· 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 ha.

1. ·
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

2. 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.

3. 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.

4. 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.
Educational History: Helen and John both have high school
diplomas. Helen is proud of her children knowing she was the
one responsible for helping them with their homework. Alec
graduated from 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

5. 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