Assignment Prompt & Instructions
– ## INSTRUCTIONMSW525—-MODULE3–.docx
– ## SamplePaper-CaseAnalysis.pdf
**## INSTRUCTIONMSW525—-MODULE3–.docx**
**Week 3 Readings**
Perry, B. D., & Szalavitz, M. (2017).
_The boy who was raised as a dog: And other stories from a child psychiatrist's notebook – what traumatized children can teach us about loss, love, and healing_. Basic Books.
·
**Chapter 3: Stairway to Heaven**
**Write a Case Analysis of Stairway to Heaven from Chapter 3 of**
**The Boy Who Was Raised as a Dog. Students must address the following prompts in their papers:**
**Analyze** and discuss the role that relationships play in the treatment and healing of childhood trauma.
·
·
**Analyze a** nd discuss the role that fear played in the lives of the Branch Davidian children.
·
·
**Assess** the impact that culture played in the lives of the Branch Davidian children and how they adjusted to a change in their culture.
**Guidelines**
**Case analysis **of Stairway to Heaven in chapter 3 of The Boy Who Was Raised as a Dog. Students must address the following prompts in their papers:**
·
**Analyze- and discuss the role that relationships play in the treatment and healing of childhood trauma.**
·
**Analyze- and discuss the role that fear played in the lives of the Branch Davidian children.**
·
**Assess the impact that culture played in the lives of the Branch Davidian children and how they adjusted to a change in their culture.**
**Grading Criteria**
| | | |
| — | — | — |
| **Criteria** | | **Description** |
| **Analyze and discuss the role that relationships play in the treatment and healing of childhood trauma.** | | The student provides an excellent analysis of the role that relationships can play in the intervention and healing process. The students provide multiple examples of the importance of relationships in the case of the Branch Davidian children. |
| **Analyze and discuss the role that fear played in the lives of the Branch Davidian children.** | | The student provides an excellent analysis of the role that fear played in the lives of the Branch Davidian children and offer multiple examples from the case. |
| **Assess the impact that culture played in the lives of the Branch Davidian children and how they adjusted to a change in their culture.** | | The student provides an excellent analysis of the role the culture played in the case of the Branch Davidian Children and offer multiple examples from the case. |
**## SamplePaper-CaseAnalysis.pdf**
1
Case Analysis: The Case of Tina
STUDENT NAME
Master of Social Work, Chamberlain University College of Health Professions
MSW 525: Trauma Treatment for Children and Adolescents
Dr. Jessica Benito
DATE
2
Case Analysis: The Case of Tina
Tina, a seven-year-old girl, was brought to the University of Chicago child psychiatry
clinic by her mother for evaluation after her school insisted due to troubling behaviors like
aggression, exposing herself, attacking peers, using sexual language, and engaging in sexual
play. From ages four to six, she was repeatedly sexually assaulted, raped, and threatened by her
babysitter's son over two years until she was six years old (Perry & Szalavitz, 2017),
significantly affecting her development. Consequently, her planning and processing higher-order
brain systems were deactivated, overshadowed by the survival-oriented low road brain (Saxe &
Brown, 2015). This case analysis will explore how her trauma and environmental factors
influence Tina's behaviors. Her adversities would likely yield a high Adverse Childhood
Experiences (ACE) test score, increasing her vulnerability to chronic health issues and mental
illness (Harris, 2018). Dr. Perry employed several interventions with Tina, although their
effectiveness was limited by time constraints, which will be reviewed.
Impact of Trauma on Tina's Neurobiology
Physical
Dr. Perry examined Tina's previous charts and found her heart rate elevated at 112 beats
per minute. The average heart rate for children in her age group is below 100 beats per minute.
Tina exhibits symptoms and behaviors that suggest abnormalities across all four brain regions.
Her sleep and attention difficulties, fine motor skills and coordination, social and relational
delays, and issues with speech and language reflect complications within the brainstem, cortex,
limbic system, and diencephalon regions (Perry & Szalavitz, 2017).
Cognitive
3
Tina felt confused during her first encounter with Dr. Perry. As she climbed onto his lap
and tried to unzip his pants, he gently set her down. Her expression showed fear and anxiety,
reflecting her toxic belief about what she thinks men desire from her. She believes men to be
sexual predators based off her lack of positive male figures present in her the course of her life
and the trauma she endured. She believes that sexual behavior in public is normal. Also suffers
from language and speech delays.
Emotional
Tina demonstrated fear and anxiety when Dr. Perry turned her away. In school and with
her peers, she would be aggressive with her teachers and peers. She consistently attacked other
children, which relates to her fear of being in danger.
Behavioral
When first meeting Dr. Perry, she crawled into his lap and snuggled him, before rubbing
his thigh and attempting to unzip his zipper. She does not have healthy boundaries. The school
reported that she was aggressive, inappropriate, exposed herself, attacked other children, used
sexual language, and attempted to get other students to engage in sexual play. She also admitted
to engaging in sexual play when left alone with her brother. She struggles with paying attention,
lacks patience, and exhibits impulse control issues. Overreact to the slightest indications of
possible aggression, leading to conflicts.
Behavioral Changes
As Tina learned that her behavior was unacceptable, she learned to hide her impulses to
avoid getting in trouble. Her toxic associations led her to expose herself to others and engage in
sexual play with her peers and brother. She would scan faces for threats, searching for signs that
4
someone might be trying to harm her. At ten years old, she was found engaging in sexual
activities with an older boy at school.
Dr. Perry’s Interventions and Effectiveness
Dr. Perry started his initial session with Tina by joining her in coloring. They shared
updates about their artwork, which effectively fostered trust and rapport. For the first time, Tina
saw Dr. Perry as a man who was not pursuing her for sexual reasons, making her feel
comfortable enough to discuss her interests and future aspirations. Following their first session,
contrary to his supervisor's recommendation to diagnose Tina with Attention Deficit Disorder
and explore suitable psychopharmacology, he chose to pursue a therapeutic approach instead.
Holding off on any diagnosis before he gets to know Tina more. He later diagnosed her after
getting to know her with post-traumatic stress disorder. Dr. Perry gave her and her family a ride
home one day and assisted them with shopping at a local store. While this is against typical
practices, it allowed him to better understand Tina's environment and home life. Opening his
eyes to the difficulties her family faced.
During their therapy sessions, he included activities that allowed her to lead and choose
the focus. He capitalized on spontaneous moments to introduce ideas such as patience and the
importance of careful consideration before reacting. She felt comfortable discussing various
topics, and he fostered clarification by posing questions. As her communication skills improved,
she became more receptive to feedback, which, in turn, bolstered her confidence. He often
modeled behaviors or gave explicit guidance, depending on what best fit the situation. This
method proved successful, as she began to display better behavior at school, avoiding conflicts
with peers, completing assignments, and consistently attending classes. However, despite her
school improvement, she was caught performing a sexual act with an older boy at school. Thus,
5
while the treatment effectively enhanced her interactions at school and with peers, it also taught
her to conceal her sexual activities to evade trouble.
Environmental Impact on Tina's Ability to Heal from her Trauma
Risk Factors
Tina lives with her single mother and her two siblings. They struggle with severe poverty
and rely on public transportation, which is dangerous in Chicago winters, as the bus is their main
transport. They live in one of the poorest areas in the city. Her mother has introduced
inappropriate boyfriends, leaving Tina without positive male role models. Their one-bedroom
apartment was messy and had trash during Dr. Perry’s visit. Tina often stays home with her
brother after school while their mother works, feeling uncomfortable hiring a babysitter due to
past experiences. During this time, they have engaged in sexual play and typically watch TV.
They lack nearby family support.
Protective Factors
Tina’s mother consistently ensures her daughter attends all her appointments, regardless
of the challenges faced by the family. She supports her daughter and followed the school's
suggestion to have her evaluated, demonstrating her willingness to assist her the best she can
through her trauma. Tina is actively participating in therapy and treatment, and her school
routine keeps her engaged and connected with her peers. Recently, the family relocated to an
apartment closer to the clinic, making appointments just a 20-minute bus ride away. When the
children are home alone, their mother has provided an emergency contact for them to contact if
necessary.
6
References
Harris, B. N. (2018). The deepest well: Healing the long-term effects of childhood
adversity. Houghton Mifflin Harcourt
Perry, B. D., & Szalavitz, M. (2017). The boy who was raised as a dog: And other stories from a
child psychiatrist's notebook: What traumatized children can teach us about loss, love,
and healing. Basic Books.
Saxe, G., Ellis, B.H. & Brown, A. (2015). Trauma systems therapy for children and teens.
Guilford Press
**## SamplePaper-CaseAnalysis.pdf**
1
Case Analysis: The Case of Tina
STUDENT NAME
Master of Social Work, Chamberlain University College of Health Professions
MSW 525: Trauma Treatment for Children and Adolescents
Dr. Jessica Benito
DATE
2
Case Analysis: The Case of Tina
Tina, a seven-year-old girl, was brought to the University of Chicago child psychiatry
clinic by her mother for evaluation after her school insisted due to troubling behaviors like
aggression, exposing herself, attacking peers, using sexual language, and engaging in sexual
play. From ages four to six, she was repeatedly sexually assaulted, raped, and threatened by her
babysitter's son over two years until she was six years old (Perry & Szalavitz, 2017),
significantly affecting her development. Consequently, her planning and processing higher-order
brain systems were deactivated, overshadowed by the survival-oriented low road brain (Saxe &
Brown, 2015). This case analysis will explore how her trauma and environmental factors
influence Tina's behaviors. Her adversities would likely yield a high Adverse Childhood
Experiences (ACE) test score, increasing her vulnerability to chronic health issues and mental
illness (Harris, 2018). Dr. Perry employed several interventions with Tina, although their
effectiveness was limited by time constraints, which will be reviewed.
Impact of Trauma on Tina's Neurobiology
Physical
Dr. Perry examined Tina's previous charts and found her heart rate elevated at 112 beats
per minute. The average heart rate for children in her age group is below 100 beats per minute.
Tina exhibits symptoms and behaviors that suggest abnormalities across all four brain regions.
Her sleep and attention difficulties, fine motor skills and coordination, social and relational
delays, and issues with speech and language reflect complications within the brainstem, cortex,
limbic system, and diencephalon regions (Perry & Szalavitz, 2017).
Cognitive
3
Tina felt confused during her first encounter with Dr. Perry. As she climbed onto his lap
and tried to unzip his pants, he gently set her down. Her expression showed fear and anxiety,
reflecting her toxic belief about what she thinks men desire from her. She believes men to be
sexual predators based off her lack of positive male figures present in her the course of her life
and the trauma she endured. She believes that sexual behavior in public is normal. Also suffers
from language and speech delays.
Emotional
Tina demonstrated fear and anxiety when Dr. Perry turned her away. In school and with
her peers, she would be aggressive with her teachers and peers. She consistently attacked other
children, which relates to her fear of being in danger.
Behavioral
When first meeting Dr. Perry, she crawled into his lap and snuggled him, before rubbing
his thigh and attempting to unzip his zipper. She does not have healthy boundaries. The school
reported that she was aggressive, inappropriate, exposed herself, attacked other children, used
sexual language, and attempted to get other students to engage in sexual play. She also admitted
to engaging in sexual play when left alone with her brother. She struggles with paying attention,
lacks patience, and exhibits impulse control issues. Overreact to the slightest indications of
possible aggression, leading to conflicts.
Behavioral Changes
As Tina learned that her behavior was unacceptable, she learned to hide her impulses to
avoid getting in trouble. Her toxic associations led her to expose herself to others and engage in
sexual play with her peers and brother. She would scan faces for threats, searching for signs that
4
someone might be trying to harm her. At ten years old, she was found engaging in sexual
activities with an older boy at school.
Dr. Perry’s Interventions and Effectiveness
Dr. Perry started his initial session with Tina by joining her in coloring. They shared
updates about their artwork, which effectively fostered trust and rapport. For the first time, Tina
saw Dr. Perry as a man who was not pursuing her for sexual reasons, making her feel
comfortable enough to discuss her interests and future aspirations. Following their first session,
contrary to his supervisor's recommendation to diagnose Tina with Attention Deficit Disorder
and explore suitable psychopharmacology, he chose to pursue a therapeutic approach instead.
Holding off on any diagnosis before he gets to know Tina more. He later diagnosed her after
getting to know her with post-traumatic stress disorder. Dr. Perry gave her and her family a ride
home one day and assisted them with shopping at a local store. While this is against typical
practices, it allowed him to better understand Tina's environment and home life. Opening his
eyes to the difficulties her family faced.
During their therapy sessions, he included activities that allowed her to lead and choose
the focus. He capitalized on spontaneous moments to introduce ideas such as patience and the
importance of careful consideration before reacting. She felt comfortable discussing various
topics, and he fostered clarification by posing questions. As her communication skills improved,
she became more receptive to feedback, which, in turn, bolstered her confidence. He often
modeled behaviors or gave explicit guidance, depending on what best fit the situation. This
method proved successful, as she began to display better behavior at school, avoiding conflicts
with peers, completing assignments, and consistently attending classes. However, despite her
school improvement, she was caught performing a sexual act with an older boy at school. Thus,
5
while the treatment effectively enhanced her interactions at school and with peers, it also taught
her to conceal her sexual activities to evade trouble.
Environmental Impact on Tina's Ability to Heal from her Trauma
Risk Factors
Tina lives with her single mother and her two siblings. They struggle with severe poverty
and rely on public transportation, which is dangerous in Chicago winters, as the bus is their main
transport. They live in one of the poorest areas in the city. Her mother has introduced
inappropriate boyfriends, leaving Tina without positive male role models. Their one-bedroom
apartment was messy and had trash during Dr. Perry’s visit. Tina often stays home with her
brother after school while their mother works, feeling uncomfortable hiring a babysitter due to
past experiences. During this time, they have engaged in sexual play and typically watch TV.
They lack nearby family support.
Protective Factors
Tina’s mother consistently ensures her daughter attends all her appointments, regardless
of the challenges faced by the family. She supports her daughter and followed the school's
suggestion to have her evaluated, demonstrating her willingness to assist her the best she can
through her trauma. Tina is actively participating in therapy and treatment, and her school
routine keeps her engaged and connected with her peers. Recently, the family relocated to an
apartment closer to the clinic, making appointments just a 20-minute bus ride away. When the
children are home alone, their mother has provided an emergency contact for them to contact if
necessary.
6
References
Harris, B. N. (2018). The deepest well: Healing the long-term effects of childhood
adversity. Houghton Mifflin Harcourt
Perry, B. D., & Szalavitz, M. (2017). The boy who was raised as a dog: And other stories from a
child psychiatrist's notebook: What traumatized children can teach us about loss, love,
and healing. Basic Books.
Saxe, G., Ellis, B.H. & Brown, A. (2015). Trauma systems therapy for children and teens.
Guilford Press
**## INSTRUCTIONMSW525—-MODULE3–.docx**
**Week 3 Readings**
Perry, B. D., & Szalavitz, M. (2017).
_The boy who was raised as a dog: And other stories from a child psychiatrist's notebook – what traumatized children can teach us about loss, love, and healing_. Basic Books.
·
**Chapter 3: Stairway to Heaven**
**Write a Case Analysis of Stairway to Heaven from Chapter 3 of**
**The Boy Who Was Raised as a Dog. Students must address the following prompts in their papers:**
**Analyze** and discuss the role that relationships play in the treatment and healing of childhood trauma.
·
·
**Analyze a** nd discuss the role that fear played in the lives of the Branch Davidian children.
·
·
**Assess** the impact that culture played in the lives of the Branch Davidian children and how they adjusted to a change in their culture.
**Guidelines**
**Case analysis **of Stairway to Heaven in chapter 3 of The Boy Who Was Raised as a Dog. Students must address the following prompts in their papers:**
·
**Analyze- and discuss the role that relationships play in the treatment and healing of childhood trauma.**
·
**Analyze- and discuss the role that fear played in the lives of the Branch Davidian children.**
·
**Assess the impact that culture played in the lives of the Branch Davidian children and how they adjusted to a change in their culture.**
**Grading Criteria**
| | | |
| — | — | — |
| **Criteria** | | **Description** |
| **Analyze and discuss the role that relationships play in the treatment and healing of childhood trauma.** | | The student provides an excellent analysis of the role that relationships can play in the intervention and healing process. The students provide multiple examples of the importance of relationships in the case of the Branch Davidian children. |
| **Analyze and discuss the role that fear played in the lives of the Branch Davidian children.** | | The student provides an excellent analysis of the role that fear played in the lives of the Branch Davidian children and offer multiple examples from the case. |
| **Assess the impact that culture played in the lives of the Branch Davidian children and how they adjusted to a change in their culture.** | | The student provides an excellent analysis of the role the culture played in the case of the Branch Davidian Children and offer multiple examples from the case. |
**## SamplePaper-CaseAnalysis.pdf**
1
Case Analysis: The Case of Tina
STUDENT NAME
Master of Social Work, Chamberlain University College of Health Professions
MSW 525: Trauma Treatment for Children and Adolescents
Dr. Jessica Benito
DATE
2
Case Analysis: The Case of Tina
Tina, a seven-year-old girl, was brought to the University of Chicago child psychiatry
clinic by her mother for evaluation after her school insisted due to troubling behaviors like
aggression, exposing herself, attacking peers, using sexual language, and engaging in sexual
play. From ages four to six, she was repeatedly sexually assaulted, raped, and threatened by her
babysitter's son over two years until she was six years old (Perry & Szalavitz, 2017),
significantly affecting her development. Consequently, her planning and processing higher-order
brain systems were deactivated, overshadowed by the survival-oriented low road brain (Saxe &
Brown, 2015). This case analysis will explore how her trauma and environmental factors
influence Tina's behaviors. Her adversities would likely yield a high Adverse Childhood
Experiences (ACE) test score, increasing her vulnerability to chronic health issues and mental
illness (Harris, 2018). Dr. Perry employed several interventions with Tina, although their
effectiveness was limited by time constraints, which will be reviewed.
Impact of Trauma on Tina's Neurobiology
Physical
Dr. Perry examined Tina's previous charts and found her heart rate elevated at 112 beats
per minute. The average heart rate for children in her age group is below 100 beats per minute.
Tina exhibits symptoms and behaviors that suggest abnormalities across all four brain regions.
Her sleep and attention difficulties, fine motor skills and coordination, social and relational
delays, and issues with speech and language reflect complications within the brainstem, cortex,
limbic system, and diencephalon regions (Perry & Szalavitz, 2017).
Cognitive
3
Tina felt confused during her first encounter with Dr. Perry. As she climbed onto his lap
and tried to unzip his pants, he gently set her down. Her expression showed fear and anxiety,
reflecting her toxic belief about what she thinks men desire from her. She believes men to be
sexual predators based off her lack of positive male figures present in her the course of her life
and the trauma she endured. She believes that sexual behavior in public is normal. Also suffers
from language and speech delays.
Emotional
Tina demonstrated fear and anxiety when Dr. Perry turned her away. In school and with
her peers, she would be aggressive with her teachers and peers. She consistently attacked other
children, which relates to her fear of being in danger.
Behavioral
When first meeting Dr. Perry, she crawled into his lap and snuggled him, before rubbing
his thigh and attempting to unzip his zipper. She does not have healthy boundaries. The school
reported that she was aggressive, inappropriate, exposed herself, attacked other children, used
sexual language, and attempted to get other students to engage in sexual play. She also admitted
to engaging in sexual play when left alone with her brother. She struggles with paying attention,
lacks patience, and exhibits impulse control issues. Overreact to the slightest indications of
possible aggression, leading to conflicts.
Behavioral Changes
As Tina learned that her behavior was unacceptable, she learned to hide her impulses to
avoid getting in trouble. Her toxic associations led her to expose herself to others and engage in
sexual play with her peers and brother. She would scan faces for threats, searching for signs that
4
someone might be trying to harm her. At ten years old, she was found engaging in sexual
activities with an older boy at school.
Dr. Perry’s Interventions and Effectiveness
Dr. Perry started his initial session with Tina by joining her in coloring. They shared
updates about their artwork, which effectively fostered trust and rapport. For the first time, Tina
saw Dr. Perry as a man who was not pursuing her for sexual reasons, making her feel
comfortable enough to discuss her interests and future aspirations. Following their first session,
contrary to his supervisor's recommendation to diagnose Tina with Attention Deficit Disorder
and explore suitable psychopharmacology, he chose to pursue a therapeutic approach instead.
Holding off on any diagnosis before he gets to know Tina more. He later diagnosed her after
getting to know her with post-traumatic stress disorder. Dr. Perry gave her and her family a ride
home one day and assisted them with shopping at a local store. While this is against typical
practices, it allowed him to better understand Tina's environment and home life. Opening his
eyes to the difficulties her family faced.
During their therapy sessions, he included activities that allowed her to lead and choose
the focus. He capitalized on spontaneous moments to introduce ideas such as patience and the
importance of careful consideration before reacting. She felt comfortable discussing various
topics, and he fostered clarification by posing questions. As her communication skills improved,
she became more receptive to feedback, which, in turn, bolstered her confidence. He often
modeled behaviors or gave explicit guidance, depending on what best fit the situation. This
method proved successful, as she began to display better behavior at school, avoiding conflicts
with peers, completing assignments, and consistently attending classes. However, despite her
school improvement, she was caught performing a sexual act with an older boy at school. Thus,
5
while the treatment effectively enhanced her interactions at school and with peers, it also taught
her to conceal her sexual activities to evade trouble.
Environmental Impact on Tina's Ability to Heal from her Trauma
Risk Factors
Tina lives with her single mother and her two siblings. They struggle with severe poverty
and rely on public transportation, which is dangerous in Chicago winters, as the bus is their main
transport. They live in one of the poorest areas in the city. Her mother has introduced
inappropriate boyfriends, leaving Tina without positive male role models. Their one-bedroom
apartment was messy and had trash during Dr. Perry’s visit. Tina often stays home with her
brother after school while their mother works, feeling uncomfortable hiring a babysitter due to
past experiences. During this time, they have engaged in sexual play and typically watch TV.
They lack nearby family support.
Protective Factors
Tina’s mother consistently ensures her daughter attends all her appointments, regardless
of the challenges faced by the family. She supports her daughter and followed the school's
suggestion to have her evaluated, demonstrating her willingness to assist her the best she can
through her trauma. Tina is actively participating in therapy and treatment, and her school
routine keeps her engaged and connected with her peers. Recently, the family relocated to an
apartment closer to the clinic, making appointments just a 20-minute bus ride away. When the
children are home alone, their mother has provided an emergency contact for them to contact if
necessary.
6
References
Harris, B. N. (2018). The deepest well: Healing the long-term effects of childhood
adversity. Houghton Mifflin Harcourt
Perry, B. D., & Szalavitz, M. (2017). The boy who was raised as a dog: And other stories from a
child psychiatrist's notebook: What traumatized children can teach us about loss, love,
and healing. Basic Books.
Saxe, G., Ellis, B.H. & Brown, A. (2015). Trauma systems therapy for children and teens.
Guilford Press
**## INSTRUCTIONMSW525—-MODULE3–.docx**
**Week 3 Readings**
Perry, B. D., & Szalavitz, M. (2017).
_The boy who was raised as a dog: And other stories from a child psychiatrist's notebook – what traumatized children can teach us about loss, love, and healing_. Basic Books.
·
**Chapter 3: Stairway to Heaven**
**Write a Case Analysis of Stairway to Heaven from Chapter 3 of**
**The Boy Who Was Raised as a Dog. Students must address the following prompts in their papers:**
**Analyze** and discuss the role that relationships play in the treatment and healing of childhood trauma.
·
·
**Analyze a** nd discuss the role that fear played in the lives of the Branch Davidian children.
·
·
**Assess** the impact that culture played in the lives of the Branch Davidian children and how they adjusted to a change in their culture.
**Guidelines**
**Case analysis **of Stairway to Heaven in chapter 3 of The Boy Who Was Raised as a Dog. Students must address the following prompts in their papers:**
·
**Analyze- and discuss the role that relationships play in the treatment and healing of childhood trauma.**
·
**Analyze- and discuss the role that fear played in the lives of the Branch Davidian children.**
·
**Assess the impact that culture played in the lives of the Branch Davidian children and how they adjusted to a change in their culture.**
**Grading Criteria**
| | | |
| — | — | — |
| **Criteria** | | **Description** |
| **Analyze and discuss the role that relationships play in the treatment and healing of childhood trauma.** | | The student provides an excellent analysis of the role that relationships can play in the intervention and healing process. The students provide multiple examples of the importance of relationships in the case of the Branch Davidian children. |
| **Analyze and discuss the role that fear played in the lives of the Branch Davidian children.** | | The student provides an excellent analysis of the role that fear played in the lives of the Branch Davidian children and offer multiple examples from the case. |
| **Assess the impact that culture played in the lives of the Branch Davidian children and how they adjusted to a change in their culture.** | | The student provides an excellent analysis of the role the culture played in the case of the Branch Davidian Children and offer multiple examples from the case. |
**## SamplePaper-CaseAnalysis.pdf**
1
Case Analysis: The Case of Tina
STUDENT NAME
Master of Social Work, Chamberlain University College of Health Professions
MSW 525: Trauma Treatment for Children and Adolescents
Dr. Jessica Benito
DATE
2
Case Analysis: The Case of Tina
Tina, a seven-year-old girl, was brought to the University of Chicago child psychiatry
clinic by her mother for evaluation after her school insisted due to troubling behaviors like
aggression, exposing herself, attacking peers, using sexual language, and engaging in sexual
play. From ages four to six, she was repeatedly sexually assaulted, raped, and threatened by her
babysitter's son over two years until she was six years old (Perry & Szalavitz, 2017),
significantly affecting her development. Consequently, her planning and processing higher-order
brain systems were deactivated, overshadowed by the survival-oriented low road brain (Saxe &
Brown, 2015). This case analysis will explore how her trauma and environmental factors
influence Tina's behaviors. Her adversities would likely yield a high Adverse Childhood
Experiences (ACE) test score, increasing her vulnerability to chronic health issues and mental
illness (Harris, 2018). Dr. Perry employed several interventions with Tina, although their
effectiveness was limited by time constraints, which will be reviewed.
Impact of Trauma on Tina's Neurobiology
Physical
Dr. Perry examined Tina's previous charts and found her heart rate elevated at 112 beats
per minute. The average heart rate for children in her age group is below 100 beats per minute.
Tina exhibits symptoms and behaviors that suggest abnormalities across all four brain regions.
Her sleep and attention difficulties, fine motor skills and coordination, social and relational
delays, and issues with speech and language reflect complications within the brainstem, cortex,
limbic system, and diencephalon regions (Perry & Szalavitz, 2017).
Cognitive
3
Tina felt confused during her first encounter with Dr. Perry. As she climbed onto his lap
and tried to unzip his pants, he gently set her down. Her expression showed fear and anxiety,
reflecting her toxic belief about what she thinks men desire from her. She believes men to be
sexual predators based off her lack of positive male figures present in her the course of her life
and the trauma she endured. She believes that sexual behavior in public is normal. Also suffers
from language and speech delays.
Emotional
Tina demonstrated fear and anxiety when Dr. Perry turned her away. In school and with
her peers, she would be aggressive with her teachers and peers. She consistently attacked other
children, which relates to her fear of being in danger.
Behavioral
When first meeting Dr. Perry, she crawled into his lap and snuggled him, before rubbing
his thigh and attempting to unzip his zipper. She does not have healthy boundaries. The school
reported that she was aggressive, inappropriate, exposed herself, attacked other children, used
sexual language, and attempted to get other students to engage in sexual play. She also admitted
to engaging in sexual play when left alone with her brother. She struggles with paying attention,
lacks patience, and exhibits impulse control issues. Overreact to the slightest indications of
possible aggression, leading to conflicts.
Behavioral Changes
As Tina learned that her behavior was unacceptable, she learned to hide her impulses to
avoid getting in trouble. Her toxic associations led her to expose herself to others and engage in
sexual play with her peers and brother. She would scan faces for threats, searching for signs that
4
someone might be trying to harm her. At ten years old, she was found engaging in sexual
activities with an older boy at school.
Dr. Perry’s Interventions and Effectiveness
Dr. Perry started his initial session with Tina by joining her in coloring. They shared
updates about their artwork, which effectively fostered trust and rapport. For the first time, Tina
saw Dr. Perry as a man who was not pursuing her for sexual reasons, making her feel
comfortable enough to discuss her interests and future aspirations. Following their first session,
contrary to his supervisor's recommendation to diagnose Tina with Attention Deficit Disorder
and explore suitable psychopharmacology, he chose to pursue a therapeutic approach instead.
Holding off on any diagnosis before he gets to know Tina more. He later diagnosed her after
getting to know her with post-traumatic stress disorder. Dr. Perry gave her and her family a ride
home one day and assisted them with shopping at a local store. While this is against typical
practices, it allowed him to better understand Tina's environment and home life. Opening his
eyes to the difficulties her family faced.
During their therapy sessions, he included activities that allowed her to lead and choose
the focus. He capitalized on spontaneous moments to introduce ideas such as patience and the
importance of careful consideration before reacting. She felt comfortable discussing various
topics, and he fostered clarification by posing questions. As her communication skills improved,
she became more receptive to feedback, which, in turn, bolstered her confidence. He often
modeled behaviors or gave explicit guidance, depending on what best fit the situation. This
method proved successful, as she began to display better behavior at school, avoiding conflicts
with peers, completing assignments, and consistently attending classes. However, despite her
school improvement, she was caught performing a sexual act with an older boy at school. Thus,
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while the treatment effectively enhanced her interactions at school and with peers, it also taught
her to conceal her sexual activities to evade trouble.
Environmental Impact on Tina's Ability to Heal from her Trauma
Risk Factors
Tina lives with her single mother and her two siblings. They struggle with severe poverty
and rely on public transportation, which is dangerous in Chicago winters, as the bus is their main
transport. They live in one of the poorest areas in the city. Her mother has introduced
inappropriate boyfriends, leaving Tina without positive male role models. Their one-bedroom
apartment was messy and had trash during Dr. Perry’s visit. Tina often stays home with her
brother after school while their mother works, feeling uncomfortable hiring a babysitter due to
past experiences. During this time, they have engaged in sexual play and typically watch TV.
They lack nearby family support.
Protective Factors
Tina’s mother consistently ensures her daughter attends all her appointments, regardless
of the challenges faced by the family. She supports her daughter and followed the school's
suggestion to have her evaluated, demonstrating her willingness to assist her the best she can
through her trauma. Tina is actively participating in therapy and treatment, and her school
routine keeps her engaged and connected with her peers. Recently, the family relocated to an
apartment closer to the clinic, making appointments just a 20-minute bus ride away. When the
children are home alone, their mother has provided an emergency contact for them to contact if
necessary.
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References
Harris, B. N. (2018). The deepest well: Healing the long-term effects of childhood
adversity. Houghton Mifflin Harcourt
Perry, B. D., & Szalavitz, M. (2017). The boy who was raised as a dog: And other stories from a
child psychiatrist's notebook: What traumatized children can teach us about loss, love,
and healing. Basic Books.
Saxe, G., Ellis, B.H. & Brown, A. (2015). Trauma systems therapy for children and teens.
Guilford Press
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