GC SOC 386 Week 7 Case Study Analysis

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SOC 386 Week 7 Case Study Analysis Grand Canyon

GC SOC 386 Week 7 Case Study Analysis

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Review the following theoretical perspectives: ecological, systems, strengths, task-centered, cognitive and behavioral. Read the following upon which to reflect:

Read “Case Study 3-4: Challenging the Tradition: In Some Families, Violence Is a Way of Life,” by Steven Krugman in Case Studies in Social Work Practice by LeCroy & LeCroy. Write a 750-1,000-word reflection on the role of the social worker in the attached domestic violence case study.

For each case reflection discuss the following:

  1. Discuss the primary theoretical perspective reflected in the case study. Discuss one other theoretical perspective that could be applied.
  2. What competencies and behavioral practices did the social worker utilize?
  3. What did you find challenging about the case?
  4. What strategies did the social worker use that surprised you?
  5. What skills, practices, and behaviors do you think were critical for managing the case?

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. Please include a thesis statement in introductory paragraph and include a conclusion paragragh.

Prepare this assignment according to the guidelines found in the APA Style Guide. Case study listed below.

Case Study 3-4 Challenging the Tradition: In Some Families, Violence Is a Way of Life

Steven Krugman3

The couple in this case developed a relationship that incorporated significant incidences of violence. Breaking this pattern of violence became the goal for successful resolution of the problem.

Questions 1. How does the social worker challenge the family’s values in this case?

  1. What factors could be attributed to maintaining the violence in this family?
  2. How was the couple kept involved in the treatment?
  3. What personal attributes or family experiences do you have that could affect your ability to work with similar cases?

A dog barked at me while I waited on the porch of the ramshackle house for someone to open the door. A young woman in her mid-twenties wordlessly let me into the kitchen. There, five or six adults were sitting around the table, smoking cigarettes and drinking coffee. A baby slept in a port-a-crib, while two older boys played with used auto parts in the living room. The baby and the two boys were the ostensible reason I was there. A social worker at the hospital where the baby had just been born had learned that the infant’s mother, “Kathy”—the young woman who had let me in— had a long history of drug abuse and that both she and her two young sons had been beaten by her first husband. The worker, concerned about Kathy’s ability to take care of her new baby, had filed a child abuse and neglect report. I was there following up on that report as the representative of a family intervention team of the State Department of Mental Health. I had already gotten some background information on Kathy. She was a tough Irish girl from Boston who had grown older and a little wiser over the years. At 17 she had married a man who worked sporadically, sold drugs, and regularly abused her and their two boys. After one especially vicious beating, Kathy’s brothers helped her escape and return to her parents’ home. That ended the marriage. Back home she quickly resumed her long-standing job of taking care of everyone else and keeping the lid on the ever stewing pot of family conflict. She was the fourth of 10 children. She had kept out of trouble by staying close to her volatile, sometimes alcoholic, mother; running errands; and hauling in stray family members. Then she met 40-year-old “Tony,” whose maturity seemed to offer the possibility of a more stable, less violent family life. They had been married for 2 years at the time of this first visit. The relationship with Kathy was Tony’s third try at a family. His first marriage had broken up because his wife wouldn’t take his abuse and left with their daughter. According to him, the second marriage “just ended,” that’s all. Tony carried himself like a coiled spring and let everyone know he was not someone to mess with. But evidently someone had ignored those signals along the way, because Tony had once done 10 months in prison for assault. As I entered the kitchen, Tony offered me a seat and went on talking with his buddies. I just sat there wondering if either Tony or Kathy would acknowledge that we had set up a meeting a few days before. Neither one of them did. Finally I said we needed to get started. With drudging ceremony, Tony ushered his friends from the kitchen, shrugging his shoulders and asking one of them to wait in the living room. I explained about the report I had received from the hospital’s protective worker. Tony immediately let me know that he wanted to be no part of whatever I was selling. Everything was fine except for the “goddamned Department of Social Services.” He stated that neither he nor Kathy needed any help, and I should leave. I felt like an intruder and was more than a little intimidated by Tony and his friends. Kathy hardly said a word. There was no room for discussion. As I left, I told Kathy and Tony to call if they felt I could be of use.

A Surprise Call The following Sunday night, I answered a crisis call. It was Tony. Kathy was in the hospital. She’d “hurt herself ” while high on Valium and alcohol. Could I see the two of them? The next morning, I learned that Kathy had been stuporous and badly bruised when she was admitted to the hospital. The emergency room sent her to a shelter for battered women. The kids seemed to be all right. Later that day, Kathy came to the session with an advocate from the shelter. She and Tony cried together while the shelter worker and I sat by uncomfortably. They were both tremendously apologetic and remorseful. Kathy was angry at herself for breaking a promise she had made to Tony about using pills. She was, however, confused about how she had gotten so bruised. Tony swore he had only “slapped her around a little” to revive her. He said that he had been scared to death when he saw her looking all doped up. I asked Kathy if she knew what Tony wanted her to do. She said, “Sure. Stop using pills. Be home when the boys get home from school. Stay in at night because it’s too dangerous. Not see anyone, just wait for him.” As she spoke, she got angrier and more sarcastic. “Yeah, I know what he wants. He wants to control me.” Still smarting from my first encounter and puzzled by Tony’s call to me, I wanted to shift the responsibility for choosing therapy to the clients. “It seems to me that you’ve both apologized and forgiven each other. The last time I spoke with you, Tony told me that everything was okay. I wonder if there’s any need for us to meet? Maybe Kathy should go for counseling at the shelter.” This time they both said that they wanted to go to therapy; they didn’t want this relationship to go down the tubes like the others had.

Challenging the Family’s Values Once I began meeting with Tony and Kathy, it was clear that they were much more experienced than I with violence of all kinds. Both had grown up witnessing violence at home and in the street. They jokingly called their neighborhood “Dodge City.” During the 2 years they had been married, Tony had threatened Kathy numerous times; shoved her on two occasions (prior to the current incident); pushed around Kathy’s 9-year-old son, Kevin, several times; and had a fight with her ex-husband. Yet these acts had barely registered on their scale of life events. With Kathy and Tony, as with other violent couples I see, the first phase of treatment was governed by three principles: 1.Safety first . I help the victim and the family establish as much safety as they can. To do this I negotiate an explicit contingency plan in which both partners agree on how they will deal with a violent crisis. The plan then becomes a technique for creating alternative choices, like timeout periods and physical separation, to counter abuse and victimization. My emphasis on the plan challenges the family’s belief that now that treatment has begun, the danger is over. I insist that it lies ahead. Responsibility and control .

  1. Responsibility and control With violent couples it is essential to give a clear message that the hitter is responsible for his hitting and that rationalizations like “she provoked me” or “I couldn’t help it” are not acceptable. Tony insisted that when he hurt Kathy he was “out of control.” I told him that I had a hard time believing that an experienced streetfighter like him had so little control over his hands. He repeated my observation, enjoying the irony. There was something about this way of looking at his relationship with Kathy that struck home with him. Invoking the image of the battle-scarred streetfighter who was unable to control himself with his wife provided tremendous leverage throughout the course of therapy.
  2. The rights of the victim . Along with the emphasis on the responsibility of the abuser comes a concern with the rights of the victim— namely, the right not to be hit. In many families, this challenges the accepted value system regarding the use of physical force. While emphasizing that Tony was also hurting and needed help, I strongly supported Kathy’s right not to be hit or coerced. “I’ve never had a safe place,” she told me. “I want my home to be safe.”

After 4 months of weekly meetings with Tony and Kathy, there had been no further physical battles, and I confronted a familiar problem in working with violent couples. If you succeed in putting a check on the violence, then the family’s motivation to change is likely to diminish dramatically. Going from the crisis and initial engagement to a longer-term working alliance is difficult. Many cases get lost at this point. Making the transition to ongoing treatment requires either a high degree of motivation within the family (often the wife says “Unless you change, I’m leaving”) or consistent external pressure coming from the courts or the Department of Social Services (DSS). At times, family and church networks can provide it as well. Violent families rely heavily on denial and minimization as a way of warding off their feelings of being out of control and vulnerable. Dropping out of therapy at the first sign that things are better is a predictable response. After all, going on in treatment means dealing with upsetting memories and experiences. So, when Christmas arrived, Tony and Kathy decided to break for the holidays and call me if they wished to see me again.

Phase Two:  What happened next makes the case of Tony and Kathy unusual in my experience. Typically, either one or both of the partners in a violent relationship are reluctant to be in treatment. The investment of the mental health system with such couples is more in the way of crisis intervention than ongoing treatment. If therapy is to continue past the initial crisis, then the therapist must ally with both partners while insisting that the violence must stop. This can be a difficult balancing act to pull off. Somehow, in this case, both Kathy and Tony had come to see me as someone who had something to offer, and 4 months later, I heard from them again. Tony, working long hours and under a lot of financial pressure, “lost his cool” one night, pushed Kathy around, and slapped her. In a similar incident some days before, Tony slapped Kevin after the boy told him “not to yell at his mother.” Kathy was furious. She told Tony, “I did what you asked. I haven’t used Valium. But I married you to spend time with you, and you’re never home. I need my own life. You can’t control me. I won’t put up with your hitting and shoving me and the boys. I don’t want those kids hit by anyone ever again.” Tony seemed to get the message and reaffirmed his commitment to no more hittings. I agreed with Kathy that Tony was trying to control her life, but I reframed it as “too much caring.” Tony agreed to see me individually to find some better way of handling Kathy’s wish for more autonomy.

Meanwhile, Kathy’s son Kevin told his guidance counselor about the violence at home. Another DSS worker got involved and raised the question of whether Kathy’s three boys should be removed from the home. Although no specific action resulted, Kathy became very anxious at the possibility of losing custody. She even talked about leaving Tony if staying with him jeopardized her custody of her sons. For the first time, Kathy and Tony were faced squarely with the possibility of losing either their children or their marriage.

Other Systems:  A basic ground rule in working with violent family situations is to make use of all available community resources. Yet anyone who has ever dealt with the courts and DSS knows that their interventions are often ineffective and poorly coordinated. In this case, though I had worked closely with the protective agency, the threat to remove Kathy’s children was never discussed with me. I suggested a meeting to develop a plan including the school and DSS, but before the meeting could be held, the caseworker left the agency. The case, evaluated now as “low risk,” went unassigned for months. A relieved Kathy and Tony left therapy once again. About six months later, Tony and one of Kathy’s brothers had a terrible fight over some money that had disappeared from the house. The police, arresting no one, filed a child abuse report. A new worker was assigned, and the family was once again encouraged to resume treatment. By this time the pattern of ebb and flow of tension was becoming clear, and together we focused on understanding how the episodes of violence fit into Tony and Kathy’s life with each other. Tony had long ago cut himself off from all familial ties. As is true for many men, abusive and nonabusive, his wife had become his sole source of emotional attachment. Yet her wish that he be home more left him feeling “hemmed in” and anxious about making enough money. The later and harder Tony worked, the more entitled he felt and the more alone and vulnerable to her family Kathy found herself to be. Furious at Tony for not fulfilling the role of protecting her from her family, which he had assumed earlier in their relationship, she distanced herself by using drugs and going out with friends. Tony experienced this withdrawal as deeply threatening. His fear and anxiety would generate a crisis of violence that, like a powerful summer storm, would clear the air and reestablish their connection. As they came to recognize that violence was their way of regulating closeness when no other means seemed available, Kathy and Tony began to feel more connected. He began to come home for dinner several nights a week. They agreed to set limits with Kathy’s intrusive family and become more involved with the boys. By this time, the pattern in Tony and Kathy’s relationship with me was also becoming clearer. Some crisis or external push (e.g., from a new DSS worker) would trigger a new round of therapy. We’d meet regularly for several months, and then the demands of daily life would override our scheduled meetings. I framed the waning energy as Tony and Kathy’s taking control of the therapy. We ended this phase with me saying, “Call me when you’d like to meet again. Remember, you don’t have to wait for a crisis.”

Transgenerational Issues:  Tony called 6 months later to report another crisis: Kathy had moved out with the boys. They had had a fight, but— he emphasized— he hadn’t hit her. When I saw Tony and Kathy together, I learned that her mother had died, her father had moved in, and in his wake the brothers and sisters followed through the open door. “I’ve lost control of my house,” she said. Tony said, “This is how it started. I thought that when her mother died, we should take care of her dad. Kathy blew up. She said, ‘If you like my family so much, you can have them.’ I was hurt. But when she said she was leaving I saw red.” The death of Kathy’s mother brought all of the transgenerational themes underlying their conflicts into focus. Kathy had been ambivalent about her mother all along. Her covert function as surrogate mother became overt when “Mom” died, as did her lifelong resentment about being put in that role. For Tony, having Kathy’s father around was a little like having his own deceased father around again. Creating boundaries around the nuclear family with Kathy’s father living there was next to impossible. Finally, pursuing the issue of how Kathy and Tony could be available to each other in the midst of all this conflict generated the idea of a vacation. “Pops” could either go with them to Florida or go stay with one of her older sisters. With great difficulty, Kathy allowed her father to live elsewhere. A year later he was still living with her older brother, and Kathy and Tony were together and doing well.

Conclusion: Physically violent families tend to be closed systems. They are organized around secrets and a fearful view of the world. Obtaining the trust of such families is a trick in itself. Engaging the abusive members, along with others in the family, means going from being seen as a nosy intruder to a valued resource who can help the family to change what hurts. Engaging any closed or rigid family system is a challenge, but with violent families the challenge goes deeper. The therapist takes a clear moral position on the unacceptability of violence in the family, a position that typically challenges the family’s subcultural values. By supporting the vulnerable members— both those being hit and victimized and those who feel emotionally one-down and disempowered— the therapy begins to help the individuals and the family reorganize around their needs for physical and emotional safety. Although they hardly matched the stereotype of the ideal therapy consumers, Kathy and Tony went much further in exploring the roots of the violence in their relationship than most couples I have treated. In each installment of their treatment, we were able to focus more on the larger familial context maintaining their problem. Recently, I spoke with Kathy to sound out how things were going for her and Tony. “Good and bad,” she told me. “Things between Tony and me are fine. He hasn’t been violent in years. When things get ‘tight’ we talk it out— like you taught us. I’m not afraid anymore that he’s going to hurt me. That’s the good news. The bad news is that my dad’s back with us, and he’s driving me nuts!”

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