For this Discussion, review one of the case studies in the Learning Resources and consider your knowledge of the client’s culture.
Post by Day 4 a description of your level of familiarity with the culture of the client. Describe at least two additional pieces of information you would need to gather from the client in order to best assist him or her.
Angela is a 27-year-old, Caucasian female, who first came to counseling to address her history of sexual abuse. She graduated from college with a BS in chemistry and has since been employed by pharmaceutical companies. After obtaining a new job, she relocated to an apartment in an East Coast city where she knew no one. Both of Angela’s parents live on the West Coast, and she has one younger brother who also lives in a different state. Angela has limited contact with both her mother and brother and does not have any contact with her father. Angela is obese and disclosed a history of struggling with her weight and eating issues. She has few friends, and those she does have live far away. Angela has a long history of trauma in her life. She was sexually abused between the ages of 9 and 21 by her father, sexually assaulted at the age of 14 by a classmate in school, and mugged as a young adult. There was domestic violence in the home, also perpetrated by her father. Angela’s father is considered an upstanding member of the community, and he is well liked and respected by others. No one in Angela’s family believes that she was sexually abused, and her father joined a “false memory syndrome” group and is outspoken about that issue. There has been little discussion in her family about what took place in the home while she was growing up. Angela struggled with daily functioning and exhibited symptoms of post-traumatic stress disorder (PTSD). She had a history of cutting herself and binge eating and displayed some characteristics of borderline personality disorder. Angela also mildly dissociated when under duress. Angela suffered from depression and anxiety and had trouble establishing new relationships, both socially and at work. Although Angela has a stable job and was able to complete her work each day, at times she became overwhelmed by her emotions and retreated to the bathroom where she cried and sometimes cut herself before returning to her workstation. Angela relied on writing, artwork, and her cat for solace SOCIAL WORK CASE STUDIES: FOUNDATION YEAR 30 and comfort. She was also very active outdoors, often hiking, biking, and going on camping trips by herself. Her goals in life were to own her own home, lose weight, enjoy relationships with others, and find peace with her traumas. As a result of the abuse she experienced, it was necessary to begin treatment focusing heavily on establishing trust and a relationship with the client. After 1 year of therapy, deeper process work was being done around her traumas, and she was able to open up much more. She disclosed more painful experiences to the therapist and began expressing her feelings, including intense anger at her family members. Angela also joined a group for survivors of sexual violence in the same program where she was receiving individual therapy. She was thus able to meet other survivors and engage them in relationship building and obtain support. Over time, she lost 100 pounds and made new friends, and her level of functioning increased dramatically. Six months into the group, however, I noticed boundary issues between the members of the group and the group facilitator. After speaking with the group facilitator about these concerns and others regarding her clinical judgment and boundary crossing, the decision was made to terminate her. As a new group facilitator began engaging the group, I noticed that Angela was not sharing as much in her individual sessions and, overall, seemed guarded. I tried on numerous occasions to address the shift, and while Angela acknowledged that trust had become an issue, she would not directly express her concerns or feelings. After some discussion, I explained to Angela that while I could not discuss the issues concerning the group facilitator, she should feel free to talk about her feelings and concerns in general. However, it became obvious that trust could not be rebuilt, particularly in light of the professional boundary issues with the group facilitator. I asked if she wanted to terminate counseling with me and find a new therapist, and Angela agreed. I provided Angela with three referrals so that she could continue her treatment. I learned that Angela and the former group facilitator had become friends and remained so after both had left the program in their respective capacities.
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