It is common for social workers to be presented with a crisis situation brought forth by clients, families, communities, and/or organizations. The ultimate goal is to restore the client to equilibrium. The five stages of the crisis are (1) the hazardous event, (2) the vulnerable stage, (3) the precipitating factor, (4) the state of active crisis, and (5) the reintegration or crisis resolution phase.There are times when a social worker will use more than one theory to assist in conceptualizing the problem and intervention, particularly if the theories complement each other. For example, resiliency theory can be used alongside crisis theory.To prepare: Review and focus on the same case study that you chose in Week 2. (The case of Tiffani Bradley)Submit a 1- to 2-page case write-up that addresses the following:Map the client’s crisis using the five stages of the crisis.Describe the client’s assets and resources (in order to understand the client’s resilience).Describe how you, the social worker, will intervene to assist the client to reach the reintegration stage of the crisis. Be sure that the intervention promotes resiliency.Evaluate how using crisis theory and resiliency theory together help in working with a client.Be sure to:Identify and correctly reference the case study you have chosen.Use literature to support your claims.Use APA formatting and style.Remember to double-space your paper.
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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 use a different theory, and your perspective of the problem
changes—which then changes how you ask assessment questions and how you
intervene.
These case studies are based on the video- and web-based case studies you encounter
in the MSW program.
Table of Contents
Tiffani Bradley ………………………………………………………………………………………………….. 2
Paula Cortez ……………………………………………………………………………………………………. 9
Jake Levey …………………………………………………………………………………………………….. 10
Helen Petrakis ………………………………………………………………………………………………… 13
1
Tiffani Bradley
Identifying Data: Tiffani Bradley is a 16-year-old Caucasian female. She was raised in
a Christian family in Philadelphia, PA. She is of German descent. Tiffani’s family
consists of her father, Robert, 38 years old; her mother, Shondra, 33 years old, and
her sister, Diana, 13 years old. Tiffani currently resides in a group home, Teens First,
a brand new, court-mandated teen counseling program for adolescent victims of
sexual exploitation and human trafficking. Tiffani has been provided room and board
in the residential treatment facility for the past 3 months. Tiffani describes herself as
heterosexual.
Presenting Problem: Tiffani has a history of running away. She has been arrested on
three occasions for prostitution in the last 2 years. Tiffani has recently been court
ordered to reside in a group home with counseling. She has a continued desire to be
reunited with her pimp, Donald. After 3 months at Teens First, Tiffani said that she
had a strong desire to see her sister and her mother. She had not seen either of
them in over 2 years and missed them very much. Tiffani is confused about the path
to follow. She is not sure if she wants to return to her family and sibling or go back to
Donald.
Family Dynamics: Tiffani indicates that her family worked well together until 8 years
ago. She reports that around the age of 8, she remembered being awakened by
music and laughter in the early hours of the morning. When she went downstairs to
investigate, she saw her parents and her Uncle Nate passing a pipe back and forth
between them. She remembered asking them what they were doing and her mother
saying, “adult things” and putting her back in bed. Tiffani remembers this happening
on several occasions. Tiffani also recalls significant changes in the home’s
appearance. The home, which was never fancy, was always neat and tidy. During
this time, however, dust would gather around the house, dishes would pile up in the
sink, dirt would remain on the floor, and clothes would go for long periods of time
without being washed. Tiffani began cleaning her own clothes and making meals for
herself and her sister. Often there was not enough food to feed everyone, and Tiffani
and her sister would go to bed hungry. Tiffani believed she was responsible for
helping her mom so that her mom did not get so overwhelmed. She thought that if
she took care of the home and her sister, maybe that would help mom return to the
person she was before.
Sometimes Tiffani and her sister would come downstairs in the morning to find empty
beer cans and liquor bottles on the kitchen table along with a crack pipe. Her parents
would be in the bedroom, and Tiffani and her sister would leave the house and go to
school by themselves. The music and noise downstairs continued for the next 6
years, which escalated to screams and shouting and sounds of people fighting.
Tiffani remembers her mom one morning yelling at her dad to “get up and go to
work.” Tiffani and Diana saw their dad come out of the bedroom and slap their mom
so hard she was knocked down. Dad then went back into the bedroom. Tiffani
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remembers thinking that her mom was not doing what she was supposed to do in the
house, which is what probably angered her dad.
Shondra and Robert have been separated for a little over a year and have started
dating other people. Diana currently resides with her mother and Anthony, 31 years
old, who is her mother’s new boyfriend.
Educational History: Tiffani attends school at the group home, taking general
education classes for her general education development (GED) credential. Diana
attends Town Middle School and is in the 8th grade.
Employment History: Tiffani reports that her father was employed as a welding
apprentice and was waiting for the opportunity to join the union. Eight years ago, he
was laid off due to financial constraints at the company. He would pick up odd jobs
for the next 8 years but never had steady work after that. Her mother works as a
home health aide. Her work is part-time, and she has been unable to secure full-time
work.
Social History: Over the past 2 years, Tiffani has had limited contact with her family
members and has not been attending school. Tiffani did contact her sister Diana a
few times over the 2-year period and stated that she missed her very much. Tiffani
views Donald as her “husband” (although they were never married) and her only
friend. Previously, Donald sold Tiffani to a pimp, “John T.” Tiffani reports that she was
very upset Donald did this and that she wants to be reunited with him, missing him
very much. Tiffani indicates that she knows she can be a better “wife” to him. She
has tried to make contact with him by sending messages through other people, as
John T. did not allow her access to a phone. It appears that over the last 2 years,
Tiffani has had neither outside support nor interactions with anyone beyond Donald,
John T., and some other young women who were prostituting.
Mental Health History: On many occasions Tiffani recalls that when her mother was
not around, Uncle Nate would ask her to sit on his lap. Her father would sometimes
ask her to show them the dance that she had learned at school. When she danced,
her father and Nate would laugh and offer her pocket change. Sometimes, their
friend Jimmy joined them. One night, Tiffani was awakened by her uncle Nate and his
friend Jimmy. Her parents were apparently out, and they were the only adults in the
home. They asked her if she wanted to come downstairs and show them the new
dances she learned at school. Once downstairs Nate and Jimmy put some music on
and started to dance. They asked Tiffani to start dancing with them, which she did.
While they were dancing, Jimmy spilled some beer on her. Nate said she had to go to
the bathroom to clean up. Nate, Jimmy, and Tiffani all went to the bathroom. Nate
asked Tiffani to take her clothes off and get in the bath. Tiffani hesitated to do this,
but Nate insisted it was OK since he and Jimmy were family. Tiffani eventually
relented and began to wash up. Nate would tell her that she missed a spot and would
scrub the area with his hands. Incidents like this continued to occur with increasing
levels of molestation each time.
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The last time it happened, when Tiffani was 14, she pretended to be willing to dance
for them, but when she got downstairs, she ran out the front door of the house. Tiffani
vividly remembers the fear she felt the nights Nate and Jimmy touched her, and she
was convinced they would have raped her if she stayed in the house.
About halfway down the block, a car stopped. The man introduced himself as Donald,
and he indicated that he would take care of her and keep her safe when these things
happened. He then offered to be her boyfriend and took Tiffani to his apartment.
Donald insisted Tiffani drink beer. When Tiffani was drunk, Donald began kissing her,
and they had sex. Tiffani was also afraid that if she did not have sex, Donald would
not let her stay— she had nowhere else to go. For the next 3 days, Donald brought
her food and beer and had sex with her several more times. Donald told Tiffani that
she was not allowed to do anything without his permission. This included watching
TV, going to the bathroom, taking a shower, and eating and drinking. A few weeks
later, Donald bought Tiffani a dress, explaining to her that she was going to “find a
date” and get men to pay her to have sex. When Tiffani said she did not want to do
that, Donald hit her several times. Donald explained that if she didn’t do it, he would
get her sister Diana and make her do it instead. Out of fear for her sister, Tiffani
relented and did what Donald told her to do. She thought at this point her only
purpose in life was to be a sex object, listen, and obey—and then she would be able
to keep the relationships and love she so desired.
Legal History: Tiffani has been arrested three times for prostitution. Right before the
most recent charge, a new state policy was enacted to protect youth 16 years and
younger from prosecution and jail time for prostitution. The Safe Harbor for Exploited
Children Act allows the state to define Tiffani as a sexually exploited youth, and
therefore the state will not imprison her for prostitution. She was mandated to
services at the Teens First agency, unlike her prior arrests when she had been sent
to detention.
Alcohol and Drug Use History: Tiffani’s parents were social drinkers until about 8
years ago. At that time Uncle Nate introduced them to crack cocaine. Tiffani reports
using alcohol when Donald wanted her to since she wanted to please him, and she
thought this was the way she would be a good “wife.” She denies any other drug use.
Medical History: During intake, it was noted that Tiffani had multiple bruises and burn
marks on her legs and arms. She reported that Donald had slapped her when he felt
she did not behave and that John T. burned her with cigarettes. She had realized that
she did some things that would make them mad, and she tried her hardest to keep
them pleased even though she did not want to be with John T. Tiffani has been
treated for several sexually transmitted infections (STIs) at local clinics and is
currently on an antibiotic for a kidney infection. Although she was given condoms by
Donald and John T. for her “dates,” there were several “Johns” who refused to use
them.
4
Strengths: Tiffani is resilient in learning how to survive the negative relationships she
has been involved with. She has as sense of protection for her sister and will sacrifice
herself to keep her sister safe.
Robert Bradley: father, 38 years old
Shondra Bradley: mother, 33 years old
Nate Bradley: uncle, 36 years old
Tiffani Bradley: daughter, 16 years old
Diana Bradley: daughter, 13 years old
Donald: Tiffani’s self-described husband and her former pimp
Anthony: Shondra’s live-in partner, 31 years old
John T.: Tiffani’s most recent pimp
5
Paula Cortez
Identifying Data: Paula Cortez is a 43-year-old Catholic Hispanic female residing in New
York City, NY. 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 five-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 fulltime 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.
6
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, NY. 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.
Mental Health History: Paula was diagnosed with bipolar disorder. She experiences
periods of mania lasting for a couple of weeks 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,
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 three years later when she was diagnosed with a severe brain infection and a Tcell 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 the ability to walk. After
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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,
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 is recommending 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 have also led 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 not to comply 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 successfully got 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 organization The Family Center. She named Miguel as her daughter’s guardian
should something happen to her.
Alcohol and Drug Use History: Paula became an intravenous drug user (IVDU), using
cocaine …
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