Treatment plan

Kim-Ly Case Scenario Kim-Ly is a 25 year old 2nd generation Vietnamese woman who comes into counseling at the suggestion of her female friend who she sees in church weekly. She comes to counseling now because she wishes to move out of her parents’ home and is quite conflicted about doing so. Kim-Ly has never been in counseling before and her family does not believe in seeking help from ‘outsiders’ or from agencies. Their belief is that the family takes care of its own. Kim-Ly is a petite, thin and attractive woman who currently lives at home with her parents (both in their 40’s), her two younger sisters (16 & 20) and her younger brother who is 22 years old. The family lives in Orlando and socioeconomically, the family still struggles but manages to make ends meet and most months can pay their rent on time. Her parents complain that their landlord is constantly threatening to evict the family and often tells them that ‘they should return to their own country’. Her parents have owned a small grocery store in Orlando for about 15 years and have been able to provide basic necessities for the family. Prior to that and up to about the time that Kim-Ly was 10, the family was quite poor and struggled on a day to day basis, often depending on relatives. But 15 years ago, Kim-Ly’s father visited his father in Vietnam and while there Kim-Ly’s paternal grandfather gave her father a small sum of money, enough for the family to purchase the small grocery store they now own. Her parents have worked very hard and things have gone okay for the family since then. Her parents however, are always stressed out about paying bills and making ends meet—always fearing that they will lose their apartment and the store. Kim-Ly’s parents immigrated to the United States 27 years ago. Kim-Ly was born in New York City where her parents first lived. The family lived in Vietnamese community in New York City known for incidents where female children were kidnapped and sent to live as domestic servants in non-Vietnamese homes. Kim-Ly was taken off the streets at the age of 8 and forced to work in a wealthy woman’s home for two years. After living there, she managed to escape and found a friend who helped her return to her family. When she returned her family, especially her father considered her ‘damaged goods’ and felt that Kim-Ly brought shame to the family as she had been sexually abused repeatedly by the wealthy woman’s boyfriend. The relationship between her and her father has remained ‘tense’. Her family is now very protective of all the female relatives in the family as they fear that they too can have the same experience. Right after this incident and when Kim-Ly was 10 years old, the family moved to Orlando. She has been educated through the American school system and is bilingual in English and Vietnamese. Kim- Ly considers herself quite Americanized and has adopted many of the American values, though she seldom shares those viewpoints with any members of her family. She fears that the family would not approve and that it would be disrespectful for her to go against her parent’s values and traditions. Her parents are very rooted in the traditional Vietnamese ways including practicing Buddhism. Kim-Ly is a practicing Catholic and this often causes friction between herself and other family members. She feels like she’s living a double life: a Vietnamese life at home that she is not comfortable with and an American life outside her family that she wishes to pursue but cannot. Because her parents are so traditional and not accepting of American values and ways, Kim-Ly was not allowed to date, to leave the house past a certain hour in the evening and was escorted to places by her brother. She has always been considered a compliant daughter who has been respectful towards her parents. But lately, Kim-Ly has experienced tense moments and even arguments with her parents about her wish to have an American boyfriend and her desire to have her own life. She secretly has an American boyfriend who appears to have a drinking problem and on several occasions has verbally and physically abused Kim-Ly. She has not told anyone about the abuse she experiences at the hands of her boyfriend. She wishes to get her own apartment but is tortured by guilt about not following traditional Vietnamese values that include her leaving her parents’ home married to a Vietnamese man. Lately during these altercations, Kim-Ly has accused her parents of being physically abusive to her as a child. They respond by pointing out that as parents their responsibility is to ‘discipline’ their children and remind her that the physical discipline made her the successful person she is

today. Kim-Ly often feels rage over this but doesn’t know what to do with the rage so she continues to “keep it to herself”. She often finds herself (on most days) feeling hopeless and feeling that she is not worth much. Kim Ly often feels as though she is ‘suffocating’ and is very sad most days. She feels isolated from her peers and outside of her job as an event planner for the Convention Center and her helping her parents at the store, she does not have other interests nor does she have many support systems. She is indeed quite successful in her job but doesn’t feel good about life or feels any joy. Because of these responsibilities she only sees her boyfriend 2x a week and not for very long. Her anxiety related to her unhappiness and her wish to have a different kind of life has recently resulted in trouble sleeping, nightmares, anxiety, poor appetite, trouble concentrating on her job and crying spells. She recently lost her small dog who died of cancer and who she considered her ‘only true friend’. She feels that she has very low self-esteem. Kim Ly has concerns that she is always tired and not motivated to do much outside of work and reports that she has felt this way for at least 2 years. She reports that her supervisor at work has made racist comments about Kim-Ly’s ethnic background and treats Kim-Ly differently than the other workers. Kim-Ly has attempted to discuss this with her male supervisor, but he instead has responded with sexual comments about Kim-Ly and has indicated that “life would be easier for Kim-Ly if she would cooperate with him”. The supervisor also reminds Kim-Ly that she is the youngest employee and that he doesn’t usually hire anyone under 35 years of age. He reports that he made an exception to this when he hired Kim-Ly assuming that she would “be a cooperative and friendly employee towards him”. Kim-Ly has never been hospitalized in a psychiatric hospital nor has she sought out any counseling help previously. Though she admits that in the past she has thought about wishing she were dead and questioning why she was ever born. She reports that her mother was seen by a medical doctor years ago for ‘sadness’ and prescribed medication, which her mother refused to take. She reports that she has been feeling all of these things more for the past two years. Kim Ly herself does not like doctors as she fears that she will be given ‘bad news’. She has recently noticed two lumps in her breasts but cannot afford healthcare to see a doctor. Her parents also cannot afford health care and do not have any money saved up since all of it goes into maintaining their store and they do not make much a profit—just enough to pay their mortgage. She is currently feeling that “something has to change since she cannot go on living this way”.