Imagine you are working in a shelter for people experiencing homelessness. There is a woman named Maria staying at the facility with her two young children. She came to the U.S. from Mexico with her boyfriend, Jose. She has a history of substance misuse, including cocaine, narcotics, and other pills. She has just left Jose because he has become increasingly physically abusive over the past few years, particularly when he was intoxicated and since he lost his job. Maria is having migraine headaches. She is becoming more impatient with her children and unwilling to push them to go to school. She lies in bed while they watch TV and tells them to go away when they disturb her. You suspect that Maria has been using narcotics bought on the street. If this is confirmed, she will have to leave the shelter because there are no drugs allowed there. Questions to guide your reflective journal writing:

What would be the risks and benefits of confronting Maria about her suspected substance misuse (aside from just her having to leave the facility)? What options for managing Maria's pain do you think would be most feasible?

Describe the psychological and cultural factors that may be influencing Maria's pain.

How would you feel about working with Maria in this situation? What attitudes, reactions, values, and personal experiences do you think might influence or hinder your working and communicating effectively with her?

Resources:

Managing Chronic Pain - YouTube

Managing chronic pain: How psychologists can help with pain management (apa.org)