Assignment 1 Cultural CompetenceAs with all areas of the social.docx

Assignment 1: Cultural Competence
As with all areas of the social work process, cultural
competence is essential when engaging and assessing a child’s
concerns. Being culturally competent includes understanding
the unique needs of your client and asking how those needs can
be fulfilled. Using an empowerment perspective treating clients
as experts on their lives and their needs is essential. Not only
does this establish your commitment to being culturally
sensitive and aware, but it will enhance the therapeutic
relationship. While it is essential to learn and master social
work skills and techniques to be a successful practitioner,
another significant indicator of a successful intervention is the
relationship a social worker builds with his or her client. Some
research suggests that the quality of the therapeutic relationship
will account for 30% of the clinical outcome of the treatment
(Miller, Duncan, and Hubble, 2005, as stated in Walsh, 2010, p.
7). Exhibiting a dedication to learning about a client’s culture,
history, and current environmental factors exemplifies a social
worker’s desire to build that client–worker bond.
For this Assignment, read the case study for Claudia (in
attachments) and find two to three scholarly articles on social
issues surrounding immigrant families.
In a 3 page paper, explain how the literature informs you about
Claudia and her family when assessing her situation.
· Describe two social issues related to the course-specific case
study for Claudia that inform a culturally competent social
worker.
· Describe culturally competent strategies you might use to
assess the needs of children.
· Describe the types of data you would collect from Claudia and
her family in order to best serve them.
· Identify other resources that may offer you further information
about Claudia’s case.

· Create an eco-map to represent Claudia’s situation. Describe
how the ecological perspective of assessment influenced how
the social worker interacted with Claudia.
· Describe how the social worker in the case used a strengths
perspective and multiple tools in her assessment of Claudia.
Explain how those factors contributed to the therapeutic
relationship with Claudia and her family.
Support your Assignment with specific references to the
resources. Be sure to provide full APA citations for your
references.
Assignment 2: Application of Attachment Theory to a Case
Study
As you have read, theory guides the conceptualization of the
client’s problem and how social workers assess and intervene
relative to the problem. However, theory can also shape the
self-reflective questions social workers ask themselves. Clients
often come to social workers under stress or distress. This then
affects how the social worker responds and thus the client-
social worker relationship. As a result, Foley, Nash, and
Munford (2009) employed attachment theory as a “lens in which
to view the reflective process itself and to gain greater
understanding and empathy for what each social worker within
each unique social work-client relationship can access of that
relationship for reflection”.
This week, you will apply attachment theory to the case study
of Tiffani Bradley from Week 2 (in attachments). In other
words, your theoretical orientation—or lens—is attachment
theory as you analyze the case study.
To prepare:
· Review the same case study of Tiffani Bradley (in
attachments). (Remember, you will be using this same case
study throughout the entire course). Use the “Dissecting
a Theory and Its Application to a Case Study” (in attachments)
worksheet to help you dissect the theory. You do not need to
submit this handout. It is a tool for you to use to dissect

the theory, and then you can employ the information in the table
to complete your assignment.
· Review attachment theory and the following article listed in
the Learning Resources: Foley, M., Nash, M., & Munford, R.
(2009). Bringing practice into theory: Reflective practice and
attachment theory. Aotearoa New Zealand Social Work Review,
21(1/2), p39–47. Retrieved http://dx.doi.org/10.11157/anzswj-
vol21iss1-2id318 (in attachments)
Submit a 2 page case write-up that addresses the following:
· Summarize the assumptions of attachment theory in 2 to 3
sentences.
· Identify the problem in your chosen case study to be worked
on from an attachment theory perspective.
· Explain how attachment theory defines and explains the cause
of the problem in one to two sentences.
· Develop two assessment questions that are guided by
attachment theory that you would ask the client to understand
how the stress or distress is affecting the client.
· Discuss two interventions to address the problem. Remember,
the theory should be driving the interventions. In other words,
you would not identify systematic desensitization since this is
not an intervention guided by attachment theory.
· Formulate one self-reflective question that is influenced by
attachment theory that you can ask yourself to gain greater
empathy for what the client is experiencing.
· Explain which outcomes you could measure to evaluate client
progress based theory.
Be sure to:
· Identify and correctly reference the case study you have
chosen.
· Use literature to support your claims.
· Use APA formatting and style.
· Remember to double-space your paper.

Worksheet: Dissecting a Theory and Its Application to a Case
Study
Most theories can be dissected and analyzed. All theories will
tell you something about their focus or unit of analysis. A
theory will identify its major or key concepts. It will also point
to the definition of the problem and its cause. This then guides
how the social worker assesses and intervenes, because the
theory will also articulate the role of the social worker and how
change occurs.
Basic Assumptions of the Theory
Directions: For each section, respond in 2 to 3 sentences to the
following prompts. Where relevant, provide citations to support
your claims.
Name of theory
Name of theorist
What are the major assumptions of the theory?
What are the theory’s key concepts?
What is the theory’s focus or unit of analysis?
What is the theory’s overall explanation for the cause of
problems?

Application to a Case Study <insert the name of the client>
Directions: For each section, respond to the following prompts.
Where relevant, provide citations to support your claims.
In 1 to 2 sentences, how does the theory define the client’s
presenting problem?
In 1 to 2 sentences, how does the theory explain the cause of the
client’s presenting problem?
In 1 to 2 sentences, how does the theory explain the role of the
social worker for this client?
In 1 to 2 sentences, what does the theory say about how this
client will improve or how change will occur?
Using the theory, list 2 to 3 assessment questions to ask this
client to explore the client’s goals and how they will get there.
According to the theory, identify 2 to 3 specific practice
intervention strategies for the client relative to the presenting
problem. For each, explain in 1 sentence how it will help meet
the client’s goals.

Based on the theory, list 2 to 3 outcomes when evaluating
whether an intervention is effective.
What is one strength and one limitation in using this theory for
this client?
Questions to Consider When Evaluating the Theory
You are not required to answer these questions for this
assignment. However, these questions could help stimulate
thinking whenever you are asked to evaluate a theory.
To what extent does the theory apply widely to diverse
situations? Or does it apply narrowly to particular situations?
Is the theory ethical? Is it consistent with the NASW Code of
Ethics?
Is the theory congruent with the professional value base of the
social work field?
How cost effective would it be to implement interventions based
on the theory?
To what extent does the theory fit within the organization’s or
agency’s philosophy?
What do research studies say about how effective the
interventions are?

ISSUES 1 AND 2, 2009 AOTEAROA NEW ZEALAND SOCIAL
WORK PAGE 39
Bringing practice into theory:
Reflective practice and attachment
theory
Maree Foley, Mary Nash and Robyn Munford
Maree Foley is a PhD candidate in the Department of
Management and International Business at
the University of Auckland Business School, a NZ Registered
Psychotherapist and full member of
NZACAP.
Mary Nash is a Life Member of ANZASW and lectures at
Massey University.
Robyn Munford is co-leader of a FRST-funded research project
on young people’s pathways to resil-
ience and works in the School of Health and Social Services,
Massey University.
Abstract
The relationship between social work practice and attachment
theory has been longstand-
ing across decades. While much attention has been paid to the
use of attachment theory
within specific social work practice settings, less attention has
been focused on the use of
attachment theory to guide the social worker in their practice

based reflections. This article
explores the potential relevance of attachment theory for use
within a reflective practice set-
ting. This exploration is based on key findings from a recent
study conducted in Aotearoa
New Zealand. A proposed beginning framework of attachment
theory informed reflective
practice is offered for practitioners to explore in their reflective
practice.
Introduction
Exploration of the relationship between theory and practice has
been a longstanding endea-
vour within many disciplines including social work (Longhofer
& Floersch, 2004; D’Cruz,
Gillingham, & Melendez, 2007, p.74). This paper explores the
use of attachment theory to
inform reflective practice and, in turn, to potentially inform
social work practice. This explo-
ration is based on a recent Aotearoa New Zealand Masters
research study that explored the
relationship between theory and practice, from the vantage point
of the social worker (Foley,
2007). This paper begins by providing a brief overview of this
study, including a review of
current attachment theory literature for social work practitioner
use. Next, a summary of
the study’s findings is reported.
The remainder of this paper attends to the authors’ reflections
on how the raw findings
might usefully inform reflective practice. It is postulated that
knowledge of attachment
theory can be useful for the practitioner to increase
understanding of both shared and unique

protective and adaptive behaviours within a practice setting
where their capacity to think,
reflect and make meaningful connections may become
compromised. Based on these postu-
PAGE 40 AOTEAROA NEW ZEALAND SOCIAL WORK
ISSUES 1 AND 2, 2009
lations, an exploration of bringing key dynamics of social work
practice with children and
families into attachment theory is explored. This exploration is
followed by the beginning
formulations of an attachment theory informed reflective social
work practice.
Overview of the study
This study began with a review of the literature on attachment
theory and social work prac-
tice, where it was clear that interest in attachment theory as a
relevant social work practice
theory has been sustained over a number of decades (Bowlby
1969, 1973 and 1980; Ainsworth
& Bowlby, 1991; Cassidy and Shaver, 1999). As such a plethora
of relevant literature for this
study was found (Fahlberg, 1991; Howe, 2005; Howe, Brandon,
Hinings & Schofield, 1999;
Nash, Munford, & O’Donoghue, 2005; Atwool, 2006).
Surprisingly, studies that investigated
social work practitioners’ knowledge of attachment theory to
inform their practice, found
that attachment theory knowledge was not as prominent as
expected (Hesse, 1982; Grigsby,
1994; Hendemark, 2004). In addition, recommendations from

these social work practice
specific studies each implied a view that advocating for
increased attachment theory ori-
ented education would equate with the capacity to use this
theory in practice. As such there
seemed to be an underlying assumption within the
recommendations of these studies that
theoretical knowledge equates with use, and use amidst the real
time and moments of the
social work-client relationship.
Given the above paradoxical findings above, Foley (2007)
conducted a study that
sought to gather Aotearoa New Zealand data regarding the
practice status of attachment
theory and research developments as experienced by social
workers within their social
work practice with children and their families. While keeping in
mind socio-cultural-
contextual issues, the primary focus of this study was the
microsphere of practice. This
study endeavoured to understand the journey of a theory,
attachment theory, through
the vehicle of the social worker in their practice descriptions of
using attachment theory
to inform their practice.
In this qualitative phenomenological study (Van Manen, 1990),
eight social workers who
self-identified as being interested in and knowledgeable about
attachment theory were in-
terviewed and were invited to reflect on their experiences of
putting attachment theory into
social work practice with children and families. One of the

interview questions included:
‘What aspects of attachment theory have made the most sense to
you as a social worker?’
That is, most of the social workers in this study began their
reflections not with accounts of
attachment theory knowledge, but with their own responses to
the theory.
Following these interviews, an analysis process (Colaizzi,1978;
van Manen, 1990) en-
sued, guided by a key question: ‘Are there identifiable patterns,
implicit and or explicit,
being used by the interviewed social workers in their processing
of attachment theory
as a social work practice theory, to inform child and family
oriented social work?’ The
initial analysis focused on ascertaining from the descriptions an
anticipated pattern of
‘putting theory into practice’. However, the descriptions of
these social workers in this
study did not fit this pattern. Instead a different pattern was
identified: That is, when
the participants’ responses were analysed, the self of the
practitioner along with practice
knowledge preceded any theoretical comment, reflecting a
process more akin to ‘Bringing
practice into theory’(Foley, 2007).
WORK PAGE 41
As the coded analysis continued, a general pattern emerged
where it appeared that each
social worker was bringing their experience of attachment

theory along with their under-
standings to their practice. In turn, bringing social work
practice into attachment theory
became understood to represent a process where neither practice
nor theory was privileged.
Instead, privileged was the social worker. It was this finding
that largely informed a key
recommendation of this study:
Attachment theory as a relational theory requires a broadening
of the potential scope of rel-
evance within attachment theory informed social work practice
theory to be inclusive of the
social worker, the client and the social worker-client
relationship (Foley, 2007, p. 138).
In addition, the attachment theory foundations prominent in this
study were consid-
ered a useful theoretical framework to support re-positioning of
the social worker to
the centre of the theory – practice dance. As such, this paper
returns to the relevant
literature of this study but with a different purpose in mind: to
view attachment theory
as being potentially useful to inform the social worker about
themselves and their
relationships; and for this exploration to be supported and
developed in a reflective
practice structure.
Re-viewing attachment theory for practitioner use
While there are many comprehensive reviews of attachment
theory across disciplines
(Cassidy & Shaver, 1999) within social work, attachment theory
is commonly identi-

fied as most relevant to specific fields of practice such as the
care and protection needs
of infants and young children (Howe, 2005; Schofield & Beek,
2006). While attachment
theory is often associated with infants and young children,
current studies have sought to
examine the activation of the attachment system in adulthood at
times of stress/distress
(Mikulincer, Birnbaum, Woddies & Nachmias, 2000;
Mikulincer, Gillath & Shaver, 2002).
That is, to explore whether adults continue to seek out a
significant other (someone in a
caregiving role) at times of high stress, with the goal of that
other providing relief and
support that in turn facilitates exploration of possible problem-
solving routes. It has been
repeatedly found that under stress all adult participants
‘underwent preconscious activa-
tion of the attachment system’ (Mikulincer & Shaver, 2003, p.
89). These findings highlight
that the attachment system is relevant throughout the life span
and optimally viewed in
relationship to and with two other interdependent systems: the
caregiver system and the
exploratory system.
Central to these stress/distress-based understandings within
attachment theory is the
construct of ‘the secure base’ (Bowlby, 1988; Schofield &
Beek, 2005). In attachment theory,
an experience of ‘felt security’(Sroufe & Waters, 1977, p. 1186)
increases the capacity to ex-
perience stress without being overwhelmed. In turn ‘felt
security’encouraged exploration
at difficult times, it kept problem solving mobile, creative and
relational. Bowlby proposed

that when ‘felt security’at times of stress was compromised then
one way to create security
was to become self protective through using processes of the
mind referred to as ‘defensive
exclusion’ and/or ‘selective exclusion’ (Bowlby, 1980, p. 52).
As a consequence of these
mind processes, aspects of experience could be excluded from
awareness and therefore not
as readily available to remember, share and/or prompt help
seeking to resolve the stress
which was being experienced.
Central to the development of attachment theory has been the
development of the hy-
pothesis that repeated experiences of the attachment-caregiving
and exploratory system
become internalised as implicit mental maps of how
relationships when under stress best
function. These maps, referred to as ‘internal working models’,
are open to adaptation and
change yet often remain unchanged in structure across
generations (Cassidy & Shaver, 1999).
It is thought that the greater opportunity for felt security on
offer from the caregiver system
at times of high need/stress, the more open, dynamic and
creative the exploratory system
can remain for problem solving. In contrast, when ‘felt security’
is compromised in some
way, it is more likely as Bretherton (1985) stated that if
‘material is defensively excluded
from awareness, it cannot be restructured or updated…’(p. 13).

Therefore attachment theory infers that in the presence of
ongoing stress within the at-
tachment-caregiver and exploratory systems, a working model
exists of how relationships
function when stress develops. In turn, this implicit model
includes experiences and expecta-
tions of self concerning one’s capacity to seek out and make use
of help and support at the
times it is most needed. Included also are experiences and
expectations of how others are
likely to respond to requests for help and support. For example,
information can become
repeatedly excluded for the purpose of self-protection from
unbearable pain. The more infor-
mation is excluded from attention and processing, the less
responsive a person can become
to considering new information that does not fit the current
view of their relationships.
In summary, attachment theory advocates that at times of
overwhelming stress/pressure,
our capacity to experience stress/pressure and be able to think
and act in ways to reduce
the stress/pressure is related to the quality of the relationship
that we have, or can in the
present establish, with a secure base. In turn attachment theory
asserts that the quality of
relationship made possible with the sought-after secure base is
influenced by the internal
working model of relationships and the type of
exclusion/inclusion defences activated to
protect against any expected suffering specific to attachment-
caregiving experiences. In
addition the experience with the secure base at times of high
stress impacts on the capacity

and content possibilities of reflection.
Bringing social work practice into attachment theory
Social work with children and families is often conducted
amidst high anxiety, uncertainty
and emotion. Within this emotional context, the social worker is
both ethically and profes-
sionally responsible to reflect, think and act with coherence.
However, Fonagy, Steele and
Steele (1991) assert that ‘day-in, day-out, social workers (and
their agencies) practise in
emotionally demanding environments which trigger
characteristic coping styles, defensive
strategies and adaptive behaviours’ (p. 205).
In addition, in a social work setting, the nature of social work
service provision often
structures the social worker-client relationship with the social
worker in the helper/help
provider role and the client in the helpee/help seeking role.
Therefore, regardless of the
social work field of practice, when a context of stress/pressure
is recognised for the social
worker and or the client, attachment theory can be relevant in
understanding the follow-
ing. First, unique responses of the social worker and the client
to distress-stress; second,
the impact of these responses on the capacity of the social
worker and the client to reflect
on and then become exploratory towards possible solutions; and
third the social worker’s

WORK PAGE 43
practice capacity to enact the social work plan along with the
client’s capacity to experience
being helped and supported.
In a social work relationship it is often the social worker who is
working with the client
to co-construct a secure base within the client’s family and
community. At best a secure
base is where the conditions for ongoing experiences of ‘felt
security’are on offer. Within
an attachment theory informed social worker-client relationship,
it is the task of the social
worker, in the role of helper to assess and, where possible,
structure conditions for the client
that will optimally provide the conditions for the client to
experience ‘felt security’.
While in principle it is easy to concur with the global social
work goals of providing
help, support and the conditions for felt security for clients,
most social workers will have
stories and experiences where help offered to another in need is
rejected, not made use of,
fought against. We know from practice that while some clients
who meet the criteria for
high needs, who have multiple needs, who concur with the
social worker that they need
help are also at times the most challenging to a social worker’s
sense of efficacy. Failure, fear
and hopelessness can quickly overshadow the original quest to
provide/offer social work
service. In addition, some of these very clients with high needs,
can also be the clients who
are the most difficult to listen to and to spend time with. A

social worker may feel embar-
rassed, ashamed, private about their own practice responses to
these clients. For example,
a social worker who wishes to provide help and support may
repeatedly find themselves
at work acting in ways that are unresponsive, inconsistent,
avoiding responding to phone
calls and dismissing or minimising a family’s needs.
Recent social work practice research by Ruch (2005a; 2005b;
2007) advocates that for social
workers to engage in best practice, social workers need
organisational support to develop
their reflective capacities. Ruch (2007) proposes one way to
support social workers in this
endeavour is to step up the secure base that their respective
practice agencies offer to social
workers to support them in their practice. Therefore, by
increasing organisational support,
a social worker is more likely to experience felt security within
their organisation, in turn,
increasing a social worker’s reflective capacities (Ruch, 2005b,
p. 111).
Attachment theory can further develop this proposition.
Attachment theory can be useful
to guide the reflection process concerning relationships that are
functioning within stress-
ful/overwhelming experiences/situations, and where these
relationships reflect a helpee-
helper dynamic. As such attachment theory could be used to
inform reflective practice, the
place where it is commonly agreed social workers bring
themselves and their practice into
view, for theoretical and practical review, often within a
supervisory relationship.

Bringing the social work practitioner into attachment theory:
Reflective
practice
In addition to the original understandings espoused by Bowlby
(1969; 1973; 1980), Ainsworth
and Bowlby (1991) plus the recent work on adult attachment
(Mikulincer & Shaver, 2003) three
useful constructs have emerged from attachment theory research
that have direct relevance
to reflective social work practice: ‘Coherence’(Main 1991);
‘reflective functioning’(Fonagy
et al., 1991) and ‘mind-mindedness’ (Meins, Fernyhough,
Fradley & Turkey, 2001). While
there is not the space to delve into each of these constructs,
they each extend an assump-
tion in attachment theory: That what is held in mind of a
relationship functions to guide
what can be observed, acknowledged, and attended to in a way
that provides the security
seeker with relief.
As such, based on the theoretical exploration above, for a social
worker in a caregiver,
helper role, it is possible to hypothesise from an attachment
theory perspective, that what
is available for reflection, and the degree of relational capacity
that can be sustained while
reflecting, in turn impacts on the social worker’s capacity to

provide ‘sensitive responding’
(Ainsworth, Blehar, Waters & Wall, 1978) to their client. That
is to attune, to interpret and
to respond within the client’s time frame. Bowlby’s constructs
of selective and defensive
exclusion, referred to above, function to self protect from
experiencing affects and thoughts
that are perceived as overwhelming and unbearable. As a
consequence this impacts on what
is available to be reflected on. Therefore, attachment theory
does not assume that what we
report, and have immediate access to for reflection, is all that
there potentially is to reflect
on. It assumes instead, that by increasing our capacity for
‘reflective functioning’(Fonagy
et al., 1991) and ‘mind-mindedness’(Meins et al., 2001) we will
come to know much more
of what is there to be known within the helper-helpee
relationship.
A working model of attachment theory informed reflective
social work practice
While social work has a strong tradition of reflective models of
social work practice (for
example see: Redmond, 2004; Ruch, 2005a and 2005b),
attachment theory provides a lens in
which to view the reflective process itself and to gain greater
understanding and empathy
for what each social worker within each unique social work-
client relationship can access
of that relationship for reflection.
What follows is the beginning formulations of an attachment
theory informed framework
for reflective practice. Central to this formulation are two key

attachment theory constructs:
the attachment-caregiver and exploratory systems and the secure
base. These key constructs
in turn can inform the development of guiding questions for use
within a reflective prac-
tice setting. As such, it is suggested here that the following
needs consideration: the social
worker’s internal working model; how the social worker
functions in the presence of intense
affect and stress and how they relate to others when in a helper-
caregiving role; knowledge
about defensive exclusion strategies used, when they are used
and with whom.
For the purposes of an attachment theory model of reflective
practice:
Knowledge of self becomes inclusive of knowing how one feels,
thinks and acts when stressed
and when needing to be in a help provider role at this time. To
develop attachment theory
informed questions that are structured so that at all times the
challenge to think and act in a
relational way is present (Foley, 2007, p. 146).
A working example is presented in the diagram below: Secure-
base reflective questions.
This diagram has been developed from drawing on the work of
Zeanah, Boris, Scott Heller,
Hinshaw-Fuselier, Larrieu, Lewis, Palomino et al. (1997), who
during infant-parent assess-
ments keep in mind a key question throughout the process. That
is: ‘what it feels like to
be this particular infant in this particular relationship with this
particular caregiver at this
particular time’ (p. 186). The study showed it is possible to

extend and adapt this key ques-
tion to assist reflective practice concerning social worker-client
relationships.
WORK PAGE 45
For example, the diagram below portrays a refl ective circle
posing a number of questions,
with the social worker taking in turn the position of the key
relationships, and refl ecting on
what it is like to be in this position in relationship with self and
others. These formulated
questions are not intended to be exhaustive nor necessarily
representative of all key rela-
tionships. They are but as working examples in which to begin
to anchor the social worker
in considering the interplay of multiple attachment-caregiver-
exploratory systems within
a single social work interaction.
Figure one. Secure-base refl ective questions (Foley, 2007, p.
147).
In addition it is suggested that following reflection on social
worker-client experiences, that
an attachment theory-informed framework of reflective practice
include reflections on how

to ensure as best as possible an experience of ‘felt security’for
both the social worker and the
family as a precursor to any social work intervention. As such
the following questions were
formulated within the study as a guide to provide further
relational support to the social
worker and the family as an integral aspect of any other social
work. The following practice
based attachment theory informed questions are represented
below in Table one.
Table one. Practice based attachment theory informed questions
(Foley, 2007, p.148).
1. Based on what I have understood about the internal working
model of help seeking-provision of
this client/client family, what do I need to offer this
client/client family to provide the conditions
for them to have an experience of ‘felt security’? What support
might they need to optimally feel
safe in receiving help and support?
2. What does the client/family need to offer to their own family,
so as to provide the conditions for
their own family to have an experience of ‘felt security’? What
support and/or systems would
optimally provide the conditions for the family to experience
efficacy and family belonging/mem-
bership.
3. Based on what I know of my own internal working model of
help seeking-provision, what do
I need to be offered and receive from my team/colleagues for
me to have an experience of ‘felt
security’, so I can help this client/client family?

4, What other key relationships and social resources might I
consider as being useful to have on offer
for this client family so as to provide further conditions for ‘felt
security’?
Conclusion
In conclusion, while attachment theory and social work have
shared a longstanding relation-
ship, the potential for social workers to use attachment theory
for their own personal and
professional development has been explored here. Highlighting
the attachment-caregiver
and exploratory system in relationship to the secure base and
relating this to the social
worker-client relationship, extends the potential use of
attachment theory to any social work
interaction functioning in a context of stress and/or distress.
The above suggestions of how
one might include these theoretical underpinnings into a
reflective practice setting are the
reflective fruit of research-based conversations with the social
work participants who were
generous enough to share their practice into theory approaches
at work.
References
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Running head: CASE STUDY OF TIFFANI BRADLEY 1
CASE STUDY OF TIFFANI BRADLEY 3
Case Study of Tiffani Bradley
Week 2 Assignment
September 8, 2018
Case Study of Tiffani Bradley
Tiffani Bradley’s case study is a systems theory because it
elaborates about the systems of her family from her parents,
sister to her relatives. This Theory assumes that Tiffani is

considered to be a prostitute where she is jailed for two years
and put in a group home for counseling. She is a victim of
human trafficking and sexual exploitation. The fundamental
concepts of the system’s theory are the concept of prostitution
and the mistreatment of women in the society. Tiffani’s uncle,
Nate, is one of the people who are responsible for her abuse
(Cone, 2001). The theorist analyzes the problems faced by
Tiffani Bradley and the reason she persevered.
The theory describes how the different characters in it respond
and react to different situations. The approach is used to
develop mix principles by the integration of various facts.
Tiffani is involved in prostitution and human trafficking by her
‘pimp’ (boyfriend) and other men. Donald tells Tiffani that if
she refuses her offer, he will use her sister where she refuses
because she protects her sister. The problem started eight years
ago when Tiffani used to see her parents engaging sexually. She
grew up knowing that a woman is treated as a sexual object to
be a good wife.
Tiffani went to a counseling place where the role of her social
worker was to help her cope with her family problems and
understand the difficulties she was engaging herself in. She
only accepted to be there because of her sister and that she
missed her family so much. Counseling, medical attention and
avoiding her previous relationships were the only things needed
to do to prevent her from going back to prostitution. She got
sexually transmitted diseases due to the lack of using
protection. She relied on antibiotics to get better. Leaving
Donald, her ‘pimp,’ was the only solution even though she still
wanted to go back (Beehler, 2006).
Some of the assessment questions would include, what were the
challenges? Life doesn’t always bring things what people
desire. Tiffani should be resilient in the face of challenge and
also take time to acknowledge problems. The challenges she
faced should encourage her to be better and do good. Who are
the people and relationships I should get myself in? This
question is to help her step back and be more intentional about

the attention and presence of the link. If it’s her mother
interfering with her goals, she should avoid her. If it’s her
boyfriend, she should get out of the relationship.
Tiffani’s sister was her only strength left. She says that she
would do anything for her sister even if it meant getting hurt
and suffering the consequences. The theory’s limitation is the
fact that Tiffani’s family are the ones who had involved her in
the human traffic starting with her mother. She loved her family
so much despite the problems they faced. An intervention
should evaluate when the statistics of success have been
checked and plans made towards achieving the progress and the
strategies to be implemented. After everything has been put in
place, use lessons to improve the performance of the
intervention.
Prostitution, human traffic is a massive crime and should be
abolished. Human trafficking refers to the action of illegally
transporting people from one area to another, typically for
forced labor or commercial sexual exploitation. Tiffany being a
victim clearly shows how she suffered and wouldn’t want
anyone especially her sister to face what she went through at an
early age. Sexual exploitation should be stopped by educating
the public about the consequences. The government should
enforce laws and punishments such as imprisonment resulting
from sexual exploitation. Rehabilitation centers should be built
to prevent prostitution.
References
Top of Form
Beehler, R. (2006). The theory, not the theorist: The case of
Karl Marx. Lanham, Md: Univ. Press of America.
Cone, J. D. (2001). Evaluating outcomes: Empirical tools for
effective practice. Washington, D.C: American Psychological
Association.
Bottom of Form

1
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 use a different theory, and your
perspective of the problem
changes—which then changes how you ask assessment questions
and how you
intervene.
These case studies are based on the video- and web-based case
studies you encounter
in the MSW program.
Table of Contents
Tiffani Bradley
...............................................................................................
.................. 2
Paula Cortez
........................................................................................... ....
.................... 9

Jake Levey
...............................................................................................
..................... 10
Helen Petrakis
............................................................................. ..................
................ 13
2
Tiffani Bradley
Identifying Data: Tiffani Bradley is a 16-year-old Caucasian
female. She was raised in
a Christian family in Philadelphia, PA. She is of German
descent. Tiffani’s family
consists of her father, Robert, 38 years old; her mother,
Shondra, 33 years old, and
her sister, Diana, 13 years old. Tiffani currently resides in a
group home, Teens First,
a brand new, court-mandated teen counseling program for
adolescent victims of
sexual exploitation and human trafficking. Tiffani has been
provided room and board
in the residential treatment facility for the past 3 months.
Tiffani describes herself as
heterosexual.

Presenting Problem: Tiffani has a history of running away. She
has been arrested on
three occasions for prostitution in the last 2 years. Tiffani has
recently been court
ordered to reside in a group home with counseling. She has a
continued desire to be
reunited with her pimp, Donald. After 3 months at Teens First,
Tiffani said that she
had a strong desire to see her sister and her mother. She had not
seen either of
them in over 2 years and missed them very much. Tiffani is
confused about the path
to follow. She is not sure if she wants to return to her family
and sibling or go back to
Donald.
Family Dynamics: Tiffani indicates that her family worked well
together until 8 years
ago. She reports that around the age of 8, she remembered being
awakened by
music and laughter in the early hours of the morning. When she
went downstairs to
investigate, she saw her parents and her Uncle Nate passing a
pipe back and forth
between them. She remembered asking them what they were
doing and her mother
saying, “adult things” and putting her back in bed. Tiffani
remembers this happening
on several occasions. Tiffani also recalls significant changes in
the home's
appearance. The home, which was never fancy, was always neat
and tidy. During

this time, however, dust would gather around the house, dishes
would pile up in the
sink, dirt would remain on the floor, and clothes would go for
long periods of time
without being washed. Tiffani began cleaning her own clothes
and making meals for
herself and her sister. Often there was not enough food to feed
everyone, and Tiffani
and her sister would go to bed hungry. Tiffani believed she was
responsible for
helping her mom so that her mom did not get so overwhelmed.
She thought that if
she took care of the home and her sister, maybe that would help
mom return to the
person she was before.
Sometimes Tiffani and her sister would come downstairs in the
morning to find empty
beer cans and liquor bottles on the kitchen table along with a
crack pipe. Her parents
would be in the bedroom, and Tiffani and her sister would leave
the house and go to
school by themselves. The music and noise downstairs
continued for the next 6
years, which escalated to screams and shouting and sounds of
people fighting.
Tiffani remembers her mom one morning yelling at her dad to
“get up and go to
work.” Tiffani and Diana saw their dad come out of the
bedroom and slap their mom
so hard she was knocked down. Dad then went back into the
bedroom. Tiffani

3
remembers thinking that her mom was not doing what she was
supposed to do in the
house, which is what probably angered her dad.
Shondra and Robert have been separated for a little over a year
and have started
dating other people. Diana currently resides with her mother
and Anthony, 31 years
old, who is her mother’s new boyfriend.
Educational History: Tiffani attends school at the group home,
taking general
education classes for her general education development (GED)
credential. Diana
attends Town Middle School and is in the 8th grade.
Employment History: Tiffani reports that her father was
employed as a welding
apprentice and was waiting for the opportunity to join the
union. Eight years ago, he
was laid off due to financial constraints at the company. He
would pick up odd jobs
for the next 8 years but never had steady work after that. Her
mother works as a
home health aide. Her work is part-time, and she has been
unable to secure full-time
work.
Social History: Over the past 2 years, Tiffani has had limited

contact with her family
members and has not been attending school. Tiffani did contact
her sister Diana a
few times over the 2-year period and stated that she missed her
very much. Tiffani
views Donald as her “husband” (although they were never
married) and her only
friend. Previously, Donald sold Tiffani to a pimp, “John T.”
Tiffani reports that she was
very upset Donald did this and that she wants to be reunited
with him, missing him
very much. Tiffani indicates that she knows she can be a better
“wife” to him. She
has tried to make contact with him by sending messages through
other people, as
John T. did not allow her access to a phone. It appears that over
the last 2 years,
Tiffani has had neither outside support nor interactions with
anyone beyond Donald,
John T., and some other young women who were prostituting.
Mental Health History: On many occasions Tiffani recalls that
when her mother was
not around, Uncle Nate would ask her to sit on his lap. Her
father would sometimes
ask her to show them the dance that she had learned at school.
When she danced,
her father and Nate would laugh and offer her pocket change.
Sometimes, their
friend Jimmy joined them. One night, Tiffani was awakened by
her uncle Nate and his
friend Jimmy. Her parents were apparently out, and they were
the only adults in the

home. They asked her if she wanted to come downstairs and
show them the new
dances she learned at school. Once downstairs Nate and Jimmy
put some music on
and started to dance. They asked Tiffani to start dancing with
them, which she did.
While they were dancing, Jimmy spilled some beer on her. Nate
said she had to go to
the bathroom to clean up. Nate, Jimmy, and Tiffani all went to
the bathroom. Nate
asked Tiffani to take her clothes off and get in the bath. Tiffani
hesitated to do this,
but Nate insisted it was OK since he and Jimmy were family.
Tiffani eventually
relented and began to wash up. Nate would tell her that she
missed a spot and would
scrub the area with his hands. Incidents like this continued to
occur with increasing
levels of molestation each time.
4
The last time it happened, when Tiffani was 14, she
pretended to be willing to dance
for them, but when she got downstairs, she ran out the front
door of the house. Tiffani
vividly remembers the fear she felt the nights Nate and Jimmy
touched her, and she
was convinced they would have raped her if she stayed in the
house.

About halfway down the block, a car stopped. The man
introduced himself as Donald,
and he indicated that he would take care of her and keep her
safe when these things
happened. He then offered to be her boyfriend and took Tiffani
to his apartment.
Donald insisted Tiffani drink beer. When Tiffani was drunk,
Donald began kissing her,
and they had sex. Tiffani was also afraid that if she did not have
sex, Donald would
not let her stay— she had nowhere else to go. For the next 3
days, Donald brought
her food and beer and had sex with her several more times.
Donald told Tiffani that
she was not allowed to do anything without his permission. This
included watching
TV, going to the bathroom, taking a shower, and eating and
drinking. A few weeks
later, Donald bought Tiffani a dress, explaining to her that she
was going to “find a
date” and get men to pay her to have sex. When Tiffani said she
did not want to do
that, Donald hit her several times. Donald explained that if she
didn’t do it, he would
get her sister Diana and make her do it instead. Out of fear for
her sister, Tiffani
relented and did what Donald told her to do. She thought at this
point her only
purpose in life was to be a sex object, listen, and obey—and
then she would be able
to keep the relationships and love she so desired.
Legal History: Tiffani has been arrested three times for
prostitution. Right before the

most recent charge, a new state policy was enacted to protect
youth 16 years and
younger from prosecution and jail time for prostitution. The
Safe Harbor for Exploited
Children Act allows the state to define Tiffani as a sexually
exploited youth, and
therefore the state will not imprison her for prostitution. She
was mandated to
services at the Teens First agency, unlike her prior arrests when
she had been sent
to detention.
Alcohol and Drug Use History: Tiffani’s parents were social
drinkers until about 8
years ago. At that time Uncle Nate introduced them to crack
cocaine. Tiffani reports
using alcohol when Donald wanted her to since she wanted to
please him, and she
thought this was the way she would be a good “wife.” She
denies any other drug use.
Medical History: During intake, it was noted that Tiffani had
multiple bruises and burn
marks on her legs and arms. She reported that Donald had
slapped her when he felt
she did not behave and that John T. burned her with cigarettes.
She had realized that
she did some things that would make them mad, and she tried
her hardest to keep
them pleased even though she did not want to be with John T.
Tiffani has been

treated for several sexually transmitted infections (STIs) at
local clinics and is
currently on an antibiotic for a kidney infection. Although she
was given condoms by
Donald and John T. for her “dates,” there were several “Johns”
who refused to use
them.
5
Strengths: Tiffani is resilient in learning how to survive the
negative relationships she
has been involved with. She has as sense of protection for her
sister and will sacrifice
herself to keep her sister safe.
Robert Bradley: father, 38 years old
Shondra Bradley: mother, 33 years old
Nate Bradley: uncle, 36 years old
Tiffani Bradley: daughter, 16 years old
Diana Bradley: daughter, 13 years old
Donald: Tiffani’s self-described husband and her former pimp
Anthony: Shondra’s live-in partner, 31 years old
John T.: Tiffani’s most recent pimp
6

Paula Cortez
Identifying Data: Paula Cortez is a 43-year-old Catholic
Hispanic female residing in New
York City, NY. 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 five-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
Paula’s low income, health, and Medicaid status, Paula is able
to receive in-home
childcare assistance through New York’s public assistance
program.
7
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, NY. 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 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,
then raising 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 three 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
the ability to walk. After
8
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,
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 is

recommending 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 have also
led 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 not to
comply 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 successfully got 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 organization The Family Center. She named Miguel as
her daughter’s guardian
should something happen to her.
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 her resilience over the years. She
has artistic skills and has
found a way to utilize them. Paula has the foresight to seek
social services to help her
9
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.
David Cortez: father, 46 years old
Paula Cortez: mother, 43 years old
Miguel Cortez: son, 20 years old
Jesus (unknown): Maria’s father, 44 years old
Maria Cortez: daughter, 5 years old
10
Jake Levy
Identifying Data: Jake Levy is a 31-year-old, married, Jewish
Caucasian male. Jake’s
wife, Sheri, is 28 years old. They have two sons, Myles (10) and
Levi (8). The family
resides in a two-bedroom condominium in a middle-class
neighborhood in Rockville,
MD. They have been married for 10 years.
Presenting Problem: Jake, an Iraq War veteran, came to the
Veterans Affairs Health
Care Center (VA) for services because his wife has 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 has
gotten out of control
and is making him mean and distant. Jake reports that he and his
wife have been
fighting a lot and that he drinks to take the edge off and to help
him sleep. Jake
expresses fear of losing his job and his family if he does not get
help. Jake identifies
as the primary provider for his family and believes that this is
his responsibility as a
husband and father. Jake realizes he may be putting that in
jeopardy because of his
drinking. He says he has never seen Sheri so angry before, and
he saw she was at
her limit with him and his behaviors.
Family Dynamics: Jake was born in Alabama to a Caucasian,
Eurocentric family
system. He reports his time growing up to have been within a
“normal” family system.
However, he states that he was never emotionally close to either
parent and viewed
himself as 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. Jake was raised to believe that
real men do not
show weakness and must be the head of the household.

Jake’s parents are deceased, and he has a sister who lives
outside London. He and
his sister are not very close but do talk twice a year. Sheri is an
only child, and
although her mother lives in the area, she offers little support.
Her mother never
approved of Sheri marrying Jake and thinks Sheri needs to deal
with their problems
on her own. Jake reports that 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.
Employment History: Jake is employed as a human resources
assistant for the
military. Jake works in an office with civilians and military
personnel and mostly gets
along with people in the office. Jake is having difficulty getting
up in the morning to go
to work, which increases the stress between Sheri and himself.
Shari is a special
education teacher in a local elementary school. Jake 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: Jake and Sheri identify as Jewish and attend a
local synagogue on
major holidays. Jake tends to keep to himself and says he
sometimes feels
pressured to be more communicative and social. Jake believes
he is socially inept

11
and not able to develop friendships. The couple has some
friends, since Shari gets
involved with the parents in their sons’ school. However,
because of Jake’s recent
behaviors, they have become socially isolated. He is very
worried that Sheri will leave
him due to the isolation.
Mental Health History: Jake reports that since his return to
civilian life 10 months ago,
he has difficulty sleeping, frequent heart palpitations, and
moodiness. Jake had 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 that he also begin counseling.
Jake says that he does
not really understand what PTSD is but thought it meant that a
person who had it was
“going crazy,” which at times he thought was happening to him.
He 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. Jake
describes that he
sometimes thinks he is back in Iraq, 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 he 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.
Educational History: Sheri has a bachelor’s degree in special
education from a local
college. Jake has a high school diploma but wanted to attend
college upon his return
from the military.
Military History: Jake is an Iraqi War veteran. He enlisted in
the Marines at 21 years
old when he and Shari got married due to Sheri being pregnant.
The family was
stationed in several states prior to Jake being deployed to Iraq.
Jake left the service
10 months ago. Sheri and Jake had used military housing since
his marriage, making
it easier to support the family. On military bases, there was a lot
of social support and
both Jake and Sheri took full advantage of the social systems

available to them
during that time.
Medical History: Jake is physically fit, but an injury he
sustained in combat sometimes
limits his ability to use his left hand. Jake reports sometimes
feeling inadequate
because of the reduction in the use of his hand and tries to push
through because he
worries how the injury will impact his responsibilities as a
provider, husband, and
father. Jake 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: Jake and Sheri deny having criminal histories.
12
Alcohol and Drug Use History: As teenagers, Jake 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. Jake
reports that he has four to
five drinks in the evenings during the week and eight to ten
drinks on Saturdays and
Sundays. Jake spends his evenings on the couch drinking beer

and watching TV or
playing video games. Shari reports that Jake drinks more than
he realizes, doubling
what Jake has reported.
Strengths: Jake is cognizant of his limitations and has worked
on overcoming his
physical challenges. Jake is resilient. Jake did not have any
disciplinary actions taken
against him in the military. He is dedicated to his wife and
family.
Jake Levy: father, 31 years old
Sheri Levy: mother, 28 years old
Myles Levy: son, 10 years old
Levi Levy: son, 8 years old
13
Helen Petrakis
Identifying Data: Helen Petrakis is a 52-year-old, Caucasian
female of Greek descent
living in a four-bedroom house in Tarpon Springs, FL. 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.
14
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 the

Greek Orthodox Church. Helen has used her faith to help her
through the more
difficult challenges of not believing she is performing her “job”
as a wife and mother.
Helen reports that her children are religious but do not regularly
go to church
because they are very busy. Helen has stopped going shopping
and out to eat with
friends because she can no longer find the time since she
became a caretaker for
Magda.
Mental Health History: Helen consistently appears well
groomed. She speaks clearly
and in moderate tones and seems to have linear thought
progression—her memory
seems intact. She claims no history of drug or alcohol abuse,
and she does not
identify a history of trauma. More recently, Helen is
overwhelmed by thinking she is
inadequate. She stopped socializing and finds no activity
enjoyable. In some
situations in her life, she is feeling powerless.
15
Educational History: Helen and John both have high school
diplomas. Helen is proud
of her children knowing she was the one responsible in helping
them with their

homework. Alec graduated high school and chose not to attend
college. Dmitra
attempted college but decided that was not the direction she
wanted. Althima is an
honors student at a local college.
Medical History: Helen has chronic back pain from an old
injury, which she manages
with acetaminophen as needed. Helen reports having periods of
tightness in her
chest and a feeling that her heart was racing along with trouble
breathing and
thinking that she might pass out. One time, John brought her to
the emergency room.
The hospital ran tests but found no conclusive organic reason to
explain Helen’s
symptoms. She continues to experience shortness of breath,
usually in the morning
when she is getting ready to begin her day. She says she has
trouble staying asleep,
waking two to four times each night, and she feels tired during
the day. Working is
hard because she is more forgetful than she has ever been.
Helen says that she
feels like her body is one big tired knot.
Legal History: The only member of the Petrakis family that has
legal involvement is
Alec. He was arrested about 2 years ago for possession of
marijuana. He was
required to attend an inpatient rehabilitation program (which he
completed) and was

sentenced to 2 years’ probation. Helen was devastated,
believing John would be
disappointed in her for not raising Alec properly.
Alcohol and Drug Use History: Helen has no history of drug use
and only drinks at
community celebrations. Alec has struggled with drugs and
alcohol since he was a
teen. Helen wants to believe Alec is maintaining his sobriety
and gives him the
benefit of the doubt. Alec is currently on 2 years’ probation for
possession and has
recently completed an inpatient rehabilitation program. Helen
feels responsible for his
addiction and wonders what she did wrong as a mother.
Strengths: Helen has a high school diploma and has been
successful at raising her
family. She has developed a social support system, not only in
the community but
also within her faith at the Greek Orthodox Church. Helen is
committed to her family
system and their success. Helen does have the ability to
multitask, taking care of her
immediate family as well as fulfilling her obligation to her
mother-in-law. Even under
the current stressful circumstances, Helen is assuming and
carrying out her
responsibilities.
John Petrakis: father, 60 years old

Helen Petrakis: mother, 52 years old
Alec Petrakis: son, 27 years old
Dmitra Petrakis: daughter, 23 years old
Althima Petrakis: daughter, 18 years old
Magda Petrakis: John’s mother, 81 years old
PRACTICE
13
Working With Children
and Adolescents:
The Case of Claudia
Claudia is a 6-year-old, Hispanic female residing with her
biological mother and father in an urban area. Claudia was born
in the United States 6 months after her mother and father moved
to the country from Nicaragua. There is currently no extended
family living in the area, but Claudia’s parents have made
friends
in the neighborhood. Claudia’s family struggles economically
and
has also struggled to obtain legal residency in this country. Her
father inconsistently finds work in manual labor, and her mother
recently began working three nights a week at a nail salon.
While
Claudia is bilingual in Spanish and English, Spanish is the sole
language spoken in her household. She is currently enrolled in a
large public school, attending kindergarten.
Claudia’s family lives in an impoverished urban neighborhood

with a rising crime rate. After Claudia witnessed a mugging in
her
neighborhood, her mother reported that she became very
anxious
and “needy.” She cried frequently and refused to be in a room
alone without a parent. Claudia made her parents lock the doors
after returning home and would ask her parents to check the
locks
repeatedly. When walking in the neighborhood, Claudia would
ask her parents if people passing are “bad” or if an approaching
person is going to hurt them. Claudia had difficulty going to
bed
on nights when her mother worked, often crying when her
mother
left. Although she was frequently nervous, Claudia was
comforted
by her parents and has a good relationship with them. Claudia’s
nervousness was exhibited throughout the school day as well.
She
asked her teachers to lock doors and spoke with staff and peers
about potential intruders on a daily basis.
Claudia’s mother, Paula, was initially hesitant to seek therapy
services for her daughter due to the family’s undocumented
status in the country. I met with Claudia’s mother and utilized
the initial meeting to explain the nature of services offered at
the agency, as well as the policies of confidentiality. Prior to
the
SOCIAL WORK CASE STUDIES: CONCENTRATION YEAR
14
meeting, I translated all relevant forms to Spanish to increase

Paula’s comfort. Within several minutes of talking, Paula
notice-
ably relaxed, openly sharing the family’s history and her
concerns
regarding Claudia’s “nervousness.” Goals set for Claudia
included
increasing Claudia’s ability to cope with anxiety and increasing
her
ability to maintain attention throughout her school day.
Using child-centered and directed play therapy approaches,
I began working with Claudia to explore her world. Claudia was
intrigued by the sand tray in my office and selected a variety
of figures, informing me that each figure was either “good” or
“bad.” She would then construct scenes in the sand tray in
which
she would create protective barriers around the good figures,
protecting them from the bad. I reflected upon this theme of
good
versus bad, and Claudia developed the ability to verbalize her
desire to protect good people.
I continued meeting with Claudia once a week, and Claudia
continued exploring the theme of good versus bad in the sand
tray
for 2 months. Utilizing a daily feelings check-in, Claudia
developed
the ability to engage in affect identification, verbalizing her
feelings
and often sharing relevant stories. Claudia slowly began asking
me
questions about people in the building and office, inquiring if
they
were bad or good, and I supported Claudia in exploring these
inquiries. Claudia would frequently discuss her fears about
school

with me, asking why security guards were present at schools.
We
would discuss the purpose of security guards in detail, allowing
her to ask questions repeatedly, as needed. Claudia and I also
practiced a calming song to sing when she experienced fear or
anxiety during the school day.
During this time, I regularly met with Paula to track Claudia’s
progress through parent reporting. I also utilized psychoeduca-
tional techniques during these meetings to review appropriate
methods Paula could use to discuss personal safety with Claudia
without creating additional anxiety.
By the third month of treatment, Claudia began determining
that more and more people in the environment were good. This
was reflected in her sand tray scenes as well: the protection of
good figures decreased, and Claudia began placing good and
bad
PRACTICE
15
figures next to one another, stating, “They’re okay now.” Paula
reported that Claudia no longer questioned her about each indi-
vidual that passed them on the street. Claudia began telling her
friends in school about good security guards and stopped asking
teachers to lock doors during the day. At home, Claudia became
more comfortable staying in her bedroom alone, and she signifi-
cantly decreased the frequency of asking for doors to be locked.
APPENDIX

99
7. What local, state, or federal policies could (or did) affect
this case?
Chase had an international adoption but it was filed within
a specific state, which allowed him and his family to receive
services so he could remain with his adopted family. In addi-
tion, state laws related to education affected Chase and
aided his parents in requesting testing and special educa-
tion services. Lastly, state laws related to child abandonment
could have affected this family if they chose to relinquish
custody to the Department of Family and Children Services
(DFCS).
8. How would you advocate for social change to positively
affect this case?
Advocacy within the school system for early identification and
testing of children like Chase would be helpful.
9. Were there any legal or ethical issues present in the case?
If so, what were they and how were they addressed?
There was a possibility of legal/ethical issues related to the
family’s frustration with Chase. If his parents had resorted to
physical abuse, a CPS report would need to be filed. In addi-
tion, with a possible relinquishment of Chase, DFCS could
decide to look at the children still in the home (Chase’s adopted
siblings) and consider removing them as well.
Working With Children and Adolescents:
The Case of Claudia
1. What specific intervention strategies (skills, knowledge, etc.)

did you use to address this client situation?
Specific intervention skills used were positive verbal support
and encouragement, validation and reflection, and affect
identification and exploration. Knowledge of child anxieties/
fear and psychoeducation for the client and her mother were
also utilized. Child-centered play therapy was utilized along
with sand tray therapy to provide a safe environment for
Claudia.
SOCIAL WORK CASE STUDIES: CONCENTRATION YEAR
100
2. Which theory or theories did you use to guide your practice?
I used theoretical bases of child- (client-) centered nondirective
play therapy.
3. What were the identified strengths of the client(s)?
Client strengths were a supportive parenting unit, positive peer
interactions, and the ability to engage.
4. What were the identified challenges faced by the client(s)?
The client faced environmental challenges. Due to
socioeconomic
status, the client resided in a somewhat dangerous
neighborhood,
adding to her anxiety and fear. The client’s family also lacked
an
extended support system and struggled to establish legal
residency.
5. What were the agreed-upon goals to be met to address the

concern?
The goals agreed upon were to increase the client’s ability to
cope with anxiety and increase her ability to maintain attention
at school.
6. Did you have to address any issues around cultural compe-
tence? Did you have to learn about this population/group
prior to beginning your work with this client system? If so,
what type of research did you do to prepare?
Language barriers existed when working with the client’s
mother. I ensured that all agency documents were translated
into Spanish. It was also important to understand the family’s
cultural isolation. Their current neighborhood and culture is
much different than the rural Nicaraguan areas Claudia’s
parents
grew up in. To learn more about this, I spent time with Paula,
learning more about her experience growing up and how this
affects her parenting style and desires for her daughter’s future.
7. What local, state, or federal policies could (or did) affect
this situation?
The client and her parents are affected by immigration
legislation.
The client’s family was struggling financially as a result of
their
inability to obtain documented status in this country. The
client’s
mother expressed their strong desire to obtain legal status, but
stated that lawyer fees, court fees, and overwhelming paperwork
hindered their ability to obtain legal residency.

APPENDIX
101
8. How would you advocate for social change to positively
affect this case?
I would advocate for increased availability and funding for
legal aid services in the field of immigration.
9. How can evidence-based practice be integrated into this
situation?
Evidenced-based practice can be integrated through the use
of proven child therapy techniques, such as child-centered
nondirective play therapy, along with unconditional positive
regard.
10. Describe any additional personal reflections about this case.
It can be difficult to work with fears and anxiety when they
are rooted in a client’s environment. It was important to help
Claudia cope with her anxiety while still maintaining the
family’s
vigilance about crime and violence in the neighborhood.
Working With Children and Adolescents:
The Case of Noah
1. What specific intervention strategies (skills, knowledge, etc.)
did you use to address this client situation?
I utilized structured play therapy and cognitive behavioral
techniques.
2. Which theory or theories did you use to guide your practice?
For this case study, I used cognitive behavioral theory.

3. What were the identified strengths of the client(s)?
Noah had supportive and loving foster parents who desired to
adopt him. He quickly became acclimated to the foster home
and started a friendship with his foster brother. He started to
become engaged in extracurricular activities. Noah was an
inquisitive and engaging boy who participated in our meetings.
4. What were the identified challenges faced by the client(s)?
Noah faced several challenges, most significantly the failure
of his mother to follow through with the reunification plan.
He has had an unstable childhood with unclear parental role
models. There may be some unreported incidences of abuse
and trauma.

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