Using Research to Select a Therapeutic Modality
Tiffani Bradley
Identifying Data:
Tiffani Bradley is a 16-year-old Caucasian female. She was raised in a Christian family in Philadelphia, PA. She is of German descent. Tiffani’s family consists of her father, Robert, 38 years old; her mother, Shondra, 33 years old, and her sister, Diana, 13 years old. Tiffani currently resides in a group home, Teens First, a brand new, court-mandated teen counseling program for adolescent victims of sexual exploitation and human trafficking. Tiffani has been provided room and board in the residential treatment facility for the past 3 months. Tiffani describes herself as heterosexual.
Presenting Problem:
Tiffani has a history of running away. She has been arrested on three occasions for prostitution in the last 2 years. Tiffani has recently been court ordered to reside in a group home with counseling. She has a continued desire to be reunited with her pimp, Donald. After 3 months at Teens First, Tiffani said that she had a strong desire to see her sister and her mother. She had not seen either of them in over 2 years and missed them very much. Tiffani is confused about the path to follow. She is not sure if she wants to return to her family and sibling or go back to Donald.
Family Dynamics:
Tiffani indicates that her family worked well together until 8 years ago. She reports that around the age of 8, she remembered being awakened by music and laughter in the early hours of the morning. When she went downstairs to investigate, she saw her parents and her Uncle Nate passing a pipe back and forth between them. She remembered asking them what they were doing and her mother saying, “adult things” and putting her back in bed. Tiffani remembers this happening on several occasions.
Tiffani also recalls significant changes in the home’s appearance. The home, which was never fancy, was always neat and tidy. During this time, however, dust would gather around the house, dishes would pile up in the sink, dirt would remain on the floor, and clothes would go for long periods of time without being washed. Tiffani began cleaning her own clothes and making meals for herself and her sister. Often there was not enough food to feed everyone, and Tiffani and her sister would go to bed hungry.
Tiffani believed she was responsible for helping her mom so that her mom did not get so overwhelmed. She thought that if she took care of the home and her sister, maybe that would help mom return to the person she was before.
Sometimes Tiffani and her sister would come downstairs in the morning to find empty beer cans and liquor bottles on the kitchen table along with a crack pipe. Her parents would be in the bedroom, and Tiffani and her sister would leave the house and go to school by themselves. The music and noise downstairs continued for the next 6 years, which escalated to screams and shouting and sounds of people fighting. Tiffani remembers her mom one morning yelling at her dad to “get up and go to work.”
Tiffani and Diana saw their dad come out of the bedroom and slap their mom so hard she was knocked down. Dad then went back into the bedroom. Tiffani 3 remembers thinking that her mom was not doing what she was supposed to do in the house, which is what probably angered her dad.
Shondra and Robert have been separated for a little over a year and have started dating other people. Diana currently resides with her mother and Anthony, 31 years old, who is her mother’s new boyfriend.
Educational History:
Tiffani attends school at the group home, taking general education classes for her general education development (GED) credential. Diana attends Town Middle School and is in the 8th grade.
Employment History:
Tiffani reports that her father was employed as a welding apprentice and was waiting for the opportunity to join the union. Eight years ago, he was laid off due to financial constraints at the company. He would pick up odd jobs for the next 8 years but never had steady work after that. Her mother works as a home health aide. Her work is part-time, and she has been unable to secure full-time work.
Social History:
Over the past 2 years, Tiffani has had limited contact with her family members and has not been attending school. Tiffani did contact her sister Diana a few times over the 2-year period and stated that she missed her very much. Tiffani views Donald as her “husband” (although they were never married) and her only friend. Previously, Donald sold Tiffani to a pimp, “John T.” Tiffani reports that she was very upset Donald did this and that she wants to be reunited with him, missing him very much. Tiffani indicates that she knows she can be a better “wife” to him. She has tried to make contact with him by sending messages through other people, as John T. did not allow her access to a phone. It appears that over the last 2 years, Tiffani has had neither outside support nor interactions with anyone beyond Donald, John T., and some other young women who were prostituting.
Mental Health History:
On many occasions Tiffani recalls that when her mother was not around, Uncle Nate would ask her to sit on his lap. Her father would sometimes ask her to show them the dance that she had learned at school. When she danced, her father and Nate would laugh and offer her pocket change. Sometimes, their friend Jimmy joined them. One night, Tiffani was awakened by her uncle Nate and his friend Jimmy. Her parents were apparently out, and they were the only adults in the home. They asked her if she wanted to come downstairs and show them the new dances she learned at school.
Once downstairs Nate and Jimmy put some music on and started to dance. They asked Tiffani to start dancing with them, which she did. While they were dancing, Jimmy spilled some beer on her. Nate said she had to go to the bathroom to clean up. Nate, Jimmy, and Tiffani all went to the bathroom. Nate asked Tiffani to take her clothes off and get in the bath. Tiffani hesitated to do this, but Nate insisted it was OK since he and Jimmy were family. Tiffani eventually relented and began to wash up. Nate would tell her that she missed a spot and would scrub the area with his hands. Incidents like this continued to occur with increasing levels of molestation each time.
The last time it happened, when Tiffani was 14, she pretended to be willing to dance for them, but when she got downstairs, she ran out the front door of the house. Tiffani vividly remembers the fear she felt the nights Nate and Jimmy touched her, and she was convinced they would have raped her if she stayed in the house.
About halfway down the block, a car stopped. The man introduced himself as Donald, and he indicated that he would take care of her and keep her safe when these things happened. He then offered to be her boyfriend and took Tiffani to his apartment. Donald insisted Tiffani drink beer. When Tiffani was drunk, Donald began kissing her, and they had sex.
Tiffani was also afraid that if she did not have sex, Donald would not let her stay— she had nowhere else to go. For the next 3 days, Donald brought her food and beer and had sex with her several more times. Donald told Tiffani that she was not allowed to do anything without his permission. This included watching TV, going to the bathroom, taking a shower, and eating and drinking.
A few weeks later, Donald bought Tiffani a dress, explaining to her that she was going to “find a date” and get men to pay her to have sex. When Tiffani said she did not want to do that, Donald hit her several times. Donald explained that if she didn’t do it, he would get her sister Diana and make her do it instead. Out of fear for her sister, Tiffani relented and did what Donald told her to do. She thought at this point her only purpose in life was to be a sex object, listen, and obey—and then she would be able to keep the relationships and love she so desired.
Legal History:
Tiffani has been arrested three times for prostitution. Right before the most recent charge, a new state policy was enacted to protect youth 16 years and younger from prosecution and jail time for prostitution. The Safe Harbor for Exploited Children Act allows the state to define Tiffani as a sexually exploited youth, and therefore the state will not imprison her for prostitution. She was mandated to services at the Teens First agency, unlike her prior arrests when she had been sent to detention.
Alcohol and Drug Use History:
Tiffani’s parents were social drinkers until about 8 years ago. At that time Uncle Nate introduced them to crack cocaine. Tiffani reports using alcohol when Donald wanted her to since she wanted to please him, and she thought this was the way she would be a good “wife.” She denies any other drug use.
Medical History:
During intake, it was noted that Tiffani had multiple bruises and burn marks on her legs and arms. She reported that Donald had slapped her when he felt she did not behave and that John T. burned her with cigarettes. She had realized that she did some things that would make them mad, and she tried her hardest to keep them pleased even though she did not want to be with John T. Tiffani has been treated for several sexually transmitted infections (STIs) at local clinics and is currently on an antibiotic for a kidney infection. Although she was given condoms by Donald and John T. for her “dates,” there were several “Johns” who refused to use them.
Strengths:
Tiffani is resilient in learning how to survive the negative relationships she has been involved with. She has as sense of protection for her sister and will sacrifice herself to keep her sister safe.
Robert Bradley: father, 38 years old
Shondra Bradley: mother, 33 years old
Nate Bradley: uncle, 36 years old
Tiffani Bradley: daughter, 16 years old
Diana Bradley: daughter, 13 years old
Donald: Tiffani’s self-described husband and her former pimp
Anthony: Shondra’s live-in partner, 31 years old
John T.: Tiffani’s most recent pimp
Description
To prepare:
Use the case study of Tiffani.
Use cognitive behavior therapy
Use one peer-reviewed research study about the effectiveness of the Cognitive Behavior therapy.
Remember when looking for studies to take into account your client’s age and developmental stage and presenting problem.
A. Briefly paraphrase, in 2 to 3 sentences, the methodological context (i.e., research method, how data was collected, and the instruments used) of the study and the findings.
B. Evaluate the findings in terms of its applicability or appropriateness for the client in your case study.
C. Determine whether you would use or not use the therapy you selected for the client in your selected case study (consider how culturally relevant it is, how aligned it is with social work ethics, etc.) and explain why.
Last Completed Projects
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