Terrorism: Convergence Between Terrorism Organized Crimes in Mexico
Assessment Report for Marceline
123 Crawford Lane
Phone: +54-675 5545
Presenting Problem or Reason for Referral
Marceline is a 19yr old that is self-referred, with a 26-month-old male child. Marceline is very frustrated with her child and her boyfriend, Leon, for whom she is seeking counseling. Marceline's frustration with her child is making her think of giving him off to her mother-in-law. M reports feeling frustrated, uses alcohol and other substances to calm her nerves, is miserable from her job loss four months ago, and mounting bills. M also indicates to be confused on to stay with Leone her current live in boyfriend or gets back to her husband Michael the father to Michael Junior. She also indicates to be depressed with suicidal thoughts, which she overcomes with alcohol and substance abuse. The need for referring Marceline arises from the apparent hazard and unhealthy condition in her studio, from her indication of using alcohol in the evening, with Leone after picking M. Jr. There is indication that the use of alcohol by Marceline or substances to calm her nerves presents a safety and health hazard if she cooks and cares for her son under the influence. Based on the self-report by Marceline an assessment was conducted in assisting in determining a diagnosis and a course of treatment.
An assessment of Marceline began with obtaining consent from Marceline and explaining to her the importance of the counseling session rather than working with Leone. The goal is to have Marceline work around her issues, and with time if the treatment requires include Leone or Michael in the treatment process. This began by disregarding what the mother-in-law was indicating about Marceline and Michael, and allowing Marceline to participate in the counseling session voluntarily without inhibition. According to the APA code of ethics (2012), there is need to maintain privacy and confidentiality by reducing interruptions from family members during the sessions as seen with the mother-in-law's phone call. According to the APA code of ethics, there is need to minimize intrusions on privacy, by not informing on reports or communicating with a fellow psychologist when professional assistance is required. Therefore, this implies that a need to maintain and determine disclosures procedures with the consent of Marceline. At this point, Marceline is made aware that if she requires her mother-in-law to be informed, she should indicate in writing. However, the prerogative is to maintain confidentiality and minimal disclosure to family members. Since Marceline had initially begun by indicating to search for help for Leone, the session begins by defining the limits of confidentiality.
Marceline indicates that she comes from a single parent home, where she was raised by her mother after her father walked out on them when she was five years. She has a younger brother of 18 years who she indicates to present him as a confident, well groomed, and attentive young man. Marceline indicates that these are positive characteristics of her brother, whom she also indicates to be a high school dropout. Marceline says her family is a happy and open family that enjoys the company of others and each other. However, despite this apparent happiness, Marceline has not visited her mother in the last three years after eloping with Michael. Marceline argues that the first years after her father left were the most difficult, but their mother pulled through. She was able to maintain her job and provide for them.
However, despite Marceline's indication of a healthy working relationship at home, she cannot maintain a strong eye contact while talking, and cannot express her ideas in a knowledgeable manner. Marceline indicates that her mother maintained a tight and limited social life consisting of four female friends, who were all single mothers, with only one an unmarried woman. The friends were constantly visiting Marceline's home and held open, trusting, and friendly relationships in which they raised their children. Marceline says her mother believed in strong Christian values that were marked by faithfulness, devotion, loyalty, and family. These devotions imply her father's departure was an emotional and mental blow to the mother. Despite the values and close social group, Marceline makes an impression that they were raised in fear. She reports that her mother drank a lot of bourbon, which she mixed her coffee, and was often frustrated and high. In her state, her mother limited her social life, prevented Marceline and her bother to have any contact with people, even with relatives. She at times would blame herself for her husband walking out on them, or would in a bout of drunkenness insult and abuse Marceline and her brother.
Significant Medical Counseling History
The initial interaction with Marceline produces reports of depression, frustration, substance abuse, and suicidal thoughts from the patient and in her family background. Therefore, an analysis of her medical psychological and counseling history is carried out. It is revealed that by fifteen years, Marceline was evaluated using several psychological tests and counseling treatment and therapy recommended. According to the APA code of ethics (2012), the assessment requires obtaining permission from Marceline to obtain her medical and counseling history. Marceline gives her consent, and the history indicates at fifteen she had undergone a psychological assessment using the DASS (Depression, Anxiety, Stress/Tension Scale) that has 42 items. The report indicates using the DASs scale with fourteen basic symptoms, in which Marceline responded to statements in the scale with a four point likert scale (Kaplan & Saccuzzo, 2005). In the scale, 0-did not apply to me, 1-applied to me to some degree, or some of the time, 2-applied to me a considerable degree, or a good part of the time, and 3-applied to me very much, or most of the time (Kaplan & Saccuzzo, 2005). The scores indicate at the time Marceline's scores for depression and stress were high with a mean of 8 and 5 respectively. At the time, Marceline has an elevated score on the anxiety sub-scale with a mean of 18.
The medical report indicates that Marceline was also assessed using the Social Avoidance and Distress Scale (SADs). This scale uses 28 true or false questionnaire items that quantify social anxiety and distress. The medical report indicated a need to evaluate Marceline from two different aspects of anxiety given her family background. This was based on discomfort, anxiety, fear, distress, and avoidance of social situations, and the true-false scale, responses are rated 0-lowest avoidance and distress, and 28-highest avoidance and distress (Alloy et al., 1990). The test shows that Marceline had a score of 27, which was high, indicating that she was distress and tended to avoid social situations. The report indicates that the initial assessment found that Marceline's social isolation was the result of her mother's depression and denial. This reflected on Marceline who was acting out and externalizing. The report indicates that Marceline at 15 was difficult, defiant, and aggressive, associated with parent-teen interactions problems. Marceline was placed in a counseling program that also involved her mother to deal with the more general marital, family, or family therapy. The report identified Marceline was depressed with anti-social distress a reflection of problems in adjustment reactions to her parent's separation and her mother's commands. The counseling goals at the time dealt with improving parental management skills and competencies in dealing with children behavior problems associated with family issues. It also focused on increasing parental knowledge of cause of behavior problems in Marceline, and the underlying concepts and principles associated with social learning of children's behavior. Thirdly, it focused on improving Marceline's coping skills and cooperation with parent's rules and handling parental maladjustments. Fourthly, the counseling focused on improving family harmony by improving parental use of positive consequences, provision of clear guidance, instructions, discipline, and emotional skills. Fifth, the program aimed at assisting in improving Marceline and her mother's problem solving skills and communication skills during interactions a problem-focused discussion. Lastly, the counseling focused on altering parental beliefs and behaviors that were reflecting on Marceline, and assist parent to learn proper parent-teen problem-focused interactions.
However, though the parent-teen problem-focused approach is a successful counseling tool for children from problem family backgrounds, the programs did not succeed in Marceline's case. This is because Marceline was removed from the program by her mother who had strong spiritual beliefs. Marceline's mother identified that Marceline and her family required to follow the teachings of their Christian beliefs rather than attend counseling. Apart from this counseling program, Marceline is physically healthy, has not suffered any childhood or teenage diseases apart from the common cold, sore throats, and bruises and cuts. Marceline is healthy without congenital or acquired diseases, and had a normal birth.
Substance Use and Abuse
Marceline states that she uses alcohol to calm down, but it is apparent she drinks every day especially in the evening after picking Michael Junior from her mother-in-law. Marceline also indicates to use "other stuff" occasionally…