Social Science

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Dear all, please choose your assigned case study. Work hard!

Case Study #1 A psychiatrist from Elmhurst Hospital called saying the mother, Andrea overdosed on Zoloft last night and was brought to the hospital at 6:30 A.M. She was accompanied by her 9-year-old son, Vincent. She was admitted to the hospital, but refused to give any information to assist in making a plan for Vincent. Andrea is a 27-year-old White woman who lives with her 9-year-old son, Vincent in a one- bedroom apartment in Queens that is described as spacious and clean. She is unemployed and receives $23 daily in food stamps, $68.50 biweekly in cash, and $624 monthly for SSI due to Vincent’s autism/chronic asthma. Vincent’s father, John is 33-years-old, and is unemployed. He receives SSI due to an accident that occurred when he was 14 and left him unable to use his arm. John provides Andrea with occasional financial support and is involved with Vincent, visiting him 3 times a month. Both Andrea and John report having positive experiences with each other. Andrea has been hospitalized at least 3-4 times according to her sister, Elizabeth. She has been diagnosed at different times with schizophrenia, bi-polar disorder, major depression, and epilepsy. She currently takes Zoloft and seizure medication. There have been five prior Child Protective Service reports dating from 2001 to January 2007 against this family, all but one of which was ruled that no abuse was found.

Case Study #2

Family Members: Anne M.- mother, DOB 5/11/75- Peter M.- father, DOB 11/9/69, children- Thomas, DOB 3/15/01 Megan, DOB 2/20/04. The Social worker from the hospital that treated Ms. M. for injuries resulting from the beatings inflicted on her by her husband during their vacation in Jamaica is concerned about mother’s capacity to care for and protect children. Children were present during father’s attacks on their mother. Family Background: Anne M. is a 32 years old woman employed for the past year as a secretary, earning about $30,000 a year. She has been married to Peter M. for 7 years. They have two children, Thomas, aged 6, and Megan, aged 3. Peter is an insurance agent who earns approximately $70,000 a year. Peter and the 2 children are all U.S. citizens. Anne, who was born in Jamaica, is a permanent resident of the US. Peter’s family is also from Jamaica, but he was born in the City. They are both Episcopalians. Since the DV incident and subsequent return to the States, Mr. M. has been living in an apartment he co-owns with his mother in Brooklyn. There was no prior ACS contact with this family, but a search of Domestic Incident Reports at the Police department revealed two prior domestic violence incidents in which Mr. M. was named as the suspect in 12/2002 and 10/2003.

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Case Study #3 Current Allegation: Inadequate Guardianship Adults in home: Mary S., maternal grandmother and legal guardian- Susan, biological mother, children: Jason, 15 y/o Case Details & Allegation: Jason’s mother, Susan, alleged that Mary S., the boy’s maternal grandmother and legal guardian, is physically abusive and intimidating to 15yr old Jason. Yesterday, Mary S. reportedly punched the adolescent in the face after she told him to clean his bedroom. This is not the first time Mary S. has used physical force to intimidate Jason. He is afraid of his grandmother, as she has threatened to shoot him if he ever hits her back. Also, the grandmother goes out of town for days at a time and does not leave Jason any money for food. The last time she left was on Saturday and she did not return until Monday. Mary does not make an alternate plan for Jason’s care when she travels out of state.” Jason’s mother, Susan, says she and her husband gave custody of him to her mother when she was 17 because they did not have any health insurance. Susan says she went to court and filed a petition to revoke her mother’s guardianship and the next court date is next month. However, she has to serve her mother the paperwork first. Susan says her mother is a retired New York State corrections officer, and she may still have her weapon.” Mary S. is a retired corrections officer. She receives $6400.00/month in pension benefits and an undisclosed amount from disability. Mary has diabetes and high blood pressure and takes medication for the condition. Mary was granted legal guardianship of Jason in December 2002, when Susan was 17-years old. It was documented that Susan and Jason’s father signed over guardianship to Mary, so that Jason could be covered by her medical insurance. Since that time, Jason has alternated between living with Susan and with Mary.

Case Study #4 Joaquín Olivares, a 38-year-old Mexican immigrant, and his 35-year-old wife presented to a family services agency with the complaint of “family problems.” The Olivares have been married for twelve years and they have two children (a son aged 6 and a daughter aged 8). They have lived in the U.S. for eight years. He worked as a machine worker in a factory for five years before being recently “laid off.” He presently works as a day laborer. Mrs. Olivares works as a housekeeper for a family. Mr. Olivares complains that his wife has recently started “to nag” him about his drinking. He admits that during the last few months he has increased his intake of alcohol, but denies that this is a problem for him, as he drinks “only on the weekends, and never during the week.” He drinks every weekend, but is vague about the actual amount.

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Mr. Olivares and his wife speak of the difficulties they experience in living in the U.S. Neither speaks much English. Mr. Olivares admits to being quite worried about his previous lay off, adding that he didn’t want to “let the family down” in his responsibilities. As a result, he works long days in order to make ends meet. His weekend drinking is, for him, his way of relaxing, which he feels that he deserves. Mr. and Ms. Olivares were born in Mexico. Both came to the US with a Visa however both have overstayed their Visas and are both now without status and therefore treated as “undocumented” or “unauthorized” by the law. Both children however are US native born citizens.

Case Study #5 You are a social work advocate at a domestic violence shelter. During your evening shift, the police bring in a woman, Damaris from Central America with her three children who have all just been cleared and released from a local emergency room. The youngest child is only one month old and was born two months premature due to suspected physical abuse by the father; the two other children, girls, ages 3 and 4 appear traumatized and are hiding behind their mother. The police explain that the father (and husband) tried to kill the mother in a drunken rage earlier in the evening and that he is arrested and in jail. (Sarah escaped out a window and ran to a neighbor’s house to call 911). The police also report that they suspect a long history of domestic violence by the husband. Sarah is indigenous and only speaks fluently her native language with some Spanish. Both girls only speak their mother’s native language. Damaris entered the United States without inspection and is therefore not authorized, however all three of her children were born in the United States and are US Citizens. You find out later that Damaris was forced to marry her husband and to come to the US against her will.

Case Study #6 Marcel is a 21-year-old White male, self-referred for inpatient treatment due to drug and alcohol abuse. He is currently unemployed, homeless, and has charges pending due to a number of “bounced” checks written over the past several months. Marcel reports that both of his parents were drug addicts and he experienced physical, sexual, and emotional abuse throughout childhood at their hands. His father died of liver disease at the age of 37. Marcel also reports that at the age of 14, he was kicked out of his family’s home because his father suspected that he was gay. Although they live in the same town, he has not had any contact with either parent for 7 years. Marcel describes his relationship with his older sister as “fair.” Marcel is not presently involved in a steady relationship, but does have a network of friends in the local gay community with whom he has been staying off and on. At the time that he left home, Marcel survived by becoming involved in sexual relationships with older men, many of whom were also abusive. He has had numerous sexual partners (both male and female) over the past 7 years, has traded sex for drugs and money, has had sex under the influence of drugs and

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alcohol, and has been made to have sex against his will. Marcel identifies himself as bisexual, not gay. Marcel first used alcohol at age 14, when he had his first sexual encounter with a man. He began using other drugs, including inhalants and marijuana by age 16 and amphetamines and cocaine by age 19. At 21, four months prior to entering treatment, he began using meth.

Case Study #7 You are part of an ethnographic research team with the goal of helping the U.S. Census Bureau find better ways to count the population of homeless individuals and families. Over 12 months, the team has been closely following 156 households as they move in and out of various homeless situations. In the course of the project, the team has had over 45 separate recorded contacts with an African American man in his fifties, named Sam. Sam used heroin, cocaine, and alcohol. He suffered from chronic liver disease and various intestinal ailments. He was evicted from public housing because “they didn’t like my friends” (referring to the drug dealers) and he was “persona non grata” at the local single room occupancy (SRO) hotel. When the team first met Sam he was sleeping at friends’ apartments and in the hotel lobby. A frequent fear of Sam’s is that he would fall asleep and be robbed. The research team became advocates in Sam’s quest for housing. At the suggestion of a team member, Sam spent several weeks in a local shelter, but the nuns asked him to leave when he wanted to keep his bed, but spent nights outside of the shelter. The team helped him to get a security deposit that was needed for an apartment. One of the team members went to look at rooms with Sam, and after a full ten months, they found a landlord who would accept him. One of the team members, a fourth year medical student, often called the local hospital to find out the results of laboratory tests for Sam. The team also paid for Sam’s birth certificate, which he had lost a long time before, but needed for access to some forms of housing. Through the 12 months of the study period, Sam went from sleeping in lobbies, at friends’ places, in a shelter, and finally in his own room. At the end of the 12 months, Sam told the team that he was very worried about his health because he kept passing out. He said that he was not using “a lot” of drugs or alcohol, but he was not abstinent. He still had his own room. Now that the study is over and the research team is moving on, Sam has been referred to you as the social worker for the local Recovery and Substance Dependence Center.

Case Study #8

COZY is a shelter that houses 19 men and women in a modest house, located in a semi- industrialized part of a small town. The building was last used as a pizza parlor, and people still come in asking for pizza. The shelter also houses a community soup kitchen and seven additional “Transitional Program” beds for people who stay for up to two years. The people who stay at COZY feel as if they have finally arrived in a place of safety. They feel secure and can sleep

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safely at night. As a result, they also feel that they can finally begin to address some of their problems. COZY has a maximum stay limit of 30 days. Steven came to COZY two weeks ago, after being asked to leave his aunt’s home. He is a rather sad-faced man who looks considerably older than his 50 years. Steven says that he has been drinking heavily throughout all of his life, and that he also used drugs a lot in Vietnam. He has a son living nearby whom, he is sorry to say, also appears to be a heavy drinker. Steven is very proud of his daughter (she is a teacher), and wishes that he could see his grandchildren more often. Steven is very grateful to the staff at COZY because in the two weeks that he has been with them. He still need a medical screening as he has severe cataracts, stomach upset, fatigue and depression. Steven feels that he could stay sober if he could stay in a place like this. He is applying for their transitional program. You have been assigned to his case.

Case Study #9 Jaclyn is 20 years old and is four months pregnant. She is visiting a comprehensive “wrap around services” health clinic for prenatal care for the first time. The medical team advises prenatal nutritional counseling and vitamins, and assesses her pregnancy as “progressing normally” at this stage. However, she has been referred to you because in the health assessment she responded that she has “always” consumed one or two drinks, almost every day, when she comes home from work to unwind from the stress of her job. There are also social events on weeknights and weekends with family and friends that typically involve light to moderate drinking.

Case Study #10 As the social worker in a large elementary school, you regularly provide information over the intercom during morning announcements about problems or issues that may be of concern to the children in your school. Your goal is to encourage the children to come and talk to you if needed. You recognize that children are fearful and think that they are the only ones with a problem. Because this is April and National Child Abuse Prevention month, you decide to make a brief educational statement about child sexual abuse. About an hour after your PSA, a 7-year-old second grader named Ariel came to your office and reported that a family member was “touching her” and it made her feel uncomfortable.

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Case Staffing # 11 Sal Franco is a 74-year old man, living alone in an apartment complex for older adults. You are the Senior Services social worker associated with the housing units. Sal and his wife, Maria, owned and operated a small, local grocery for 44 years (they emigrated from Italy when they were newlyweds at age 19). They sold the business to their son Dominic when Sal turned 70. The plan was to enjoy travel and retired life together. However, shortly after retiring, Maria was diagnosed with an aggressive leukemia, and she died within 4 months. Mr. Franco has been living alone for over 3 years. Because Sal and Maria spent most of their time working and involved with family activities, there are few close friends in his life. Dominic’s family has Sal to dinner every Sunday, but has little time during the week because of competing demands. Sal’s other children include a daughter living in another state who calls daily (but seldom visits because of the cost), a daughter oversees in military service, and a son with Down’s Syndrome who lives in a group home about an hour away. Sal indicates that he was a “hard drinker” during his 20s and 30s, when he developed stomach problems and high blood pressure. At that point, he limited his use of alcohol to his Friday night poker club and to Sunday dinner with the family. Since Maria’s death, Sal has regularly consumed 3 to 4 drinks a day. He says it alleviates some of the pain, stress, and loneliness. It also helps him sleep, along with the over-the-counter medications that he takes for arthritis pain and as sleep aides. He came to the clinic because his hypertension and gastritis have become extremely labile and intractable. When you ask Mr. Franco how he is doing, he says, “Oh, I guess I’m okay for an old widower. I don’t think it really matters how I feel or what I do anymore at my age.”

Case Study #12

Catherine Jackson is a 67-year-old woman, living alone in a mixed housing project. For the past month, she has received visiting nurse services from your agency. These services were assigned to her upon discharge from the hospital with a diagnosis of anemia and uncontrolled adult-onset diabetes. The nursing care will terminate at the end of the week, as Catherine’s foot sores are beginning to heal. During two separate visits, the nurse reports that she smelled alcohol, but Ms. Jackson did not appear to be intoxicated. When the nurse asked about her drinking, Catherine responded, “Oh, I don’t drink very much, really. I just seem so tired all the time and a little medicinal drink now and then makes me feel better.” A homemaker visits Ms. Jackson two times per week. In addition, she has an elderly friend nearby, and the two women visit with each other daily. However, for the past two months, Catherine has been unable to leave her apartment because of her poor health. The homemaker

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states that she has, on several occasions, had to launder Ms. Jackson’s bedding and sleep wear because of vomit on them. She also takes out the trash, which contains varying numbers of empty hard liquor bottles each time. The homemaker complains that Catherine is not cleaning herself very well, and that she and the apartment smell bad. She doesn’t want to keep working there, and wants to be reassigned to someone else.

Case Study #13

You work for a local faith based, Catholic food pantry that also provides some basic case management services to homeless people living around your church offices. You receive a walk in at 8:00 am from Sarah, a woman in her mid-sixties in traditional African tribal dress. She reports that she has been waiting all night outside the door because another homeless person told her that she could be helped at your office. Sarah came to the United States as a domestic worker (nanny) for a family on the East Coast but she was never allowed to leave the house, and she was not paid. Her employer told her that he was sending money back to her family in Africa, however she had no way to confirm this. Her employer also kept her ID and her VISA so she could not leave. After a year of “not feeling the sun”, Sarah escaped the house and has been wondering around the country for the past year, working at whatever job she could find to survive. Her health seems poor however she is pleasant and happy.

Case Study #14

One of the students you serve is a severe diabetic. He has a 504 Plan in place to help manage the diabetes which includes regular visits to the nurse to check blood sugar levels and take insulin shots when necessary. As a component of the 504 Plan, you are responsible for reminding the student to visit the nurse at certain intervals when the student is under your charge. You have noticed that the student has started to forget these visits where they had been remembering them previously. You also notice signs and symptoms that you (along with all other staff serving this student) were trained by the school nurse to recognize at the beginning of the school year indicating that the diabetes may not be under control.

You call the student over to you and mention that it is time to visit the nurse, that you have been surprised that they have been forgetting to go recently, and that you are concerned about their health given some of the things you are seeing. The student reports that he has run out of diabetic supplies and medication again because his parents won’t go to the pharmacy to pick up the prescriptions. Because the class is covered by the inclusion teacher, you are able to accompany the student to the clinic. The nurse is very concerned about the student’s medical stability when the two of you arrive at her office. She immediately tries to contact the parents and the emergency contact (paternal grandmother). All the numbers have been disconnected. Ultimately, an ambulance is called and the student is taken to the hospital accompanied by one of the Assistant Principals. In debriefing with the nurse, you find out that the family has been

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experiencing financial problems, has refused help from the school social worker, and that this is not the first time he has run out of vitally necessary supplies and medication to manage his fragile case of diabetes.

Case Study #15

You are a social worker with a new initiative to provide comprehensive, multi-disciplinary case management to people in the community that over utilize the emergency room for their medical care. Your first case referral is Joe. Joe is currently 48 years old and has had Type I Diabetes since age 13. He also has a history of alcohol abuse, psychiatric admissions and severe family conflicts. When you arrange to meet him after a hospitalization for high blood sugar, you find out that he is living on the back porch of his parent’s home and sleeping on the picnic table on the porch. He isn’t allowed inside the house and has to ask every day for food and his diabetic supplies. Joe is friendly and is willing to work with your program.

Case Study #16 You work for an agency that supports returning military veterans. You receive a referral to visit Maria, the wife of a Navy officer (Pete). During your visit, Maria has difficulty at first however reports that her husband has been verbally abusive since his return from active duty. This behavior has been escalating over the past month, and Maria is afraid that Pete will hurt her physically. Maria and Pete have four children under that age of 15, and they are all having difficulty in their daily activities due to the stress in the home. Maria is also worried about Pete. He has made statements during angry rages that he wishes he were dead, and that everyone would be better off without him. Maria has asked him to get help but Pete sternly refuses.

Case Study #17 Because your office is located in Downtown Houston, you meet by chance Michael and Amanda, a homeless couple that has been living under the Commerce Street bridge for the past two years. Amanda was forced to “give up her kids” and feels that Michael is her protector. The couple are managing to survive on the streets through a combination of “hustle” and “street friends”. Despite this, they acknowledge that it is taking a toll. In particular, Amanda has epilepsy and has trouble controlling her seizures and staying connected to health care providers. Both Michael and Amanda have difficulty accessing services because they have no address and it is hard to get around the city of Houston by bus.

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Michael has a history of drug use, was in prison for a non-violent offense, and had difficulty concentration or staying focused. He is also lovingly dedicated to the welfare of Amanda and wants to get her to a safe environment. The couple have some support from their church, and from Amanda’s father in another state.

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