Case

Presentation
Portia Washington
10-26-15

 Mom brought the child, John, in today to be seen. Mom

reported that her oldest son, Adam, moved back in the home
about three weeks ago and since that time John has been
acting very aggressive and is unable to sleep. Mom reported
that Adam was sexually abused as a child and she wonders if
Adam has done something sexually inappropriate to John.
Mom stated that she had only become aware of the abuse
when Adam disclosed it to her six months ago. Adam doesnt
have any health insurance and hasnt seen a medical provider.
Nothing was found in Johns examination. Mom reported that
she is afraid of Adam and scared for her minor children.

Background Information

 Mom is afraid to put Adam out of her home. Moms stated that
she has had to hide the knives in the home and makes John
sleep with her because shes so afraid of Adam. Mom went on
to say that Adam has been very aggressive and destroyed the
home and her bedroom since he has been back in the home.
John has developmental delays due to nuero fibroma. John can
communicate, but he seems afraid to answer questions
pertaining to Adam. Jane was questioned about Adam and she
wouldnt say anything about him either. Reporter feels that
mom is trying, but at this time she is unable to protect the
children from Adam.

Background Information

 Mom is scared of son because he can become violent and

shes afraid he may hurt one of her younger children.

Problem Statement

Services

Strengths & Limitations

Behavior Management

Strengths- really good

builder
Limitation- His anger
issues and aggressive
behavior

Assessment Goals

Specific Interventions with

Timeframes

Get son into treatment

but it becomes a
challenge since Adam
has no insurance

Within 30 days get

Adams services in place.
Also get John services for
his aggressive behavior.

 Interpreter

1. What were some biases you

had going into the interview?

 One value difference is how she has no say within the home.
Even though her husband is not home during the week he still
has the most say in what goes on in the home. She can say that
she is scared of her son and wants him out but if the husband
says no then he stays.
The husband stated that if the son has to move out that he will
stop paying the bills for his wife. The money that he would use
to pay her bills will have to be used to fund the sons new place
of residence. Its either her bills and keep the son in the home or
pay for the son an apartment.
Mother does not work due to all of youngest sons apts.

2. Value differences
between you and the client?

 When Adam was about 11 or 12 he was sexually abused.

He did not disclose who abused him but that it happened
more than once.
While he was working for another company he was being
bullied by some of the other workers.

3. What events or life experiences have

shaped them into the person they are?

 No diagnosis at this moment other than aggressive

behavior and treatment is being put in place. Because he
has no insurance it is a little more difficult but treatment
is being put in place for behavioral issues.
Also because he hasnt really done anything or caused
any harm to anyone yet there is only so much that can be
done.

4. Staff recommendation about

diagnosis, intervention, or treatment?

 Research states that after a child has been sexually

abused they can suffer from anxiety, fear, aggression and
hostility, aggression, depression, and sexually
inappropriate behavior (Browne, 1986).
Psychological and interpersonal problems are more
prevalent among those who have been sexually abused
(Briere, 1994).
Group therapy, psychiatrist, and behavioral therapy

5. What does research say on their

diagnosis, problem, treatment?

 I do not recommend any changes at this point. The first

thing that needs to be addressed is the behavioral issues
by both children. Once services have been in place
afterwards more services can be put into place to help
with any other issues.

6. What changes do you recommend for

the agency or service?

 Competencies: 1, 2, 3, 4, 7, 8, 10
Practice Behaviors: 1.1, 1.2, 1.3, 1.4, 1.5, 2.1, 2.2, 3.2,
3.3, 4.1, 4.3, 7.1, 7.2, 8.2, 10.1, 10.2, 10.3, 10.5, 10.6,
10.7, 10.8, 10.9, 10.10, 10.11,

Competencies or
Practice Behaviors

 Browne, Angela, and David Finkelhor. "Impact of child

sexual abuse: A review of the research." Psychological
bulletin 99.1 (1986): 66.
Briere, John N., and Diana M. Elliott. "Immediate and
long-term impacts of child sexual abuse." The future of
children (1994): 54-69.

References