1 Theory Into Practice Four Social Work Case Studies

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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
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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.
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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.
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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

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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.
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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
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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
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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
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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
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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.
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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 emergenci es 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

1 Theory Into Practice Four Social Work Case Studies

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