CASE VIGNETTE

Family Members:
Subject of Referral – Sally (age 6)
Subject of Referral – Flora (age 9)
Father – John (age 36)

Instructions to Standardized Client

You enjoyed a happy marriage and a good family life. The sudden and unexpected death of your wife was a complete shock and left you feeling overwhelmed with the demands of child rearing and looking after the household chores. You rely on Flora to keep house and prepare meals, noting that you did this at her age. You believe this expectation is normal as children need to learn how to take care of things.

You work nights stocking shelves at a local grocery store and the children are left on their own. You lock the door when you leave, and your cell phone number is on the refrigerator in the kitchen. The children can call you if they need help and are just fine without you in the home at night. You need to keep working to pay the rent. 

You acknowledge that the weather is getting colder and indicate that you will tell Flora to search the closet for their winter clothes. You do not understand the comment about the body odour because you are pretty sure the girls take baths before they go to bed.

Background

1. Demographic Information
   

   You have a job stocking shelves at a local grocery store and work from 7 p.m. to 7 a.m. You do not have a lot of supports. Most of your extended family live in the United States. Your older sister Joanne lives 30 minutes away by car. After Mary’s death, Joanne visited frequently in the beginning, but seldom visits now. Flora and Sally feel sad about their mother’s passing. They miss their mother and do not talk much at school anymore.

2. History of Presenting Problem
   

   At home, you are grieving for your late wife while feeling overwhelmed with the tasks of caring for your children and doing housework duties. You do not have a lot of experience with being a caregiver or doing housework, as Mary was the primary caregiver for your children and did most of the housekeeping. Financial issues are another concern, which adds to your stress. You sleep a lot, while Flora takes on a more responsible role as the older sibling. She does not like seeing you sad, so she takes care of her sister, Sally. An underlying issue is the grievance that you, Flora and Sally feel due to Mary’s unexpected passing. You have not been seeking help and have been sleeping to cope.

3. Emotional State
   

   You are visibly sad but have not sought help. You are grieving Mary’s passing and feel overwhelmed with the additional responsibilities as sole caregiver. You feel very alone.

4. Verbal and Behavioural Scripts to be Used by Client
   
   In response to supports for the family:
   

• “I don’t need any support. We’re doing fine on our own.”
• “Joanne would visit me and girls at the beginning and that was great. But I don’t want to be a burden on her. She has her own family to care for. She already helped enough.”

Regarding Mary’s death:

• “I don’t know why this has happened…”
• “Mary did everything at home. I don’t know what to do without her.”
• “I don’t know how to talk to the kids about their mother… so we don’t talk about it.”

Neglect concerns:

• “I just feel so tired and overwhelmed all the time.”
• “Flora has really helped out a lot around the house. She looks after Sally and prepares the meals for her.”
• “I’ve been having trouble with my sleep lately, so I’ve been taking a sleep aide. It’s so effective that sometimes I don’t wake up until noon, and the children have already gone to school on their own.”