Reference no: EM133345863

Question: How does systems theory show up in this vignette?

The Garrett family was referred for treatment following a kinship care placement review. The family consists of Mr. and Mrs. Garrett who are raising 3 of their grandchildren, Aiden, Stephanie, and Monica. The Garretts have 3 adult children; 2 males and the youngest one, Paula (29 y/o). Paula is the mother of the 3 children living with the Garretts. Paula is living in a sober living house.

The Garretts are the legal guardians of Aiden, Stephanie, and Monica. They assumed guardianship 3 1/2 years ago. Paula was not able to care for her children due to substance abuse. Guardianship of Aiden, Stephanie and Monica was granted while Paula was incarcerated for a substance abuse related offense.

The Garretts have been married for 35 years and raised their 3 children. Mr. Garrett is a retired teacher. Mrs. Garrett is employed full-time. Although highly stressed, the Garretts continue to find their relationship an important source of support.

Paula is a 29 y/o mother of 3 living children. The children's father died of a drug overdose while Paula was pregnant with Monica. She graduated from high school but has never been employed. Her parents describe her as difficult to get along with and always angry with them. She seems irritable and moody most of the time. This has been true since she was young.

Aiden (10 y/o, male) is the oldest. Aiden has experienced more chaos and shifts in family and caregiving relationships than his siblings. He is frequently angry. Aiden calls his mother frequently to talk but is also very angry with her. Aiden is passing in school but is often in trouble. He gets in physical fights frequently. Aiden participates and excels in sports. He gets along well with his coaches and teammates. He alternates between watching out for his younger siblings and bullying them.

Stephanie (9 y/o, female) is the oldest female. She is very protective of her mother and her siblings. While living or staying with her mother, she is often the one who takes care of things. She is very attached to Amanda and is constantly worried about her. Stephanie does well in school both academically and behaviorally. She is currently involved in gymnastics once a week. She does not have many friends and stays to herself. She is reluctant to talk with her grandparents about the things that worry her.

Monica (4 y/o, female) is a hand full. She is very active and impulsive. She often dominates the adults' attention because she needs so much supervision. She is clingy with Mrs. Garrett and does not like to be separated from her. She wants to sleep in her grandparents' bed and, when she is not allowed in their bed, is often up late in the night seeking reassurance. She is in preschool and has a difficult time both with learning and with her peers.

Although the children still have frequent, ongoing contact with their mother, they accept that their grandparents are now responsible for them. Visits are now scheduled for every weekend. Most of the visits end prematurely with Paula returning the children saying she can't handle them. They arrive back home in disarray. Monica, who has lived with her grandparents since infancy, refuses to stay with her mother.

The Garretts have tried to increase safety for the children by trying to put structure and limits in place with Paula, by being available whenever they are staying with their mother, and by confronting Paula about her discipline. The children are generally safe when they are with their grandparents although adequate supervision is still an issue. The Garretts use time outs and other consequences when the children act out.

The family presented with multiple physical and mental health concerns. Mr. Garrett suffers from uncontrolled diabetes. Stephanie has asthma. Aiden and Stephanie have symptoms of traumatic stress including hypervigilance, difficulty sleeping, nightmares, and temper tantrums. Stephanie is highly avoidant and refuses to talk about her experiences. Monica has symptoms of separation anxiety, severe ADHD and some learning problems. Paula has a substance abuse problem.

Mr. and Mrs. Garrett identify a few support systems including Mr. Garrett's fishing companions and Mrs. Garrett's work colleagues. The Garretts feel that their current family life is very different from their friends and colleagues, so they do not share much or ask for much help. The Garretts do not belong to a religious organization and are not concerned at this time about introducing the children to religious concepts or ideas.

The Garretts describe their family life as chaotic, hectic, and unpredictable. They do not identify any particular family traditions or routines that they are able to successfully carry out. Something always comes up to disrupt family time. Mr. and Mrs. Garrett do travel occasionally but they are often not able to stay the whole time or are called to deal with frequent crises.