Assignment

Child and Adolescent Counseling Cases: Sex, Sexuality, and Substance Abuse

 

© 2014 Laureate Education, Inc. Page 1 of 2  

Week 9: Case 1, Sexuality

Loretta is a 17-year-old white female. She is a student in a partial-day treatment center focusing on vocational and social skill development. Loretta has a wide range of disabilities related, at least in part, to a brain injury she suffered as a toddler. She has specific learning disabilities in the areas of writing and reading. Despite her challenges, Loretta is a hard worker. Because of her positive attitude and work ethic within the day treatment setting, Loretta has a good reputation for being dependable and trustworthy. However, over the past 6 months, Loretta has decided she likes sex. She has been caught having sexual contact at the treatment center and also at home in the evenings and on the weekends. This behavior is concerning to Loretta’s parents. They are worried about her sexual safety, potential pregnancy, sexually transmitted diseases, and Loretta’s behavior is outside their comfort zone. They have tried lecturing, grounding her, and other threats and punishments. Loretta does not see anything wrong with her behavior. Apparently, the pleasure she associates with sex more than offsets the consequences she has gotten from her parents, and she seems relatively oblivious to the additional potential consequences of sexually transmitted diseases and pregnancy.

Week 9: Case 2, Sexual Orientation

Patrick is a 9-year-old African American boy enrolled in the fourth grade in a private Christian school. Patrick is exceptionally intelligent and very academically successful. However, based on reports from his parents and from his teachers, he has always struggled in the social domain. Most recently, Patrick has been causing a disturbance in the classroom by telling teachers and students that one of the other male students in the class is his boyfriend and insisting that he loves boys, not girls. This behavior has been extremely difficult for his parents to accept as they hold a rather traditional Christian perspective. The thought of their son being gay is very disturbing for them.

You initially were contacted by Patrick’s parents, who made it clear to you they think Patrick is acting out in an effort to gain attention from his peers. They also make it clear that they are either unwilling or unable to consider the possibility that Patrick might be gay. When the three of them show up in your office, the parents dominate the conversation and tell Patrick he needs to work with you to get things straightened out. Their goal is for you to work with Patrick so he will put a stop to his silly and disturbing claims of having romantic feelings for boys. Patrick refuses to offer any goals for counseling. When you meet with him alone, he slowly opens up and you end up somewhat convinced that this boy really does feel he is gay and likely needs to explore his sexual orientation, and yet you are at a loss as to how to work effectively with him and his parents.

Child and Adolescent Counseling Cases: Sex, Sexuality, and Substance Abuse

 

© 2014 Laureate Education, Inc. Page 2 of 2  

Week 9: Case 3, Substance Use

Marcus is a 15-year-old boy who was seen 2 weeks previously in the emergency room for a huffing incident. While his parents were away and after Marcus had mowed the lawn, he put the lawn mower and gasoline back into the shed and began sniffing gasoline. His parents came home and discovered him passed out in the shed next to the gasoline can and immediately transported him to the hospital emergency room. Marcus was treated and released, and his parents were concerned, but Marcus insisted this was a one-time incident. However, the next week his parents found several aerosol cans in their son’s room.

During his first session, Marcus admits to sneaking around and huffing whatever he can whenever he can. He reports feeling out of control. He says he loves the instant high and cannot help himself.

Week 9: Case 4, Substance Use

Lindsey is a 12-year-old white female referred to counseling for substance abuse problems. Lindsey lives in a foster home. She was removed from her mother and stepfather’s home at age 7, when the federal authorities conducted a raid and discovered a methamphetamine lab in the home. Lindsey and her foster mother report that Lindsey initially was given alcohol by her mother and stepfather at age 4. She began smoking cigarettes at age 7, just before the police raid. Lindsey was returned to her mother’s care at age 9. She began smoking pot shortly thereafter. At age 11, she tried methamphetamines and cocaine, had a bad experience, and ended up hospitalized and, once again, removed from her mother’s care. She is now in permanent foster care.

The foster mother is very concerned about Lindsey’s well-being. Although there have not been any incidents of methamphetamine or cocaine use, Lindsey has been caught smoking cigarettes and pot on several occasions. Lindsey was also caught at school selling a small amount of pot and sent to the local juvenile drug court. The drug court referred her for counseling. When you meet with Lindsey alone, she insists that pot is not a problem. She refers to it as an “herb” and as “all natural.” She says she would never go down the road that he mother went down but that pot is different and it just keeps her mellow and out of trouble. She claims that pot is her medicine and that she needs it to function at home and at school.