Risk and resilience framework

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The Smith family consists of Jackie (mother), Ralph (step-father/father), Gary (age 9), Jay (age 7), Jeremy (age 4), and David (age 3). The children have been diagnosed with several disorders and conditions in which medication is necessary. These diagnoses range from anxiety disorders, Attention Deficit Hyperactive Disorder (ADHD), heart transplant recipient, asthma, possible PTSD, and suicidal ideation. Jackie alleges physical abuse from Ralph, the father of Jeremy, David, and possibly Jay, and also states that Ralph has a significant drug addiction.

Jackie left in September 2011, leaving the children with her sister April. Also living in the apartment are: Bob (Jackie's boyfriend), Linda (Jackie and April's mother), Mary (Jackie and April's sister), April's six children, Linda has custody of three of her grandchildren from another daughter, and Mary's four children. When Jackie leaves Ralph and the children, Ralph moves into the three bedroom apartment with the others, bringing the total number living in the apartment to sixteen children, between the ages of 18 months and nine years, and five adults. After a short time, Ralph moves out with Jeremy and David reducing the total to eighteen people living in a three bedroom apartment.

In this case, there are an abundance of risk factors that are evident for everyone involved. One possible risk factor for Jackie could be low self-esteem, depression, anger and hostility, emotional dependency, insecurity, being a victim of physical and psychological abuse, borderline personality traits, antisocial personality traits, using poor parenting skills, marital instability, poverty, and unhealthy family relationships (1). One in three women and one in five teens are affected by domestic violence. Most of the time, only one in ten cases of domestic abuse are actually reported (2). Because Jackie was in and out of foster care as a child, there is a good chance that some type of abuse was taking place when she was a child.

The next risk factors discussed will be for Ralph, Jackie's husband. Ralph has allegedly been physically abusive to Jackie, and Jackie has also reported that Ralph also has a severe drug problem. After Ralph moves out of April's house, Gary and Jay begin to visit him and report witnessing gun use and being threatened with a gun by an older cousin, and have also disclosed drug use and physical abuse by Ralph. The risk factors could be low self-esteem, control issues, low income, depression, aggressive behavior, possible abuse as a child, anger and hostility, unemployment, desire for power with control in relationships, marital instability and conflicts, dominance and control in the relationship, criminal behavior due to gun use could include prison or jail time, and drug addiction and possible overdose risk (1).

Gary is a nine year old boy who suffers from anxiety disorders, ADHD, asthma, and has been diagnosed with a learning disability, although his learning ability level seems to be high. Since Gary's mother left him with his Aunt, he has been displaying anger control issues and acting out in school. He has been shuffled back and forth between his step-father's home, where gun use, ...