To prepare:

• Recall the client from the case study of ( Helen Petraski) you have been using in this course. You will apply your research for this Discussion to that client.
• Select one therapy from the following: cognitive behavior therapy, dialectical behavioral therapy, acceptance and commitment therapy, or reality therapy.
• Conduct a search in the Walden Library for one peer-reviewed research study about the effectiveness of the therapy you selected.
  • Note: You must select a study that has not already been used by a colleague in the Discussion. Each student is required to identify a unique research study.
• Remember when looking for studies to take into account your client’s age and developmental stage and presenting problem.

Case Study 

 Helen Petrakis Identifying Data: Helen Petrakis is a 52-year-old, Caucasian female of Greek descent living in a four-bedroom house in Tarpon Springs, FL. Her family consists of her husband, John (60), son, Alec (27), daughter, Dmitra (23), and daughter Althima (18). John and Helen have been married for 30 years. They married in the Greek Orthodox Church and attend services weekly. Presenting Problem: Helen reports feeling overwhelmed and “blue.” She was referred by a close friend who thought Helen would benefit from having a person who would listen. Although she is uncomfortable talking about her life with a stranger, Helen says that she decided to come for therapy because she worries about burdening friends with her troubles. John has been expressing his displeasure with meals at home, as Helen has been cooking less often and brings home takeout. Helen thinks she is inadequate as a wife. She states that she feels defeated; she describes an incident in which her son, Alec, expressed disappointment in her because she could not provide him with clean laundry. Helen reports feeling overwhelmed by her responsibilities and believes she can’t handle being a wife, mother, and caretaker any longer. Family Dynamics: Helen describes her marriage as typical of a traditional Greek family. John, the breadwinner in the family, is successful in the souvenir shop in town. Helen voices a great deal of pride in her children. Dmitra is described as smart, beautiful, and hardworking. Althima is described as adorable and reliable. Helen shops, cooks, and cleans for the family, and John sees to yard care and maintaining the family’s cars. Helen believes the children are too busy to be expected to help around the house, knowing that is her role as wife and mother. John and Helen choose not to take money from their children for any room or board. The Petrakis family holds strong family bonds within a large and supportive Greek community. Helen is the primary caretaker for Magda (John’s 81-year-old widowed mother), who lives in an apartment 30 minutes away. Until recently, Magda was self-sufficient, coming for weekly family dinners and driving herself shopping and to church. Six months ago, she fell and broke her hip and was also recently diagnosed with early signs of dementia. Helen and John hired a reliable and trusted woman temporarily to check in on Magda a couple of days each week. Helen would go and see Magda on the other days, sometimes twice in one day, depending on Magda’s needs. Helen would go food shopping for Magda, clean her home, pay her bills, and keep track of Magda’s medications. Since Helen thought she was unable to continue caretaking for both Magda and her husband and kids, she wanted the helper to come in more often, but John said they could not afford it. The money they now pay to the helper is coming out of the couple’s vacation savings. Caring for Magda makes Helen think she is failing as a wife and mother because she no longer has time to spend with her husband and children. 14 Helen spoke to her husband, John (the family decision maker), and they agreed to have Alec (their son) move in with Magda (his grandmother) to help relieve Helen’s burden and stress. John decided to pay Alec the money typically given to Magda’s helper. This has not decreased the burden on Helen since she had to be at the apartment at least once daily to intervene with emergencies that Alec is unable to manage independently. Helen’s anxiety has increased since she noted some of Magda’s medications were missing, the cash box was empty, Magda’s checkbook had missing checks, and jewelry from Greece, which had been in the family for generations, was also gone. Helen comes from a close-knit Greek Orthodox family where women are responsible for maintaining the family system and making life easier for their husbands and children. She was raised in the community where she currently resides. Both her parents were born in Greece and came to the United States after their marriage to start a family and give them a better life. Helen has a younger brother and a younger sister. She was responsible for raising her siblings since both her parents worked in a fishery they owned. Helen feared her parents’ disappointment if she did not help raise her siblings. Helen was very attached to her parents and still mourns their loss. She idolized her mother and empathized with the struggles her mother endured raising her own family. Helen reports having that same fear of disappointment with her husband and children. Employment History: Helen has worked part time at a hospital in the billing department since graduating from high school. John Petrakis owns a Greek souvenir shop in town and earns the larger portion of the family income. Alec is currently unemployed, which Helen attributes to the poor economy. Dmitra works as a sales consultant for a major department store in the mall. Althima is an honors student at a local college and earns spending money as a hostess in a family friend’s restaurant. During town events, Dmitra and Althima help in the souvenir shop when they can. Social History: The Petrakis family live in a community centered on the activities of the Greek Orthodox Church. Helen has used her faith to help her through the more difficult challenges of not believing she is performing her “job” as a wife and mother. Helen reports that her children are religious but do not regularly go to church because they are very busy. Helen has stopped going shopping and out to eat with friends because she can no longer find the time since she became a caretaker for Magda. Mental Health History: Helen consistently appears well groomed. She speaks clearly and in moderate tones and seems to have linear thought progression—her memory seems intact. She claims no history of drug or alcohol abuse, and she does not identify a history of trauma. More recently, Helen is overwhelmed by thinking she is inadequate. She stopped socializing and finds no activity enjoyable. In some situations in her life, she is feeling powerless. 15 Educational History: Helen and John both have high school diplomas. Helen is proud of her children knowing she was the one responsible in helping them with their homework. Alec graduated high school and chose not to attend college. Dmitra attempted college but decided that was not the direction she wanted. Althima is an honors student at a local college. Medical History: Helen has chronic back pain from an old injury, which she manages with acetaminophen as needed. Helen reports having periods of tightness in her chest and a feeling that her heart was racing along with trouble breathing and thinking that she might pass out. One time, John brought her to the emergency room. The hospital ran tests but found no conclusive organic reason to explain Helen’s symptoms. She continues to experience shortness of breath, usually in the morning when she is getting ready to begin her day. She says she has trouble staying asleep, waking two to four times each night, and she feels tired during the day. Working is hard because she is more forgetful than she has ever been. Helen says that she feels like her body is one big tired knot. Legal History: The only member of the Petrakis family that has legal involvement is Alec. He was arrested about 2 years ago for possession of marijuana. He was required to attend an inpatient rehabilitation program (which he completed) and was sentenced to 2 years’ probation. Helen was devastated, believing John would be disappointed in her for not raising Alec properly. Alcohol and Drug Use History: Helen has no history of drug use and only drinks at community celebrations. Alec has struggled with drugs and alcohol since he was a teen. Helen wants to believe Alec is maintaining his sobriety and gives him the benefit of the doubt. Alec is currently on 2 years’ probation for possession and has recently completed an inpatient rehabilitation program. Helen feels responsible for his addiction and wonders what she did wrong as a mother. Strengths: Helen has a high school diploma and has been successful at raising her family. She has developed a social support system, not only in the community but also within her faith at the Greek Orthodox Church. Helen is committed to her family system and their success. Helen does have the ability to multitask, taking care of her immediate family as well as fulfilling her obligation to her mother-in-law. Even under the current stressful circumstances, Helen is assuming and carrying out her responsibilities. John Petrakis: father, 60 years old Helen Petrakis: mother, 52 years old Alec Petrakis: son, 27 years old Dmitra Petrakis: daughter, 23 years old Althima Petrakis: daughter, 18 years old Magda Petrakis: John’s mother, 81 years old