Ways of maintaining a healthy level of functioning

Effects of Trauma

Part 1

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a. What are your thoughts and reactions to this case? How does this case not follow the FTS (Family Therapeutic Services) model?

The permanency worker did not understand what was required to make the interstate transfer, and they were operating like the child was being placed with a relative in the same county. Surprisingly, the Permanency Worker does not understand the urgency of Trenton staying with a close relative. A childs critical developmental years are immediately after birth, and they make connections and bonds with family at this time. Therefore, the delays that took place denied Trenton the opportunity to create a bond with his biological parents and family. It is distressing and disappointing to read such a case because numerous opportunities are available to ensure the child is placed with a family member. However, the lack of competency on the part of the Permanency Worker has resulted in Trenton staying in foster care for 11 months. Trenton is unaware of his parents and would struggle to recognize them in his life. The trauma Trenton will suffer stems from being placed in foster care at an early age, where he did not get to connect with his biological mother.

Family Therapeutic Services assists families in alleviating suffering, recovering from trauma, and maintaining a healthy level of functioning. The case failed to assist the family in alleviating suffering because the parents had to wait for 11 months before they could have their child placed with a close family member. Trentons trauma was not managed since no attempts were made to reunite the family during his formative months. A bond is formed between the mother and child when in the womb. However, the bond was broken when Trenton was placed in foster care. The chances of the family reuniting were slim because Trenton has formed connections with his foster family, and to him, these are his relatives. Therefore, he will struggle to form a connection with his aunt and uncle even though he has finally been placed with them.

b. How could permanency be achieved differently for this child? What are some of the long-term effects for this child?

Permanency could have been achieved differently for the child by making an exception and allowing the parents to take the child home after being released from the hospital. The paper could have been filed as the child stays with the parents, allowing him to form connections with his family and parents. Trentons parents did all they could to offer someone who stayed close to them and was a good candidate for child placement. However, the paperwork processing delays reduced the chances of reuniting the family. The parents could have been willing to fulfill their service plan, but the delay in placing their child with his aunt caused tension in their lives, making it hard to fulfill their service plan. Permanency Workers should be better trained on the importance and immediacy of the Interstate Compact (Menn, 2015). Without understanding the adverse effects, it would have on the child and parents when trying to reunite the family, Permanency Workers will continue taking their sweet time filing papers.

Some long-term effects for Trenton are struggling to form deep and lasting relationships, his life could be plagued with violence and substance abuse, and he might lack empathy. Being placed in foster care at an early age disrupts the childs connection to its mother, and the shock of seeking a connection but being denied causes the childs brain to stop trusting people. The lack of trust makes it hard for Trenton to develop or form deep connections with others as he grows and becomes an adult. Since Trenton lacked nurturing at an early age, he might fail to develop the necessary brain connections, and violence becomes his way of getting what he needs (Winston & Chicot, 2016). Substance abuse will be an escape method since Trenton is unaware of what is lacking in his brain and life. Being denied nurturing causes a child not to develop the necessary feelings to understand the impact of their actions on others. Therefore, Trenton might lack empathy because he did not develop the necessary emotions and feelings early.

Part 2

a. What would happen if you needed to be placed in foster care? Who comes to mind first for a placement option? Who would you and your parents choose and why?

My parents would try to prevent that from happening, but they would be distraught if they could not fight off the placement. The separation from my parents would not be an easy one since I have built bonds with them that would be broken. The trauma of being separated from the birth parents is too massive a burden for a child to carry, and assistance should be offered to the child to overcome the trauma. The placement option would be my grandparents, who live close to our home, and we have built a good bond with them, considering how often they visit. My grandparents would be willing to take up the responsibility of caring for and raising me because they had done it in the past when my parents traveled or needed some time alone. The maternal grandparents have been welcomed to our home and enjoy spending time with their grandchildren. However, they might be a challenge in their age, and questions might arise about their capability to care for a young child.

My parents would prefer to send me to my fathers brother who lives in the same county though a bit far from our home. He has a big house and has managed to raise his children well. There is uncertainty about his willingness to accept being a placement option. I would prefer my grandparents since I have spent countless times with them, and they have supported me. My fathers brother though known to me is distant, and we do not have a close connection. We only see each other on major occasions, and the interactions are brief. However, I understand why my parents would prefer to have him take care of me. He is still young and energetic, and he has the potential to raise me properly. My grandparents might be frail and unable to care for me the way they should, which would lead to me being placed in a foster home later in life.

b. Should Walter have been placed in this home in the first place? What community-based services should have been put into place prior to the crisis with Mrs. Dees heart attack and fire? How could extended family have been used to fill in professional and social service gaps?

Yes, Walter should have been placed in the grandmothers home in the first place. It is always good to retain the family connection with a child before seeking placement in a foster home or group. The grandmother was willing to care for her grandchild, and she had demonstrated how vital it was for her to retain custody of her grandchild. Even with her advanced age, she still fought to have Walter in her home. Mrs. Dees was a familiar face to Walter, and they had a family connection that would enable Walter to overcome the trauma he suffered. To ensure Walter was safe and well taken care of by his grandmother, there should have been community services like home care, assisted living, and counseling for Walter. Walters trauma could be addressed while he was still living with his grandmother, and he would have had a familiar support system. Home care services will have enabled the grandmother to continue living with Walter and receive support in areas she might struggle with, like cleaning and cooking. Assisted living services come in handy when older adults cannot perform certain essential functions alone. For Mrs. Dees, it would have been a life saver since there would be a person helping her raise her grandson. Counseling services would have given Walter the support he needed to process and understand the trauma he suffered.

The extended family could have filled the gaps left by supporting their grandmother in areas where she struggles, like cooking and cleaning. They could also take Walter out on the weekends so he spends time outside the home in a play area and interacts wit other children. Walter could have been left to stay with the grandmother, and the extended family was encouraged to support their grandmother in raising Walter. By spending time with Walter, they would have realized he is not a difficult child, and all he needs is love and care.

Part 3

Outcome/Action Steps Worksheet


Strengths that support the needs of the family/individual: Elena needs to end her relationship with William Smith Sr. even though he is the father of one of her children.

Desired Outcome: Providing care and safety for the children

Action Steps:

1. Who: Elena Martinez

Needs to Do What: Elena needs to end her romantic relationship with William Smith Sr. because it is not healthy for her and her children.

Start Date/Target Completion Date

1. Who: Case Worker

Needs to Do What: Demonstrate to Elena how her romantic relationship with William Smith is unhealthy and detrimental to her family. Without ending the relationship, she would continue to abuse substances, impacting her chances of being reunited with her family.

Start Date/Target Completion Date



Strengths that support the needs of the family/individual: Counseling services to address the trauma she suffered as a child.

Desired Outcome: Healthy coping/overcoming the trauma she suffered as a child

Action Steps:

1. Who: Elena Martinez

Needs to Do What: Attend weekly counseling sessions for at least 12 weeks with a qualified therapist.

Start Date/Target Completion Date

1. Who: Case Worker

Needs to Do What: Follow up with Elena and the therapist to establish the progress of the counseling sessions.

Start Date/Target Completion Date


Strengths that support the needs of the family/individual: Rehabilitation of Elena Martinez to Overcome her Addiction

Desired Outcome: Lead a life without needing to use substances/drugs

Action Steps:

1. Who: Elena Martinez

Needs to Do What: Join a rehabilitation clinic or group that will offer her support to overcome her addiction to cocaine and marijuana. The meetings should be weekly, with random drug testing sessions.

Start Date/Target Completion Date

1. Who: Case Worker

Needs to Do What: Ensure that Elena attends the weekly addiction group meetings and conducts random drug tests to establish if she is still using drugs.

Start Date/Target Completion Date

Part 4

a. Dawn danced into the party and immediately became the center of attention. With sweeping gestures of her arms and dramatic displays of emotion, she boasted about her career as an actress in a local theater group. During a private conversation, a friend inquired about the rumors that she was having some difficulties in her marriage. In an outburst of anger, she denied any problems and claimed that her marriage was as wonderful and charming as ever. Shortly thereafter, while drinking her second martini, she fainted and had to be taken home.

Dawn has histrionic personality disorder. The disorder is characterized by a person having constant attention-seeking, emotional overreaction, and seductive behavior (Dawood et al., 2020). Dawn displayed attention-seeking by how she danced at the party and sought to be the partys center of attention. Dawn used her physical appearance to draw attention to herself and dramatic display of emotions to focus on herself. Dawn boasted of her acting career, demonstrating self-centeredness and a desire to remain the center of attention.

When Dawn was asked about her marriage challenges, she refuted the claims and stated her marriage was solid. Dawn demonstrated she believed her relationship was more intimate than it actually was, leading to her response when asked about it. Due to the question regarding her marriage, Dawns symptoms caused her to have significant distress, causing her to faint.

b. Justin wandered into the party, but didnt stay long. The negative forces in the room were unsettling to his psychic soul-spot. The few guests he spoke to felt somewhat uneasy being with this aloof space cadet.

Justin has a schizotypal personality disorder, characterized by discomfort in social situations, odd beliefs, odd speech, suspiciousness or paranoia, odd behavior, and odd speech (Gray & Zide, 2016). Justin tends to warp and misinterpret social interactions making him believe there are negative forces in the room. He felt distrust and paranoia about being at the party, leading to his early exit. Justin believed he had psychic powers, and the party was unsettling for his psychic soul-spot.

The odd speech was evident in how the few guests who interacted with him felt. They felt he was aloof mainly due to his beliefs. The guests who interacted with him indicated he was aloof, meaning he held odd beliefs or fantasies that were uncommon. Social anxiety made it hard for him to stay in a social gathering prompting his early exit from the party. Justin prefers solitude because he gets uneasy in social situations.

c. Sherry paraded into the party drunk and continued to drink throughout the night. Laughing and giggling, she flirted with many of the men and to two of them expressed her deep affection. Twice during the evening she disappeared for almost half an hour, each time with a different man. After a violent argument with one of them, because he took too long to get her a drink, she locked herself into the bathroom and attempted to swallow a bottle of aspirin. Her friends encouraged her to go home, but she was afraid to be alone in her apartment.

Sherry has borderline personality disorder due to her mood instability, difficulty with interpersonal relationships, and high suicidal behavior and self-injury rates (Trull et al., 2018). Sherry flirted with many men because she was avoiding real or imagined abandonment. Due to her fear of abandonment, Sherry preferred to flirt with multiple men so she could have options in case one of them left her. Sherry had bouts of intense anger, as demonstrated when one of the men took too long to get her a drink. Due to her anger, she attempted to take a bottle of aspirin, demonstrating suicidal and self-injury behavior.

When Sherrys friends tried to encourage her to go home, she exhibited paranoid behavior by being afraid to be alone. A person with a borderline personality disorder will exhibit stress-related paranoid thinking, as demonstrated by Sherry.

d. Elliott spent most of the time talking about his trip to Europe, his new Mercedes, and his favorite French restaurants. People seemed bored being around him, but he kept right on talking. When he made a critical remark about how one of the woman was dressed – and hurt her feelings – he could not apologize for his obvious blunder. He tried to talk his way around it, and even seemed to be blaming her for being upset.

Elliot has narcissistic personality disorder exhibited by his lack of empathy, grandiosity, and a need for admiration (Dawood et al., 2020). The people Elliot was talking to were bored of his stories, but he did not notice because his grandiosity made him believe he was important and others should listen to what he said. Elliot was seeking excessive admiration from others, making him speak to others about his trips and experiences even when the people he was telling these stories were uninterested.

There is a sense of arrogance in how he talks to people without reading their disinterest in what he is saying. Elliots lack of empathy is demonstrated by his comment about a womans dressing and his failure to recognize he hurt her feelings. By blaming her for how she felt, Elliot demonstrated his lack of care for her feelings and not recognizing how others felt about what he said.

e. Paul arrived at the part exactly on time. He made a point of speaking to every guest for five minutes. He talked mostly about technology and finance and avoided any inquiries about his feelings or personal life. He left precisely at 10 PM because he had work to do at home.

Paul has an obsessive-compulsive personality disorder, characterized by excessive focus on details, rules, and orders and the need to achieve a perfect outcome (Gray & Zide, 2016). Paul arrived at the party precisely on time, indicating his excessive focus on details. Rarely will you find people observing exact timings for a party. Pauls need to interact with everyone at the party and having a set time for the interaction indicates his excessive focus on rules and order.

In social interactions, we cannot assign a time for how long we interact with others. However, Paul managed to do so to ensure he maximizes his time at the party. Paul needs to achieve a perfect outcome, and we see this by his arrival and exit from the party. From his interactions with guests, Paul had a mission to interact with everyone at the party before his exit.

f. Before entering, Rosie watched the party for several minutes from outside through the window. Once she went in, she seemed very uncomfortable. When people tried to be nice to her, she looked guarded and distrustful. People quickly became uncomfortable with her habit of finding fault with everything little thing you said or did. She seemed to be picking fights with people. She didnt stay very long at the party.

Rosie presents with symptoms of paranoid personality disorder based on her distrust and suspicion of people, which are the hallmarks of the disorder (Gray & Zide, 2016). Before entering the party, Rosie observed the party for several minutes through a window, indicating an attempt to establish if everything was okay or if she could trust the people at the party. Rosie was very uncomfortable when she finally went in, demonstrating further distrust of the people at the party.

Rosie was suspicious of the people who tried talking to her and initiated arguments based on what others said to her or did (Gray & Zide, 2016). Her picking arguments demonstrate how Rosie reads benign remarks as threatening and opts to attack before being hurt. Rosie bears grudges, making it hard for people to interact with her at the party.

g. Roger wasnt invited to the party. No one really knows him very well because he rarely talks. In fact, he spends most of his time alone at home reading.

Roger has schizoid personality disorder characterized by lacking friends, choosing solitary activities, having no desire for close friendships, and taking little pleasure in activities (Gray & Zide, 2016). Since roger spends most of his time at home reading, he has not formed any close friendships with anyone at the party. The people at the party might know who Roger is, but they dont know Roger that well because he rarely talks. Roger is a loner who enjoys spending time alone, and he has not managed to form any meaningful relationships with others.

Roger was not invited to the party because he prefers staying alone, so no one thought he would like to come to the party. Since he rarely talks, Roger appears aloof and detached. People find it hard to interact with a person who rarely talks or desires to spend time with others.

Part 5

The Roommate Observe Rebecca

Rebecca demonstrates characteristics associated with antisocial personality disorder (ASPD). According to Gray and Zide (2016) a person diagnosed with ASPD has an ingrained pattern f behavior where they disregard and violate the rights of those around them. ASPD causes a person to behave violently, impulsively, or recklessly. In most cases, they have little regard for what others want or need. Rebecca seemed charming initially when she befriended her roommate. However, she was irritable and aggressive and managed to hide it perfectly from her roommate. In the movie, one would assume Rebecca is a good roommate as she tries to do lots of activities with her roommate in an attempt to get close to her. Her ASPD symptoms begin being demonstrated when Tracy invites them to a nightclub, but Rebecca declines. Sara accompanies Tracy to the nightclub, irritating Rebecca though she hides it. Rebecca could not conform to social norms and violated the law in numerous ways. The first time, she went through her roommates stuff and wore her perfume and necklace without permission. While this was not a legal violation, it demonstrated her lack of conformity to social norms.

Irritability and aggression are demonstrated when Sara delays getting home. Rebecca kept calling Sara, but she never got a response until she finally heard her voice in the hall. Rebecca comes out of their room and finds Sara and Stephen kissing. She yells at Sara, demanding to know where she was and stating how worried she was. Rebecca demonstrated a lack of remorse after hurting someone by attacking Tracy when she was in the shower, stabbing Jason when she went to his hotel room, recording Professor Robert and playing the audio to the dean, and when she took their cat and put in the dryer and started it up. Rebecca frequently violates the physical and emotional rights of others by interfering in Saras life.

Black Swan Observe the mother (played by Barbara Hershey) of the ballet dancer

The mother, Erica Sayers, presents characteristics of obsessive-compulsive personality disorder. The characteristics presented by the mother are excessive focus on the details, order, and rules, and she desires to have a perfect outcome in her daily life (Diedrich & Voderholzer, 2015; Gray & Zide, 2016). Erica exerts control over the daughter because she is a former ballerina herself. She wants her daughter to do better than she did and pushes her to become better. However, her insistence on following the rules and order creates tension between the two. Erica wants to live through her daughter, pushing her to do better so she can see herself in her daughter. Since she couldnt become a ballerina after she got pregnant, she wants to become one through her daughter. Erica controls her daughter, pushing her to observe rules and follow a particular order. The mother insists things must be done her way, even if her way is wrong. Erica desires perfection and order, where she wants her daughter to do as she says and is angry when she fails.

The rigidity of Erica is seen when she presents Nina with a celebratory cake, and Nina refuses to take a slice. Erica gets disappointed and angry, forcing Nina to take a small bite of the cake when Nina notices her mother is upset and is throwing away the cake. Erica has a preoccupation with details, and she prefers to have her daughter present in a particular way. Her control over her daughter makes Nina anxious, resulting in Nina scratching herself. Erica is controlling of Nina, demonstrated by her willingness to lock her up because of Ninas scratching the night before her opening day. Erica wants to control what her daughter does but fails to notice its impact on Ninas life due to her preoccupation with the details and order. Erica is rigid and expects her daughter to do as she says. When Lily came to see her one night, the mother was not willing to let Lily speak with Nina, demonstrating her controlling nature. When Nina goes to speak with Lily in the hallway, Erica keeps shouting at them, demanding Nina go back to the house because she has ballet practice the next day.

Rachel Getting Married Observe Kym

Kym presents characteristics of a person with a borderline personality disorder like difficulty with interpersonal relationships, drug abuse, and impulsive aggression (Trull et al., 2018). Kym also presents feelings of being unfairly mistreated or misunderstood, as evidenced when her father keeps checking on her on how she is doing. While her father is merely concerned with her safety and wants to ensure she is okay, Kym feels like he mistrusts her. Kym resents her sisters choice of best maid, demonstrating her distortionsin thoughts. The sister is free to select whom she prefers as her best maid, and there is no justification as to why Kym would resent the choice made by her sister. Kym has intense bouts of anger, demonstrated by how she fights with her mother over the death of their brother. Kym blames her mother for leaving Ethan with her when the mother was well aware she was intoxicated. Kyms mother denies all responsibility for Ethans death and slaps Kym, who responds by hitting her mother.

Impulsive aggression is one of the symptoms of borderline personality disorder, and Kym demonstrates impulsive aggression when she intentionally crashes her fathers car. Kym was angry after arguing with her mother, who refused to accept responsibility for the death of Ethan. However, her reaction to crashing the car was unjustifiable, confirming her unstable condition. A person with borderline personality disorder can have a great attachment to their family and build immediate attachment. However, when conflict arises, they will switch immediately to the extreme and accuse the person of not caring. Kym did the same with her mother when she kept accusing her of being responsible for Ethans death. When her mother refused to accept responsibility, Kym became agitated and felt out of place at the wedding and party due to her anger. Kym accuses her mother of not caring because she refuses to take responsibility for her actions the night before Ethan died.

Part 6

What challenges have you had in regard to recognition of human rights through adherence to the NASW Code of Ethics in clinical practice at your site [Family Advocacy-Mental Health Agency]? What suggestions do you have to implement interventions to support the clients you serve?

When trying to adhere to the NASW Code of Ethics regarding the clients right to self-determination, there is a challenge. A social worker must respect and promote the clients right to self-determination and assist the client in identifying and clarifying their goals (NASW Code of Ethics, 2017). However, when looking at it through the lens of human rights, we might fail to recognize the clients human rights when we deny them their freedom and liberty. A client unable to care for their children will have the children removed from the home and placed in foster care. Looking at it from the lens of human rights, we can see that we are inhuman to the children because we are forcing them to move from their home and into a strange place where they will be away from their parents. Children have freedom from cruel, inhuman treatment, and forceful removal could be considered inhuman treatment when looking at it from a human rights perspective.

The best strategy would be to keep the children in the home and have a relative come live with the children as the parent(s) undergo treatment or rehabilitation. The forceful removal or separation is traumatic for children and can leave them with scars that will be hard to treat later in life. There is no way a social worker can leave children in an unsafe home. The principle of self-determination indicates that a social worker can limit the right to self-determination if the client poses a serious risk to themself or others. Therefore, in our attempt to keep the children with their parents, it cannot be possible to leave them in the home when we know it is unsafe. However, we can encourage the parents to invite a close relative who can watch the children as they undergo treatment. Using this strategy, we would respect the childrens human rights and the clients right to self-determination. Sadly, it might not be possible to do this in all family advocacy cases.


Dawood, S., Wu, L. Z., Bliton, C. F., & Pincus, A. L. (2020). Narcissistic and histrionic personality disorders. https://doi.org/10.1017/9781108333931.049

Diedrich, A., & Voderholzer, U. (2015). Obsessivecompulsive personality disorder: a current review. Current psychiatry reports, 17(2), 1-10. https://doi.org/10.1007/s11920-014-0547-8

Gray, S. W., & Zide, M. R. (2016). Empowerment Series: Psychopathology: A Competency-Based Assessment Model for Social Workers (4th ed.). Cengage Learning.

Menn, J. (2015). States\\\’ borders keep foster children from families: policy implications and improvements for the American foster care system. Kennedy School Review, 15, 34-40.

NASW Code of Ethics. (2017). The National Association of Social Workers Code of Ethics.

Trull, T. J., Freeman, L. K., Vebares, T. J., Choate, A. M., Helle, A. C., & Wycoff, A. M. (2018). Borderline personality disorder and substance use disorders: an updated review. Borderline personality disorder and emotion dysregulation, 5(1), 1-12. https://doi.org/10.1186/s40479-018-0093-9

Winston, R., & Chicot, R. (2016). The importance of early bonding on the long-term mental health and resilience of children. London journal of primary care, 8(1), 12-14. https://doi.org/10.1080/17571472.2015.1133012

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