A typical case study is a written narrative of some real-life event, situation, or experience centered in a problem or issue faced by a person, group of persons, organization, community, or even an entire society. Case studies are intended to test your understanding of important concepts and discover how to sharpen your intellectual skills of analysis, synthesis, evaluation, critical thinking, and application. Cases add realism to the course and allow you to apply the concepts in a controlled setting while increasing your involvement in the material.
For this Case Study assignment, you will begin by reviewing the case study of a three-year-old child named Tessie, whose mother has come in for an assessment of trauma. Please refer to the following four (4) readings for this module and the CANS assessment tool:
• National Child Traumatic Stress Network. (n.d.) What is a trauma screen tool or process? https://www.nctsn.org/treatments-and-practices/screening-and-assessments/trauma-screening
• National Child Traumatic Stress Network. (n.d.) What is trauma-informed mental health assessment and why is it important? https://www.nctsn.org/treatments-and-practices/screening-and-assessments/trauma-informed-mental-health-assessment
• Scheeringa, M. (n.d.). PTSD for Children 6 Years and Younger. Retrieved from PTSD: National Center for PTSD, US Department of Veteran Affairs. https://www.ptsd.va.gov/professional/treat/specific/ptsd_child_under6.asp
• Kisiel, C., Lyons, J.S., Blaustein, M., Fehrenbach, T., Griffin, G., Germain, J., Saxe, G., Ellis, H., Praed Foundation, & National Child Traumatic Stress Network. (2010). Child and adolescent needs and strengths (CANS) manual: The NCTSN CANS Comprehensive – Trauma Version: A comprehensive information integration tool for children and adolescents exposed to traumatic events. Chicago, IL: Praed Foundation/Los Angeles, CA & Durham, NC: National Center for Child Traumatic Stress. http://cctasp.northwestern.edu/pdfs/NCTSN-CANS-Comprehenvise-Manual.pdf
Case Study of Tessie
Consider this case study of a 3-year-old girl, named Tessie. In this scenario, you are the counselor who will meet with Tessie’s mother, Barbara, who was referred to your agency to treat Tessie and the family following the opening of a child protective services case on the family. This is the only information you have on Tessie, her mother Barbara, and their family:
Barbara had noticed a rash on Tessie’s genital area that would not go away for several months and so she took Tessie to the doctor. The doctor took an STD test, found it to be positive, and called CPS. Barbara was stunned knowing that no men had been near Tessie. She half thought it must be the devil’s work.
Barbara is a single mother with four children living in their two-bedroom apartment in Washington Heights, NY: Tessie, 3; Hector, 16; Etan, 17; and Victor, 19. Barbara has been depressed and does not keep up with the home or with her own self-care since the father of the three older children left the family eight years ago. Tessie’s father has not been involved with the family.
CPS required the three sons to be tested for STDs as none would admit to having sexual contact with Tessie and there were no other males who had contact with her. Victor was found to have an STD and he was arrested for the sexual abuse of Tessie. The family was torn up: furious, disbelieving, anguished about Victor’s and Tessie’s welfare, etc.
In her initial interview with CPS, Barbara told the worker that Tessie was just a “problem child”: refusing lately to go to bed and insisting that she sleep with her mother, whom she kept constantly awake by her nightmares and tossing and turning. Barbara said that Tessie’s bad temper, throwing things, and never settling down forced Barbara to smack her sometimes. “Then she got nice and quiet and didn’t make a peep for days,” Barbara said.

Directions
Your role is to assess the possible exposure to trauma and the trauma reactions that Tessie is showing by using the multiple domains of a comprehensive trauma assessment. To accomplish this, imagine you have the opportunity to interview Barbara. Then, in a written format answer the following five questions:

1. What questions you would like to ask Barbara? Please list ONLY your top 6 questions! For each question, state your reason for asking it. How does each question contribute to the assessment of an important domain of Tessie’s life covered in a CANS assessment?
2. Please identify 3-4 possible signs that would indicate that Tessie is having some longer-term trauma reactions. Describe each sign and what it might indicate that would need further exploration with Barbara.
3. Please describe how you will engage Barbara in the assessment process knowing that she is guarded and overwhelmed herself.
4. Please spell out the picture that is forming in your mind about Tessie’s possible trauma exposure.
5. What are the risk and protective factors in Tessie’s situation that could enter into her treatment?