course material

1. (Rate mother in caregiver domain) Alex is a 15-year-old male,
(Rate mother in caregiver domain)Alex is a 15-year-old male, recently discharged after a
thirty-day stay in an in-patient psychiatric hospital. He was hospitalized because he heard
voices telling him “terrible things about himself” and telling him to kill himself. He reported
this to the school social worker who notified his parents. He was taken from school to the
hospital. Alex presents as depressed and withdrawn, but will engage in one-on-one
interaction with an adult. Alex has been telling people that he has been hearing voices since
he was 5 years old. The parents have expressed their gratitude to the school personnel for
believing Alex and responding quickly because when he has said similar things at home,
they didn’t know what to do. Now they are worried that they might not be able to keep him
safe at home.Alex lives with his mother, father, and two older sisters. It is a loving family
with close emotional ties. All of the children are kind, obedient, and care about other people.
Alex’s mother has severe mental illness and is often overwhelmed by Alex’s needs which
causes a lot of stress in their family. She says she feels a special connection to Alex because
she can relate to his feelings of being unable to escape the ‘voices in his head’. Alex’s older
sisters have also struggled with mental health issues in the past. Alex has no relatives in the
area and the family has no child care resources.Although his family has moved many times
over the past few years, Alex has remained enrolled in the same school district. He exhibits
no behavioral problems at school but he often responds verbally to his auditory
hallucinations. In addition, these hallucinations make it difficult for him to concentrate
which has impacted his grades. While he has educational goals appropriate for a tenth-
grader, he is currently struggling to complete his requirements. He also often comes to
school in the same clothes, which appear unwashed, several days a week. The teacher has
expressed concern because he is regularly teased by other children. The teacher and the
school social worker have met with Alex’s parents who have a hard time understanding the
immediate risk that Alex’s hallucinations pose for him. Alex has no friends at school but is
interacts well with all staff. He attends school regularly.Alex and his family have been seen
at the same clinic for the past four years. His mother was recently referred to a treatment
program that she attends Monday through Friday during the day and is doing well. In an
effort to get good housing in a safe neighborhood, the family has moved six times in the past
18 months. The family receives financial assistance through programs such as Section 8
benefits, SSI, and food stamps and is able to provide for the basic needs of their family.When
Alex was six years old, he witnessed the shooting of his uncle in front of their house. His
uncle died on the sidewalk. The police questioned Alex a number of times about the

2. incident. He experienced sleeplessness consistently for months after the incident and still
does periodically. He will randomly ask his parents if they remember “when Uncle Sammy
got killed.” He sometimes refers to the ‘voices in his head’ as Uncle Sammy’s killers who tell
him he is to blame for Sammy being killed.Place ratings in the section that are marked red
using the key above Put rating (number) next to each.0. No evidence of need 1. History
or Suspicion 2. Action Needed, Need interferes with Functioning 3. Immediate
Action Needed, Need is dangerous or disabling 1.
Psychosis 2. Impulsivity/Hyperactivity 3. Depression 4. Anxiety 5. Oppositional 6.
Conduct 7. Anger Control 8. Substance Use 9. Adjustment to Trauma Caregiver Needs &
Resources 0. No evidence of need 1. History or Suspicion 2. Action Needed, Need interferes
with Functioning 3. Immediate Action Needed, Need is dangerous or disabling 1.
Supervision 2. Involvement with Care 3. Knowledge 4. Safety 5. Residential Stability 6.
Organization 7. Social Resources 8. Mental Health/Substance
Use 9. Medical/Physical/Developmental Cultural Factors Domain 0. No evidence of
need 1. History or Suspicion 2. Action Needed, Need interferes with Functioning 3.
Immediate Action Needed, Need is dangerous or disabling 1. Language 2. Traditions
and Rituals 3. Cultural Stress Life Functioning Domain 0. No evidence of need 1. History or
Suspicion 2. Action Needed, Need interferes with Functioning 3. Immediate
Action Needed, Need is dangerous or disabling 1. Family Functioning 2. Living
Situation 3. School Achievement 4. School Attendance 5. School Behavior 6. Social
Functioning 7. Developmental/Intellectual 8. Decision-Making 9. Medical/Physical 10.
Sexual Development 11. Sleep Risk Behaviors Domain 0. No evidence of need 1. History
or Suspicion 2. Action Needed, Need interferes with Functioning 3. Immediate
Action Needed, Need is dangerous or disabling 1. Suicide Risk 0 2. Non-Suicidal Self-
Injurious Behavior 3. Other Self-Harm 4. Danger to Others 5. Sexually
Problematic Behavior 6. Delinquent Behavior 7. Runaway Strengths Domain 0.
Centerpiece Strength 1. Useful Strength 2. Identified Strength 3. No Evidence 1. Family
Strengths 2. Interpersonal 3. Educational Settings 4. Talents and Interests 5.
Spiritual/Religious 6. Cultural Identity 7. Community Life 8. Natural Supports 9.
Optimism 10. Resilience 11. Resourcefulness