Case Study – Adolescent Male Geneva Giles Oakland University Dr. Scott Smith social work 311 June 13, 2010 Introduction Role of Person in the Environment theory in Understanding Social Problems Sexual Assault and Homeless Male Adolescent Sexual assault overview Homeless/Runaway differences Paper Intent and Overview This paper will present a hypothetical case study of a 17-year-old African American male who has been referred for social work services after being a forced recipient partner during oral and anal intercourse.
Using the person in the environment theory, antecedents of the adolescent’s behavior will be presented in he context of his family, social environments, with specific attention to the unique experience of male homeless/runaways in the United States. The adolescent’s current functioning and likely trajectory will be presented, informed by current research on male sexual assault, social networks of high-risk youth, and statistics from the RAINN 1998 report. Demographics and Social History Biographical Information M. H. is a 17-year-old, heterosexual, African American male who was born in the U.
S. M. H. was brought up practicing Islam, and enjoyed worship along side his maternal grandparents sunset on Thursday to sunset on Friday. His grandfather taught him how to pray daily, which is performed five times (after dawn, at noon, at mid afternoon, after sunset, and at night). M. H. smiles as he speaks of his religious practices, then distress came across his face as he states, “l stop doing it all around 11 months ago when my grandfather died. First my grandmother when I was 10, then my grandfather and they where what love is. Physically, M. H. presents with poor hygiene, pacing, wringing his hands and is tearful. He complains of sore throat, chest pressure, palpitations, and shortness of breath. He is diaphoretic and his hands are trembling. His blood pressure is 140/90, pulse 1 10, and respirations 30 and shallow. Visible laceration bruises, and abrasions are noted along with torn clothing. Psoriasis is apparent, characterized by large, red patches covered with thick silvery scales in the outermost layer of the epidermis of the neck, arm, legs, and upper shoulders.
Secretion of blood from a patchy scale on the upper left shoulder, and the fingernails are pitting with yellow discoloration of both hands. Detroit Receiving Hospital on three occasions. At 10-years-old he was brought in by biological mother with a fractured femur and various bruises. Mother states that her son was horse playing and fell with a cousin in the basement. At 11-years-old he was brought in by step-father and mother with a dislocated left shoulder and abrasions to the left torso; step-father and minor states they were playing football. At 13-years- old M.
H. was brought in via emergency medical technicians and step-father, non- responsive to stimuli and lab results indicates high doses of acetaminophen and codeine phosphate and tested positive for Human Papilloma Virus (HPV). Social Environment For the past 1. 5 years, M. H. , has resided on the streets of Detroit, MI sleeping nywhere he can (e. g. , alleys, bus stations, squatting in abandon buildings, under freeway overpasses, etc). M. H. was raised by his maternal grandparents until he was 10-years-old and he moved with his biological mother and step-father.
M. H. began physical, mental, and sexual abuse from his step-father three weeks after moving in. “l didn’t trust my mother cause she let it happen to both of us,” states M. H. When asked how frequently his step-father mentally, physically, and sexually abused, M. H. offered the name calling and hitting, punching, or even pushing of me would always appen when my mother was awake, and if she protested then he would start on her; this would always happen if his step-father was drinking and/or smoking marijuana (approximately three nights per week).
The sexual abuse would always occur at night or early mornings when his mother was sleep or left for work; the sexual abuse always accompanied threats of killing him and or his mother if he ever told. The frequency of physical, mental, and sexual abuse was confirmed by his cousin, who reports observing the abuse on several occasions and was also threatened; she reports that her aunt tried to leave with M. H. n two occasions and her step-uncle police coworkers would bring her back home. M. H. ‘s cousin would witness fractures and falls caused by the step-father and the progression of years made for incidence of injury greater.
As a newborn, M. H. ‘s mother married and moved with his step-father in Detroit, MI leaving him to be raised with her parents in York, Alabama. Prior to him turning 10- years-old he had a visit from his mother twice, offers M. H. His grandfather owned numerous acres of land and a trust fund up for M. H. however; he can not touch any of the funds until his 22 birthday. At age 16. 5 M. H. as beaten by his stepfather, after the abuse he climbed out of his bedroom window and have been homeless for the last 1. 5 years. M. H. acks shelter, health insurance, and has no means of income which places him below the poverty line. M. H. ‘s grandparents obtained a fourth and sixth grade education, and felt it was important that their daughter went to college; she graduated with a Bachelors degree in Education, and although M. H. excelled in school his attendance became intermittent then ceased. M. H. states that he would like to get his G. E. D and is desperate for help in getting off the streets and repairing his life. Victimization from sexual assault while being homeless is what brought M. H. nto the local emergency room, prompting his referral to the social work department. Statement of the Problem Five hours post forced recipient partner during oral and anal intercourse M. H. was brought into the local emergency room by his cousin. Since the sexual assault, he complained of pain in his anal region, painful defecation with blood streaking of the toilet paper and a sore throat. There was a recent laceration on the right shoulder, and visible bruising on the left hip. The pharynx was inflamed, but there was no ropharyngeal ulceration. External gentialia were normal, as was abdominal examination.
Redding of the perianal region was noted, together with multiple linear shallow fissures within the anal canal along with moderate oedema of the distal 4. 5 cm of the rectum. M. H. was squatting in an abandon house with two of his friends and as he was getting dressed for the day his friends went to get food. M. H. heard someone enter but thought it was Tim (friend) because he seen that Tim forgot his favorite blue Jacket. Someone grabbed him from behind and forced him onto a box spring as he covered M. H. outh with a cloth. He was ordered not to scream as the assailant removed the cloth but placed a carving knife to this throat.