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Family Counseling Case Studies

Kay's Case: Overcoming Substance Abuse During Pregnancy

Kay is the family’s identified patient (IP). She has a history of poly-substance abuse (crack-cocaine, marijuana, and alcohol). Kay recently completed a 28-day inpatient, detoxification program, which was precipitated by her desire to be clean and sober during her pregnancy. She is approximately six months pregnant. To my knowledge, Kay is currently clean and sober.

Kay lives with her mother off and on, though her relationship with her mother is strained. Kay recently became unemployed. Her relationship with her unborn baby’s father recently came to an end, as well.

Kay has one daughter, Renee, who is seven-years-old. Kay’s mother, Brenda, stated that she is Renee’s primary caretaker. Renee’s sees her father rarely, mainly during the holidays. Kay reported a history of substance abuse in her family (grandfather, one aunt, and two uncles), but nothing else is known about the other members of her family (e.g., whether or not Kay has siblings).

After completing her 28-day detoxification program, Kay presents with a desire to engage in family counseling. Brenda and her daughter have also agreed to participate in family counseling.

When Ruth made the decision to split from her partner, Gary, she also decided to move back in with her mum so that she could take a breather and get the support she needed to get back on her feet.

“I was looking forward to moving back home with Mum, ending my relationship with Gary had been so stressful and upsetting I felt exhausted. I couldn't afford to get a place of my own and I thought being back home would help give the kids some normality.” Ruth

However, things didn’t go as smoothly as she’d hoped.

Ruth’s mum disagreed with Ruth’s decision to leave her partner, saying that she felt it was a bad move. To makes things worse, Ruth felt undermined by her mum’s treatment of her children and the rules she had put in place around things like bedtimes. Ruth would often come home to find her daughter Kimberley upset after having nightmares and her son, Alex was playing up at school.

“My mum kept suggesting I meet up with Gary to try and patch things up, I know she was only trying to help but she just didn't understand how bad things had got between us. It hurt that she didn't respect my decision to leave.” Ruth

The relationship between Ruth and her mum began to deteriorate rapidly. It was clear that everybody in the family was starting to find this new arrangement exhausting and upsetting, not least her children who desperately missed their father. However, Ruth found it difficult to address the issue with her mum - how could she maintain her authority when her mum was putting a roof over their heads?

“My mum and I kept clashing over the littlest of things, even small disagreements over allowing the kids to stay up late or eat sweets always led back to my relationship with Gary and what I'd 'thrown away'. It felt like I was either arguing with my mum or consoling the kids, I felt like I'd made a mess of everything.” Ruth

*This case study is loosely based on the kind of scenarios we work with, as opposed to a specific client. Relate never shares the stories of our clients without permission, even with names and details changed.

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