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Working with an individual patient and family

Case study:

Working with an individual patient and family

Eleanor has grown up in a family of “heavy users.”
“I mean two things by this,” she smiles derisively. “My mom, my dad, my two older sisters—even my aunts and uncles and most of my cousins, probably—they all used drugs. I finally did too when I was 17, just to have everybody quit bullying me. I was the last one to use, and now I’m the first one to try to get clean, and they hate that because everybody’s always used me. Since I’m the only one that has been straight this long, the only one able to keep a job long term, everybody thinks I owe it to them to let them crash on my couch or give them money.

“But I want to put those days behind me. I have my sister’s little boy to raise now—” At this point Eleanor begins to cry. “My sister was killed in a motorcycle accident. Her boyfriend was driving, and neither one had a helmet—” She cries a little more and says, “My sister Molly was the only one—the only one—in our family who loved and supported me when I tried to go straight. She said she was going to too, for her baby boy’s sake. Now she’s gone, and I have him, and I don’t want him to end up like the rest of us. It’s a promise I made to her after her death.”
“I feel like I’m a train wreck right now. Where do I start?”

Answer to the following 2 questions in a short essay format:

Explain the effects of mental disorder on Eleanor’s family.
Describe the skills needed when working with family systems