Reference no: EM133385460

Paula and Jane Stone are being referred to the social worker affiliated with the local mental health clinic because their 5-year-old son's kindergarten teacher is worried about the change she has seen in him over the last several months. Eric, the son, had been very engaged in the classroom activities at the beginning of the school year, but recently he has withdrawn from some of the activities, is getting in little fights with his classmates, and seems very angry. The teacher, Ms. G, has suggested to the parents that they bring him to the mental health clinic. As is typical in your clinic, the parents come in for the first interview without the child.

The Stones tell you that they agreed to make the appointment, but were surprised when Ms. G made the suggestion. They had seen Eric as functioning very well and having "no problems." They admit that they have been overwhelmed with the needs of their 3-year-old son Greg, who received a diagnosis of autism three months ago. Jane Stone sighs, and says, "I thought we didn't have to worry about Eric; he was the 'normal one.'"

The Stones, an African American couple, have lived in Los Angeles for the past three years having moved here from Louisiana when Paula Stone was transferred here by her company. She is a project manager for a construction company that builds apartment around the country. The move to LA was a promotion for Paula. Jane Stone was employed as a high school guidance counselor but has not worked since their move. She was on maternity leave after Greg's birth when the move happened, and she has not sought employment since their arrival.

They tell you that they felt some relief when Greg was diagnosed because they had known there were difficulties, but their pediatrician continued to tell them that they were overreacting. He assured them that "he'll grow out of it." Greg was very difficult to soothe, seemed to have strange reactions to particular scents or textures, and was often preoccupied with solitary activities. Disruptions in his schedule would result in a "meltdown." They are now in the process of going through an evaluation to determine what kind of treatment Greg will have and what his prognosis is.

You ask them more about how they are doing with all of this and they admit that they are overwhelmed. They have no family here to help out and few friends. They had been very sociable in Louisiana, but with all of the demands of a new baby and a toddler, they have not met many people. Greg was such a contrast to Eric who was a very good baby, and met all his developmental tasks early. "He was such a joy," Paula Stone comments, "I don't know what happened."

Read the vignette and answered the following questions.

1. What is your primary assessment of the child and their family?

2. How does your understanding of intersectionality play a role in your initial assessment?

3. How what more information would you need to develop a thorough case conceptualization?

4. Ideas for interventions?

5. What about any potential countertransference?