Case Study

Read the case study located in the Assignment Worksheet section below.o Assume the role as the Public Relations Director for Purple Cross of North Carolina. The CEO requests that you interview the Telehealth Director about the use of Telehealth with Mrs. Smith. The CEO requests that you create one thought-provoking question for each of the following topic areas:ï‚· Meeting the health needs of Mrs. Smithï‚· Decision-making process for technology selected for Mrs. Smithï‚· Benefits and risks in using Telehealth technology for Mrs. Smithï‚· Cost and staff involved in using Telehealth technology for Mrs. Smitho Note: Your questions must be original; not copied or modified from any source, including your textbook. Your questions cannot simply rephrase the above criteria. For each question, the CEO requires that you provide your rationale. Describe how the question will yield a thorough response, and not simply a “yes” or “no” answer. ï‚· Any cited sources to support your rationale statements must be identified, using APA formatting.o Prior to submission, review your responses to ensure that they contain no spelling or grammatical errors. 

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CASE STUDY

CASE STUDY

Angela is a White 17-year-old girl who is also the mother of a baby named Adam, now 11 months of age. Both Angela and her baby live with Angela’s mother, Sarah, in a small rented house in a semirural community in the Midwest. Sarah, a single mother herself, works as a food server in a local restaurant. Sarah has another child, David, who is 13. Angela’s father abandoned the family when she was 7 years old. Wayne, Angela’s boyfriend and Adam’s father, has also become estranged primarily because Sarah refuses to allow him in her house. She is angry that Angela became pregnant and views Wayne as incapable of, and uninterested in, taking on his share of the responsibility. During her pregnancy, Angela continued to attend classes at her high school. She dropped out, however, when she was 7 months pregnant. She had grown increasingly depressed about the prospect of caring for an infant, and she found dealing with schoolwork and her pregnancy overwhelming. Following Adam’s birth, Angela tried hard to be a good mother to her son. She took on most of the caretaking responsibilities by herself, which gave her some measure of satisfaction. However, she also felt deeply ambivalent. Above all, she resented the restrictions that the baby placed on her life. Adam’s frequent crying for no apparent reason was particularly frustrating. According to Angela, Adam cried even when he was not hungry or wet. Sometimes she handled Adam roughly, when he wouldn’t quiet down after a feeding or around bedtime. At other times, Angela was upset that Adam didn’t seem to smile enough at her when she wanted to play with him. Sometimes, Adam paid no attention to her when she wanted interaction. At these times, she would raise her voice and hold his face in her hands to make him look at her. She was beginning to feel that she was not a very good mother to her son after all. Sarah and Angela’s already strained relationship grew more hostile as Adam approached his first birthday. Angela felt that her mother wasn’t interested in helping her. Angela always idealized her father and believed that it was her mother’s frequent outbursts of anger that led to her father’s leaving home. For her part, Sarah believed that her daughter wasn’t doing enough to help herself. Angela chose not to go back to school, even though she could have access to school-based child care services. All through Angela’s high school years, Sarah had expected her daughter to find a steady job after graduation and to contribute to the family financially. Instead, Sarah found herself in the role of financial provider for another child. She was very angry and hurt that Angela didn’t seem to appreciate all she had done for her over the years. Whenever the mother and daughter had an argument, Angela would say that she felt her mother never really cared about her. What was even worse for Sarah was that Angela had begun seeing Wayne again, without her mother’s permission. She made it clear to Angela that she and the baby would need to move out if she ever got pregnant again.

 

Discussion Questions

1. Comment on the quality of the attachment relationship between Angela and Adam and between Sarah and Angela. Do you think that Adam is at risk for developmental problems? Discuss.

2. Using the model of intergenerational transmission of attachment presented in this chapter, discuss the transmission sequence as it applies in this case.

3. What kinds of interventions could you suggest to help the members of this family?

 

CASE STUDY

Terry and Bill, married for 5 years, are a Black couple who live in a small suburban community. Terry graduated from high school and worked as a receptionist before her marriage to Bill, a communications company manager. Because both of them believed that mothers should stay at home with young children, Terry quit her job when she had her first child, who is now an intense and active 4-year-old daughter named Dawn. Both parents were very attentive to their daughter and enjoyed caring for and playing with her when she was a baby. As Dawn got older, she became more active and assertive. When Dawn fussed, resisted, or showed frustration, Terry was patient and affectionate with her. She was able to coax Dawn out of her bad temper by making up little games that Dawn enjoyed. Both Terry and Bill liked Dawn’s spirited personality. Because her parents wanted her to have access to playmates, Dawn attended a church-related program for toddlers and preschoolers three mornings a week. When Dawn was 3 years old, Terry gave birth to the couple’s second child, a son named Darren. Soon after the baby’s birth, the family learned that Darren had a congenital heart problem that would require ongoing medical treatment and a specific regimen of care at home. Darren was an irritable baby. He fussed for long periods and was very difficult for Terry to soothe. Because of Darren’s need for medical care and the limitations of Bill’s medical insurance, the couple soon found themselves in financial difficulty. Bill began to take on overtime work at the company to subsidize some of the bills and was away from the home several nights a week and part of each weekend. Terry found the care of two demanding young children and the worries about money to be increasingly more stressful. She was always tired and seemed to have less patience with her family. whereas she once had the leisure time to read to Dawn, to take her for walks, and to help her master tasks that proved frustrating, Terry now had to shift her attention to the care of her medically fragile infant. Because Dawn looked so grown-up compared to the vulnerable newborn, Terry began to perceive her daughter as able to do many things for herself. When Dawn demonstrated her neediness by clinging or whining, Terry became abrupt and demanded that Dawn stop. Many battles revolved around Terry’s new rule that Dawn have a nap or “quiet time” each afternoon so that mother and baby could get some rest. One day, Dawn’s preschool teacher, Mrs. Adams, asked to speak with Terry. Mrs. Adams noted that Dawn’s behavior was becoming a problem in the morning preschool sessions. Dawn had begun throwing toys when she became upset and often refused to cooperate in group activities. Terry was greatly embarrassed to hear about her daughter’s misbehavior. Dawn was the only Black child in the small class, and her mother wondered if this was part of the problem. When Terry got home, she put her tearful, clinging daughter in her room for time-out for being bad at school. She loved Dawn, but she could not tolerate this kind of behavior, especially when Darren needed so much of her time. She began to wonder if she and Bill had spoiled their daughter. Terry feared that Dawn would have problems when it came time for her to enter kindergarten if they didn’t take a strong stand with her now.

Discussion Questions 1. Explain Dawn’s behavior from an attachment point of view. How would you describe Dawn’s attachment history?

2. Describe Terry’s parenting style. Has the style changed? What suggestions would you make to Terry and Bill about handling this problem?

3. What are some of the contextual influences on Dawn’s behavior?

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