Term Paper: Biopsychosocial Study

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Social Work - Biopsychosocial Case Study


The client is a divorced, 37-year-old Hispanic mother of three girls, aged 11, 9, and 4. She has been employed for almost a decade as an X-ray technician. She is a repeated victim of domestic violence on the part of her ex-husband and of numerous instances of date rape in college.

The client's former husband was never prosecuted for domestic violence, because the client never reported it throughout the four-year marriage, the six years preceding it, or the year preceding his arrest for child sexual abuse in the year following their divorce in 2006.

Law enforcement authorities had responded to several requests for service after neighbors overheard abusive situations, but the client never provided sufficient assistance to prosecute her former husband on domestic violence charges. The former husband is presently incarcerated after conviction on the charges relating to his sexual abuse of his oldest daughter. Since his incarceration he was also convicted of attempted murder in connection with a prison altercation that he instigated and is now ineligible for parole until 2020.

The client was sexually abused by her father for several years ending when she was 12 years of age. She was ordinarily subjected to emotional abuse by both of her parents and to severe corporal punishment throughout childhood and adolescence administered by her father. As often as not, she was punished for allegations that were completely false or imaginary. In time, she stopped protesting her innocence, suffering in silence instead as her father beat her for things she never did

The client had a past history of alcoholism that predated the birth of her first child but which recently recurred for the first time. Previously, she had not abused alcohol in more than a decade, drinking socially but responsibly, and only infrequently until recently. In the past, the client had self-medicated with alcohol in order to cope with specific stressful circumstances. Without it, she was not usually able to fall asleep throughout much of high school when she lived with her parent and during two years of college when she was repeatedly raped as a freshman and sophomore by the same four upper class students in various combinations until their graduation after her sophomore year. Her previous alcoholism coincided with this four or five-year period. During high school, she drank primarily to help her sleep; in college, she drank in two contexts: to cope with unwanted sexual relations after they transpired, and (later) to facilitate her role as a seductress when voluntarily acting out sexually.

Presenting Problems:

The client was mandated to the supervision of a child welfare agency after another Law enforcement agency call for service in connection with a physical assault against her by her most recent male companion pursuant to which he was incarcerated after violating an order of protection issued on the client's behalf after the initial physical assault.

She recently resumed self-medicating with alcohol as a sleep aide after her children are asleep and has indicated experiencing increasing feelings of anxiety for which her general practitioner had prescribed diazepam. The client did not disclose to her physician that she had resumed self-medicating with alcohol. She also mischaracterized her symptoms as "general anxiety" instead of relating very specifically to a traumatic flood of previously repressed memories of her childhood sexual abuse.

Since then, the client has experienced increasing difficulty managing her daily responsibilities; she has overslept and missed work several times and her youngest daughter's school attendance has suffered. On the occasions when the client overslept, her oldest daughter took over some of her morning responsibilities by waking up her nine-year-old sister and preparing their breakfast. Because it was more difficult for her to gain the cooperation of her youngest sister, the oldest child simply allowed her to continue sleeping and then saw to her needs upon returning home from school as early as possible.

On the fourth occasion of the youngest daughter's absence, her teachers inquired of the oldest child into the whereabouts of her youngest sister and authorities were then alerted to the situation.

Subsequent investigation into the circumstances has revealed that the client has suffered from incapacitating emotional trauma after suddenly recovering the full memory of her father's sexual abuse for approximately two years from the age of 10 until the age of 12. Previously, she was completely unaware of any sexual abuse in childhood, but she recovered conscious memory in the manner described by Graziano (1992) of that time period after being triggered by a specific event in the natural maturation of her oldest daughter.

Specifically, while assisting her oldest daughter accommodate her first menses in their bathroom at home, the client suddenly experienced a vivid visual memory of being molested by her father at the same age. She found herself unable to continue assisting her daughter at that time and excused herself saying she had been feeling ill.

Beginning almost immediately, the client began to experience overpowering anxiety, in particular with respect to the intensity of acute trauma, likely in proportion to the degree of her successful repression of those reactions previously (Graziano 1992).

Within the next few days, the client eventually recovered very detailed memories of two years of sexual abuse by her father, as is often observed in the case of prolonged trauma after the initial memory is precipitated by a specific trigger (Kasl

1989). After suffering from acute insomnia since the initial recollection, the client resorted to self-medicating with alcohol in exactly the same manner in which she had coped with similar symptoms as a teenager and in college.

Recognizing the dangers of slipping into alcoholism again, the client sought alternate solutions in the form of prescription sedatives which she had intended to use instead of alcohol. Ultimately, she did reduce her total alcohol intake but found herself combining diazepam with alcohol inadvertently, with predictable results (Reding & (Wijnberg 2001).

Since the intervention of child welfare authorities, the client has expressed her commitment to full participation in her own therapy which she realizes is essential to recovery of her independent ability to provide for the needs of her family. Whereas her initial reaction to recovering the memory of her childhood trauma was overwhelming and incapacitating anxiety, her active participation in therapy has mirrored the benefits noted by Butler (1997) in the case of emotional resiliency and cooperation in therapy.

Case workers report that the client is genuinely appreciative of their assistance, particularly in connection with providing competent child care to enable her to pursue her therapy. This client is naturally insightful and readily understands the applicable conceptual connections between her past behavior and the factors that have begun to emerge with respect to some of her past choices and responses.

Detailed Interview Summary Synopsis:

The client has participated extensively in a series of detailed interviews during which she described her newly-recovered traumatic memories as well as other relevant events and circumstances in connection with their specific relation to elements of her past. In many respects, some of her conscious choices and reactions to events in young adulthood were precipitated specifically by the classical effects (Shapiro 1999) of her having repressed traumatic experiences.

The client seems to be benefiting profoundly by virtue of the conceptualization the degree to which her abuse accounts for certain subsequent behavior on her part for which she had previously experienced tremendous guilt and shame.

Detailed Interview Summary:

The client relates a very difficult childhood characterized by emotional abuse, physical abuse, and denial of privacy throughout childhood and adolescence. Both parents continually stressed the obligations of children toward their parents and emphasized the client's role in draining their resources and energy as parents in a manner known to be conducive to the development of shame and indebtedness within families (McPhatter 1991).

Physical abuse was routinely and regularly inflicted on the client under the guise of punishment for breaking the rules of the housed, "shaming" the family or the family's cultural heritage, or embarrassing her parents. Perfectionism was a predominant theme in the family and the client was whipped with leather belts for failing to achieve a grade of "A" on any assignment or test in school. Consequently, the client devoted herself to scholastic achievement but primarily to spare herself from the consequences of any less than perfect grades.

The client was deprived of personal privacy in that her father first removed the locking mechanisms from her bedroom door and from the only bathroom she was allowed to use in the home. Both parents regularly entered her room without knocking or providing any warning of their intentions; they expressed the belief that, as parents, it was their right to know what their daughter was doing at all times and they purposely surprised her by opening her door on their whim while attempting to "catch her" doing wrong. When she improvised a method of locking her bedroom door, her father administered a particularly severe belt whipping and removed the door from its hinges altogether.… [END OF PREVIEW]

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Biopsychosocial Study.  (2008, January 22).  Retrieved October 14, 2019, from https://www.essaytown.com/subjects/paper/biopsychosocial-study/86946

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"Biopsychosocial Study."  Essaytown.com.  January 22, 2008.  Accessed October 14, 2019.