emotional state

CASE STUDY

Lupe is a 45-year-old Mexican American woman. She has two adult children, a son and a daughter, as well as one granddaughter. She lives in a small apartment near her mother, now in her late 60s. Lupe visits her mother several times a week to check on her health and her emotional state. Although she is relatively self-sufficient, Lupe’s mother expects this kind of attention from her daughter. Lupe has always been very responsible and concerned about the well-being of her family members. Even though this takes a lot of her time, she faithfully attends to her mother’s needs without complaint.

When Lupe’s children were young, she and her children’s father lived together. He left the family after a few years, however, because he found the stress of family life to be overwhelming. In particular, he felt that he could not make enough money to support two children. Although he and Lupe were never legally married, she considered them to be a “married” couple. Single now for 16 years, she feels that she would like to meet someone with whom she could share her life. This is a new feeling for Lupe. Until recently, she was too distracted with the problems of raising her children to think about herself. Now she feels that she only has a limited amount of time left to pursue some of her own wishes. She can envision herself, like her mother, old and alone, and that prospect disturbs her. She has started to attend social functions at her church and has accepted some social invitations from members of the congregation. Lupe feels comfortable with this approach, because she is very close to the members of her parish community.

Lupe’s life has recently become more complicated. Her daughter, Lucia, and her 2-year-old granddaughter, Eva, have moved in with her. Lucia and her boyfriend, Tomas, were living together and were planning to marry. Their relationship deteriorated after the baby’s birth, and the couple fought frequently. Lucia accused Tomas of spending too much of his paycheck on frivolous things. Tomas, in response, withdrew even further, spent more time with his friends, and continued to spend money as he pleased. Lucia finally took the baby and threatened not to come back.

In addition to this, Lupe was injured on her job as a practical nurse in a large hospital. She was trying to prevent a patient from falling and hurt her back in the process. She will need to receive physical therapy, which means she will be out of work for a few months. Her physician, noticing her depressed mood, referred her to a counselor at the local mental health clinic.

Discussion Questions

1.

What are the developmental stresses (age-related) and contextual stresses (nonnormative) in Lupe’s life at the present time? Consider her age, family role, and cultural context.

2.

What are Lupe’s sources of strength? What aspects of her cognitive functioning and her personality might support her resilience in the face of difficulties?

3.

What is the potential impact of Lucia’s return on her mother? On Eva? On Tomas?

4.

What advice might you give to Lupe? To Lucia and Tomas?

PRACTICE USING WHAT YOU HAVE LEARNED

In the Pearson etext, apply these ideas to working with others.

CASE STUDY

David is a 52-year-old White male who has spent the last 24 years in the human resource field. Most recently, he held the position of supervisor in the billing department of a midsized hospital in a rural state. He worked hard to obtain a master’s degree while on the job at the hospital and always had high aspirations for himself professionally David has three children from his first marriage, which ended in divorce. His first wife Anne, who is 50, works as a preschool teacher in another part of the state. Their children’s ages are 16, 20, and 22. Both older children started to attend college but may have to drop out temporarily due to financial difficulties. David feels that it is his responsibility to support his children’s education, and he has been paying as much of their tuition as he can afford. David and his second wife live in a new, but modest home in a community on the outskirts of the state capital close to David’s job. David’s second wife, Sandy, has twin 14-year-old boys. One of the twins has a serious learning disability and needs extra tutoring and a great deal of parent support to keep up academically. Sandy works part time in a department store to be home to help her sons. David and Sandy have a good relationship. Sandy’s widowed mother lives nearby and helps with the twins on a regular basis.

Recently, the hospital system that employs David merged with a large network of medical providers to cut costs and use resources more efficiently. David’s job at the hospital is becoming more complicated, requiring more and more processing of information that involves advanced computer technology. At a recent professional meeting, David learned from others in his network that many jobs were being cut and many tasks redistributed to the employees that remained. David feels that this has already happened in his workplace. He has noted a dramatic increase in the amount of paperwork required and a distinct decrease in the time allotted to meet deadlines. His supervisory responsibilities have expanded to include workers from another unit that merged with his own in a major departmental realignment. David’s direct supervisor will be retiring soon, and David will be a candidate for that position. He knows that this promotion would mean more income, but it would also mean even more work responsibility. David now spends his weekends going to the office to catch up on tasks. He is not as available as he once was to spend time with his children, and this has caused some problems in his relationship with his wife. He is starting to feel that all the paperwork his job requires is not meaningful in ways that are important to him.

David has recently begun to suffer from significant pain in his lower back that he believes might be related to a traffic accident that happened when he was younger. The pain keeps him from sleeping well and has contributed to his feeling more “on edge” during the day. David’s physician prescribes two medications to help him sleep better and to reduce anxiety. David has started to drink a few beers when he comes home at night to “calm himself down” as well. The sleep medication he has been taking helps him fall asleep, but now he wakes up at 3:00 am with his mind racing. He’s recently learned that his 16-year-old son has been cutting classes and failing tests. His ex-wife, who has custody of their teenage son, has been pressuring him to help her with this problem situation.

Discussion Questions

1.

Identify the risks and protective factors that are present in David’s life story. What information, not presented here, would be helpful to know if you were to make a more comprehensive list of risks and protections?

2.

How do you conceptualize David’s situation? What aspects are relate to his midlife stage?

3.

What treatment approach would you take if he were to come to you for help? What other behavioral changes might you s

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