Using Genograms
6
Final Project Case study: Social History
Basic Data
Client: Sarah Smith
DOB: 10/23/ 88
Chronological age: 17
Brief Client Description
Sarah is a 17-year-old high school senior who currently resides at home with her parents and two brothers. She attends B____ High School where she is a senior and involved in student government and girls volleyball and basketball. Sarah is approximately 5’8” with shoulder length hair. She is African American. Her weight is in the average range and she appears muscular in her build. Sarah was dressed appropriately for the interview in jeans and a sweater. She was well groomed. Initially she was quiet but as our session progressed she opened up more and was open to sharing both her thoughts and feelings. Several times in the interview she appeared to be anxious as she would bite her nails and play with her hair. By the end of the session she appeared eager to proceed with counseling and stated she was a “little bit hopeful things might improve.”
Developmental History
Sarah was born to a single mother who was 15 years old and unable to care for her. She was subsequently placed in a foster home for three weeks prior to being placed in her adoptive home. Little is actually known about her birth parents except that they were both in high school at the time and believed adoption was the best option for their child. The delivery was reported to be normal however; her biological mother only received pre natal care in the last two months of her pregnancy. Sarah was reportedly born two weeks early and weighted 7lbs. 6oz. at birth.
Sarah was placed with the Smiths at age 3 weeks. Her mother states that she was “beautiful” and a good baby who rarely cried and had a pleasant disposition. She did have ear infections on a frequent basis and subsequently had tubes inserted into her ears at 8 months of age. Ms. Smith describes herself as an “anxious mother.” She stated she “wanted to do everything right.” She relates that the couple had been trying to have a child naturally and had been unsuccessful during the first six years of marriage.
Ms Smith reports that Sarah sat alone at 3 months, walked alone at 9 months and generally did most physical activities earlier than other children her age. Her first words were Dada and dog at about 13 months. She was toilet trained at 2.5 years but had difficulty being dry at night until she was 3.
Social/Emotional Development
Ms. Smith describes Sarah as a delightful child who was spoiled by her grandparents and great grandparents because she was the only grandchild in the family and she had been “long awaited.” Sarah has loved animals since she was a child. She remembers enjoying riding her tricycle and playing with other children in the neighborhood. Sarah states that her father worked a lot during her childhood but that she loved to see him come home and no matter how tired he was he always played with her and made her feel like “his Princess.”
Sarah felt very close to her grandmother and great grandmother in her early years. She states they ‘were crazy” about her and she loved them both very much.
Significant childhood events include the birth of her brother when she was two followed by another brother at four. Sarah states that she does not remember much about the birth of either of her brothers except that her great grandmother passed away the week after the birth of her youngest brother. She remembers being very upset and not understanding why “Grannie would not speak to her and just lay in the box.”
School History
Sarah attended B______ Elementary School and ________ Middle. She is now at B___________ where she is a senior. She plans to attend __________next year and study Psychology. Sarah has “decent grades.” She admits she does not study much but maintains a B average. The only problems she has had in school have been daydreaming and not getting her work done and talking. She reports no problems with attendance and no behavior problems.
Sarah has always been involved with sports. She currently plays basketball and volleyball for her school. She has participated in other sports as well including soccer, softball, and swimming. She won state wide races with her swim team but quit when she was 12 years old because she was tired of it. She has been a cheer leader also.
Sarah has friends at school and in her neighborhood. However, she states that her parents don’t like some of her new friends and that has created friction in the home.
Employment History
Sarah is currently working part time at her father’s company in order to pay for damage she did to her mother’s car. She also worked there during the summer. She files, answers phones, and “does whatever people tell her to.” She says it is “OK” but she would prefer to work in a vet’s office.
Current Social/Emotional Issues
Sarah has recently been experiencing some difficulties. She was referred for counseling with her parents when she took her mother’s car without permission and drove it around all night. When she returned with the car she drove it into the garage causing significant damage. Her mother states she is “sure” alcohol was involved in the incident. Sarah denied this.
Sarah admits she often feels like an outcast in her family. She is not as smart, or talented, or “socially acceptable” as her brothers. As a result of these feelings she has had a difficult time finding her place in the family and often thinks of herself as a “leftover” which is her term for her place in the family.
Sarah has long standing issues about her adoption and questions about her birth mother. She states she often wonders if her birth mom thinks about her and if she wishes she had kept her. She adds that her birth mom is “probably crazy or on crack.”
Sarah states she sometimes sips alcohol at parties but has not tried drugs. She does have a boyfriend but denies they are sexually active. She says her parents don’t approve of many of the friends she really likes and prefer to have her spend time with their “snobby friends’ children.”
Self Description
In describing herself Sarah says she is friendly and cares about people. These are her strengths along with her sense of humor and that she is down to earth despite growing up in what she calls “a snooty” environment. She dislikes her looks wishing she was skinnier and wonders aloud, “Why don’t I have my moms figure?” She quickly adds” cause she is not my Mom” and giggles.
Sarah does not like that other people judge her based on what her parents do and don’t give her a chance to be herself. She worries sometimes that she is “crazy” for the way she feels about things and states she never met anyone she knows who thinks like she does. She also worries about going off to college and “making it in the world.”
Sarah sees her greatest accomplishment as her interest in helping others and that she cares about old people and the poor. She volunteers at an area nursing home and a day care center serving underprivileged children.
Sarah describes her greatest pain as her grandmother dying last year, her great grandmother’s death when she was four and she quietly adds “being adopted.”
When asked what she would change about herself if she could, she mentioned her looks, her athletic ability, and her brains. She wants to be happy, to help others, and to find someone special in her life to love.
Family History
Little is known about Sarah’s family of origin but she was adopted at 3 weeks by the Smith family and she has lived with them for her entire life. The Smith family is well known in town and well respected. Mr. and Mrs. Smith married after graduating from college and became involved in the family textile business. They tried for six years to have children but were unsuccessful.
After adopting Sarah they had two natural children, Greg who is now 15 and Davada who is 13. Greg and “D” as he is known both live in the home and attend school in the area. Sarah reports she has a good relationship with Greg and they often talk and share things. Sarah states he always says she is “too emotional” and “thinks too much.” He tries to encourage her not to fight with her mother and not get into trouble. Sarah states Greg is perfect. He is never a problem to the family. She says “he makes straight As, plays all sports perfectly, is the president of everything at school… He really is that great like you would think there was something wrong with him but there isn’t .” She describes her brother as “tall, light skinned, skinny with great pecs and loved by all the girls” He is outgoing and loves sports. He and his father attend many sporting events together including hockey, basketball, and football.
D is her younger brother who she describes as a “Greg wanabe” He is tall for his age and very involved in sports. He does not excel like Greg but gets good grades. Sarah states he sometimes gets in trouble for not cleaning his room and being a slob but Sarah is quick to add that at “least he didn’t wreck the Jag” referring to her incident with the car. Sarah states she and D are not as close as she is to Greg but they don’t have any major problems.
Ms Harriet Smith is 48 years of age. She is very attractive, dressed neatly and in the latest designer styles. She is tall, thin, and well groomed. She states she comes from a rural Baptist family where her and her three brothers grew up working on the family farm. She describes her parents as “strong Christians” who were very strict and loved their children very much. She was popular in school and very involved in church activities. She graduated from college with a degree in Accounting. She met her husband there and they married a year after graduating. He was working in the family business and she joined him there shortly after the marriage. She states she always wanted to be a mother and was devastated when she was unable to get pregnant after six years of trying to conceive.
Infertility and the death of both her parents three years after her marriage in a car accident were the most painful events in her life. She states when she was pregnant within two years of adopting it was sort of funny but a little embarrassing. She still wonders why she did not get pregnant prior to the adoption but states it was “God’s way of bringing Sarah into their home.”
Ms Smith worked part time at the company after Sarah was born often taking Sarah with her to the office or she was cared for by her husband’s mother or grandmother both who “adored” Sarah. When Greg was born she became a full time mom and spent her time raising the children and as they got older she began to become involved in community activities and volunteer work. Ms Smith stated that she often thought she would return to work once the children were older but the company had grown so much she really was not needed there and the family did not need the income. She states she enjoys her family and her community activities.
She reports feeling as if Sarah is always mad at her and describes it as if Sarah “blames” her for something although she has “no clue” what she did wrong. “Ozzie and I loved our kids and worked hard to give them the best life we could. She describes her sons as “typical boys always going somewhere, doing something and never neat.” She states she argues with all the children about normal parent/child issues such as curfews, family rules, cleaning up and doing homework” She usually grounds them or takes away privileges when they break the rules and feels she is the primary disciplinarian in the family and her husband is the “fun parent.”
Mr Ozzie Smith is 50 years of age, tall and thin and has salt and pepper hair. He is the CEO of a large business that was started by his great grandfather and has remained in the family since then. He is articulate with a bright smile. He describes his childhood as an “only child of a hard working family.” His father always worked the family business and his mother did also. He states he was the only child in his class all through school whose mother worked outside the home. He began to work there too after school emptying trash, opening mail and completing other tasks. He always played sports in high school both basketball and football and states “sports are my passion.” He also played college basketball and earned a business degree. He later returned to college on a part time basis and earned his MBA. He has worked all his life in the family business and is proud of the success it has achieved. The company currently employs over 450 people and is very successful. He hopes that one day one of his children will follow his footsteps into the business. His regret in life is that his grandparents never lived to see how successful their venture became. His grandmother and grandfather always lived next door to his parents during his childhood and were very involved in his life. His grandfather died before he graduated from college and his grandmother died around the time D was born. He describes his father as a rather “cold man who never praised me and always seemed to criticize me.” His mother is described as outgoing, social, and loved to have family around her. His father died four years ago from a heart attack and his mother is currently in a nursing home suffering with Alzheimer’s. He visits her regularly.
Mr Smith states he values his family time and describes it as his favorite way to relax. He also enjoys sports and reading. Mr. Smith describes Sarah as always “stepping to her own drummer.” He says she reminds him of his mother because she is always talking and full of life. He states his wife was “devastated” when they did not conceive early in their marriage. He states he was not worried as his parents did not have him until late in the lives and he always figured it would happen. However, his wife was eager for a child and he was glad to adopt. He found Sarah to be a delightful baby and after she came into their home he realized what he had been missing. He was also surprised by the quick pregnancy and birth of Greg. He stated he noticed changes in Sarah when Greg was born. Mr Smith states that everyone went “on and on” about how much Greg looks like his father and they still do. People always seem to mention how much Greg is like him and he thinks this has bothered Sarah since she was small. He remembers when she was young and Greg had just started to walk, people were saying Greg even walked like him and Sarah started following Mr. Smith around asking if she walked the way he did. He says these remarks pained him and yet he did not know how to stop these people who meant well. He states he would tell people when they would say these things that “Greg will probably sue me when he is older for looking like me and not being pretty like Sarah” However, as Greg got older, he stopped saying this because he did not want Greg to think he was unattractive.
Mr. Smith feels that Sarah may be happier if they could help her to find her birth mother. He has looked into hiring a professional searcher to try and locate her. Ms. Smith is totally against the idea but he states that he knows Sarah loves them and would not leave home. However, he states she is “haunted” by her adoption and feels this may help. Mr Smith states his wife is somewhat of a perfectionist and may have high expectations for Sarah. His main goal is for Sarah to be happy but he is unsure how to help her. He made clear that he is willing to spend any amount of money, attend workshops or sessions if he can see her happy. He states “we did not adopt her to make her miserable; we love her and want her to have a good life.”
The Smiths state that they do argue about household issues such as parenting issues, how permissive to be with family finances and household chores. Mr. Smith tends to be more permissive believing he worked hard to be financially successful and he wants to be able to spoil his children including a new car when they graduate from high school and the purchase of a beach home the family can enjoy. Ms Smith believes that the children will develop character through working for things and having chores. While Ms Smith wants the children to participate in household chores Mr. Smith has hired a housekeeper and wants her to work more hours to help relieve Ms. Smith of the burden.
When the issues of Sarah’s adoption were discussed with the Smiths, Ms Smith stated that allowing Sarah to work with a searcher to locate her birth mother was “the craziest thing he had ever suggested in their marriage” When asked what she thought would happen Ms Smith became silent and her eyes began to tear. She said that Sarah loved Mr. Smith and she was glad she did. However, she felt Sarah hated her and if she had another mother she would leave their home and move in with” her real mom.”
