Can we help Janet
1
Controlling Janet?1
After parking the county station wagon,
walked slowly
toward the administration building at Oak Hill, a residential treatment center for
adolescents. It was a beautiful, sunny day, with a clear blue sky in fall 1993.
While waiting at the main office, Marie could see
approaching with
a staff member. Janet was walking with her shoulders bent down. The 14-year-
old wore ripped black fishnet stockings and a black skirt that she had cut
unevenly. The shoulder of her black silky shirt sagged, exposing a bra strap. She
had splotchy black makeup under both eyes. With a quick look, Marie guessed
where this meeting was headed. She felt tired before it began.
Marie held the door open as Janet arrived and silently escorted her into a
private office. Janet slumped into a chair, then blurted, “What the fuck do you
want?” Before Marie could answer, Janet said, “I’m not going back to that bitch!
She loves Mike more than me.”
Cautiously, Marie ventured, “Can you tell me what happened last night?”
“I don’t want to talk about it,” Janet announced defiantly, and as abruptly as
the angry torrent began, it ended.
Where do we start, and where do we go from here, Marie wondered silently.
Located across the mountains east of San Francisco, in Modesto, California,
the Stanislaus County Department of Social Services (SCDSS) provided a range
of child welfare services for dependent children. The Special Placement Unit
(SPU), with four professional staff members, focused on some of the more
challenging children in agency custody. Like the rest of the agency, it adhered to
permanency planning philosophy and worked within parameters set by law. But
for the older children it placed, family reunification was often unusually
complicated, messy, and sometimes impossible.
Marie Johnson
Marie Johnson had spent 2 years as a foster care caseworker in the Special
Placement Unit, her first position after earning the MSW at the University of
California (Berkeley). Because she had gone directly from college to graduate
1 Development of this decision case was supported in part by funding from the University of South
Carolina College of Social Work. It was prepared solely to provide material for class discussion and
not to suggest either effective or ineffective handling of the situation depicted. While based on field
research regarding an actual situation, names and certain facts may have been disguised to protect
confidentiality. The author thanks the anonymous case reporter for her cooperation in making this
account available for the benefit of social work students and instructors. Copyright © 2004
2
school, it was also her first full-time social work position. Fortunately for Marie,
one of her graduate field placements was at a residential treatment center for
adolescents so she was quite familiar with their mental health needs. She was
also bright, a quick learner, and the type of person who threw herself into a new
job. For the most part, this job had been a good challenge for her and, as she told
friends, “a great place to begin my career in social work.”
Something Marie enjoyed most about the job was the regular contact with a
wide variety of community professionals. Work with particular youth sometimes
required that she communicate with school administrators, guidance counselors
and teachers, attorneys for families or the agency, juvenile court judges, the
police, and emergency shelter staff. But she especially enjoyed working with
other mental health professionals, including those from Stanislaus Community
Mental Health Center, Oak Hill Center, and other group facilities, as well as
school psychologists, several psychiatrists, and assorted private practitioners. All
these people provided a fascinating learning context.
Earlier that morning, on reaching her DSS office minutes after 9 A.M., Marie
had immediately noticed a fax from the child abuse hotline lying on her chair.
She picked it up to see what had gone wrong. As a caseworker assigned to the
SPU, she only received these faxes when there was a problem with one of her
ongoing cases. This one referenced Janet Oswalt. Because Janet was already a
dependent, and this was not an allegation of abuse, the form was scarcely filled
out. In the allegation box at the bottom, the intake screener had summarized a
phone call from Janet.
“Oh, no!” Marie spoke softly as she read. “This, this is not good.” Then,
almost flippantly, “Oh, great, I had plans to go visit the Oswalt kids anyway but
I guess I have something else to focus on now.”
Disappointment welled up because Marie had repeatedly encouraged Janet
and her mother,
, to let Marie know first before they reached a
crisis. She just didn’t want to get to the point where a kid was so angry that he or
she became physical and had to be moved. She had often reminded them, “Call
me, use the on-call worker, use the therapist, use the on-call therapist, don’t let it
get to a crisis. We’re here to help you.” Now, shaking her head in frustration, she
muttered, “Oh, why didn’t they call first? After all that work, the placement
blows up.” But almost immediately, she felt guilty because her team had not
arranged outpatient mental health services fast enough. “Well, I guess we have
to go in there and somehow figure out what to do,” she told herself. “Whether
they live together or not, we have to start over, to rebuild the relationship.”
Marie felt sure this could have been prevented. But first, she needed to know
what had happened.
3
As Marie eventually learned, Janet and her family had gone to dinner at
Burger King the night before. The family included Janet, Janet’s three younger
siblings, her mother, and her mother’s boyfriend. Janet started talking about
African Americans, making loud, racist comments. Partly because there was an
African American in the restaurant, her mother’s boyfriend felt uncomfortable
with Janet’s comments. After glancing at Paula, he started to reprimand the girl,
“I don’t care what your beliefs are, you don’t talk like that in public.”
She snapped back, “You have no right! You’re not the boss of me.”
Their disagreement quickly turned into a quarrel, and the two adults
decided the family should leave the restaurant.
Now the kids were angry with Janet, too, because they knew her behavior
caused this conflict and ruined their outing.
After they arrived home, Janet went to the phone to call the hotline operator
for child protective services. Janet gave her name and address, said that she was
in agency custody, and matter-of-factly explained that she was going to kill her
mother’s boyfriend. Then she hung up, went outside, and tried to slap him. At
this point, Paula grabbed her and tried to restrain her.
Because of the phone call, the police came. Janet told them angrily,
“I’m not going to live here anymore.” The police reacted by pulling her
from the home and taking her to a shelter for the night.
The Burger King incident was a relatively minor one, the latest in a series of
problems for Janet. Her mother and father divorced when she was 5 years old.
Following the divorce, Janet and one of her younger sisters lived with their
father and paternal grandparents in Nevada for one year. However, Nevada
child welfare officials removed them from the father’s care by after the sister
reported that she had been sexually molested. At the time, Janet denied any
similar abuse.
After being returned to Arizona, Janet and her siblings moved back and forth
between their mother’s and their maternal grandparent’s homes. During this
period, Paula was drinking heavily and became addicted to cocaine. As a result,
she was often unable to provide food or shelter for the family. Although she
resented their involvement, Paula frequently requested help from her parents to
meet the basic needs of her children. Despite their help, Paula could not maintain
a household and the family eventually became homeless.
While Paula lived on the streets with her boyfriend who was also addicted,
she left all four children in the care of their maternal grandparents, Mr. and Mrs.
Dunleavy. Shortly after moving to this household, 11-year-old Janet began to
behave in ways that troubled the grandparents. For example, she cut her hair
4
into a Mohawk, dated an 18-year-old man she met at a city park, recited Nazi
and hate propaganda, and began to cut herself, usually on her forearms and legs.
Concerned over her behavior, school officials referred her for psychological
assessment. A school psychologist diagnosed her as suffering from severe
depression. As a result, the school placed her in a special education class for
emotionally disturbed children. As part of this class, Janet received weekly
individual, family, and group counseling from a school social worker.
Janet resented being placed in a special education classroom, believing that
middle- and upper-class peers saw her as inferior because of it. She began to
make threatening gestures toward herself and classmates. The Dunleavys, who
did not believe in therapy, expressed little hope of curbing her self-destructive
behavior and seemed resigned to accepting it.
Soon after her 12th birthday, Janet disclosed that she had a plan to commit
suicide. After learning this, the school social worker initiated a psychiatric hold
and arranged for Janet’s admission to Charter of Phoenix, a local private
psychiatric hospital. At Charter, Janet continued to talk about committing
suicide, so the hospital extended the hold for 21 days.
Because Janet’s grandparents had never been given legal guardianship, they
were not able to legally act on her behalf nor could they afford to pay for Janet’s
hospital stay. Therefore, the school social worker made a report to child
protective services. As a result, the family court made Janet and her siblings
dependents of the court and initiated family reunification services. The
grandparents agreed to keep the younger children but, because of her
increasingly dangerous behaviors, refused to accept Janet back into their home.
Under authority of child protective services, the hospital discharged Janet to Oak
Hill. Soon after Janet was placed at the center, Marie became involved with the
Oswalt family.
Paula Oswalt
After hearing all the raving reports about Paula’s progress, Marie could
never forget the first time she met Paula. Nearly 6 feet tall, Paula was slightly
heavy. The first thing out of Paula’s mouth was, “I stood before the judge and the
judge said if I didn’t follow through on the service plan I was going to lose my
kids. I thought, ‘I never meant for it to get this far, and I’m not going to let this
happen.’ ”
In fact, drug rehab program staff described Paula as a model patient, one
who took the drug rehab program seriously and used it to turn her life around.
Paula got herself into this particular program by calling every day, advocating
on her own behalf. She was actively engaged both in her program and outside
5
Narcotics Anonymous (NA) groups, passing her random drug screens every
time. She attended all the parenting programs offered. In addition, she
participated in weekly family therapy with Janet and separate sessions with the
other, younger children. After completing the drug program, program staff even
invited her to stay on as a resident mentor to the new mothers coming in. In that
capacity, she was allowed to have one or two children living with her, so she
took in the two youngest children who had been staying with the maternal
grandparents. Although staff observed that she had trouble setting limits for her
children, they said that she was always open to feedback.
Likewise, Marie thought of Paula as a model child welfare client because she
consistently followed through on case plans. For 18 months, beginning while she
was in the drug rehab program, Paula visited Janet each week to attend their
family therapy session at Oak Hill. Lacking her own transportation, Paula had to
catch a bus and then walk the half mile to the center. Before leaving the drug
rehab program, Paula surprised Marie by obtaining a HUD certificate for a three-
bedroom house in an upscale neighborhood. Then, she collected used furniture
for the new household. Shortly after that, the court reunited one more child with
her and the two youngest children. Marie was impressed with Paula’s
determination and felt inspired to help her succeed.
Janet Oswalt
At 12 years old, Janet was already 5’5” tall, a large big-boned girl with a
freckled complexion. Because Janet was physically mature for her age, child care
staff often treated her as an older teen. She had naturally reddish hair, but had
bleached and dyed it several colors. Cut in a narrow Mohawk, her hair flopped
stiffly to one side of her shaved head. Janet liked to cut her clothing, too,
especially skirts and sleeves.
Janet often appeared depressed, alternately sullen or attacking. She felt angry
with her grandparents for not taking her back. Janet faulted her mother for her
current situation. She didn’t think there was anything in life worth living for:
“life sucks” was her stock response. She identified with, even worshipped, singer
Kurt Cobain, and the group, Nirvana. She claimed to be a Nazi, spouting white
supremacist ideas, without regard for Latinos and African American staff and
youth at the residential facility. Even when among peers, she seemed socially
isolated and unhappy.
In contrast to her mother, Janet was not doing well at Oak Hill, creating
trouble in so many ways that it was hard for staff to keep up with her. Although
Janet was bright, she didn’t like school. Often, she would blow up about
something and walk out, heading toward the lake and looking for sharp things.
School staff would always go after her, creating dramatic chase scenes.
Sometimes, she would pick up a paper clip or staple and, back at the center, she
would cut herself, usually on her arms. Other times, Janet would stick sharp
6
objects into her tongue. But invariably, she also showed someone what she had
done. She did not want to be in a residential treatment center—she was angry
about that. Center staff suspected that she wanted to go back to the hospital.
During home visits, Janet’s siblings were simply afraid of her. Because she
was so emotionally labile, with dramatic mood swings, they never knew when
she would sullenly withdraw or lash out indiscriminately. Because several of the
younger children were hyperactive, they often antagonized Janet. Even though
they were terrified of her, they sometimes poked fun at her clothes and manner.
Janet’s case was among the first assigned to Marie after she began work as a
Special Unit foster care worker. Despite all the problems, she was drawn to Janet.
As Marie told Luis Medina, her coworker from mental health, “Janet’s really
tough on the outside but the sweetest, softest kid underneath that shell.” Marie
enjoyed the girl’s colorful style and could usually deal with her anger. But Marie
struggled to reach her during the intermittent sullenness and felt frustrated
when the girl would withdraw and refuse to talk. One time, for instance, when
Marie and Luis took Janet to McDonald’s, she sat on the curb outside and simply
refused to go in or to explain why.
Of all the mental health caseworkers with whom she worked, Marie probably
enjoyed Luis the most. He was fun, usually taking work more lightly than Marie
did. But Luis felt more frustrated with Janet than Marie did. Naturally
gregarious and playful, he easily established rapport with clients, especially
children. Janet, however, sometimes thwarted even Luis’s efforts to connect with
her. In his presence, she would make derogatory remarks about Latinos. But
these comments never seemed aimed at Luis personally, as if she excluded him
from the category.
At Oak Hill, Janet was assigned to Samantha Myers, a 28-year-old
psychologist, with a new Ph.D. Because Samantha’s office was located on the
grounds, Janet stopped by to see her almost every day, in addition to their
weekly therapy session. From Samantha’s verbal reports, it sounded as though
Janet took everything to the young psychologist and opened up with her a great
deal. Over time, it came out that Janet didn’t trust her mother to stay sober nor to
hold a job and make money and keep a house. Janet didn’t trust her mother to
parent the younger kids and was frightened about them being in her care. She
feared that Paula would blow it and the family would end up homeless again.
Janet was tired of moving from place to place. Although Marie perceived
Samantha to be bright and a good therapist, she worried that Samantha was
becoming Janet’s only ally. Further, Marie feared that Janet could “pull the wool
over” Samantha. Rather like Janet, Samantha was sometimes not very
forthcoming, generally giving information only when asked directly. Despite her
misgivings, Marie was glad that Samantha had developed this relationship with
7
Janet, that someone seemed to be reaching the girl.
While Paula was being reunited with the younger children, Janet was not
doing better at Oak Hill. Though talking less about suicide, she was still sticking
things into her tongue, still walking out of class, still dressing the same. With
Marie, Janet remained rather unpredictable. At some sessions she could be fairly
talkative while at others she would just sit there, refusing to talk. But she was
always negative, looking and sounding as though she felt persecuted and
unhappy.
It appeared to Marie that Janet relied primarily on Samantha, not on any
other peers or staff, for interaction or individual attention. Based on what
Samantha told Marie and Luis, she had more success than anyone else in talking
with Janet but generally declined to confront her about problems Paula
identified. For example, Samantha reported that during a home visit Janet had
yelled at the little kids, telling them the TV was too loud, slammed doors, and
then refused to come out of her room. As a result, the family couldn’t follow
through on plans for an outing, and the kids had renewed fear of Janet. When
Paula mentioned this incident in therapy, Janet countered, “The kids were so
loud, and you couldn’t control them. “Besides,” she said, “I didn’t want to go on
that outing anyway.” In response, Samantha would usually empathize with
Janet, saying, “I know it’s very stressful when you go home, kinda
overwhelming.” But it wasn’t clear to Marie that Samantha would take the next
step to challenge Janet on how she and her mother were going to work through
these problems.
After 15 months at Oak Hill, staff constructed a behavior contract with Janet.
The girl wanted out of the center, and Paula wanted her daughter to come home.
Marie knew that foster placement was not an option because of Janet’s age and
problems. Teen placements were hard enough to secure for kids who had never
been suicidal, who were not so difficult. After 3 months, Janet was following
through pretty well so staff lobbied for longer home visits. Janet spent 2 weeks
with her mother over Easter break. For a couple of months, Paula kept Janet part
of each week. Then, at the beginning of the summer vacation, Janet moved home.
Paula was terrified to have Janet back but wanted her to come home. She also
worried that the longer Janet stayed away from home, the harder it would be to
make it work. Paula felt confident that she would not break her sobriety and
would not be abusive or neglectful. But Paula was not sure she could provide the
in-home supervision Janet needed. In addition, she worried for the physical and
emotional safety of the younger children because she didn’t know what Janet
would do.
When Janet left the treatment center, she became eligible for outpatient
mental health services. Luis was working to arrange for outpatient mental health
8
services through the county, though not so urgently as Marie would have done.
As a result, the services were not yet in place when Janet moved home. To bridge
the gap, under special arrangements, Samantha continued seeing Janet to help
her adjust. But because of funding restrictions, everyone knew Samantha’s
services could only be temporary.
As the foster care worker, Marie had experienced subtle pressure to reunify
this family. Intellectually, Marie was convinced about the importance of
achieving permanent plans for children, and was committed to reunification,
even when this seemed improbable. In this case, reinforcing Marie’s own desire,
her supervisor clearly favored reunifying Janet with the mother and strongly
affirmed Marie’s efforts to do so. When Janet fulfilled Oak Hill’s behavioral
contract, staff members were ready to move on. Paula was doing very well
personally and wanted to have Janet come home. The various attorneys seemed
pleased with Marie’s emphasis on reunifying the families rather than merely
rescuing children. Because Arizona state law required that child welfare staff
have a permanent plan in place within 18 months of placement, the court had
affirmed the time frame for reunification.
Marie felt disheartened by the disruption after the Burger King incident. She
had spent nearly 2 years working up to this point, on a case opened soon after
she arrived at the agency. But now, less than a month after returning home, Janet
had already moved out. This incident substantially set back the process, even
undermined the possibility, of reunifying Janet and her family.
Where do we start, and where do we go from here, Marie wondered silently.
-
Terry A. Wolfer
Stanislaus County Department of Social Services, Special Placement Unit
Marie Johnson
The Fax Alert
Burger King Incident
Family Problems
Child Protective Services Intervenes
Paula Oswalt
Janet Oswalt
Caseworkers and Therapists
Reunification
Reunification, Not
Chris Johnson
January 25, 2023
Case Analysis 2: Marie and Janet
Introduction
As a foster care worker in the Special Placement Unit (SPU) at the Stanislaus County Department
of Social Services (SCDSS), Marie Johnson has been assigned to reunify Janet Oswalt with her mother,
Paula Oswalt. Marie’s specialties include regular contact with community professionals and
communication amongst school administrators, guidance counselors and teachers, attorneys for families
or the agency, juvenile court judges, the police, and emergency shelter staff. Samantha Myers and Luis
Medina have also been assigned to work on this case with Marie and based off verbal reports that have
been presented by Samanta, it appears as if Janet has been more receptive to Samantha than Marie.
Problem Statement
Marie is sort of at a standstill because progress is starting to deteriorate ever since the Burger King
situation. Marie was convinced that Janet and Paula could live together again since Paula was able to
complete the various drug programs, but Janet still needed more time to cope with her depression, as well
as rekindling her relationship with Paula.
Contextual Analysis
It appears as if Marie had her suspicions pertaining to the relationship between Janet and Paula
Oswalt as soon as she received the case on her desk when she walked into her office. She immediately
became aware of the racist remarks that Janet had made at Burger King during an outing that she had with
her family, and often reminded them to call immediately as soon as a crisis occurred, or even if there is a
possibility of one occurring. Marie was categorized as a smart and quick learner, and even though she
figured that this case would be a great start to her social work career, she more than likely didn’t realize
what she was about to get herself into, even though she has had experience with residential treatment
centers for adolescents and addressing mental health needs.
Janet Oswalt was diagnosed with severe depression at the age of 12 due to her moving back and
forth between her parents and grandparents’ houses (both maternal and paternal), as well as feeling as if
no one could ever understand her circumstances. Her mother, Paula Oswalt, started drinking heavily when
Janet was young, which not only resulted in homelessness, but she also had a cocaine addiction which left
Janet and her other three siblings behind. Paula completed an extensive drug rehabilitation program,
which granted her a HUD certificate for Janet’s three younger siblings to have a place that they can call
home. Paula also had the privilege of receiving weekly therapy sessions with Janet and had opportunities
to have separate sessions with the other children, while attending various Narcotics Anonymous (NA)
meetings. She was able to pass all her drug screenings, was invited to stay as a resident mentor for other
mothers of the groups and sessions, and even though one or two children were allowed to live with her at
one time, her primary goal was to be able to live with the three youngest children so that she can be a
better mother for them.
Since Marie felt as if she couldn’t build the strongest relationship with Janet, she decided to
incorporate help from Samantha Myers, even though Marie felt as if Janet was going to take advantage of
her, just like she did Marie. Samantha is a 28-year-old psychologist who just received her PhD, and the
Oak Hill treatment center considered that to be an advantage because they felt as if she would be able to
relate to Janet as much as Marie would’ve liked to. She had reported that Janet was able to be more
receptive towards Samantha, claiming that she could never trust her mother to stay sober and that she
would continue to be homeless if she were to stay with her. Janet had also mentioned that she fears for the
safety of her younger siblings, even though she would instill fear in them due to her outbursts, but the one
Chris Johnson
January 25, 2023
Case Analysis 2: Marie and Janet
thing Marie knew from the beginning was that Samantha’s services were going to be temporary due to
funding restrictions.
Alternative Strategies
Now that Janet has moved out again and the reunification between her and her family are starting
to become less of a possibility, Marie can result to these three options:
1. Marie could contact Charter of Phoenix to see if they can start a new psychiatric hold for Janet.
This will allow Janet to be in a comfortable setting and it could build on the relationship that she
has with Samantha. The only disadvantage of this solution is that it could prompt Janet’s suicidal
ideations to the point where she immediately commits suicide after discharge, or it could get to
the point where the hospital wouldn’t know what to do with her anymore. This will also delay the
main goal which is to reunite Paula with Janet
2. Paula could provide proof of income, as well as participation in NA meetings to assure Janet that
she is clean and is doing what she needs to do to take care of the other siblings. This would
probably be the best solution because Janet doesn’t fully trust her mother and believes that she
could easily fall back into addiction. A disadvantage of this could be where Paula currently works
because even if she has a job, Janet may feel as if Paula’s income isn’t substantial enough to raise
four children on her own.
3. Marie could try to have a separate session with the maternal grandparents to show them that both
Janet and Paula are doing well and trying to get better for themselves. This would probably be the
worst option to go with because the grandparents don’t believe in therapy, and they expressed
little resentment towards Janet. This however could be a good option because the maternal
grandparents are going to be the best source of care for Janet, especially since the paternal
grandparents had sexually molested one of Janet’s siblings.
Recommendation and Evaluation
I recommend the second option for reunification because Marie nor Samantha had the opportunity to tell
Janet about Paula’s progression and how she desperately wants Janet back in her life so this could be a
good start for Janet to open more about her depression. This could also allow her to reduce her suicidal
ideations since she is in a state of isolation, as well as making sure people truly understand what is going
on with her emotions. Once the reunification process shows overall improvement, this could also allow
Samantha to be more active in the relationship between the Oswalt’s, and this could also allow the other
siblings to be more accepting of Janet.
Rationale
My recommendation is based off the reading and my interpretation of the problem that needed to be
addressed.
Case #1- Controlling Janet
Introduction:
Janet Oswalt is a 12-year-old female who does not like living at home and does not trust her mother. Mary Johnson, who is a caseworker, assigned to Janet’s case tries to reunite Janet and her mom Paula Oswalt. Paula was unable to provide for her children due to her drug addiction. Janet’s grandparents, Mr., and Mrs. Dunleavy, provided for Janet and her siblings.
Problem Statement:
Janet does not have the support and/or the attention she needs from her mother. She finds ways to cope with her feelings. The caseworker is trying to keep Janet and her mom Paula together.
Contextual Analysis:
Janet feels her mom loves her boyfriend Mike more than her and threatens to kill him when he tries to chastise her. Her parents divorced when she was the age of 5. She has inappropriate behavior in school and in public places. She was having suicide ideations which lead to her being admitted to a psychiatric hospital in Phoenix. Janet does not have much support from her mom. She does not trust her due to her addiction and not being able to provide for her and her siblings. Mary the caseworker works hard trying to reunite Janet and her mom Paula back together; however, it leads to an unending battle trying to keep them united. The grandparents have trouble adapting to Janet’s personality and behavior which lead them not wanting to care for her. Her grandparents refuse to allow Janet back into their home.
Alternative Strategies:
The protagonist needs to first find out what is the main reason that Paula and Janet are not getting along. When did this resentment behavior first start between Janet and her mom. Was it after when Janet’s parents separated and that Janet does not have a father figure in her life. Has Paula sat down and expressed to Janet how she feels or vice versa. Janet has made it very clear that she does not trust her mother; however, her mom does not want Janet at the psychiatric hospital but wants her home but not living with her. How often do Janet and her mom spend time together? It’s probably not a good idea for Paula to bring her dates around Janet now until whatever trauma experience that Janet is dealing with, she learns to adapt to. Finding out why she does not have a good bond with her siblings, as stated her siblings are afraid of her. Why is that? Why is Janet finding attention from others such as with older men? Does she blame her mom for her parents divorcing?
I chose these strategies because it appears that Janet is seeking attention that she lacks from her mother. It appears this has been an ongoing situation which caused Janet to be admitted to a psychiatric hospital. I feel once the protagonist gets to the bottom of why Janet is behaving this way, the protagonist may be able to help restore the bond between Janet and her mother. Communicating more gives a chance to hear Janet and to understand how she is feeling. Paula needs to do more trying to establish a bond with Janet before it’s too late if it’s not already. Outpatient behavioral health services for Janet needs to be implemented due to her background of suicide ideations and attempts and her diagnosis.
Recommendation:
Sometimes writing down your thoughts on how you feel may be helpful. I would recommend Janet to journal her thoughts daily about how she feels about everything going on in her life. She has mentioned that life is not worth living. Finding out why she feels that way and when those thoughts or feelings started. How often does she feel that way. What triggers that behavior of feeling like life sucks and not worth living. What causes it to become difficult to reach out to the caseworker when she becomes angry? Taking walks when the weather is nice, breathing the fresh air and/ or watching a good movie or favorite tv show may help Janet to feel calm now. I would also recommend before Janet reacts towards her anger is to use the deep breathing techniques to help with easing her anger thoughts. It may help her not to react to her emotions. Providing outpatient services and having the psychiatrist prescribe a medication may also be helpful along with these suggestions.
Ways of Knowing:
My first thought after reading this case was Janet is seeking some attention that she is not getting from her mom. Not sure if her siblings were getting more attention from Paula. It saddened me when I was reading about the case when Janet and her siblings spent some days with their father; however, they had to move out because of one of the younger siblings being molested by their father. I wonder did Janet had some resentment towards her mom because of what happened to her sister. I have interacted with adolescents in the same age group as Janet; that had thoughts of suicide ideations. Some have responded that they didn’t have the support they needed from their parents. They learned how to cope with their thoughts and feelings by cutting themselves. After treatment they were willing to interact with their parents. One of the therapists suggested when interacting with the parent and if he or she becomes frustrated it is okay to walk away until you are calm.
I feel like more counseling should’ve been offered to Janet. This relationship between Janet and her mom has been ongoing. If more services were offered, I feel Janet may not had to be placed in a psychiatric hospital. I know Mary the caseworker’s job is to reunite families back together and keep them out of foster care; however, it’s still unsure if Janet and her mom would ever have a healthy relationship towards one another. I believe this will be an open case until treatment is established to where Janet can adapt and cope in her living environment.
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