where she was receiving individual therapy.
She was thus able to meet other survivors and engage them in
relationship building and obtain support. Over time, she lost
100 pounds and made new friends, and her level of functioning
increased dramatically. Six months into the group, however, I
noticed boundary issues between the members of the group and
the group facilitator. After speaking with the group facilitator
about these concerns and others regarding her clinical judgment
and boundary crossing, the decision was made to terminate her.
As a new group facilitator began engaging the group, I noticed
that Angela was not sharing as much in her individual sessions
and, overall, seemed guarded. I tried on numerous occasions to
address the shift, and while Angela acknowledged that trust had
become an issue, she would not directly express her concerns or

33. feelings. After some discussion, I explained to Angela that
while I
could not discuss the issues concerning the group facilitator,
she
should feel free to talk about her feelings and concerns in
general.
However, it became obvious that trust could not be rebuilt,
particularly
in light of the professional boundary issues with the group
facilitator. I asked if she wanted to terminate counseling with
me
and find a new therapist, and Angela agreed. I provided Angela
with three referrals so that she could continue her treatment. I
learned that Angela and the former group facilitator had become
friends and remained so after both had left the program in their
respective capacities.
activities as Veronica did. She went to school every day and did
not appear very different from other children in her area. It is
important to note that families in poverty-stricken countries like
Guatemala are deceived by traffickers who offer them money
equivalent to a year’s income in exchange for their children. All

34. the details of this case are not clear as of yet but it is believed
that
the maternal aunt was working in conjunction with someone
else.
9. Describe any additional personal reflections about this case.
This was a hard case to digest. It is one of those cases that you
end up taking home with you in your heart. This 13-year-old
girl has been through a lifetime of exploitation. For the first few
weeks she would just look at me as if she were looking right
through me. She needed a lot of coaxing to participate.
Although
she still has a great deal of healing ahead of her, Veronica is in
a
much better place and is making every effort to live a normal
life.
Working With Survivors of Sexual Abuse and Trauma:
The Case of Angela
1. What specific intervention strategies (skills, knowledge,
etc.) did you use to address this client situation?
Knowledge of trauma and child sexual abuse was key as was

35. active listening, validation, boundary setting, and, at times,
confrontation.
2. Which theory or theories did you use to guide your practice?
I applied relational, cognitive behavioral, empowerment, and
strengths-based theories.
3. What were the identified strengths of the client(s)?
Angela’s strengths were her ability to persevere and be
resilient,
as well as her ability to find time for self-reflection and
self-care. Despite everyone around her telling her otherwise,
she was still able to stand firm in the knowledge that she was
sexually abused and therefore needed to have clear boundaries
with those who did not believe her.
4. What were the identified challenges faced by the client(s)?
Angela’s challenges included an occasional inability to function
at work, self-harm, and isolation.
5. What were the agreed-upon goals to be met to address
the concern?

36. The goals were to increase functioning, enhance ability to
create and sustain relationships with others, reduce isolation,
address and increase self-esteem, refrain from cutting, and
work through early sexual trauma.
6. What local, state, or federal policies could (or did) affect
this situation?
The statute of limitations in both civil and criminal cases
affected Angela’s case.
7. How would you advocate for social change to positively
affect this case?
I would advocate with legislators in the state to eliminate the
statute of limitations so that survivors of sexual abuse could
prosecute and/or sue their perpetrator when they were ready.
8. Were there any legal or ethical issues present in the case?
If so, what were they and how were they addressed?
There were ethical issues regarding boundaries and dual
relationships. The group facilitator in this case was
inappropriate

37. with her clients and became personal friends with this
particular client along with the other women in the group. I
addressed this by trying to work with the group facilitator, as
well as by encouraging her to discuss this in her off-site clinical
supervision. Because no change was occurring, eventually
the group facilitator was terminated.
9. How can evidence-based practice be integrated into this
situation?
The use of a sequenced, titrated approach using relational
theory to address complex PTSD is incredibly helpful,
especially
for those survivors of sexual trauma with multiple
victimizations and difficulty with daily functioning.
10. Describe any additional personal reflections about this case.
As the individual therapist, this case was heartbreaking for
me. The relationship and trust I had built with this client was
destroyed, and I was placed in a very precarious position. The
client did not want to discuss the changing dynamic and had
clearly been influenced by the group facilitator, who was

38. incredibly
friendly and outgoing. There was no other choice but
termination,
and the realization that the damage could not be repaired was
disappointing. However, had I disclosed “my side” of what was
happening, I would have been making the same errors as the
group
facilitator and involving myself in a dysfunctional and
unhealthy
dynamic, including crossing boundaries—exactly what survivors
do not need. There are times when you must “swallow your
pride”
to do what is right and best for the client, especially given the
different variables and considering the ethical issues at play.
Working With Survivors of Sexual Abuse and Trauma:
The Case of Brenna
1. What specific intervention strategies (skills, knowledge,
etc.) did you use to address this client situation?
I used reflective listening and reframing to assist Brenna in
setting goals and determining her unmet needs. I used
knowledge

39. of local systems and social service agencies to provide
referrals and to secure needed services.
2. Which theory or theories did you use to guide your practice?
I utilized systems theory.
3. What were the identified strengths of the client(s)?
Brenna’s strengths were her resiliency and self-sufficiency.
Brenna viewed her desire to provide a better future for her
child as a strong motivating factor for changing her life.
4. What were the identified challenges faced by the client(s)?
Brenna lacked a familial support system and network of friends,
and she was socially isolated. Upon entry to the shelter, she
lacked
medical care, employment, income, and housing. Brenna also
struggled
with difficulty reading and writing. Brenna had experienced
trauma and violence in her past and would be raising her child
alone.
5. What were the agreed-upon goals to be met to address the
concern?

40. Brenna and I agreed to secure medical care, a housing plan,
and a source of income. Brenna also set goals to improve her
mental
6. What local, state, or federal policies could (or did) affect
this situation?
State policies regarding photo ID affected Brenna’s ability to
apply for various assistance programs through Social Services.
Temporary Assistance for Needy Families (TANF) policies will
also affect her ability to obtain financial assistance after giving
birth. Paternity is required on forms for TANF, and she may
need to explore domestic violence waivers when completing
TANF applications.
7. How would you advocate for social change to positively
affect this case?
I would advocate for improved assistance to be offered through
Social Services. Brenna was often met with anger and
frustration
at Social Services due to her difficulty reading and writing,
so she had given up on trying to secure medical care and

41. financial
assistance early in her pregnancy.
8. Were there any legal or ethical issues present in the case?
If so, what were they and how were they addressed?
Brenna and I discussed future plans for applying for TANF and
the impact the child’s paternity has on approval of the
application.
We discussed the parental rights of Cameron and identified
resources for legal assistance if needed in the future.
9. Describe any additional personal reflections about this case.
When working on a strict timeline, it is important to balance
client empowerment with health and safety.
Human Behavior and the Social Environment
Working With Children and Adolescents:
The Case of Dalia
1. What specific intervention strategies (skills, knowledge,
etc.) did you use to address this client situation?
This case required that active and reflective listening,
reframing,

42. and validation be employed as part of the assessment,
engagement,
and goal-setting process. In addition, working from the
strengths-based perspective and meeting the client system
Project: Agency Visit
In order to function as change agents, social workers interact
with others in a wide variety of organizations. Visiting a social
work agency allows students of social work to get a glimpse of
the form that these interactions may take.
For this Assignment, visit a nonprofit social service agency in
your area and interview a social worker there.
By Day 7 of this week
, you identify your agency and the social worker you will
collaborate with.
Your Final Project, submitted in Week 10
of the course, should focus on the following.
During the interview:
1.
Focus on the social worker’s educational background and
training.