Case Presentation: Ginny
Complete an 8-10 page paper using the questions at the end as
a guideline. Please include relevant literature to support
your assessment of Ginny.
You receive a call from Ginny, a 21 year old female, married
since 2010 to Alex, 25 years old. You had previously seen
Ginny 3 months after the stillbirth of her first child, at 7 months
gestation. You worked with her over 3 months, with her
husband attending a couple of sessions. She was very sad and
tearful at the death of her baby in 10/10; she had difficulty
sleeping and had no appetite. She had reported heavy drug use
during the first 3 months of the pregnancy and felt responsible for
the death. She had been using drugs when she had called you
after the birth. You had recommended that she go through a
drug treatment program, but her insurance would not cover the cost
of an inpatient program.
At this time, Ginny has a 2 month old son, Matthew, who is a
very fussy, colicky baby—he screams all the time, sleeps for only
short periods of time, and refuses to be consoled. He wants
to be held all the time, does not eat well, and has gained very
little weight. He was born at 8 months gestation and was
considered low birth weight. Ginny had dropped out of high
school in her junior year, moving out into Alex’s apartment.
She had been working on her GED but hasn’t gone back to her classes
since Matthew was born. Ginny also discloses a pattern of
compulsive eating and dreams where she feels she is being
smothered.
She has recently been attending a local church, and has found
their emotionally intense worship services to be very uplifting,
but is concerned that the pastor has told her that she can’t join
the church unless she is willing to tithe and to give a love
offering to support his community outreach work. She has
given him her extra money each week, but it is coming out of her
food money. She has been to a weekly prayer group at the
church, and finds the women in the group to be very
supportive. She has gone out for coffee after the group once
or twice with two of the women, one of whom she knows from the
neighborhood. She has invited a friend of hers to go with
her; the two women have known each other since Ginny left home.
Alex works as a night manager at a local 24-hour restaurant
and sleeps during the day. He was very frustrated with Ginny’s
reaction to the first pregnancy, and can’t sleep at home with
Matthew’s screaming, so he’s moved out and is sleeping at a
friend’s house. He has a high school diploma. He hangs
out with his friends from high school on the weekends—they all
drink heavily at these gatherings, and occasionally use
drugs. Alex believes that his job has no opportunities for
advancement and would like to do something else, but when he has
tried to get other opportunities, his lack of higher education has
held him back. He has talked about going to the local
community college, but when Ginny got pregnant with the second
child his plans got put on hold.
Ginny’s mother and father were separated when she was in high
school; her mother is an alcoholic, but refused to get
treatment. Her father was a brittle diabetic, and was in and
out of the hospital with wild fluctuations in his blood
sugar. He died a month after the miscarriage of her
first child. Ginny has no contact with her mother, who
was physically abusive to Ginny and her younger sister, Amy, while
they were growing up. Amy ran away from home after Ginny
moved out and went to live with her father’s younger sister in
another state. Ginny keeps in touch with Amy sporadically.
Alex has an older brother (35) and an older sister (40), who
are both professionals, married; and living in 2 different
states. He has little contact with them. His father
(69) was a steel worker, who was laid off when the mills closed
down in the 80’s. He reportedly smoked and drank a lot and
spent his free time with his buddies from work. According to
Alex, his life centered on sports, and he regularly played the
numbers using the neighborhood “bookie”. He is now in a
nursing home, with severe emphysema. His mother died of a
stroke in 1996 when she was 65, a month before she was going to
retire from a lifetime of working as a bookkeeper for her older
brother’s appliance repair shop. She had always dreamed of
traveling around the country after her retirement, and had been
saving up for a small RV with the money her husband won on the
numbers. She was a heavy smoker. Alex has been close to
his parents, but rarely visits his father since he was
institutionalized after his mother’s death.
Alex wants to be more available to Matthew, and dreams about
playing ball with him when he’s older. He does not know what
to do with him now when he’s crying; he has never been around
babies before and thinks that he might “do it wrong”. He has
expressed hope that he and Ginny can work things out and dreams
about a life when he has a good day job, and Ginny can work
part-time and take care of their son.
Ginny would like to talk to you about the problems that she’s
having with her life right now—it feels like everything is out of
control. When you talked to her on the phone, she was
tearful, and said, “I don’t know how much longer I can go on like
this”.
Questions for Assessment
1. What persons and systems are involved in
Ginny’s life? Complete an eco-map.
2. How and in what way are the participants
involved?
3. Identify unmet needs or wants.
4. What developmental stage or life
transition is relevant to this case situation?
5. Identify the problematic behaviors
present in this case scenario. What meaning do the clients
ascribe to the various identified problems?
6. How has the client attempted to cope
with her problems, and what are the required skills to resolve
them?
7. What are the skills and strengths of the
client?
8. What external resources are needed?
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