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 Post an explanation of the skills and considerations needed to conduct an initial assessment with Aaron. Specifically:

  • What does Aaron need, and why?
  • What questions would you, as the social worker, ask to provide him with support and better understand his story?

Then, analyze Aaron’s experience as a marginalized ethnic group in the United States.

  • What systems does Aaron interact with?
  • In what ways might the dominant ethnic group be impacting Aaron’s experience?


© 2021 Walden University, LLC. Adapted from Plummer, S. -B., Makris, S., & Brocksen, S. M. (Eds.). (2014). Social

work case studies: Foundation year. Laureate International Universities Publishing.


Aaron is a 24-year-old, unmarried, heterosexual, Caribbean immigrant male who is
experiencing symptoms of anxiety and depression. Aaron reports no history of mental
health treatment nor any medical or legal problems. He admits to social drinking but
denies use of illegal substances. He lives alone in a room he rents above the restaurant
where he works. He works 24 hours a week as a waiter, has few friends, and is a part-
time student at a local university, where he is working on an undergraduate degree in
biology. Aaron came to speak with me, a university counselor, because he is having
difficulty concentrating and finding the motivation to study. Aaron denied any thoughts
or plans of suicide or homicide and stated that he felt hopeless and nervous.


In the first session, Aaron presented as preoccupied and was indifferent to attempts to
engage him in the intake process. When asked what he thought precipitated counseling,
Aaron said that he had a difficult relationship with his parents, who, he stated, “don’t
have a clue” what he’s going through. He also reported that his younger brother passed
away not long ago. When asked what he wanted to work on in counseling, he said that
he wanted to address the dynamics of his family and the inability to communicate.
Subsequent sessions explored Aaron’s perspective on his family, the strained
relationship between Aaron and his parents, and the loss of his sibling.

During one session, Aaron said his parents had always favored his younger brother,
which had been a source of conflict between Aaron and his parents for years. Aaron
shared that his academic interests and achievement had been ignored by his parents
and had never been a source of interest for them.

In a subsequent session, Aaron stated that he had always felt disconnected and
different from his parents and brother. Aaron’s family immigrated to the United States
from Guyana when Aaron was 8 years old and his brother was 2 years old. His parents
brought only his brother and left Aaron with his grandmother, informing him they would
”send for him” when they were settled. Seven years later, at the age of 15, he joined his
family. Aaron reported that reuniting with his family after all that time was difficult. Aaron
had always felt rejected by his parents because they did not bring him to the United
States with his brother. He experienced a void in his relationship with his parents and
brother, and he felt there was an unspoken alliance between his parents and his
younger brother that he did not share.

Aaron said that he was often made fun of by peers for not losing his accent and that he
struggled with feeling a part of his new community. His family put pressure on him to
quickly adapt to this new way of life, ridiculing him for being homesick and missing his
grandmother. He said that his parents rarely attended the West Indian activities he
participated in, and when they did, they spent more time critiquing his performance than
enjoying it.


© 2021 Walden University, LLC. Adapted from Plummer, S. -B., Makris, S., & Brocksen, S. M. (Eds.). (2014). Social

work case studies: Foundation year. Laureate International Universities Publishing.

In the following sessions, Aaron was encouraged to tell the story of his family and how
the immigration process disrupted their connections with one another and how this may
have affected their ability to grieve together as they faced the death of his brother.
Using genograms and having Aaron educate me about his country, I was better able to
understand his family’s immigration history and the roles played by extended family
members. This approach allowed Aaron to talk more about how and when his anxiety
and depression manifested. Later, I learned that these symptoms had always been
mildly present but became more acute after the death of his brother. Aaron grieved the
loss of a brother and examined feelings of loss around his relationship with his parents,
who were both limited in their ability to include him in their own grieving processes.

After several sessions, Aaron was able to talk more openly about his frustration and
disappointment with his family and identify the losses they had all incurred. He allowed
himself the opportunity to grieve his brother and the lack of relationship with his parents
and began to consider the possibility of a new relationship with them. Aaron reported a
reduction in his feelings of anxiety and depression and resumed interest in his academic
work. Aaron and I discussed termination at the end of the semester with a
recommendation that he continue with individual therapy in the summer months.