You are working at an outpatient clinic when a woman, Maria, is referred to you for an intake session. Three days ago, the police were called to the Luna household for domestic violence. Maria has an 8-year-old daughter named Sofia. Maria is 26 years old and speaks little English. She grew up in Honduras with her mother, grandmother, and nine brothers and sisters. She never knew her father who abandoned the family when she was an infant. Her mother had several other long-term relationships but never married. Her family was "very poor" and she did not finish school past fifth grade. Maria was raped when she was 10. At 13 years of age, she began a life of prostitution to help her mom with feeding the rest of the family. She met her husband, Jamie, when she was 18 and quickly got pregnant. She illegally entered the States and began to work in a home in Texas. After she had the baby, Jamie was able to illegally enter the States and began working odd construction jobs to pay their bills since Maria no longer was working to care for Sofia. Maria reports that they have not been successful in having any more children, which Jamie blames on Maria's previous sexual history. He is ashamed since in his culture, "men are supposed to have many children." Maria reports that she had many difficulties in having Sofia and did not get the proper medical care she needed. Sofia was born premature and has speech and other motor skill delays. Maria admits she used drugs in the past but adamantly denies any current drug use because she knows it would affect their immigration status. The police found drug paraphernalia in the household, but Maria stays in a condo with two other families and reported the material was not hers. Maria stated that when Jamie gest angry he hits and punch her. Maria says that she will not be kept in a system like the one in which she was raised in Honduras where she is supposed to be subordinate and just take whatever Jamie gives her. She accuses him of having affairs and sleeping around with everyone. She reports that they have arguments at least two to three times a week and have separated several times to get away from each other. Maria says that she is dependent on him since she is not working. Maria says that on the night of the police incident, she caught him with another woman at the corner store, and when he got home, she asked him who she was. He became very angry that she would question him. He stated that it was none of her business and she was to stay home and take care of the house. He grabbed a knife and threatened to cut her if she questioned him again. Maria reports having difficulty concentrating. She has flashbacks of a time that Jamie did cut her, and she thought she was going to die. She does not want to talk about that incident. She only states that he cut her, and she thought she was going to die. Now anytime she hears loud voices she feels frightened and wants to cower in the corner. She reports that she feels like walking on eggshells and worries constantly that something bad will happen. Sofia is 8 years old. She is very shy but speaks English well. She is in the second grade and was held back in kindergarten due to her developmental delays. She is currently at risk of being held back again, and her attendance record is very poor. She reports that she hates to see her mom and dad fight all the time. She gets very scared, has trouble sleeping, and hides in her closet. She does not have many friends because the kids "pick on me for being dirty". She mentions that one of the other male children living in the condo does come to "comfort her" at

night and gives her "lots of hugs and squeezes." Maria reports that she has caught Sofia "rubbing her private parts" on the couch arm and trying to kiss all the other little boys in the house. She denies that Sofia has been sexually abused and blames it all on Sofia. After completing the intake, your supervisor tells you that you can decide which person in the family system you want to focus on for individual counseling sessionsMarie, or Sofiawith the understanding that the other family member will work with your colleagues with possible joint sessions in the future.

How would one discuss the background characteristics, presenting complaints, history of the problem, and social and cultural considerations for Sophia.