Sunday, May 01, 2016

Case Summary of an At Risk Youth: Rachel from Georgia Rule


Case Summary of an At Risk Youth, Rachel: A character from Georgia Rule
An at risk youth is an adolescent who is in danger of future negative outcomes due to possessing a “set of presumed cause and effect dynamics” (McWhirter et al., 2013, p. 8). The circumstances that create an at risk youth are “developmental and ecological” (McWhirter et al, 2013, p.224). During a teens early childhood he or she is effected by multiple factors, including: economic, lack of bonding, inconsistent parenting, ineffective or abusive parenting, poor monitoring, training in antisocial behaviors, as well as ecological, cultural, and environmental factors (McWhirter et al., 2013, p. 225).
Character Overview
Georgia Rule is the story of a rebellious and out of control teenager Rachel. The movie opens with Rachel and her mother, Lilly fighting in the car on the way to Lilly’s mother’s home in Idaho. Rachel’s delinquent behaviors led to Lilly deciding the best place for her was her grandmother Georgia’s home in rural Idaho. The car fight ends when Rachel demands her mother lets her out and proceeds to walk to town. Harlan, a handsome yet innocent minded teenager from town found Rachel and attempted to help her. Harlan and Rachel find a ride with Simon, a friend of her mother’s, who stopped to offer them help. Harlan and Simon both find Rachel is too much to handle as she makes multiple overt sexual gestures and comments on the short trip into town.
Rachel’s mother Lilly makes it to Georgia’s first and does not bother to wait and see if Rachel made it ok before heading back to California to be with her husband, Rachel’s stepfather, Arnold. Lilly and Georgia do not have a good relationship either and it is clear that the decision to bring Rachel to her was made in desperation after all other attempts to intervene had failed.
Rachel’s overly sexual and rebellious nature causes quite a scene in the small Mormon town, but through all of the behaviors, a hurting adolescent can be seen. Rachel responds positively to the strict “Georgia Rules” imposed by her grandmother and while she bucks against them at first, she seems to thrive on them. While in her grandmother’s home she begins working in a veterinary clinic and befriends Simon and Harlan, the men she met in the opening scenes of the movie while hitch hiking.
Rachel repeatedly attempts to break boundaries with Simon, but he does not allow her, to do so. Because of this, she develops a trusting relationship with Simon. This trust leads to her disclosing the sexual abuse she had experienced for years at the hands of her stepfather, Arnold. Rachel also discusses her father’s death, which occurred when she was younger with Simon. While her father’s death is not discussed at length, it is clear that the loss has had an effect on Rachel.
Simon tells Georgia who in turn tells Rachel’s mother Lilly about the abuse. Lilly comes to town to confront Rachel. For the first time in the movie the viewers see a weakness in Rachel. After telling what happened in the middle of an argument by saying, No he never touched me, he never…and describing multiple incidents of abuse, she shuts the door and can be heard crying. Georgia checks on Rachel and tells her she is proud of her for telling.
Talking about the abuse and the consequences becomes too much for Rachel and she again recants her story. After telling her mother, Lilly spends days drunk in Georgia’s home and makes multiple hurtful statements to Rachel. This behavior led Georgia to send Rachel to stay with Simon. Arnold, her Stepfather arrives and denies everything. Even with Rachel recanting her story, Georgia does not fall for it and continues to encourage Rachel to tell the truth. In a last ditch effort, Rachel confronts her stepfather and threatens him with telling everything if he does not give her money and make sure her mother is happy, along with giving her his car. The stepfather agrees.
Tragically for Rachel, the mother chooses to believe that Rachel was lying rather than accept she had allowed her daughter to be raped by her husband for years. She decides to go home with Simon. On the drive out of town the stepfather tells Lilly he decided to give his car to Rachel. Knowing that a car was the first bribe that Arnold gave Rachel when he raped her makes Lilly realize Rachel was telling the truth when she disclosed the abuse in the first place. The movie ends with Rachel, her mother, Harlan, Simon, and Georgia in various scenes discussing moving forward and working on healing as well as prosecuting Arnold for the abuse.
For the first time in Rachel’s life, she has a positive and healthy support system. By coming to her grandmother’s home she was able to form positive relationships and healthy boundaries. Georgia’s rules taught Rachel responsibility and respect for both herself and others. While the road ahead will be difficult, with proper treatment Rachel will be able to heal from a lifetime of hurt and poor life choices.
Legal and Ethical Issues
Treating a teen that has experienced childhood sexual abuse is complex. Complex family interactions make navigating ethical issues while ensuring that the rights of multiple parties are not violated is difficult (Haverkamp & Daniluk, 1993). According to Thompson (1990) the following ethical principles should be utilized in the decision-making process regarding childhood sexual abuse: beneficence, autonomy, fidelity, justice, nonmalficence, and self-interest.
The primary responsibility of the counseling relationship is “to respect the dignity and to promote the welfare of the clients” (American Counseling Association, 2005, A.1.a.). This responsibility includes the principle of nonmalficence, commonly known as “do no harm” (ACA, 2005, A.4.a.). In order to prevent causing harm to Rachel, it becomes necessary to protect her from outside harm, her stepfather, and help improve the relationship with her mother Lilly
Autonomy is the “maximization of the individuals ability to choose freely and competently how to conduct his or her life” (Haverkamp & Daniluk, 1993). There is a conflict when it comes to protection and autonomy when it comes to Rachel’s case. Rachel chooses to recant her story after becoming overwhelmed with the consequences. While it may be the easier route, and the one that Rachel chose, her autonomy is trumped by the need for protection.
The American Counseling Association (ACA) code of ethics states that, “through a chosen ethical decision-making process and evaluation of the context of the situation, counselors are empowered to make decisions that help expand the capacity of people to grow and develop” (American Counseling Association, 2005). The goal of beneficence is essentially to improve the lives of those the counselor is working with (Haverkamp & Daniluk, 1993).  This universal guideline is imperative to understanding any of the other codes, as without a commitment to protect and help clients improve, there is no need for other goals.
Fidelity includes protection by keeping the client safe from harm, regardless of where that harm originates (Corey, Corey, & Callahan, 2011). As a counselor there will be times when one is made aware that the client is no longer safe. In Rachel’s case, her primary source of harm is her stepfather Arnold. The American Psychological Association (2002) posits that counselors have a primary responsibility to protect clients confidentiality, but that the client needs to be informed of potential situations when that confidentiality must be breached (APA, 2002, 4.01). Protection is one of those times when the client’s need for safety trumps the need for their information to remain private.
Justice as described by Haverkamp & Daniluk (1993) as fair and equal treatment applies in Rachel’s case because she is a nonequal person compared to her stepfather. She deserves protection from his sexual abuse that outweighs his right to privacy. In Rachel’s case, a report should be made to child protective services or other authorities to begin the investigative process and hopefully and ultimately make the stepfather pay for the harm he has caused.
Self-interest includes the “responsibility of self knowledge, self improvement, self protection, and self care ((Haverkamp & Daniluk, 1993). Rachel’s case is one that is incredibly complicated; it will take a well skilled therapist to help her navigate out of the destructive world that both she and her family have created. A therapist must first make sure they are competent to handle the complexities of Rachel’s case. The ACA Code of Ethics (2005) cautions counselors to “practice only within the boundaries of their competence” (ACA, 2005, C.2.a.). Continuing education and seeking the advice and guidance of others are listed as ways to maintain and improve confidence within the counseling relationship (ACA, 2005).
Individual Characteristics of High Risk Youth
Rachel posses multiple individual characteristics of a high risk youth including: low self esteem, depression, drug and alcohol use, legal trouble, negative peer influences, sexually aggressive, early sexual activity, hopelessness, impulsive, and anger (McWhirter et al., 2013). Rachel endured years of sexual abuse at the hands of her stepfather which lead to multiple delinquency behaviors manifesting including defiance of authority, impulsive behavior, and drug use as described by Ford, Chapman, Mack, & Pearson (2006). Ford et al., (2006) report three types of psychological and behavioral problems are involved with delinquency: problems maintaining attention and managing impulsive or hyperactive behavior, pervasive indifference, negativity, or hostility towards others, and aggressive violations of social rules, norms, and laws. Rachel’s behaviors clearly follow adhere to the definition of delinquency outlined by Ford et al. (2006). Throughout the movie she makes impulsive and sometimes-dangerous decisions such as hitch hiking, running away, acting out sexually with strangers. While talking with others Rachel discusses previous behaviors such as stealing and wrecking a car, drug use, and major school behavioral issues that resulted in her being expelled.
Family Problems Related to At Risk Youth
Rachel grew up in a blended family following the death of her father. Her mother was an alcoholic and her stepfather sexually abused her. Rachel lacked having an extended family or support system until her mother dropped her off at her grandmother Georgia’s home. Rachel and her mother shared a tumultuous relationship built on years of the effects of alcoholism and her mother’s lack of protection for the sexual abuse. While the mother was unaware of the abuse until after dropping Rachel at Georgia’s, a child looks to their mother to protect them. In Rachel’s mind it is likely she felt that her mother should have known and should have protected her. Rachel also likely felt that if her mother were not an alcoholic she would have been clearer headed and been able to see what was happening.
Rachel experienced traumatic victimization due to the sexual abuse by her stepfather. Kerig & Becker (2012) posits that research shows that delinquency female adolescent problem behaviors commonly “relates to an abusive and traumatizing home life” so it is not shock that Rachel has multiple behavioral issues and at risk behaviors  (p.121). Clinton and Clark (2010) report that the victim of child abuse often loves their abuser, which makes them vulnerable. Despite his abuse, Rachel recounts feeling loved when Arnold would hold her tried to focus on that instead of the abuse that was happening. The sexual abuse lead to significant social and psychological problems for Rachel that include anxiety, depression, emotional detachment, sexual dysfunction, withdrawal and a compulsion to participate in risky and delinquent behavior (Clinton & Clark, 2010). Paolucci, Genuis, and Violato (2001)  elaborate on the problems found in victims of childhood sexual abuse stating that they may experience many detrimental effects including those presented by Rachel: Post Traumatic Stress Disorder (PTSD), depression, sexual promiscuity, and poor academic achievement.
Children who have experienced sexual abuse display sexualized behavior that often includes promiscuity and sexual aggression (Paolucci, Genuis, & Violato, 2001). There are multiple instances in Rachel’s history where she uses her sexuality to obtain perceived control of the situation. In the opening of the movie Rachel gets out of her mother’s car and into a strangers. She tries multiple ways to get him to look at her, including hiking up her dress and putting her legs up on the dash. When he does not give her that type of attention she becomes frustrated and gets out of his car. Later she meets a young man named Harlan. She makes multiple sexual comments to Harlan and eventually performs a sexual act on him. When girls in the community bully her, rather than fight back in a traditional way, she threatens to sleep with all of their boyfriends if they do not leave her alone. Finally, when she feels escape from her stepfather is hopeless, she shows up at his hotel room dressed provocatively and again attempts to repeat the abuse cycle but on her terms.
While to the outsider, Rachel’s behavior looks promiscuous; in reality it is just a child taking control of the thing that was taken from her. Children who have been repeatedly sexually abused feel they have no escape, so they make sexuality their weapon (Briere & Runtz, 1986). If they choose to have sex then they aren’t being abused or raped. While it is distorted thinking, it is a protective measure that allows them to maintain some sense of control in an otherwise scary and unpredictable world (Paolucci, Genuis, & Violato, 2001).
School Issues That May Impact At Risk Youth
School is not discussed much in the movie, though it is clear that she experienced difficulties in school related to her behavior and choice of peers. She also failed to apply for college despite pretending to do so. Rachel does briefly discuss being involved with a boy who was a juvenile delinquent, but her purpose in doing so was to get him to threaten her stepfather. In essence, Rachel found a bigger monster to protect her from the one she dealt with on a daily basis. 
Rachel’s self-reporting of negative school behavior and statements by her mother indicate that she is a maladjusted adolescent at risk for dropping out of school (McWhirter et al., 2013). Maladjusted dropouts have “high levels of misbehavior, a weak commitment to education, have poor school performance, invest little in school life and are frequently a disciplinary problem” (McWhirter et al., 2013, p.159). It is this writers opinion that a great deal of Rachel’s previous negative and acting out behavior were cries for help attempting to get out of the situation she was in with her stepfather. By removing her stepfather from the picture and pairing Rachel with strong support systems, Rachel’s intelligence and creativity make her a good candidate for completing her college education.
Prevention, Intervention, and Treatment Options
An adolescent’s response to trauma is the development of adaptive or maladaptive behavior patterns “reflects the interplay of past and current stress and support factors (Wolfe & Gentile, 2013). Working within a family systems framework will help change the dysfunctional patterns of behavior and communication that have developed between Rachel and Lilly as well as Lilly and Georgia (McWhirter et al., 2013).
Adolescents are typically accused of having an attitude problem and Rachel most certainly is the definition of that. Rachel has a persistent negative attitude about life which is “evidenced by grumpiness, social detachment, and frequent complaining (Clinton & Clark, 2010, p.58). Throughout the movie Rachel complains about everyone and everything she encounters. She frequently finds a weakness of someone else’s and points it out. While some level of these behaviors is normal, the extensive nature of Rachel’s negativity indicates that she needs professional help (Clinton & Clark, 2010). The first step in helping Rachel learn respect is to respect her thoughts and feelings (Clinton & Clark, 2010). The years Rachel spent with her voice, feelings, and mind state being ignored have lead to her thinking that the only way to get her point across is to cause a scene and that she has to fight for and protect herself because no one else is going to. When she goes to her grandmother’s home, Rachel sees that Georgia cares about where she goes, what she says, and most importantly what she does. When the abuse is revealed, Georgia validates Rachel and praises her for being brave and telling her story. A strong and positive support system will be the greatest help in Rachel becoming a healthy and well-adjusted adult.
While a difficult notion to consider, forgiveness is vital for Rachel to heal. According to Clinton and Clark (2010) forgiveness has multiple benefits that include: decreased anger and negative thoughts, decreased anxiety, decreased depression and grief, decreased vulnerability to substance abuse. Rachel has a history of hurt, which includes neglect by her mother, alcoholism on the part of her mother, loss of her father, and sexual abuse by her stepfather.
When it comes to school it is imperative to find ways to reduce her antisocial behavior, increase academic performance, and increase the connection between Rachel and other teens and adults who are supportive of positive school performance (McWhirter et al., 2013). Clinton and Clark (2010) report that adolescents who have parents involved in their education and who have positive relationships with their parents are more likely to do well in school. By increasing the positive interactions between Rachel and Lilly and improving their overall relationship it is hoped that her school performance will improve as well.
Rachel’s treatment plan should include helping her improve her problem solving and communication skills. She needs to become involved in positive peer groups where she can find a place of belonging and acceptance. She needs to work towards repairing the relationship with her mother and increasing the support she receives from her grandmother Georgia, Simon, and any other adults who have a positive influence on her life. Along with the before mentioned interventions, it would be beneficial to offer opportunities to continue to experience success and build self-esteem such as working at the veterinary office when she is not pursing school. (Corey, Corey, & Callanan, 2011). Rachel seemed to thrive at the veterinary office and enjoyed getting the office organized as well as the power involved in getting people to pay their bills. This success can be a bulding block for other positive steps in Rachel’s life.
Rachel’s disclosure of abuse has lead to her mother’s decision to pursue divorce; in addition to that, there will most likely also be a legal process involving the stepfather and the sexual abuse. Testifying in court against the perpetrator has been shown to be traumatic for victims, especially those who are not yet adults (Kapardis, 2003). Both confrontation of the perpetrator and the “anxiety-provoking atmosphere of the courtroom” have detrimental effects on the victim (Kapardis, 2003). Rachel will need a great deal of support during this time. It is advisable to get her involved with a local support groups for survivors of incest or a local children’s advocacy center in addition to her regularly scheduled therapy.
Rachel is an at risk youth who suffered greatly at the hands of her stepfather and the alcohol induced neglect by her mother. She displays multiple at risk attitudes and behaviors, which left unchecked, can lead to a lifetime of devastation. In the few short months Rachel lived in her grandmother’s home, she made tremendous progress. This can be attributed to a positive support system, effective and consistent discipline, and positive peer and social influences (McWhirter et al., 2013).  A continuation of these circumstances along with multiple therapeutic interventions can help change her at risk status to one of success and triumph.
References
American Association of Christian Counselors (AACC). (2004).  AACC code of ethics: The Y2004 final code. Retrieved from http://www.aacc.net/about-us/code-of-ethics/
American Counseling Association (ACA). (2005). Code of ethics and standards of practice (Rev. ed.) Alexandria, VA: Author. 
Briere, J., & Runtz, M. (1986). Suicidal thoughts and behaviors in former sexual abuse victims. Canadian Journal of Behavioural Science/Revue canadienne des sciences du comportement, 18(4), 413.
Clark, C., Clinton, T., & Straub, J. (2010). The quick-reference guide to counseling teenagers.  Grand Rapids, MI: Baker Books.
Corey, G., Corey, M. S., & Callanan, P. (2011). Issues and ethics in the helping professions (8th ed.). Belmont, CA: Brooks/Cole.
Ford, J. D., Chapman, J., Mack, J. M., & Pearson, G. (2006). Pathways from traumatic child victimization to delinquency: Implications for juvenile and permanency court proceedings and decisions. Juvenile and Family Court Journal, 57(1), 13–26.
Haverkamp, B., & Daniluk, J. C. (1993). Child sexual abuse: Ethical issues for the family therapist. Family Relations: An Interdisciplinary Journal of Applied Family Studies.
Kapardis, A. (2010). Psychology and law: A critical introduction. Cambridge University Press. Retrieved from http://rx9vh3hy4r.search.serialssolutions.com/?ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info:sid/summon.serialssolutions.com&rft_val_fmt=info:ofi/fmt:kev:mtx:book&rft.genre=book%20item&rft.au=Kapardis%2C+Andreas&rft.atitle=Children+as+witnesses&rft.date=2003-01-01&rft.isbn=9780521531610&rft.externalDBID=CINCH&rft.externalDocID=0521531616tnesses_050278_CINCH&paramdict=en-US
Kerig, P. K., & Becker, S. P. (2012). Trauma and girls’ delinquency. In Delinquent girls (pp. 119-143). Springer New York.
McWhirter, J.J., McWhirter, B.T. & McWhirter, E.H. & McWhirter, R. J. (2013). At-risk youth: a comprehensive response for counselors, teachers, psychologists, and human service professionals. 5th Ed. Belmont, CA: Brooks/Cole, Cengage Learning.
Paolucci, E. O., Genuis, M. L., & Violato, C. (2001). A meta-analysis of the published research on the effects of child sexual abuse. The Journal of psychology, 135(1), 17-36.
Quas, J. A., & Goodman, G. S. (2012). Consequences of criminal court involvement for child victims. Psychology, Public Policy, and Law, 18(3), 392.
Thompson, A. (1990). Guide to ethical practice in psychotherapy. New York:Wiley&Sons.
Wolfe, V. V., & Gentile, C. (2013). Psychological assessment of sexually abused children. The Sexual Abuse of Children: Volume II: Clinical Issues, 143.



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