Rosa Lee Cunningham Current Status - Book Report/Review Example

Rosa Lee Cunningham Age: 53 s of Interviews: Evaluator: Reason for Assessment: Throughout her 53-year-old journey, Rosa Lee has led an impoverished life of misfortune which has been plagued by the impacts of surviving as a part of the nation’s working class. Moreover, her childhood has been marred by a history of abuse and the absence of strong familial ties and bonds that are essential for promoting the transition into a healthy adulthood. Given Rosa Lee’s economic background and social circumstances it is apparent that her access to education and literacy in the past has been limited or even scarce. Therefore, during the course of her life she has not been provided with adequate counselling to address tormenting childhood issues and scenarios which have played a pivotal role in shaping her present. Rosa Lee’s criminal record demonstrates and reiterates the notion which assumes that social and economic factors are a critical element in advancing an individual’s motivation to resort to a life of crime and lawlessness. Rosa Lee who has been arrested and jailed for breaching the law 12 times was arrested and found guilty in 1988 for engaging in the distribution and supplying of heroin. Her counselling sessions with a jail counselor at prison revealed that her sense of duty to provide her grandchildren with food is what led to the execution of her actions. In the present scenario, Rosa Lee’s health has been sharply declining and the presence of the threatening HIV virus in her body has progressed into AIDS. The subject’s deteriorating health has reached a stage where she is no longer able to partake in daily activities in an effective manner. Sources of Information: Reporter Leon Dash’s meetings with Rosa Lee and her family, his observations and evaluations which have been comprehensively identified in Dash’s work titled Rosa Lee: A Mother and Her Family in Urban America is the primary source of information which has been utilized for the purposes of this case study. PSYCHOSOCIAL HISTORY: Growing up in Capitol Hill, North Carolina as the daughter of sharecroppers Rosa Lee was forced to withdraw from school as a consequence of teenage pregnancy at the tender age of 13. After escaping domestic abuse in a marriage which took place at the age of 16, the subject was continually faced with abuse at the hands of her mother. Rosa Lee’s relationship history indicates that she has had her eight children with five different men rather than preferring to build a stable and faithful relationship before building a family. As a consequence of familial instability and the failure of previous relationships with the fathers of her children, the subject has lived as a single mother. The economic volatility of Rosa Lee’s life has been characterized by working menial jobs and engaging in illegal activities such as selling drugs and prostitution. Moreover, it is important to highlight that because of the unstable and negative situation Rosa Lee has never been able to maintain a residence thereby, experiencing homelessness on several occasions. As stated previously, the examination of Rosa Lee’s legal history suggests identifies that she has been jailed 12 times. As a result of these convictions which are also associated with theft, she has served a total jail time of five years. Rosa Lee’s children, Ducky, 30 and another daughter aged 29 who has three children both admit to being active consumers of cocaine while, Richard, 36 is serving a prison sentence. Her eldest son, Bobby and daughter Patty, both of whom are in thirties are still reliant upon their mother and do not possess financial independence like their siblings Alvin, 37, and Eric, aged 34 who are the only two of Rosa Lee’s children to have escaped the cycle of poverty and emerge successfully from the slippery slope of misfortune. CURRENT STATUS: Since her AIDS diagnosis, Rosa Lee’s health has steeply declined and she is unable to function properly or conduct her day-to-day activities in an effective manner. Even though, she has virtually resorted to bed rest at this point, her prior health violations and abuse of substances have had a long-lasting impact on her physical and mental well-being. Regular and steady drug use has sadly remained a highlight of Rosa Lee’s life. In the present scenario, she has been experiencing frequent seizures which have transported her to the emergency room of a local hospital on a regular basis. INDICATORS OF USE/ABUSE/DEPENDENCY: Attitude and Behavior of Rosa Lee: Rosa Lee’s attitude and behavior as an adult suggests that childhood trauma and cases of abuse at the hands of her mother and ex-husband have had an adverse impact on her life, decision making and behavior. As a mother of eight children, the subject has taken questionable and seriously endangering decisions to possibly jeopardize the life of her children in several scenarios. For instance, her job history suggests that she has resorted to doing menial jobs to pay for her needs and those of her children, however, by engaging in prostitution Rosa Lee has directly exposed her children and unborn children at the time to be exposed to the risk of HIV which remains incurable and thus, fatal. Moreover, the subject has failed to acknowledge the consequences of her actions as she has chosen not to nurture her children in manner so that they could grow into responsible and respectable if not successful adults. For example, Rosa Lee’s daughter Patty, 32, openly engages in illicit sexual behavior and has developed an arrangement where she receives drugs from dealers in exchange for sex. It is evident that Rosa Lee is aware of these activities because she chooses to consume the drugs which Patty receives as a consequence of these encounters. Moreover, as a single mother Rosa Lee has been unable to keep comparatively respectable and lawful jobs such as working as a waitress and has preferred to indulge in unlawful activities for gaining additional financial benefit. These actions have twice driven her towards homelessness thus, her behavior and attitude can be classified as dangerously carefree, reckless, impressionable, unstable and highly irresponsible. Social Functioning of Rosa Lee: Rosa Lee has not been successfully able to contribute as a productive member of society. Her transmittal of her drug habit to her children is highly problematic considering the notion that it is likely that her children would now instill this habit in their children as well. Prior to her pregnancy at the age of 13, it appears that Rosa Lee intended to transition into a life which was similar to the one enjoyed by the light-skinned girls who went to her school. Even though, her circumstances would not allow it Rosa Lee was still able to carve a circle of friends and peers. This demonstrates the subject’s prior ability to successfully integrate within the community and it is likely that child abuse and domestic abuse limited her ability to assimilate in society later in life as did her circumstances. Since she descended and steeped further into the drug culture, Rosa Lee’s social relationships outside her family only extended to the friends she made at the methadone clinic or mutual acquaintances which perhaps shared the same drug dealer. However, it is apparent that Rosa Lee’s children and grandchildren comprise of a more significant part of her life in comparison with other individuals. Nonetheless, the subject’s social functioning has largely remained inadequate as it has been characterized by lawlessness and the imposition of a negative influence upon her children. Occupational Functioning of Rosa Lee: Since teenage pregnancy triggered her decision to drop out of school at the age of 13, Rosa Lee was unable to resume her education because of subsequent pregnancies which occurred within a short span, the absence of nurturing guidance of an adult and the continued abuse of her mother. Therefore, the subject had no other option but to accept menial jobs to for survival as she raised her children while living paycheck to paycheck. Even though, she initially chose to work as a waitress the low wage prompted her to explore other options which, though illicit would allow her to earn more income and fuel her drug habit. Therefore, Rosa Lee resorted to a life of prostitution, engaged in theft and shoplifting and eventually entered the illegal market of substance and drug supply. In the current scenario, given her deteriorating health Rosa Lee is occupationally functional. Financial Aspects of Rosa Lee: Rosa Lee was born in life of poverty and it is evident that she eventually entered a cycle of poverty which she has been unable to escape. As a single mother, she was never able to maintain a stable source of income and therefore, could not benefit from adequate facilities as she was unable to pay for them. Furthermore, her lack of financial planning and budgeting means that in several circumstances she has prioritized drug consumption over the purchase of necessities. Rosa Lee has changed her residence a staggering 18 times, moving across the state and settling in shelters in the locale. In the process she along with her children has also experienced circumstances where she has remained homeless on two separate occasions. Familial Relationships of Rosa Lee: Rosa Lee has eight children out which only two have been able to escape the cycle of poverty to become family men and homeowners. However, her other children still actively engage in consumption of crack, cocaine and heroin, participate in criminal activity, are unable to hold jobs or move towards financial independence. Rosa Lee’s sons Alvin and Eric who live independently with their families are aware of the circumstances at home and understand the deteriorating situation of their mother. Yet, the circumstances have become so severe that it appears that familial assistance from Alvin and Eric is not enough to rehabilitate Rosa Lee and her other children. While, serving her seven month sentence in prison, Rosa Lee informed her jail counsellor that her motive for engaging in heroin distribution was that so she could provide her three grandchildren with food. Despite of the circumstances, she has strived to maintain familial relationships and support her children by acting as their safety net. However, Rosa Lee’s decisions and encouragement of drug use for her children leans towards destructive behavior which is condemnable and damaging for her children and grandchildren. Legal History of Rosa Lee: Her illegal and illicit occupational activities have contributed towards Rosa Lee’s notorious legal record. She has been jailed for a total of 12 times and has served five years as a result of these convictions. These convictions have largely been linked with selling of illegal substances such as heroin and theft including a sentence in New York for this particular charge in 1964 for which she was later bailed. Health History of Rosa Lee: Rosa Lee’s risky exposure towards and consumption of drugs and alcohol over a prolonged period of time has jeopardized her physical, mental and emotional health and wellbeing. Under her economic circumstances and continued relocation to other areas of the state she has been unable to recognize the implications of her deteriorating condition and has simultaneously indulged and encouraged her children to take up the habit of drug consumption. The physical effects of drug use and alcoholism have manifested in the shape of stomach and body pains, inability to function properly and frequent seizures for which she has been rushed to the emergency room at Howard University Hospital and subsequently hospitalized. As a drug user, Rosa Lee chose to share needles with other individuals for injecting herself with substances and as a consequence she contracted HIV. Her lack of acceptance and realization of the severity of the virus later led to the development of AIDS. Consequently, Rosa Lee also experiences memory loss and suffers from psychological and emotional trauma. Her physical condition has become alarming and she is exposed to several risks and even fatality. Spiritual History of Rosa Lee: In the present scenario, Rosa Lee’s relationship with God has reached a point where she has accepted her situation and vowed to communicate and share her experiences with the community at church. Her visits to the church as a speaker allow her to a gather some amount of extra cash. The listeners and audience who respond to her experiences and understand the plight of the African American community living in poverty suggest her to have faith in God. DIAGNOSTIC IMPRESSION: According to the criteria presented by DSM-IV-TR regarding substance abuse the following aspects must have emerged over a period of at least 12-months or more (Fauman, 2002). 1. Inability or failure to perform major role duties and obligations: Rosa Lee has been unable to prioritize her budget and allocate her earnings to purchase necessary items in favor of spending her income on drugs for herself and her children. 2. Recurrent legal issues associated with substance abuse: Rosa Lee has been convicted of drug use on several separate occasions and jailed for seven months in 1988 for engaging in the distribution of heroin. 3. Continued substance use despite of evident issues stemming from consumption: Despite of her arrests and convictions, Rosa Lee has continued to abide by her habit of substance use. Moreover, to evaluate Rosa Lee’s status the behavior and psychological symptoms of substance abuse can also be applied to her situation to understand the implications. According to Fauman (2002) behavioral changes which emerge as a consequence of alcoholism include promiscuity, illicit sexual behavior and inability to contribute to society as a functional and productive member. Rosa Lee has mothered her eight children with five different men and also engaged in prostitution, there have also been instances where she has provided sexual favors in exchange for drugs. Moreover, despite of being aware of the fact that Patty is involved in similar transactions she approves of her daughter’s behavior. Rosa Lee has been involved in criminal activity and survived on state welfare and benefits, she has been unable to fulfill her duties as a responsible and productive citizen of the community. RECOMMENDATIONS: According to United Nations Office on Drugs and Crime (2002), a comprehensive and effective program must comprise of two distinct stages which are that of the 1) detoxification-stabilization stage and 2) rehabilitation-relapse prevention stage. The purpose of the first stage is to guide the individual towards a physical and emotional state where he/she is able to function properly without the usual or normal intake of drugs and other substances. To achieve this objective, pharmacotherapy is a valid option followed by prolonged stabilizing treatment procedures for individuals who are addicted to specific substances such as cocaine (United Nations Office on Drugs and Crime, 2002). Outpatient treatment generates the most positive results for detoxification however; in Rosa Lee’s case her residence would expose her to further drug use thus, a hospital setting is recommended. After a prolonged detoxification phase the patient would have to be transitioned towards the rehabilitation phase given the observations which satisfy the criteria that the patient is no longer experiencing any severe physical or emotional distresses because of the absence of drugs. This phase can be assessed in terms of the medical components and the adoption of psychological therapies to improve rates of success. Behavioral therapy can also be fruitful however; Rosa Lee has been ingesting drugs for a significant period of time therefore, short-term course durations of medication procedures are recommended. These medications prove to be effective for eliminating the patient’s craving for using and consuming drugs. Then the patient should be shifted to a full-time rehabilitation program in the hospital setting, receive counselling, behavioral therapy and also spend mandatory group therapy hours for achieving maximum benefits. However, the United Nations Office on Drugs and Crime (2002) recommends that residential treatment is most effective for rehabilitation phase because it has higher success rates and enhanced chances of assisting the integration of the patient to normal society once mandatory hours have been completed. Moreover, the setting is a critical element of this aspect, Rosa Lee should be transported from her current location to a setting which would not enhance her cravings by providing opportunities for consumption such as being influenced by children, regular exposure to drug dealers and inability to cope with urges. It is also important to encourage the arrival of positive influences in Rosa Lee’s life, for example, her children Alvin and Eric are successful adults and realize the negative impact of drugs on her mother. Perhaps, it would be ideal to recommend Rosa Lee’s location to her sons’ house once she has been rehabilitated to receive positive exposure. References Dash, L. (1997). Rosa Lee: A mother and her family in urban America. New York: Plume. Fauman, M. A. (2002). Study Guide to Dsm-IV-Tr. American Psychiatric Pub. United Nations Office on Drugs and Crime (2002). Contemporary Drug Abuse Treatment A Review of the Evidence Base. UNODC. Available at: http://www.unodc.org/docs/treatment/Review_E.pdf Read More