Page 520-521 Turner, F. J. (Ed.). (2017). Social work treatment.docx

521
Turner, F. J. (Ed.). (2017). Social work treatment: Interlocking
theoretical approaches (6th ed.). Oxford University Press.
Exception questions:
Inquire about times when the problem is either absent, less
intense, or dealt with in a manner that is acceptable to the
client. Ex. When don’t you have this problem? When is the
problem less bad? What is the different about these times?
Miracle question:
Provide a space for clients to separate themselves from their
problem-saturated context and construct a future vision of life
without the presenting complaint or with acceptable
improvements in the problem.
Coping Questions:
Help clients notice times when they are coping with their
problems and what it is they are doing at those times when they
are successfully coping. Ex. How have you been able to keep
going despite all the difficulties you’ve encountered? How are
you able to get around despite not being able to walk?
Scaling Questions:
Usually, ask clients to rank their situation and/or goal on a one-
to-ten scale where one would represent the worst scenario that
could possibly be, and ten is the most desirable outcome.
Relationship Questions:
When asked clients to imagine how significant others in their
environment might react to their problem or situation might
react to their problem or situation and the changes they make.
Relationship questions contextualize not only problem
definitions but also the client’s desired goals and changes. Ex.
What would your mother (or spouse, sister, etc.) notice that is
different about you if you are more comfortable with the new
environment? How would your wife or other significant other
ranks your motivation to change on a one to ten scale?

© Walden University, LLC 1
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 will use a different theory, and
your perspective of the
problem will change—which then changes how you ask
assessment questions and how
you intervene.
Table of Contents
Ella Schultz
...............................................................................................
...................... 2
Paula Cortez
...............................................................................................
.................... 9
Sam Franklin

...............................................................................................
.................. 10
Helen Petrakis
...............................................................................................
................ 13
Ella Schultz
Identifying Data
Ella Schultz is a 16-year-old White female of German decent.
She was raised in Ohio.
Ella’s family consists of her father, Robert (44 years old), and
her mother, Rose (39
years old). Ella currently resides in a residential group home,
where she has been since
she ran away from home. Ella has been provided room and
board in the residential
treatment facility for the past 3 months. Ella describes herself
as bi-sexual.
Presenting Problem
Ella has been living homeless for 13 months. She has been
arrested on two occasions
for shoplifting and once for loitering (as a teen in need of
supervision) in the last 7
months. Ella has recently been court ordered to reside in a
group home with counseling.
She refuses to return home due to the abuse she experienced.

After 3 months at Teens
First, Ella said she is thinking about reinitiating contact with
her mother. She has not
seen either parent in 6 months and missed the stability of the
way her family “used to
be,” although she is also conflicted due to recognizing the
instability of her family. Ella is
confused about the path to follow.
Family Dynamics
Ella indicates that her family worked well until her father began
drinking heavily about 3
years ago. She remembers her parents being social and going
out or having friends
over for drinks, but she never remembered them becoming
drunk. Then, her father lost
his job as an information technology (IT) support professional
and was unable to find
meaningful work. He took on part-time jobs at electronics
stores, but they left him
demoralized. Her parents stopped socializing, and then her
father was fired from his last
job because he arrived drunk. Ella’s father would regularly be
drunk by the time she
arrived home from school.
When Ella started having trouble in school, her father would
berate her when she came
home if she didn’t study immediately. Then, he would interrupt
her studies by following
her around and verbally abusing her. Soon after, he began
hitting her or throwing
objects at her. Once she went to the emergency room for
stitches on her brow when
she was struck by a drinking glass her father threw. She was
able to convince the

emergency room (ER) staff, however, that it was a bike
accident, as she was known as
an avid biker around her community, often riding to and from
school and elsewhere.
Ella’s mother did not witness these events, as they often
occurred before she returned
from work, and her father might be passed out by this time. Ella
reports that her mother
was in denial about her father, often pretending there was no
issue. When Ella tried to
report the abuse, her mother took her father’s side. Finally,
after the stitches, Ella
confronted her mom with her father present. Her father denied
it, flew into a rage, and
then physically abused both Ella and her mom.
The next day, Ella’s mom acted as if nothing happened. After
the abuse quickly
escalated in the next week, to the point where she could no
longer hide it or cover it up,
Ella fled home and has been homeless since. She left a note
before leaving for school
one morning and did not return home.
Educational History
Ella attends school at the group home, taking general education
classes for her general
education development (GED) credential. Shortly after her
father lost his job, Ella began
experiencing learning disabilities. Her difficulties began in

math, where she had difficulty
sorting and making sense of numbers. Then she began to fall
behind in her reading. Her
grades went from a B average to consistent D’s. Some of Ella’s
Instructors began to
raise the issue of a possible learning disability. A counselor
made an appointment to
discuss possible causes, but Ella left school and home just prior
to that meeting, and did
not attend.
Employment History
Ella reports that her father was employed as an IT support
professional at a bank. When
the bank downsized and closed many branches, her father was
laid off. He was unable
to secure another IT support position, as many companies had
begun outsourcing this
work to contractors or overseas. He began to work part-time
retail jobs at consumer
electronics stores but quickly became demoralized and lost a
series of those jobs. Her
mother works as a full-time home health aide.
Social History
Ella reports that the homeless encampment (where she wound
up for a long stretch)
had a group of teens that stuck together for protection and to
shield themselves and
each other from certain bad choices. It was at this time that Ella
reports she became
bisexual, seeking out and bonding to a group of women who
were able to avoid being
exploited for human trafficking.
The encampment group did still engage in risky behavior,

however, including frequent
shoplifting and other theft to secure food, supplies, etc.
Likewise, although Ella reports
that she did not engage in prostitution, she did engage in
unprotected sex with one
woman whose sexual history may have included prostitution or
intravenous drug use.
Thus Ella contracted a sexually transmitted infection (STI) in
one instance.
Ella reports she might consider trying to go home if she knew
her father was no longer
there, despite feeling betrayed by her mother. She would also be
willing to reconcile and
attend therapy with her. However, Ella feels that her mother,
who comes from a very
religious family (though does not practice much now), would
ultimately reject her due to
her bisexual identification.
Ella also feels a strong bond to the group of teens and women
with whom she stayed in
the homeless encampment. She reports that she misses them and
wishes she could
see them—especially one teen in particular named Marisol. She
says she considers
these women to be as much, if not more, her family as her
biological family.
Mental Health History

Ella began counseling to address the abuse in her history. In her
initial reports, as
detailed above, she cites mostly verbal and psychological abuse
with only two instances
of physical abuse. She denies any sexual abuse.
When Ella recounts the physical abuse specifically, however,
she shows added signs of
acute distress and trauma. The physical harm caused by the
event that triggered her
leaving was reportedly significant—bruising on both arms, a
split lip, a bloody nose, and
a bump on the head—all from punches—as well as bruises on
her leg from being
kicked. She did not seek medical help and avoided as much
social contact as possible
the day she ran away, so as not to encourage inquiries about her
home situation.
Ella does have positive memories of what she calls “the before
time,” and she shows a
desire to return to that time. She worries for her mom, despite
feeling betrayed by her.
The last time she did have contact with her mom, she promised
to leave her dad, but
Ella does not know if this ever occurred.
Legal History
Ella has been arrested three times, twice for shoplifting and
once for vagrancy. Citing
the abuse she reported at home and the fears she felt, Ella was
mandated to services at
the Teens First agency, unlike her prior arrests when she was
sent to detention.
Alcohol and Drug Use History

Ella denies any alcohol or drug use while living homeless. She
reports the homeless
encampment (where she wound up for a long stretch) had a
group of teens that stuck
together and were able to shield themselves from certain bad
choices.
Medical History
During intake, it was noted that Ella showed signs of living
homeless, including carrying
all her possessions in one bag, signs of malnourishment, feet
with heavy callouses, and
clothing in disrepair. She did not show signs of drug use or self-
harm. The STI she
contracted was diagnosed upon intake, and she received
antibiotics for treatment.
Strengths
Ella is resilient in learning how to survive in a difficult
situation. She was able to avoid
the more severe negative outcomes, such as human trafficking
and drug use. She is
able to form beneficial bonds for protection and support.
Father: Robert Schultz (44 years old)
Mother: Rose Schultz (39 years old)
Daughter: Ella Schultz (16 years old)
Paula Cortez

Identifying Data
Paula Cortez is a 43-year-old Catholic Hispanic female residing
in New York City, New
York. 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 5-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.
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, New York. 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.
Paula was diagnosed with bipolar disorder. She experiences
periods of mania lasting
for a couple of weeks, and 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, and 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 3 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 her ability to
walk. After 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;
and 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
recommends 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 led also 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 for noncompliance 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 was
successful in getting 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 Family Center organization. She named Miguel as her
daughter’s guardian
should something happen to her.
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 resilience over the years. She has artistic skills
and found a way to
utilize them. Paula has the foresight to seek social services to
help her 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.
Father: David Cortez (46 years old)
Mother: Paula Cortez (43 years old)
Son: Miguel Cortez (20 years old)
Maria’s Father: Jesus (unknown last name, 44 years old)
Daughter: Maria Cortez (5 years old)
Sam Franklin
Identifying Data
Sam Franklin is a 41-year-old, married, African American male.

Sam’s wife, Sheri, is 41
years old. They have two sons, Miles (10) and Raymond (8).
The family resides in a
three-bedroom home in a middle-class neighborhood in
Rockville, Maryland. They have
been married for 11 years.
Presenting Problem
Sam, a war veteran, came to the Veterans Affairs Health Care
Center (VA) for services
because his wife 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 is out of control and is making him mean and
distant. Sam reports he and
his wife have been fighting a lot and that he drinks to take the
edge off and help him
sleep. Sam expresses fear of losing his job and his family if he
does not get help. Sam
identifies as the primary provider for his family and believes
this is his responsibility as a
husband and father. Sam realizes he may be putting that in
jeopardy because of his
drinking. He says he has never seen Sheri so angry before, and
he sees she is at her
limit with him and his behaviors.
Family Dynamics
Sam was born in Alabama to an African American family
system. He reports his time
growing up to have been within a “normal” family system with
a large extended family in
his town and nearby towns. He states he was emotionally close
to his mother and
worshipped his father. His father was strict but loving, pushing

Sam to become 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. Sam was raised to believe that real men do not show
weakness and must be
the head of the household.
Sam’s parents are deceased, and he has three older sisters who
live in Atlanta. He is
close to the sister who is close to him in age, and they talk
frequently on the phone.
Sam has not, however, shared his current struggles with any of
his siblings. He is afraid
to let them down.
Sheri is an only child, and although her mother lives in the area,
she offers little support.
Her mother never approved of Sheri marrying Sam, so she
thinks Sheri needs to deal
with their problems on her own. Sam reports 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.
Sam and Sheri met during one of his stateside deployments prior
to being deployed to
Iraq. At the time, Sheri was still in college. Sam and Sheri both
say they “fell for each
other fast” and kept in touch during Sam’s deployment to Iraq.
When Sam’s deployment
was over, Sheri encouraged him to complete a bachelor’s degree
while stationed back

in the U.S. After Sam’s graduation, they married and had Miles
within a year.
Employment History
Sam is employed as a human resources director for the military.
Sam works in an office
with civilians and military personnel and mostly gets along with
people in the office. Sam
is having difficulty getting up in the morning to go to work,
which increases the stress
level with Sheri. Shari is a special education teacher in a local
elementary school. Sam
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
Sam and Sheri identify as Baptist and attend a local church on
major holidays. They do
not otherwise practice, though both were raised with stronger
religious community. Sam
used to be quite social in the neighborhood, but he is withdrawn
and tends to keep to
himself. He says he sometimes feels pressured to be more
communicative and social.
Sam believes he is socially inept and not able to develop
friendships. He says he is able
to “fake it” at work but is not sure how long that can last. The
couple has some mutual
couple friends, since Sheri gets involved with the parents in

their sons’ school.
However, because of Sam’s recent behaviors, their socializing
with other couples has
tapered off. He is very worried that Sheri will leave him due to
the isolation.
Sam reports that since retiring from the military 10 months ago,
he has difficulty
sleeping, frequent heart palpitations, and moodiness. After his
deployment, during his
stateside assignments, he reports he did not experience intense
feelings from his
experiences on the battlefield. He would occasionally have
intense memories, but he
reports that he was able to “lock them back up pretty quickly.”
It is only since his
retirement that these feelings arose.
Sam has 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 Sam also begin
counseling. Sam says he does
not really understand what PTSD is, but thinks it refers to a
person who is “going crazy.”
He admits he thought was happening to him at times.
Sam 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. Sam describes that
he sometimes thinks he is back on the battlefield, 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 Sam 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.
Despite his close and normally supportive relationship with his
sisters, Sam is unwilling
to share his struggles with them. He fears that he will let them
down and prove that he is
not able to carry on the strong provider and family patriarch
role of their father. He sees
this role as crucial to his self-identity. Sam reports that he never
saw his father drunk
and is ashamed that his own children may have a memories of
him being drunk.
Educational History
Sheri has a bachelor’s degree in special education from a local
college. Sam received a
bachelor’s degree in human resources management upon his

return from the military.
Military History
Sam is an Iraqi War veteran. He enlisted in the Marines at 18
years old. Sam was
stationed in several states prior to Sam being deployed to Iraq.
Sam left the service 10
months ago but still works in human resources as a civilian.
Medical History
Sam is physically fit but an injury he sustained in combat
sometimes limits his ability to
use his left hand. Sam reports sometimes feeling inadequate
because of the reduction
in the use of his hand, but he tries to push through because he
worries how the injury
will impact his responsibilities as a provider, husband, and
father. Sam 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
Sam and Sheri deny having criminal histories.
As teenagers, Sam 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. Sam reports that he has four to five drinks in the
evenings during the
week and eight to 10 drinks on Saturdays and Sundays. Sam
spends his evenings on

the couch drinking beer and watching TV or playing video
games. Shari reports that
Sam drinks more than he realizes, doubling what Sam has
reported.
Strengths
Sam is cognizant of his limitations and has worked on
overcoming his physical
challenges. Sam is resilient. Sam did not have any disciplinary
actions taken against
him in the military. He is dedicated to his wife and family.
Father: Sam Franklin (31 years old)
Mother: Sheri Franklin (28 years old)
Son 1: Miles Franklin (10 years old)
Son 2: Raymond Franklin (8 years old)
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, Florida. 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.

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.
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.
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 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.
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.
Father: John Petrakis (60 years old)
Mother: Helen Petrakis (52 years old)
Son: Alec Petrakis (27 years old)
Daughter 1: Dmitra Petrakis (23 years old)
Daughter 2: Althima Petrakis (18 years old)
John’s Mother: Magda Petrakis (81 years old)
TOCElla SchultzPaula CortezSam FranklinHelen Petrakis
Solution
-Focused Questions

Page 520-521 Turner, F. J. (Ed.). (2017). Social work treatment.docx

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Page 520-521 Turner, F. J. (Ed.). (2017). Social work treatment.docx