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Posted: December 7th, 2022

Rivera Family Case Study Part 1

Rivera Family Case Study Part 1

Please read the Rivera family case study to develop a diagnosis for Miguel Rivera age 10 based on the information provided. Follow the scoring guide and utilize the DSM 5. Identify any ethical considerations or laws. Please use the AAMFT code of ethics, HIPAA (if necessary) and your state laws or statutes. Please identify which systemic treatment you would utilize for this client and family.

The Rivera Family Demographics

The Rivera family is Puerto Rican, and they live in RiverBend City, Florida in a single-family home that they own. The family is middle class, and both parents work outside of the home.

Sosa Perez’s mother came to live with them 8 years ago after being widowed, she assists with childcare and housekeeping.

Family Demographics

· Mother: Sosa Perez de Rivera, age 44, born in Puerto Rico, teacher at RiverBend City high school

· Sosa is pragmatic and practical, yet she takes time to nurture her children when they need it.

· Father: Jose Rivera, age 45, born in Florida, orthodontist in group practice in River City

· Jose is funny and tells jokes to lighten the mood.

· Son: Pedro Rivera, age 16, born in Puerto Rico, 10th grade, RiverBend City high school

· Pedro is very serious and studious and wants to be a surgeon. He is busy with school, after school activities, and looking for good pre-med programs.

· Daughter: Tisha Rivera, age 14, born in Florida, 9th grade, RiverBend City high school

· Tisha is popular at school, is class president, and a cheerleader. She wants to be a teacher like her mother and work in a high school.

· Daughter: Maria Rivera, age 12, born in Florida, 7th grade, Palms elementary and middle school

· Maria is artistic and a dreamer. She loves butterflies and fairies and wears purple a lot.

· Son: Miguel Rivera, age 10, born in Florida, 5th grade, Palms elementary and middle school

· Miguel is a perfectionist who has to do “everything right”. He gives up when things don’t work out the way he had planned. His room is orderly.

· Maternal grandmother: Magdalena Cortez de Perez, age 71, widowed, born in the Dominican Republic, in-home child care provider and housekeeping.

· Magdalena has always been “the rock” of the family, pragmatic, practical, and stoic. She allows “no-nonsense” or emotional outbursts from anyone.

Family history:

Sosa and Jose Rivera met in Puerto Rico when they were in high school together. Jose’s parents had moved to Puerto Rico from Florida when he was 12 for his father’s work as an engineer. Sosa and Jose got married after graduating, then both moved to Florida to attend college. Sosa received her teaching credentials in mathematics and chemistry and Jose attended dental school and received his orthodontic specialization. Sosa and Jose Rivera met when they were in high school in Puerto Rico. Jose’s parents moved to Puerto Rico from Florida when he was 12 years old for his father’s engineering job. After graduating, Sosa and Jose married and moved to Florida to attend college. Sosa earned her teaching credentials in mathematics and chemistry, while Jose went to dental school and specialized in orthodontics.

Their first child, Pedro (who was named after Jose’s father) was born when Sosa was 28, following his birth the couple visited her family in Puerto Rico. The other children; Tisha, Maria, and Miguel were all born approximately two years apart in Florida.

Magdalena the children’s maternal grandmother moved in with them after her husband passed away, Miguel was 2-years old. Magdalena has assisted with child care and housekeeping allowing Sosa to work without having to transport her youngest to daycare and preschool. The 3 older children were already in school.

School Shooting Incident

Nine months ago Tisha attended a football game with her cheer squad and the RiverBend City Football team at a high school in a town 45 miles from RiverBend City. During the game there was a shooting, a student walked into the stands at the football game and fired randomly into the stands and toward the field.

The shooter injured 20 people and killed three. The shooter was a 16-year-old Caucasian student who had gotten expelled because he was aggressive at school, called the Hispanic, African American, and LGBTQIA students bad names in person, and on his social media accounts.

One of Tisha’s squad was shot in the hip, and one of their football players was seriously injured when a bullet barely missed his lung. Tisha rode to the hospital with her friend who had been injured she remained at the hospital until her father, Jose was able to pick her up. Tisha has received therapy because she was having nightmares about the incident. The legal and media encounters were stressful for Tisha and her family.

Miguel’s best friend is the youngest brother of the football player who was seriously injured. He was with the family when they received the news of the shooting and their son’s injury. The family had to rush to the hospital taking Miguel with them. He remained at the hospital with the family until his mother, Sosa was able to pick him up. When Sosa arrived Miguel was frightened, shaking, and crying. His grandmother Magdalena told him that “bad things happen and that he would need to toughen up”.

Client Referral:

You have received a referral from the Palms elementary and middle school counselor for Miguel. Miguel’s grades have fallen from As to Cs and Ds and he often says he has a stomach-ache and/or a headache and wants to go home from school

Since the shooting incident, Miguel starts crying and shaking when there are active shooter drills. He also becomes upset when there are fire drills or weather drills at school. Miguel has also become sensitive to people arguing, yelling, and loud noises like doors slamming. Miguel had an incident at school where hid at school after a kid slammed the door. The school asked the janitor to locate Miguel when the teacher reported him absent after recess.

Rivera Family Case Study Part 2 (Additional Notes)

While working with the Rivera family, Sosa talks about how this whole event has reminded her of how much she misses her own father and that she never got a chance to see him before he died and that the casket was closed during the funeral. She endorsed feeling like she never really absorbed that he was gone. Sosa’s father died suddenly in an auto accident and had a closed casket because of the damage done to his body. Magdalena told Sosa, “Shush. There is nothing we can do about it but move forward.” During family therapy, it became obvious that Sosa and Magdalena compartmentalized their feelings to move forward and neither had processed their grief.

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