Please point out 2 positives and 2 things they can do better in each part. based on original document

OG DOcument

Juno's Juno MacGuff

Introducing the Character

Juno MacGuff, a 16-year-old junior at Dancing Elk High School, is the central character in the Academy Award-winning film Juno(Reitman, 2007) about a Minnesota teenager and the poignant, occasionally humorous challenges she confronts over the course of her unplanned and unwanted pregnancy. Lauded by some critics as a feminist anthem and described by others as a powerful forum for the prolife/prochoice debate, Junoclearly stirred the hearts of millions and won box-office acclaim. Perhaps the sentiments of the film writer, Diablo Cody, best capture her creation. She noted, "You can look at it as a film that celebrates life and celebrates childbirth, or you can look at it as a film about a liberated young girl who makes a choice to continue being liberated . . . or you can look it as some kind of twisted love story, you know, a meditation on maturity." Our professional counseling view of Juno's character, including some of our own conjectures about her early years, is described in the following basic case summary and diagnostic impressions.

Basic Case Summary

Identifying Information.At the time of her first interview 7 months ago, Juno MacGuff was a 16-year-old white female who resides with her father and stepmother in Minnetonka, Minnesota, and is a junior at Dancing Elk High School. She appeared healthy, appropriately dressed for her age and context, and is of modest height, fair- skinned, and sandy-haired. She very recently revealed to her parents that she was about 2 months pregnant, but to date shows no obvious physical signs that she is pregnant.

Presenting Concern.Upon learning of their daughter's pregnancy 7 months ago, Mr. and Mrs. MacGuff immediately made an appointment for their daughter at the Minnetonka Family Services Center in order to help her decide on the best course of action as well as to provide her with a therapeutic outlet that they believed would be necessary over the coming months. The parents appeared very concerned for and supportive of Juno, but they also appeared notably distressed regarding their circumstance and, according to her mother, "the devastating effect that this pregnancy is going to have on all of us." Although Juno sat relatively quietly throughout this meeting, she asserted that "I think I'm old enough to make an important decision affecting my own life."

Background, Family Information, and Relevant History.Juno was born in Minnetonka, Minnesota, the only child of the MacGuffs. At birth and throughout early childhood, Juno experienced health problems, including cardiac and respiratory difficulties that resulted in numerous hospitalizations. According to her father's report, Juno's parents often quarreled about their daughter's care and the resulting tension led to irretrievable marital stress and a divorce that occurred when Juno was 5 years old. By that time, Juno's father had initiated a

relationship with one of his daughter's nurses at Minnetonka Regional Hospital. The couple married soon after his divorce was final. Juno's mother left town and has had only sporadic contact with the family for years (such as sending her daughter an annual "Valentine's Day cactus" in February).

By the time Juno entered third grade, her health had stabilized and she experienced normally expected, successful psychosocial development. Early written reports describe her at this time as a "vibrant, self-assured, and sociable child" who seemed to have grown immeasurably from the medical adversities that marked her earlier years. She was voted "most popular" by her elementary school peers and, by her report, eagerly moved on to Minnetonka Middle School. There, Juno's social integration was very positive and the older students regarded her as considerably more mature than her peers. She was invited to be involved in the student government and helped to establish charity efforts for the disenfranchised American Indians in the community. Juno was also described as a "fierce defender" of those whom she believed were being unfairly treated within the school and led Minnetonka Middle School's first-ever rally against bullying. Throughout her middle school years, Juno enjoyed a very close relationship with her father and moderately close relationship with her stepmother, Bren, who she regarded as "an adult who I could usually relate to."

Near the end of middle school, Juno applied for a competitive slot at Dancing Elk High School, which had a Social Justice program that was very attractive to her. By her description, much to her surprise, although not surprising to her parents, Juno was accepted after the first round. Juno described her first 2 years of high school as "the best in my life." She had a satisfying number of friends, was active on the school newspaper, and participated in several community-awareness drives. She was described in an interview with a Twin City Gazettereporter as "a promising, highly intelligent, funny, and extraordinarily wise young woman who is a

leader in her school community." As she describes the experience, on the night of the release of the interview in the newspaper, Juno and a few of her friends gathered at the gymnasium to celebrate. After the event, she and her best friend and confidant, Paulie Bleeker, had their own private celebration and in recounting that night, Juno noted, "One thing led to another and got out of hand, and before I knew it, we had had sex." Three weeks later, Juno was pregnant.

Juno reported that during the initial 2 months of pregnancy, she confided only in a few close peers. At 2 months, Juno sought the support of her parents, attended a family session here at the Minnetonka Family Services Center, and consulted her pastor. She also attempted to visit her biological mother; however, she was unsuccessful in locating her. Although not inclined to return to counseling, Juno did so for two additional

meetings at the request of her parents but held firmly that "I'm really doing okay, it's just a real big decision, and I'm not sure what the right thing to do is."

The outcome was that Juno made a determination to continue her pregnancy and pursue placing the baby for adoption. As she describes it, upon recommendation of her best friend, Juno put an ad in the local Penny Saverto see if anyone would be interested in adopting her child should she decide to carry to term. She was fortunate to find a young couple, the Lorings, who were very interested in pursuing adoption. However, shortly before the birth of Juno's child, Mr. Loring left his wife in order to pursue his music career. Three days after her 17th birthday, Juno gave birth to a healthy boy and immediately placed him in the hands of Mrs. Loring who, along with her parents and Paulie, had been in the hospital throughout her labor and delivery.

Part 1

F43.89 Other Specified Trauma-and Stressor Related Disorder

Z62.812 Personal History (Past history) of neglect in childhood

T74.02XD Child Neglect, confirmed - subsequent encounter

Discussion of Diagnostic Impression

Juno is experiencing symptoms for Other Specified Trauma-and Stressor - Related disorder. This disorder was selected instead of F43.10, PTSD and F43.0, Acute Stress Disorder since Juno has not experienced direct exposure to a threat or actual death, injury or sexual violence. However, Juno has experienced a trauma or stressor, i.e., unplanned pregnancy and faced with a decision on what to do with this child during the teenage high school years. During session, Juno shared about her visit(s) to the Minnetonka Family Services Center and the discussion on what to do with the baby. Juno has shared that "this is a real big decision, and I'm not sure what the right thing to do is". At this same time Juno attempted to re-connect with her biological mother and this attempt was unsuccessful causing additional trauma and stress, T74.02XD. This unsuccessful attempt resurrected memories of the first time her mother left the family and neglected her as a child shortly after her parent's divorce, Z62.812.

Part 2

Diagnostic Impression

Z62.821, Parent-child relational problem, Parent-biological child

Z64.0 Problems related to unwanted pregnancy

Discussion of Diagnostic Impression

At the time of her initial assessment, and given her background information, Juno does not meet diagnostic criteria for any DSM-5 diagnosis. According to her account, Juno has a high level of functioning in the social and cognitive domains. According to those around her, Juno exhibited typical psychosocial development for her age. She did not report any signs of distress and did not appear to be in a distressed state at the time of the interview. However, there are multiple relevant client concerns that should be the focus of treatment moving forward including parent-child relational problems and problems related to unwanted pregnancy.

The first relevant client concern is the parent-child relational problem between Juno and her biological mother. Juno's biological parent's divorced when she was 5 years old leaving Juno in the care of her biological father and stepmother with minimal contact from her biological mother. Juno's mother no longer lives in the same town as Juno. The most significant example of communication from her mother Juno could give was the annual gifting of a cactus on Valentine's Day. When Juno became pregnant, she tried to visit her biological mother, but was unsuccessful. The relationship between Juno and her mother is strained to the point of near nonexistence.

The second relevant client concern is the presence of problems related to unwanted pregnancy. Juno became pregnant in the middle of her high-school career. In the initial months of her pregnancy, Juno chose to withhold the news of her pregnancy from her parents. During the pregnancy, Juno expressed concerns about not knowing what decision to make regarding the baby's future. Although Juno felt as though she should make the decision, there was clear concern regarding making the "right choice". Juno gave birth at 17 years of age.