Read the attached case vignette. Then, answer the questions
hus4220_module01_assignment_questions.docx
hus4220_module01_assignment_vignette.docx
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1. What did the practitioner do well in this session?
2. What, if any, mistakes did the practitioner make?
3. Identify the ways that the practitioner used skills to enhance understanding.
4. What are additional ways that the practitioner could have enhanced understanding? Give
specific examples of what the practitioner could have said.
5. What two problems do you think the client is most concerned about?
6. Review what you learned in this module about assessing the client’s stage of change.
What is this client’s stage of change? What information do you have to support your
evaluation regarding the stage of change? What further exploration do you need to
confirm that the client is in this stage of change?
7. Discuss the client’s level of motivation. What else would you want to explore to further
determine level of motivation?
8. What strengths and resources did the practitioner identify in the client during the
exchange? What might the practitioner have said to further highlight the client’s
strengths? What questions should the practitioner ask to further explore strengths?
9. What else have you learned about level of stress and demands that might be impacting
level of motivation?
10. What do you believe is the client’s level of hope? What information do you have to
support that belief?
11. What did the practitioner say that might help the client believe that the practitioner
could help him or her?
Tony: I Just Don’t Know!
Isabella Fraticelli, a practitioner in a home-based treatment program, received the following
intake form for a new family to be seen next week.
Intake information:
The household consists of Cantrice Haywood (the mother, age 30), Anthony “Tony”
Haywood (her son, age 12), Tawni Haywood (her daughter, age 9), and Terrence Clark (her
son, age 3). This African American family lives in a townhouse apartment in a working class
neighborhood.
Terrence has significant physical challenges. He cannot walk, talk, or perform any ageappropriate tasks due to congenital disorders. He receives special services and daycare
funded by the state.
Terrence’s father, Charles, is a long-haul truck driver. Though he and Cantrice have not
married, he lives in the household when he is not on the road. Tony and Tawni have the
same biological father. Cantrice and her ex-husband have been divorced for approximately
5 years. Mr. Haywood lives in another state. He financially supports the children but usually
only sees them a few times a year.
Cantrice is a high school graduate and works approximately 40 hours per week in the food
service industry. Because she is such a responsible, hardworking employee, her employer
has been willing to work with her to allow her some flexibility to take care of Terrence’s
medical problems.
Reason for referral:
Tony has been designated a Child in Need of Services (CHINS) with a history of aggression
toward his mother, juvenile delinquency, and truancy. The judge was convinced to try
intensive home-based services before removing Tony from the home. Tony has a diagnosis
of Oppositional Defiant Disorder and has also been diagnosed with a learning disability.
Case Vignette
When Isabella entered the apartment, she met Tony, an average sized 12-year-old who
didn’t meet her eyes. To Isabella, he seemed sullen and angry. He mumbled something
when Cantrice introduced them and then he sat down and waited for the others to sit down
and begin the session.
ISABELLA: I am so glad to meet with all of you. (Turning to Tony) I want to make sure you
understand why I am here. I know the judge talked to you about the seriousness of the
charges that brought you before him last week. As you know, the judge thought you and
your family might need some extra help so you could stay at home instead of going to
another place. The judge has the power to order you to be taken out of your home, but he
would really like you to be able to stay. I am here to work with all of you so you can stay
with your family. We’ll be meeting twice a week for a while. To begin, I’d just like to hear
what each of you sees as something that you might want to change in your family.
CANTRICE: Well, first, I want to say I really want Tony to stay at home with his family, but
not if he is going to cause a lot of trouble. I have to work to bring in money, and I am a
worried about losing my job if I have to be at school or the police station because of Tony.
ISABELLA: Tell me more about what you mean by trouble.
CANTRICE: He gets in fights at school, fails some of his classes, cuts school, and hangs out
on the street with the guys who have already dropped out of school. Then they call me at
work to come in and meet with the principal about the trouble at school.
ISABELLA: So you are really concerned about losing your job if you have to miss more work
in order to help Tony. I think that is really understandable since you have a lot on your
plate taking care of Terrence and keeping everything up in the house. (pause) How about
you, Tony, would you like to see changes in the family?
TONY: I don’t really care.
ISABELLA: So you can’t think of anything you might like to be different, something that
might make it easier for you to stay out of trouble at school.
TONY: Just to be left alone to do what I want. I don’t want to be stuck at home taking care
of Terrence. If “perfect” Tawni wants to waste her time, that’s okay. She’s a girl, so she
likes to take care of babies. I don’t.
CANTRICE: Well, you’re going to have to help because I can’t do any more than I am doing
now. I mean, I have to work to earn the money we need, and I am really busy when I get
home, too. Don’t you like to eat and have a clean house?
TONY: I can take care of myself on the streets. I don’t need anything from you.
CANTRICE: (turning to Isabella) See what it is like? I can’t handle any more problems than I
already have.
ISABELLA: I know this is a hard time for all of you. Let’s just take some time to talk, so
maybe each person can understand what is troubling the others. This is a time to let
everyone talk, and then we’ll see how we can make some decisions together. Tony, could
you tell me more about what you mean by being left alone to do what you want?
TONY: I don’t need anyone to take care of me. My friends get to hang out and do whatever
they want to. No one makes them go to stupid old school!
CANTRICE: Tell me more about your friends and what you like to do with them.
TONY: They hang out and talk, play basketball, stuff like that. Some of them have a lot of
money to spend, too. I want to be just like them. School didn’t help them much at all!
ISABELLA: Even though we’ve been talking about how everyone might like the family to be,
it seems like school is a big problem for Tony. Is that how you see it, Tony?
TONY: School has always been a big problem for me. Maybe you can get me out of school?
That would be so great!
ISABELLA: I don’t think the law allows a 12-year-old to leave school permanently, but I
think trying to improve your school situation would be something to work on that might be
good for the whole family. I’m sure everyone in the family wants you to succeed in school
and be happier. (Turning to Tawni) What about you, Tawni, what would you like to see
different in the family?
TAWNI: I don’t mind helping with Terrence. I like to do things with him. I really don’t want
my mama to get upset so I try to help as much as I can. I guess I’d like to make it even
easier for her. (Thinking a bit) Maybe Charles can be home more?
ISABELLA: I’m glad you want to help. Right now, let’s talk about what we might like to see
different. Later, we’ll work on some plans to make the things different you all talk about.
(Turns to Cantrice) I know Charles isn’t here, but did you have a chance to talk about this
session’s goal?
CANTRICE: Well, just a little bit. He’s always so tired when he is here. I just hate to bother
him. I know he likes to rest when he can. (She looks a little embarrassed.) He said to tell
you he doesn’t want to have to do anything different, except when Tony causes trouble.
He’d like that to go away.
ISABELLA: I know it is hard to know what he would say if he were here.
TONY: Well, that’s what he would say! He just wants his own way, and everyone else can do
what he wants them to!
CANTRICE: That’s not true! He works hard and needs to rest when he comes home.
TONY: Yeah, like you don’t work hard at work and at home! (Shouting) This is stupid. Like
anything is going to change around here!
ISABELLA: You sound like you would like something to change, after all, Tony. This isn’t the
easiest thing to do, so maybe you and Tawni could take some time to think about it before
our next meeting. Will you do that?
TAWNI: I could try.
TONY (shrugs) Can I go now?
ISABELLA: You and Tawni can go, and we’ll talk again at the next meeting.
After Tawni and Tony leave, Isabella turns to Cantrice, who is crying.
CANTRICE: I knew this wouldn’t work. You know, they say at church, the good Lord never
gives anyone a burden they can’t handle. I wonder if they are right or not? I don’t think I
can handle any more right now. Maybe I need to have a little less just to survive! I just
don’t know why Tony can’t be more like Tawni. Can’t he see how much better it would be if
he would be more cooperative? (Silence) You know, I guess school has been hard for him
because he doesn’t read very well and he is in special classes for some subjects.
ISABELLA: It sounds like school is much more of a challenge for Tony than Tawni.
CANTRICE: You know, he doesn’t even talk to me anymore. He just lays around and
watches television and doesn’t even want to talk to me. He definitely wants nothing to do
with Charles.
Cantrice and Isabella continued talking about her concerns for Tony. When Isabella
mentioned she understood Tony had been violent toward Cantrice, Cantrice stated she had
never really discussed it with Tony. She felt it was better to “start fresh and not bring up
those bad memories from the past.” Isabella told Cantrice that she believed that they could
work together and come up with some ideas to make things better for Tony and the whole
family. They scheduled the next session for Tuesday evening. At that time Charles should be
home.
…
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