Chloe is a 14-year-old Caucasian young woman from the low income, downtown Des Moines area. She grew up living with her mother and three younger siblings. Her mother is an alcoholic and Chloe was left to care for her younger siblings. Her mother’s boyfriend moved in and he quickly developed a sexual interest in Chloe when she was thirteen. Chloe’s mother was aware of the concerns with the boyfriend but blamed Chloe for engaging in this kind of behavior with him. This led to physical abuse and domestic violence in the home.
Chloe began to struggle in school and started spending time with a rough crowd. She began using substances and was arrested for possession. She was put on probation, but dropped dirty after being on probation for one month. She was sent to residential treatment. By the time she arrived, she had an open CPS case about the physical, sexual, and substance abuse in the home. This was reported by her grandmother on her mother’s side. Chloe did not believe that she needed to be in treatment, nor did she have any interest in changing her lifestyle. During the first three months of treatment she had very aggressive and disruptive behaviors with minimal emotional regulation skills.
At this point, Chloe has spent five months in an adolescent residential treatment facility for substance use and has made little progress towards her treatment goals to complete the program. She has very low self-worth and self-love. Chloe often has issues of self-harm and has been on suicide watch the majority of her stay. She does not believe that she could have a bright future or that she can choose her own path, but she wants to. The clinical team at the residential facility is trying to refer her to a mental health facility, but there are no available beds in Iowa.
The CPS case is still in progress and mom is still living with the boyfriend. Her mother is now pregnant with the man’s child. DHS has allowed the other children to stay in the home with her mother and boyfriend because the case managers believe that he does not pose a threat to them at this time. Part of what has made this case so difficult to resolve is because Chloe refuses to discuss the accusations with the DHS worker each time she is interviewed.
This case vignette is completely fictional, though intended to reflect real-world problems. Any likeness to real people is a coincidence.
Integrated Theory and Practice 