Medical Conditions and Evolving Concerns

Part A 

From the counselor’s perspective, various issues can be determined from Lisa’s scenario are that she neglected her three children both physically and emotionally (emotional and physical neglect) as a result of drug and alcohol addiction. Physical neglect includes failure to provide her children with basic necessities like shelter, food, and clothing, and security (Physical neglect, n.d). Additionally, it involves the rejection and expulsion of the children from home, abandoning the children, and failure to properly provide them with parental supervision and guidance (Physical neglect, n.d). Poor hygiene, dressing inappropriately, and being overweight/underweight are some of the signs of physical neglect among children. Physical neglect in children may manifest severely by affecting their entire health/wellbeing. Some of the common effects of physical neglect are malnutrition and emotional, mental and psychological problems in the affected children. This may lead to the development of low self-esteem in these children. In Lisa’s situation, this may expose the children to the prospect of indulging in substance abuse and alcoholism just like their mother. According to Physical Neglect (n.d), there is an increased likelihood of these children going into anxiety and depression as they grow which increases their chances of involvement in crime and violence. This is because physical neglect exposes them to violence and low self-esteem.

Emotional Neglect means failure by the parent to provide their children with emotional support as expected of them. According to Barry et al. (2016), Emotional Neglect entails parental failure to show attention, affection, and being unresponsive to the child’s emotional requirements. This makes the child feel unwanted and undeserving or unworthy of their parent’s attention. They may not understand, differentiate or appropriately express emotions and later on control and cope with them if their parents fail to teach them on how to do it. Therefore, emotional neglect may negatively impact the development of the child psychologically. Some commonly observed signs of emotional neglect are poor self-esteem, perfectionism, and increased rejection sensitivity (Summers, 2016). Toxic stress (2018) outlines that the child may be exposed to toxic stress response when they are victims of prolonged, strong, and frequent physical or emotional abuses. The high-level stress can disrupt the development of the child’s brain which will lead to cognitive impairment in their later life. These experiences in children increase their likelihood of developing health problems such as diabetes, heart conditions, depression, and drug and substance abuse. Various research studies show that response and caring parents may reverse or avert the negative effects of toxic stress (Toxic Stress., 2018).

For Lisa’s situation and her children, for her to be a responsible parent again, starting with drug rehabilitation and parenting classes will be a great idea. The parental classes will equip her with the needed education and coaching on how to take care of her children properly. Drug rehabilitation involves giving Lisa addiction counseling which will enable her to understand the negative impacts of drug and alcohol addiction to her mind, body, family, and her general life. Through it, she will be able to get out of this problem as she will have someone who understands her situation and who is willing and ready to see her get over her condition. The plan I would implement will be working in close relation with the foster parents. Given their age, the children are in a position to explain their situation back at home and while in foster care. The plan will entail working with the family and foster care system to have the children enrolled in after-school programs; cognitive programs, peer mediation, and socialization.

Part B 

Below is an intake form that would be used during an initial meeting with Lisa’s children to get a clear view of their problems at a personal level.

Name: Justine DOB: 2010

Me: Hello, I am Michael Smith. What is your name?

Justine: I am Justine.

Me: Who do you live with, in your home?

Justine: My mother and my two siblings.

Me: Do you find school enjoyable?

Justine: Yes, but we don’t go every day because my mother wakes up late and as a result, we miss the bus to school.

Me: Does she sleep early?

Justine: No, she doesn’t. Her friends usually come to our house and they stay until late in the night, shouting and making a lot of noise.

Me: Do you and your siblings eat?

Justine: Yes, we do it when there is food in the house. But mom does not cook for us, leaving me with the responsibility to prepare our meal. But we don’t have enough food.

Me: How often do you shower and change your clothes?

Justine: Not every day and even when I shower I do not have clean clothes to put on (sounds irritated by the questions).

Me: Do you think it is your mom’s responsibility to do all these things?

Justine: Yes, but she does nothing apart from drinking, sleeping, and shouting at us.

Me: When last did she tell you she loves you or even hugs you?

Justine: She does not do that. She shouts at us even when we try to inquire something from her.

Me: Sorry for your situation but I want you to know your mother loves all of you only that she is having a small problem and we will give her the necessary help after which she will come back to you guys after she gets over this.

Justine: So, what will happen to us before then?

Me: You will stay with a good family, and they will give everything that you need

Name: Joshua DOB: 2013

Me: Hello, I am Michael Smith. What is your name?

Joshua: I am Joshua.

Me: Hello Joshua, can you tell me about your family?

Joshua: I stay with mom and my sisters, Justine and April.

Me: Do you like school?

Joshua: I enjoy it.

Me: How often do you attend school?

Joshua: When mom gets up and wakes me up early.

Me: So does mom wake up early every day?

Joshua: No, most of the time she is late and we miss school.

Me: What do you think is the reason she oversleeps?

Joshua: Because she stays up late talking with her friends.

Me: Do you and your sisters have breakfast, lunch, and supper daily?

Joshua: We eat in the morning before leaving for school and Justine cooks for us when there is some food in the house.

Me: Do you shower every day and before going to school?

Joshua: Not every day and my classmates laugh at me saying I smell bad.

Me: What do you think of all these?

Joshua: I am very sad about it and hope mom will start loving us.

Me: What you make you sad?

Joshua: Most of the time we are hungry and mom shouts at us and I feel she does not love us.

Me: Don’t worry Josh, your mother loves and cares about you only that she needs some small help and she will be there for you.

Name: April DOB: 2014

ME: Hi, what is your name?

April: April.

Me: Who do you live with at home?

April: Mommy, Justine, and Joshua.

Me: Do you go to school?

April: No.

Me: What about Joshua and Justine?

April: Yes, but not every day.

Me: Does your mom wake up early?

April: No, she wakes late.

Me: Why?

April: She drinks a smelly, adult-juice which makes her tired and angry at us.

Me: Does she love you?

April: She does not. She loves sleeping.

Me: Does your mom cook for you?

April: Sometimes, when she has not taken her juice.

Me: Thanks April. I just want you to know your mom loves you, Joshua, and Justine. We are helping her to stop taking that juice and she will come back to you guys.

Through the above discussion, it is clear how detached these children are from the outside world and their mother. They do not get any support emotionally and do not socialize properly and they are more likely to develop depression and anxiety. The conversion reveals a lot of how much the mother has failed in providing parental care to her children apart from the shelter. Justine who is the eldest among them appears to be the most affected as she understands more and she has assumed the parental responsibility of taking care and cooking for her siblings despite her tender age. Consequently, it may be difficult to convince her that her mom has changed for the better after the rehabilitation program.

Despite their tender age, the children are in a position to distinguish between wrong and right. Their young age provides them with a better chance of getting over these problems which they were exposed as they were growing with their uncaring mother. All the three children should be placed under counseling to enable them to state their issues to someone who will listen to them without judging them as they live in a safer environment. Staying with someone who understands them and who ensures all their needs are met will be a good way towards their recovery.

The treatment plan for the children will entail the provision of therapy sessions that include cognitive-behavioral therapy, play therapy, and family therapy (Barry et al., 2016). While play therapy will help in improving the learning and communicative process, family therapy will assist them to improve their communications with each as they resolve problems among themselves and strengthen the bond between them. Cognitive-behavioral therapy will provide treatment to psychological and emotional problems due to emotional and physical neglect.

References

Barry, C. L., Goldman, H. H., & Huskamp, H. A. (2016). Federal parity in the evolving mental health and addiction care landscape. Health Affairs, 35(6), 1009-1016.

Physical Neglect. (n.d.). Retrieved from https://abuseandneglectdefense.com/physical-neglect/ 

Summers, D., MA. (2016, February 18). How to Recognize and Overcome Childhood Emotional Neglect. Retrieved from https://www.goodtherapy.org/blog/how-to-recognize-overcome-childhood-emotional-neglect-0218165 

Toxic Stress. (2018). Retrieved from https://developingchild.harvard.edu/science/key-concepts/toxic-stress/