Working With Survivors of Sexual Abuse and Trauma: The Case of Brenna

Brenna is an 18-year-old, heterosexual, African American female. She is pregnant, residing in a homeless shelter, and has no income source. Brenna was raised by her biological mother in a one-bedroom apartment in an urban neighborhood. When Brenna was 15 years old, her mother began dating a new man. This man sexually assaulted Brenna while they were home alone one evening. She immediately disclosed the sexual assault to her mother who called her a liar and told her to move out. Brenna then lived in a variety of situations, sometimes residing with friends for short periods and sometimes living in a youth shelter. During this period she attended high school intermittently but did not graduate.

After her 18th birthday, Brenna moved in with her boyfriend, Cameron. Also living in the household were Cameron’s mother, his 16-year-old sister, and a 7-year-old brother. Shortly after moving in with Cameron, Brenna became pregnant with his child. Prior to the pregnancy, Cameron would often abuse her physically, verbally, and emotionally. When Brenna announced the pregnancy, Cameron became even more violent, accused her of sleeping with other men, and denied paternity of the baby. When Brenna was 4 months pregnant, Cameron attempted to strangle her, so Brenna moved to a shelter. Although the shelter was willing to house Brenna and her newborn temporarily, their policy required Brenna to secure new living arrangements prior to giving birth.

I was assigned to be Brenna’s social work case manager at this shelter. Brenna and I worked together to set manageable goals during her stay at the shelter and also developed a plan for ongoing mental health support. Utilizing individual case manage- ment sessions, I worked with Brenna to prioritize goals regarding nancial stability, permanent housing, and medical care. Brenna had dif culty reading and writing, so we worked together to

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SOCIAL WORK CASE STUDIES: FOUNDATION YEAR

complete the applications for Medicaid; General Assistance; the Supplemental Nutrition Program for Women, Infants, and Chil- dren (WIC); and a local subsidized apartment complex. Brenna often became frustrated throughout this process, struggling to locate all required documents as a result of her frequent moves and changes in residency. I advocated for Brenna to receive medical care at the local hospital’s prenatal clinic while waiting for Medicaid approval, utilizing her completed Medicaid applica- tion to support the request. The hospital also agreed to enroll Brenna in prenatal support and education groups that met on a weekly basis.

Dif culty with reading and writing made it challenging to apply for jobs to list on her application for General Assistance, so I gathered information for Brenna on available educational and self-help centers in the community. She enrolled in a group at a local agency that provided free General Educational Development (GED) training, and she was able to enhance her reading skills during her stay at the shelter. By attending a group at the agency, Brenna met several single mothers in the area and built a new support network in the community.

Throughout this process, Brenna struggled with feelings of inadequacy, low self-esteem, loneliness, and powerlessness. I worked with her to validate and process these feelings and assisted her in contacting a local therapist with experience working with survivors of dating abuse and domestic violence. Although she was initially hesitant to engage in a therapeutic rela- tionship, I assisted Brenna in making an informed decision to do so. She attended weekly therapy sessions throughout the duration of her stay at the shelter.

Brenna’s resiliency, self-suf ciency, and dedication to providing a healthy life for her unborn child gave her the motivation to set dif cult goals, and she used her time at the shelter to attain them. One month prior to giving birth, Brenna’s housing application was accepted and she moved into a small two-bedroom apartment. Working with Social Services, she was granted a voucher and was able to furnish her apartment. I accompanied Brenna to the super- market and assisted her in planning a monthly food budget with

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her Supplemental Nutrition Assistance Program (SNAP) and WIC funds. Through work with her therapist, Brenna cut off all contact with Cameron, choosing to raise her child on her own. She said she felt like a new person when she established a new phone number and address without informing Cameron, and when she left the shelter, although nervous, she expressed a sense of con – dence in her ability to move forward with her new baby.

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clearly been in uenced by the group facilitator, who was incredibly friendly and outgoing. There was no other choice but termination, and the realization that the damage could not be repaired was disappointing. However, had I disclosed “my side” of what was happening, I would have been making the same errors as the group facilitator and involving myself in a dysfunctional and unhealthy dynamic, including crossing boundaries—exactly what survivors do not need. There are times when you must “swallow your pride” to do what is right and best for the client, especially given the different variables and considering the ethical issues at play.

Working With Survivors of Sexual Abuse and Trauma: The Case of Brenna

1. What speci c intervention strategies (skills, knowledge,etc.) did you use to address this client situation?

   I used re ective listening and reframing to assist Brenna in setting goals and determining her unmet needs. I used knowl- edge of local systems and social service agencies to provide referrals and to secure needed services.

2. Which theory or theories did you use to guide your practice?I utilized systems theory.
3. What were the identi ed strengths of the client(s)?Brenna’s strengths were her resiliency and self-suf ciency. Brenna viewed her desire to provide a better future for her child as a strong motivating factor for changing her life.
4. What were the identi ed challenges faced by the client(s)?Brenna lacked a familial support system and network of friends, and she was socially isolated. Upon entry to the shelter, she lacked medical care, employment, income, and housing. Brenna also strug- gled with dif culty reading and writing. Brenna had experienced trauma and violence in her past and would be raising her child alone.
5. What were the agreed-upon goals to be met to address the concern?Brenna and I agreed to secure medical care, a housing plan, and a source of income. Brenna also set goals to improve her mental health.

APPENDIX

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SOCIAL WORK CASE STUDIES: FOUNDATION YEAR

1. What local, state, or federal policies could (or did) affect this situation?
   State policies regarding photo ID affected Brenna’s ability to apply for various assistance programs through Social Services. Temporary Assistance for Needy Families (TANF) policies will also affect her ability to obtain nancial assistance after giving birth. Paternity is required on forms for TANF, and she may need to explore domestic violence waivers when completing TANF applications.
2. How would you advocate for social change to positively affect this case?
   I would advocate for improved assistance to be offered through Social Services. Brenna was often met with anger and frustra- tion at Social Services due to her dif culty reading and writing, so she had given up on trying to secure medical care and nan- cial assistance early in her pregnancy.
3. Were there any legal or ethical issues present in the case? If so, what were they and how were they addressed?Brenna and I discussed future plans for applying for TANF and the impact the child’s paternity has on approval of the applica- tion. We discussed the parental rights of Cameron and identi- ed resources for legal assistance if needed in the future.
4. Describe any additional personal re ections about this case.When working on a strict timeline, it is important to balance client empowerment with health and safety.

Human Behavior and the Social Environment

Working With Children and Adolescents:
The Case of Dalia
1. What speci c intervention strategies (skills, knowledge,

etc.) did you use to address this client situation?

This case required that active and re ective listening, reframing, and validation be employed as part of the assessment, engage- ment, and goal-setting process. In addition, working from the strengths-based perspective and meeting the client system