Case Study Questions

 
CASE EXAMPLE
 
Michael is a 10-year-old African American boy. He is an only child and lives with his two adoptive parents, Karen and John, in a large city on the East Coast. Karen is a professor at a local university and John is a corporate lawyer. Michael was placed into foster care with Karen and John immediately after his birth, was adopted just before his second birthday, and has never had contact with his biological family. Although Karen and John instantly fell in love with Michael and hoped that they would ultimately be able to adopt him, they were unsure whether they were the best people to adopt Michael because of their own ethnic backgrounds: Karen and John are both first-generation Irish Americans. Karen and John consulted with a respected mental health professional in the city, did as much research as possible about multiracial families, and came to the conclusion that they would do their best to help Michael grow and develop by being intentional about helping him develop healthy racial, ethnic, and cultural identities.
 
At first, this seemed easy. Karen and John read books to Michael that included African American families and traditions; they provided him with dolls and action figures that matched the color of his skin; and they openly discussed how people can look different from one another and still be a family whose members love one another. Michael seemed to be receptive to these things and appeared to be well adjusted. Early on, Michael was a happy child who excelled at school, had several good friends, enjoyed playing soccer, and was an avid reader. However, as Michael entered later elementary school, things began to change. The children that he used to spend time with no longer wanted to spend time with him. His teacher reported that she suspected he was being teased at school but that she had not directly observed this. Michael refused to talk about things at school and started to say things like “I wish I was White” and “Why did God make me Black?” Karen and John were unsure of how to address his concerns, so they simply reassured him that he was unique and special and that they loved him. As Michael’s social group became smaller and eventually disappeared, his grades dropped and he became increasingly sad. Michael is currently a 5th-grade student at an affluent elementary school where he is the only African American child in his class. Karen and John tried to talk to Michael, but the son who once talked freely to them about almost everything would no longer talk with them. It was at this point that Karen and John began to blame themselves and to question how they had raised Michael.
 
Currently, there are many unknowns in Michael’s life, in part because Michael is reluctant to discuss the specific things that may be influencing his functioning and his views of himself (i.e., his various identities). This case example demonstrates (a) how identities are formed not only by familial influences but also by peer influences and environmental influences, and (b) how it can be difficult to ascertain the specific things that are contributing to a child’s struggles with developing healthy identities.
 
DISCUSSION QUESTIONS
 
Karen and John have decided to come see you (a local mental health professional) with their son, Michael. They are hoping to better understand what their son is experiencing, to find ways to best sup­port Michael’s development, and to give Michael a safe place to explore his experiences.
 
The following discussion questions were designed to help you develop a deeper understanding of the experiences of Michael and his family and to brain­storm ways to best support Michael and his family.
 
  1. Imagine for a moment that you are Michael— that you are a 10-year-old African American boy who is being raised by parents of a different race, who is attending a school where you are the only African American in your class, and who wishes to be Caucasian, like the majority of people in your life. Although you are confident that your parents love you, you are experiencing things at school, in the community, and with peers that you don’t feel comfortable talking about. What might it be like to be Michael? What sorts of struggles or messages might he encounter with peers, teachers, community members, and others? What might he be thinking about himself and others? How might he be feeling?
  2. Try putting yourself in the shoes of Karen and John. You have done your best to help your child develop healthy racial, ethnic, and cultural identities, but your child is clearly struggling. What might you do in Karen and John’s situation? What might they be thinking and feeling? What sorts of doubts might they be experiencing? What sorts of concerns might they have for their son?
  3. To most effectively work with Michael and his family, it may be helpful to think about the following questions:
    • What specific things have Karen and John done well to facilitate the healthy racial, ethnic, and cultural identities of Michael?
    • How does Michael view himself? (i.e., What are Michael’s beliefs about his own race, ethnicity, and culture?) How does he feel about other races, ethnicities, and cultures (in particular, the identities of his parents)?
    • What possible things might Michael be struggling with, and how would you go about addressing them with Michael and/or his parents?
    • How would you go about normalizing some of Michael and his parents’ experiences without coming across as dismissive?
    • What additional things might be helpful for Michael to experience (or be exposed to) in order to develop healthy racial, ethnic, and cultural identities? How can Michael be an active participant in developing these healthy identities? How can his parents be supportive of this process?
    • What are some obstacles that Michael may encounter when trying to develop positive racial, ethnic, and cultural identities, given his history, the people he interacts with on a daily basis, his school, and the community in which he lives?
    • What other identities would you like to explore with Michael and his family? Why would you want to explore these things and how would you go about doing so?
  4. Given your own racial, ethnic, and cultural identities (as well as your beliefs about these things), what challenges might you anticipate arising during your work with Michael and his family? What potential biases and strengths should you personally be aware of? What can you do to maximize your strengths as a clinician while also taking steps to make sure that potential biases and/or negative beliefs are addressed and do not affect Michael and his family?