Crisis Intervention & Management Module

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Hernandez Family Vignette

Joe and Carmen Hernandez are 47 and 46 years of age respectively. They are second generation Americans with ties to Puerto Rico. They report a close relationship with their families although they are not able to visit very often. The Hernandez family lives in south central Kansas.

Joe and Carmen have a strong marital relationship and have endured many challenges to their marriage. They were married as teenagers and their son was born during the first year of their marriage. Carmen was 16 and Joe was 17 when their son John was born. They report that their families were influential in helping them to finish high school and care for their son. Carmen gave birth to their daughter Mary 3 years later and the twins, Carmelita and Angela were born 3 years after Mary. The children are now 20, 17, and 14. Following high school, Joe worked full time and excelled in the computer classes he took at the local community college. He completed his degree in computer programming and has been steadily employed throughout their marriage. Carmen is also employed at the local hospital in the billing department. The family members report caring very much for one another and believe they are going through “growing pains” and believe therapy will help them to get back on track as a family. They report a strong support system with their extended families, work relationships, and church.

The family has sought home-based family therapy services due to problems with their 17-year old daughter Mary. Therapy is no stranger to this family and they are seeking therapy services now because of the positive interactions it helped create about 8 years ago. As a child, Mary was diagnosed with ADHD and depression. After many years of stability, Mary has become inconsistent with her medication and Mr. and Mrs. Hernandez report that they believe she has become involved in gang-related activities. She was recently arrested for burglary and subsequently resisting arrest. She is also behind academically and is not expected to graduate high school on time. Carmen and Mary report being close even during difficult times but have been struggling over the last 3 months. Mary also expresses resentment regarding the attempts by her brother John to “control her.” She reports that John follows her and shows up when she is with her friends. John reports being worried about her and you notice he has become very attentive to his mother over the last three sessions.

Throughout your work with the Hernandez family you notice that Carmen appears to be in much pain, very tired, and seems to have less energy each time you see the family. Carmen contacted the therapist for an emergency session. During this session with the family, Carmen reveals that she has been diagnosed with ovarian cancer. Carmen expects to have surgery next week. She expresses concerns that Mary has become increasingly aggressive since her mother’s diagnosis; the twins are spending more time with their friends; and John wants to move back into the house. Joe is not present for the session and Carmen reports he has not wanted to talk about her illness. Carmen is fearful of what the future will hold for her family and how they will cope with her illness and the subsequent treatment she believes will follow her surgery. She is hoping the therapist can help the family talk about the cancer and adapt to the changes to come.