The Rojas Family

The Rojas, a family of 5, are seeking services after the sudden death of Mr. Rojas' mother ("Nana" to the children) 5 days ago. Mrs. Rojas had resided with the family for many years. The youngest children, Mariana (age 5) and Gabriela (age 9), cannot recall a time when their Nana was not present in their daily activities.

The family has many strengths. Typically, they would not access services on their own, nor have they had reason to need prior services. Mr. Rojas is an administrator at the community wellness center where he has been employed over 20 years. Ms. Rojas volunteers her time between her daughters' elementary and middle schools and also provides pro-bono services for the community legal aid program. Both Mr. and Mrs. Rojas have large extended families, many of whom live close. Their support systems quickly offered assistance after Mrs. Rojas' death, and they continue to do so.

Mr. Rojas states he wants the family to start grief counseling because no one is talking about his mother's passing. He does not understand why no one seems concerned. He shares his grief openly and states, "If I hold it in, it only gets worse." He shares that Isabella, his oldest daughter (17 years old), is the only family member grieving "the right way." Isabella has not attended school since the passing of her Nana and reports being overly tired, an inability to concentrate, and a profound sense of loss. She reports coping by praying and talking to the family priest.

For her part, Ms. Rojas remains neutral about the situation. She acknowledges her husband's concerns and also supports her younger daughters' mild reactions to the death of their Nana. She explains that her younger daughters are more like her and keep their emotions "inside." She denies repressing her feelings though and states she copes by staying busy. She further asserts that she has allowed herself to mourn the loss of her mother-in-law, with whom she enjoyed a good relationship. "She will be missed," Ms. Rojas concludes.

Gabriela initially reports having difficulty sleeping, but later admits she only mentioned the sleep problems to make her father happy that she was grieving. When further questioned, she admits to pacifying him often. Mariana refuses to answer any questions and is actively engaged in conversation with her imaginary friend throughout the intake appointment. She stops at only one point to ask when Nana is going to wake up.

Mr. Rojas admits it is difficult for him to accept help from others as he has always been able to provide for the family, but he states he is "overwhelmed with grief and loss. I cannot even begin think about what to do now."

Despite Mr. Rojas' concerns, the family members believe they are functioning appropriately. Mr. Rojas appears to be struggling the most with the recent loss of his mother.

Part 4: Family Needs Assessment

Example family member: Nola

• Life stage: Early childhood
• Current or developmental needs:Seek services to address nonverbal issues, etc.
• Considerations from the person-in-environment perspective for this client: I would consider the following when assessing Nola in her environment:
  • What might be the cause of her hyperactivity?
  • How have health-related factors within the family affected Nola?
  • Since losing their housing, how is Lala's physical and mental health affecting Nola?
  • How is Gwen's age and role as her caregiver affecting Nola?
  • How does the family's network help or harm Nola's situation?
  • What is the impact of the missing dog on Nola's behavior?

1. Family member:

• Life stage:
• Current or developmental needs:
• Considerations from the person-in-environment perspective for this client:

1. Family member:

• Life stage:
• Current or developmental needs:
• Considerations from the person-in-environment perspective for this client:

1. Family member:

• Life stage:
• Current or developmental needs:
• Considerations from the person-in-environment perspective for this client:

1. Family member:

• Life stage:
• Current or developmental needs:
• Considerations from the person-in-environment perspective for this client:

1. Family member:

• Life stage:
• Current or developmental needs:
• Considerations from the person-in-environment perspective for this client:

Part 5: Service Delivery Recommendations

Part 6: Intervention Strategies