In exploring options for a family interview, I realized a family is what it is and that it does not follow a specific format. It wasn’t until I experienced the Introduction to Marriage, Couples and Family Counseling that I realized this idea. The family I interviewed is nuclear based and consists of a mother and a son who live in the same house. Although I thought this may pose some challenges as the interviewer, considering that perhaps most people were interviewing couples, when the opportunity presented itself to interview this particular family, it became clear that indeed this was the family that I would interview. Perhaps I even discovered more about this type of family than I was expecting since it is different than the families I have been exposed to, including my own. Of interest to me was the living arrangement of this family whose two only sons (ages 25 and 31), were both unmarried and living at home with the single mother.

Wanda (pseudonyms used to conserve identity) is the mother and is a single 46 year old of Puerto Rican decent. Wanda attended grammar and high school in the United States and therefore considers her primary language to be English. In exploring background information, Wanda shared with me that she became pregnant with her first son at the age of 15 and was 21 when she gave birth to her second son. The relationship with her sons’ father fizzled and so at More

Client’s Presenting Problem

Melanie is a 26-year-old Hispanic female who came in for group counseling 10 weeks ago with a presenting problem of driving under the influence of alcohol in which she lost her drivers license and was mandated to come to treatment. Melanie was referred by IDRC (Intoxicated Driver Resource Center) to mandatory substance abuse group treatment as part of the sentence. In her own words, the reason for her seeking treatment now is because, “of a DUI.” The legal pressure has taken predominance in her decision to coming to counseling now. Although Melanie’s initial treatment plan was to attend substance abuse group counseling one time per week, one-to-one counseling one time per month, and AA meetings for total of 16 weeks, she eventually accepted one-to-one counseling one time per week (instead of once per month) approximately eight weeks into her prescribed treatment plan.

Melanie is a full-time college student attending nights while also working full-time for a rental car company. She is a first generation American of Puerto Rican descent. She reported during the intake that feels like she is going “crazy in my head.” When asked how long she has been feeling this way, she said she has always felt stressed most of her life but now feels completely inundated by it especially when she thinks she is being treated like a criminal when all she did was “go out with a couple of friends for a drink.”

Melanie initially did seem apprehensive and resistant, especially during the first couple of weeks of treatment. She has a history of participating in individual counseling about one-year ago for “stress” in which she voluntarily sought treatment. In terms of the family history, she reported “I have a lot of crazy people in my family so I know my depression is inherited, but I don’t think anybody has ever gone to treatment for it.” When asked to elaborate about her family, she said it was “crazy.” There is a history of alcohol use by her father stating, “When I was younger he drank a lot and I remember when he would vomit on the bathroom floor and I would tip toe around it to be able to use the bathroom.” She said her father stopped drinking for “a while and it seems he has been picking up the habit once again since my mother left him.”

Melanie currently lives in an attic apartment and has been living alone for the last four years. Prior to that, she lived with her parents until they were divorced and sold their house. Her mother moved to Florida after the divorce. Melanie’s parents separated because her father was too demanding and her mother became “fed up with it, just like the rest of us.” She said she does not really get along with her father as well as she does with her mother. She has an older sister who is 30 years old and says she has a good relationship with her. Melanie’s maternal grandfather and uncles are also alcohol dependent.

In terms of her job, she has been working for a rental car company for about four years and has managed to move up the corporate ranks in which she started off as a receptionist, and has been promoted to a position as a Liability Representative. She says this position is financially rewarding considering that she does not have a degree yet but feels she is extremely stressed when negotiating accident cases with attorneys. This issue is pertinent to the presenting problem in that this new position which she has occupied for 8 months is overwhelming her while dealing with her own legal problems. Additionally, her job is currently in jeopardy due to this violation on her driving record. As per the client, she may lose her job because in order to work for a rental car company one needs to have a clean driving record in which they randomly check every so often. Currently, her place of employment is not aware of this violation as she is afraid to report it.

Melanie has no history of sexual and/or physical abuse or neglect although she did state her father was somewhat, “mentally abusive and nothing was ever good enough for him.” She said her father always complained about everything and was never happy.

In terms of her social history, Melanie says she does not really have a lot of “close” friends because she “too busy with school, work, and now this.” She says she is trying to expand her social life but feels people already have their “cliques” and trying to fit in, she finds, too challenging. She says she tries to go out with her cousin and his friends but still feels like she has to kind of work too hard to belong. She also reports having difficulties in maintaining romantic relationships stating, “I always feel like I need to be in control.” She says that when a relationship does not work, it is usually due to the guy not wanting to spend time with her or she feels suffocated in the relationship. According to her, she does not ever find a happy medium in relationships except in the beginning of a relationship. She also stated she wishes she had more people around her and it would help to have a little more family that she can lean on.

In regards to her feelings and thoughts about being in treatment now, she says she feels “kind of embarrassed” to be in substance abuse counseling because she does not want people to think she is “a junkie.” She also reported having difficulty sleeping because she lies in bed and just thinks to the point where instead of relaxing, she feels more anxious. She also finds school quite challenging because she is unable to fully concentrate stating, “I really like school and I usually get good grades but I’m just not into it this semester.”

Statement of Problem

Part of what is happening with Melanie seems to be connected to anger. She seems extremely angry at the things she has experienced in her family especially with her father. I believe she has chosen to inundate herself with a lot of activities as a way to not directly deal with what she is experiencing internally. She has apparently lost control as she has admittedly reported she feels the need to be in control. Her experiences at home as well as with her relationships with men seem to have always been tumultuous as she dates men with substance abuse problems, except with her most recent relationship.

She is able to identify some role these substances are playing in her life; however, she is experiencing difficulties understanding how these substances have contributed to many of the problems in her life, including her suspension of driving privileges, potential job loss, and relationship problems. She has mostly utilized anger as a defense and seems to feel somewhat controlled by this feeling where she “drinks” and smokes marijuana in order to calm and soothe herself. She has poor problem solving skills as she seems to continue to make poor life decisions. Her need to control is somehow jeopardized as she is mandated to be in counseling which was not part of her plan. She is obliged to participate in something, which is similar to what she experienced with her father’s authoritative and dominant treatment with her. This enrages her.

DSM-IV Five Axis Diagnosis

Axis I:    304.30 Cannabis Dependence

DUI (reason for visit)

Axis II:   799.9   Diagnosis Deferred

Maladaptive Use of Anger

Axis III: None

Axis IV: Problems related with the legal system, Problems with primary support group, Problems related to the social environment, Occupational problems

Melanie’s Treatment Plan