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, her mother dismissed her accusations. Only when a school nurse discovered the abuse was any official action taken.
The courts ordered Joanna to move in with her mother and to begin therapeutic treatment for herself and her daughter, and order she deeply resented. Part of the reason Joanna did not believe her daughter and felt official intervention to be an intrusion was due to the fact that Carrie had begun exhibiting highly sexualized behavior severa...