Simulation 9 Flashcards
(37 cards)
You are a Children’s Protective Services agency counselor taking a
weekend call. You were contacted by the ex-wife of a 42-year-old man named Jerry (the identified client). Divorced five years, Jerry had dropped off the children at her home on a Friday night, after a week-long vacation on a summer houseboat at a local lake. The wife was to keep the children over the weekend. Jerry was to return the next Monday and pick up the four children—ranging in age from 5 to 15— for the second half of his two-week summer vacation with them. He dropped by the next evening to wash some laundry (at her suggestion, as he was out of state from his home). At that time, she noted Jerry was behaving rather bizarrely. He rushed into the house, hurriedly shut the door behind himself, and then began drawing the curtains in the front room. He claimed he was being followed by some sort of clandestine law enforcement group intent on arresting him. When she tried to look outside, he pulled her back saying “it might not be safe.” Staying only a few minutes, he hurried out the back door, got into his car, and sped away. Looking outside, she could see nothing. Her questions of you: What is happening, and is he safe to take the minor children for another week?
You are a Children’s Protective Services agency counselor taking a
weekend call. You were contacted by the ex-wife of a 42-year-old man named Jerry (the identified client). Divorced five years, Jerry had dropped off the children at her home on a Friday night, after a week-long vacation on a summer houseboat at a local lake. The wife was to keep the children over the weekend. Jerry was to return the next Monday and pick up the four children—ranging in age from 5 to 15— for the second half of his two-week summer vacation with them. He dropped by the next evening to wash some laundry (at her suggestion, as he was out of state from his home). At that time, she noted Jerry was behaving rather bizarrely. He rushed into the house, hurriedly shut the door behind himself, and then began drawing the curtains in the front room. He claimed he was being followed by some sort of clandestine law enforcement group intent on arresting him. When she tried to look outside, he pulled her back saying “it might not be safe.” Staying only a few minutes, he hurried out the back door, got into his car, and sped away. Looking outside, she could see nothing. Her questions of you: What is happening, and is he safe to take the minor children for another week?
What unusual behavior did Jerry display when he visited his ex-wife?
He rushed into the house, shut the door, drew the curtains, and claimed he was being followed by a clandestine law enforcement group.
This behavior raised concerns about his mental state and safety around the children.
What was the duration of Jerry’s cognitive/behavioral changes?
Approximately 48 hours.
Jerry exhibited paranoia and disconnection from reality during this time.
What mental health diagnosis did Jerry receive after his military service?
PTSD.
This diagnosis was given shortly after he was discharged from active combat duty.
What did Jerry’s ex-wife suspect about his health-related behaviors?
She suspected he had hypochondria due to his frequent doctor visits and complaints about various health issues.
This included claims of heart problems and injuries.
What concerning financial behaviors did Jerry engage in after his divorce?
He engaged in financial fraud, including credit card fraud and forgery.
This behavior led to the ex-wife taking her name off financial accounts.
What substance abuse history did Jerry’s ex-wife report?
She noted unexplained expenditures and suspected drug abuse, including potential polypharmacy issues.
Concerns were heightened by his significant weight loss.
What was Jerry’s level of education?
He has a two-year college degree.
This information was deemed not immediately relevant to the situation.
Why was the date of Jerry’s last medical exam not indicated as relevant?
He is relatively young and healthy, with no recent hospitalizations.
He claimed to have seen a physician prior to dropping off the children.
What intervention was deemed necessary regarding Jerry’s situation?
Contact collateral sources, such as friends who voiced concerns about his behavior.
This would help to gather more information about his mental state.
What was the outcome of the Folstein Mini-Mental Status Examination administered to Jerry?
He scored 30 out of 30, indicating no cognitive compromise.
His grooming and hygiene were appropriate, and there were no signs of psychosis.
What was Jerry’s response when asked about substance abuse during the evaluation?
He denied any past history of illicit substance abuse.
This was contrary to his ex-wife’s detailed concerns.
What was the primary concern regarding Jerry’s behavior during the weekend?
His mental state and potential danger to the children due to paranoia and erratic behavior.
This led to the involvement of Children’s Protective Services.
What intervention was considered but ultimately not indicated regarding drug testing?
Requiring Jerry to submit to drug testing.
This would require a court order, which was not feasible in the given time frame.
What did Jerry claim as reasons for his unusual behavior during the weekend?
He attributed it to being tired, a relapse of PTSD, or a reaction to medication from a medical imaging study.
His explanations varied and were met with skepticism.
What was the children’s reaction to their father after his return?
They seemed relaxed and comfortable in his presence.
This reaction was within normal limits according to the evaluation.
What should be evaluated during the meeting with Jerry?
Current prescription medications and inquiry into his recent weight loss.
These factors could provide insight into his mental and physical health.
What medications did the client acknowledge taking recently?
Prescription muscle relaxants for a back strain.
What was the children’s reaction to their father?
The children seemed relaxed and comfortable in his presence.
What effort did the client indicate regarding his weight?
He made a deliberate effort to lose weight since becoming involved with a new romantic interest.
What is typically required for non-custodial parents when taking children out of state?
Written permission from the custodial parent.
What was noted about the father’s vacation itinerary?
It was presented as reasonable and safe for the period involved.
Was the financial stability of the client indicated as significant in this situation?
Not indicated.
What signs did the client show when discussing his previous psychiatric events?
Some signs of agitation and minimizing the significance of his experiences.
