1. Share your perception of someone who has developed a substance use illness with mood-altering substances. What are your beliefs about the characteristics, strengths and weaknesses of this individual? Discuss your capability to assist this individual in a personal face-to-face session where this person is requesting your assistance. 2. INDIVIDUAL SESSION BACKGROUND INFORMATION: This older Jewish woman's husband died after a long illness. She was referred to the practitioner by the hospital social worker after surgery for cancer. The hospital social worker described her as a woman with many strengths who is discouraged, depressed, and angry. The sessions are held in her home and the practitioner comes to her. Answer and post these questions prior to watching the first video. • How would you prepare for a first meeting with this client? • What are your hunches about what the client might be thinking, feeling, and expecting? • What are your concerns about working with this client? • What, if any, personal issues would working with this client bring up for you? 3. FAMILY SESSION BACKGROUND INFORMATION: This African American and Caucasian family includes three boys ranging in age from 7 to 13 years old. This family was referred by the school counselor who is concerned about the low grades of the oldest boy. In the initial phone call, the mother mentioned that she and her husband have serious disagreements about discipline. All of these sessions occur in the family counselor's office. Answer and post these questions prior to watching the first video. • How would you prepare for a first meeting with this client? • What are your hunches about what the client might be thinking, feeling, and expecting? • What are your concerns about working with this client? • What, if any, personal issues would working with this client bring up for you? 4. GROUP SESSION BACKGROUND INFORMATION: Psycho-educational support group: This group of women live in a low-income area of an urban community. Responding to an identified need, the local neighborhood community center announced a group for mothers who wanted to talk about issues such as parenting, stress, and family life. The group sessions will be held at the community center. Answer and post these questions prior to watching the first video. • How would you prepare for a first meeting with these clients? • What are your hunches about what the clients might be thinking, feeling, and expecting? • What are your concerns about working with these clients? • What, if any, personal issues would working with these clients bring up for you? Post answers and engage in a discussion with your colleagues about this case. Marcus Hill is the temporary practitioner in a large nursing home in a city of 25,000 in the Midwest. He is filling in for Julie Anderson, who is on medical leave. Marcus is a tall, African-American man in his 30s. He has 6 years of experience as a nursing home practitioner and now works for a private ...

1. 1. Share your perception of someone who has developed a
substance use illness with mood-altering substances. What are
your beliefs about the characteristics, strengths and weaknesses
of this individual? Discuss your capability to assist this
individual in a personal face-to-face session where this person
is requesting your assistance.
2. INDIVIDUAL SESSION BACKGROUND INFORMATION:
This older Jewish woman's husband died after a long illness.
She was referred to the practitioner by the hospital social
worker after surgery for cancer. The hospital social worker
described her as a woman with many strengths who is
discouraged, depressed, and angry. The sessions are held in her
home and the practitioner comes to her. Answer and post these
questions prior to watching the first video. • How would you
prepare for a first meeting with this client? • What are your
hunches about what the client might be thinking, feeling, and
expecting? • What are your concerns about working with this
client? • What, if any, personal issues would working with this
client bring up for you?
3. FAMILY SESSION BACKGROUND INFORMATION: This
African American and Caucasian family includes three boys
ranging in age from 7 to 13 years old. This family was referred
by the school counselor who is concerned about the low grades
of the oldest boy. In the initial phone call, the mother
mentioned that she and her husband have serious disagreements
about discipline. All of these sessions occur in the family
counselor's office. Answer and post these questions prior to
watching the first video. • How would you prepare for a first
meeting with this client? • What are your hunches about what
the client might be thinking, feeling, and expecting? • What are
your concerns about working with this client? • What, if any,

2. personal issues would working with this client bring up for you?
4. GROUP SESSION BACKGROUND INFORMATION:
Psycho-educational support group: This group of women live in
a low-income area of an urban community. Responding to an
identified need, the local neighborhood community center
announced a group for mothers who wanted to talk about issues
such as parenting, stress, and family life. The group sessions
will be held at the community center. Answer and post these
questions prior to watching the first video. • How would you
prepare for a first meeting with these clients? • What are your
hunches about what the clients might be thinking, feeling, and
expecting? • What are your concerns about working with these
clients? • What, if any, personal issues would working with
these clients bring up for you? Post answers and engage in a
discussion with your colleagues about this case.
Marcus Hill is the temporary practitioner in a large nursing
home in a city of 25,000 in the Midwest. He is filling in for
Julie Anderson, who is on medical leave. Marcus is a tall,
African-American man in his 30s. He has 6 years of experience
as a nursing home practitioner and now works for a private
company that provides social service consulting to nursing
homes. He will be working for this nursing home for 3 months.
Ann Paul, the Director of Nursing, stops by Marcus’s office just
as he is arriving on his second day of work at the facility. She is
a Caucasian woman in her early 50s with short, dark hair,
dressed in a suit. According to Julie, Ann has a reputation for
being an organized but somewhat distant manager. The nurse
aides are somewhat intimidated by her and try to stay out of her
way as much as possible.

3. ANN: Marcus, I wanted to thank you again for filling in for
Julie while she is on medical leave. I know you have only just
gotten started, but I’d like to tell you about a resident that could
really use your help. In our facility, we like the Social Services
Director to get involved with residents as much as possible so
they know them well when major problems arise. Unfortunately,
we now have a serious problem before you have had a chance to
get to know our residents.
Ann goes on to describe Bill Lee, a 48-year-old resident with
ALS who has lived in the facility for about a year. Bill, who has
never been married, is the designated health care representative
for his mother, Yue, who is also a resident.. He is her only
listed relative. There are no other contacts for Bill besides his
mother. Bill has refused to even discuss making anyone his
designated health care representative. Ann thinks that is
something to work on later after they address decisions about
his mother’s care.
MARCUS: This is really an unusual situation! Tell me more
about Yue.
ANN: Yue is an 86-year-old Chinese-American who was cared
for by Bill at their home until last year when his condition made
it impossible for him to continue to care for her. At that time,
they both moved here to the nursing home. Yue has dementia
and end stage COPD. She is unable to make any decisions for
herself. Her doctor talked to Bill about beginning hospice
services for Yue and about her code status which is currently
full code. The doctor is concerned about what will be done to
extend Yue’s life if she should stop breathing or have other
symptoms that would result in her being sent to the hospital for
what the doctor thinks would be inappropriate treatment. He
obviously can’t discuss this with Yue, so he tried to talk to Bill
about it yesterday. Bill was very hostile when the subject was

4. brought up, so Dr. Saed backed off. Since Dr. Saed is the doctor
for both Bill and Yue, he didn’t want to alienate Bill by pushing
him about this, so he asked for the practitioner to talk to Bill
about it instead.
MARCUS: So Bill knows what Dr. Saed wants but is not in
agreement?
ANN: I’m not sure exactly what Bill thinks. He can be difficult
at times and complains a lot about the poor care here. I know it
is hard to jump in on such a complicated situation, but it really
needs to be dealt with as soon as possible. Dr. Saed is counting
on it. One good thing, I think it might help that you are a man
discussing this “man-to-man” with Bill. I know he wasn’t that
friendly with Julie, so maybe you’ll have better luck.
MARCUS: You know, I think I have seen Bill in the dining
room. I spent some time there at lunch yesterday and noticed a
very thin Asian-American man slumped over in a wheelchair.
His clothes seemed about two sizes too large and much dressier
than you typically see in a nursing home. He kept beating his
hand on the arm of the wheelchair as the aide tried to feed him.
It seemed like he wanted to yell at her but didn’t have the
energy.
ANN: That sounds like Bill. He gives everyone who tries to care
for him a hard time. On the other hand, Yue is the perfect
patient – cooperative and docile. Well, I have to get going, so
good luck!
MARCUS: Thanks, I’ll talk to Bill sometime this morning.
Questions: Put yourself in the role of counselor as you address
the following questions. 1. What are your preliminary
impressions related to the case? 2. What are the key facts in the

5. case? 3. What are some of the questions you might want to
explore with the client? 4. How might your own spiritual,
gender, culture, or ethical beliefs influence interacting with this
client? 5. Do you have any biases, prejudices, or stereotypes
related to this client? See the first posting under this discussion
area for the description of Bill's case. Over the next week, have
a discussion with the other members of your group on this board