CASE STUDY 7:  Chance is a lanky 15-year-old grade 10 Portuguese Canadian student at a large (3,000-student) inner-city public high school for the Arts & Sciences. He has recently come to the attention of the school’s Attendance Officer for persistent truancy. At a school mandated parent conference, Chance’s parents revealed that Chance had been caught and charged with shoplifting at a nearby mall, and has been involved in several acts of vandalism in the larger community. His parents are afraid that Chance is involved in more than truancy, shoplifting and vandalism, and accept the Attendance Officer’s referral to an interdisciplinary Family Clinic for assessment and possible intervention. According to Mrs. Day, Chance’s mother, her relationship with Chance has gone from warm and friendly to constant anger and rage. She believes that the change in their relationship is directly related to her finding Chance and “a little slut” naked in his bed during school hours. Mr. Day counters that Chance is not appreciative of how hard he works to provide for them. He feels Chance only communicates when he wants money. Mr. Day also suspects Chance is using drugs, as he once caught him smoking pot. He suspended his allowance as a consequence, but did not pursue the matter because Chance promised him he’d stop. Documentation from Chance’s teachers indicates a gradual decline in his grades over the last year, with Chance frequently falling asleep in class. School performance and attendance has been the least of Chance’s problems. He plans to quit school the day he turns 16, and does not see the need to continue to study. He thinks the last time he attempted any schoolwork was at the beginning of the 10th grade – last semester.  Chance claimed both parents were too busy with their lives and were only doing this assessment because they worried that he would embarrass them. Chance does not communicate with his parents, and appears to ignore all their “rules”. The parents communicate with Chance only to yell at him or admonish him about things that he has or has not done. They continue to use their social influence to “bail” him out of his acts of delinquency. They feel they do not know this “monster”, and seem to see him as a threat to their younger son Harley. They want him “fixed” so they can have the old Chance back. Parents appear to have a strong committed relationship to each other, as well as memories of positive times with Chance. As an alternative to being charged with truancy, Chance and his parents agreed to follow through on the referral. Mr. Day has already arranged for Chance to meet with the judge in private chambers so that he can do community service in lieu of detention for the incidents of shoplifting and vandalism. Chance has agreed to this, and will work two evenings a week at a homeless shelter. His only emotional expression is a careless shrug. Chance admits to using pot, but feels that he is in control, as he only smokes late at night so that he can “sleep it off”. He also admitted to drinking close to a liter of vodka every couple of weeks just because it made him feel good. Chance has an older “friend” purchase the vodka and has been able to get a reliable and inexpensive supply of pot at school. Chance revealed that he has been sexually active since he was 14, but felt that he didn’t need protection against pregnancy because he was too young to get anyone pregnant. He has had several sexual partners, some he didn’t know. He now has a special girlfriend who is almost 14. They engage in sexual intercourse at her house or in his bedroom about three times a week. They never use protection.

CASE STUDY 12:  New Horizons is a group home that operates a therapeutic program in a large, city in Western Canada.  The program serves adolescent youth 13 to 17 years of age that are at-risk of serious emotional and behavioral problems.  The program serves both males and females. The backgrounds of the youth include broken families, school truancy, and shoplifting to being in provincial custody as a result of neglect, abuse and abandonment issues.  Many of the youth receive counseling and substance abuse services, and some of them are on a daily regimen of psychotropic medications.  Their assessments and diagnoses include ADHD, conduct disorders, oppositional-defiant disorder, mild depression, and a general deficit in educational achievement and personal development.  They tend to be impulsive, to have short attention spans, low frustration tolerance, low self-esteem, and a defensive response to authority figures. Problem-solving skills are limited for many of them as well.  Most of the teens in the program have had limited opportunities to be out of the city.  The program provides daily care and supervision, after school tutoring, mentoring, family crisis support, and recreational opportunities. Harry, a Youth Worker at the New Horizons home, had successfully secured a grant to plan and execute an extended summer camping trip for the residents.  Harry came to the program with extensive experience and skills in working with at-risk youth both in the community setting and in outdoor, adventure-based programs.  He wanted to include the following activities in the trip: low impact, back-country camping; river and lake canoeing; water and canoe safety; swimming; first aid instruction; food preparation; environmental awareness activities; journal writing; and group initiatives/challenges fostering cooperation and teamwork, problem solving skills, leadership development and personal growth.

In the first meeting that you have with Chance’s family, as the assigned family support worker, Chance tells his parents, “it’s not Portugal, they do things differently here,” and you realize that you know nothing about Portugese history, culture or what it’s like to be a first or second generation Portugese Canadian. Your focus for intervention at this point is developing the relationship and understanding the family dynamics. What is the best way for you to understand how being a Portugese Canadian family has influenced the dynamics between parents and children?

At what stage do adolescents typically form exclusive romantic relationships?

Which term refers to adolescents’ belief that their experiences are unique?

This semester, we conducted several simulations on religious diversity and humility in healthcare. Define religious humility and explain why religious diversity is important in healthcare. In your essay, reflect on three simulations. How did the students demonstrate religious diversity and humility in healthcare? If they did not demonstrate it, what improvements could they have made? (Include references to the simulations and the groups you took notes on). (Your essay should be 250-500 words).

Which parenting style is associated with high warmth and high control?

What type of play involves children working together to achieve a common goal?

Four youth experience the same disappointing situation.  All are visibly upset.  Fred goes to his room and starts beating his pillow.  Mary writes a lengthy and angry entry in her journal.  Sally voices her angry feelings loudly to her roommate.  James shrugs it off stating “no big deal” and refuses to participate in any other activities with the group.  Which of the youth is using the LEAST BENEFICIAL response to the stress?

What is the most common sleep-related problem for adolescents?