Case Study of an Abused Child

This paper is an examination of a case study of a mother and her young daughter who are presenting for treatment, initially as a result of the daughter's alleged sexual abuse by the mother's boyfriend. The daughter is the primary patient, but her relationship to the larger system of which she is a part is relevant to the case and to the course of treatment. Using Urie Bronfenbrenner's ecological model provides the opportunity to examine the context of the child's case, the extent to which she is at risk for future problems, the suggested course of treatment, and the additional information needed to treat her and her mother effectively. This case offers an interesting example of many of the kinds of issues and questions faced by professionals dealing with child guidance psychopathologies and family contexts.

Carrie and her mother Joanna (both names are pseudonyms) have been ordered into treatment by the court after the social workers and judge on their case determined that Carrie's allegations of sexual abuse were true. When evaluation began, Carrie was 5 and a half years old, and Joanna was approximately 24 years old. Joanna, who married at 18, is divorced from Carrie's father and estranged from him.

At the time of the referral, Joanna had been living with her boyfriend, Jim, for about a year. His molestation of Carrie had begun approximately six months earlier. The child had not told her mother at first because Jim had threatened her; when she did confide in Joanna

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out such discovery and a systematic approach to confronting these early traumas, Carrie will probably not ever be able to function in an emotionally healthy way. Interestingly, therapists' conclusions that Joanna was herself sexually abused point to some relevant considerations that may help treating both mother and daughter. These considerations may also explain some of the current psychopathologies present in both individuals. Sandra G. Boodman (1998, May) points out that childhood traumas and maladaptations are frequently repeated in later generations; children of dysfunctional families tend to create dysfunctional families of their own that follow the patterns they themselves learned growing up (p. WH7). Joanna has given Carrie the only kind of childhood she knows. In this respect, the judge's order that Joanna return to live with her mother, however well meaning, may actually put both Joanna and Carrie at greater risk. Carrie's therapists should meet with Joanna's mother to determine the potential danger inherent in being placed within what may be another destructive ecology. Jonathan B. Kotch and his colleagues (1997, November) note that abuse in all forms in likely to continue in situations of higher life stress and

Category: Psychology - C