Read the attached case vignette and answer 4 questions of your choosing from the list below. Please be sure to denote the number of the question you are answering:
- Apply Mahler’s model of separation-individuation to explain the child’s behavior.
- Examine the child’s behavior using Freud’s structural theory of the mind.
- How would you characterize the child’s attachment style?
- In terms of ego functions, describe 1 area of ego strength and 1 area of ego weakness that the child exhibits.
- Discuss 2 defense mechanisms that the child uses, and whether each appears to be adaptive or maladaptive.
- Discuss how Applegate’s (1990) concepts regarding family culture and object relations are relevant in this child’s case (see Unit 7; Applegate does not count toward reference requirement).
- Apply Erikson’s model of psychosocial development to explain the child’s behavior.
Antonio is a 4 ½ year old Filipino boy who has been referred to the social work department at Rainbow Services, a comprehensive domestic violence agency, for a mental health assessment. Antonio currently resides in one of Rainbow Services’ transitional housing units with his mother, Hilda, who is 7 months pregnant. They came to the agency three months ago when Hilda left her abusive husband, Daniel. As part of their case management plan, Hilda is training as an administrative assistant, and Antonio is in Rainbow’s pre-school program.
Presenting Problem
Miss Sharon, Antonio’s pre-school teacher, reports that Antonio has tremendous difficulty leaving his mother when she attempts to drop him off in the mornings. He wraps his arms and legs around her,crying, “No, Mommy! Please don’t leave me!” It takes several minutes for his mother to disentangle herself, even when Miss Sharon steps in to help. After his mother finally leaves, Antonio often remains by the door crying, clutching his dinosaur toy. He has trouble concentrating on classroom activities and gets easily frustrated when playing with the other children. When Hilda returns, Antonio is absolutely delighted to see her. He runs to her and jumps into her arms, oblivious to her growing stomach.
Initial Assessment
During the initial meeting with the social work intern, Antonio snuggles close to Hilda, holding his dinosaur toy. Hilda reports that Antonio has started to complain of “tummy” aches, although she cannot find anything wrong with him. He also has started having nightmares, so Hilda sits with him and rubs his back until he falls asleep. The intern pulls out a box of toys and places them on the floor close to Antonio. He grabs a big dinosaur from the pile and starts smashing his smaller one into it. He acts out a fierce battle between the two. When the big dinosaur is finally “dead”, Antonio starts racing a car around, ramming it into toys scattered on the floor.
Developmental History
Antonio was a healthy, full term baby delivered through natural childbirth. Hilda delivered the baby alone because her husband, Daniel, did not want to be in the room during the labor and delivery. For the first month, Antonioslept 15 or 16 hours a day. He liked to suck on his fingers, pacifier, and anything else that got close to his mouth.He cried when hungry or wet, but Hilda was always there to feed or change him. Within about six weeks, Antonio would smile at Hilda and turn his head whenever he heard her voice. By six months, Antonio could roll over and he was babbling some. If he got too loud, Hilda would shush him so the noise would not bother Daniel. When Antonio was nine months, he could crawl, but Hilda wouldn’t let him go too far before scooping him up. She was afraid he’d harm himself or get into Daniel’s way.
Antonio began walking at 14 months and by 20 months he was speaking in simple sentences. When he potty trained at 3, Hilda praised him verbally, gave him a big hug, and rewarded him with a toy dinosaur. Antonio liked to play at the park on the swings, slide and seesaw. Hilda would always hold his hand, as he climbed up the slide or the monkey bars because she didn’t want him to get hurt. He seldomly played with the other kids, even if Hilda encouraged him to, preferring to remain close to his mother.
Family Background
Hilda is the eldest of four daughters born to immigrants from the Philippines. She comes from a very traditional Catholic family. Hilda met her husband, Daniel, in high school. He was her first serious romantic relationship. Daniel became emotionally abusive within the first three months of dating Hilda. A couple months later, he slapped her during an argument, but begged her to forgive him and swore it would never happen again. They got married a year after graduation and moved to another state because Daniel thought his job prospects were better. Within a year, Hilda was pregnant with Antonio. Daniel accused Hilda of getting pregnant on purpose, and the emotional abuse began again.
Hilda’s sister, Marisol, and her mother, Josefina, came from out of state to help with the baby. Daniel began spending a great deal of time away from home. When he came home with alcohol on his breath, Hilda asked him to “Please behave” while her family was there. He snapped at her for talking to him like he was a child. Later that evening, Josefina gently reminded Hilda that Daniel was her husband, the head of the household, and she should respect him.
Although Hilda tried to make a good home for her family, Daniel’s drinking and abuse continued. He spent more time away from home, and she devoted more time to Antonio. When Hilda discovered she was pregnant again, Daniel punched her in the stomach. Antonio, who was playing nearby, started to cry, “Don’t hurt my mommy!” Daniel fell at Hilda’s feet apologizing: “I didn’t mean it!” When Daniel fell asleep, Hilda left with Antonio to seek medical attention. TheEmergency Room social worker referred her to Rainbow Services.
While Hilda deeply appreciates all of the support from Rainbow Services, she has decided to return home to Daniel at the end of the month. As her due date nears, she feels compelled to try to reunite her family. Each day, after she picks Antonio up from pre-school, she heads to nearby St. Catherine’s to light a candle and pray that the Virgin Mary will help her family. “Marriage is a sacrament of God,” Hilda says. “We cannot go back on the promises we made before Him.”With a hopeful smile, she tells the social work intern that Daniel has checked into a rehab program and promises to begin counseling through Rainbow Services when he’s done with treatment.
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