Client Background: Marie Quadro is a twenty-three year old Hispanic woman who lives in Bronx, New York. She lives with her boyfriend Billy in a rundown apartment in what is known to be a rough section of the city. She and Billy are addicted to heroin and have been for three years. Marie was born in the states to parents who moved here from Puerto Rico. As far back as she can remember, she and her family have lived in poverty. Marie’s father never kept a job long. He was an alcoholic who was killed in a street fight when Marie was 13. Marie’s mother withdrew from the family after her father’s death. There are six children and Marie is number 3. Her oldest sibling, Angelina, was the family’s only means of support besides welfare. She worked at a diner as a hostess. Marie’s mother eventually focused all of her energy into her religion and is somewhat fanatical about her beliefs. Marie has an older brother and a younger brother who are in prison. Marie met Billy, who is five years older than she, when she was 15. He was someone who was concrete in Marie’s life when everything else seemed to be in turmoil. She felt as though no one had time or cared for her. Billy provided drugs that allowed her to escape reality. She moved in with Billy at the age of 17 and neither she nor Billy have a legitimate job. Billy panhandles when he can but Marie is the one who provides most of the money for rent and drugs. She is a prostitute. Presenting Issue: Marie’s style of communication comes across as volatile. She seems bitter toward anyone who tries to suggest change. She has visited the clinic because she thinks she is pregnant. Her breasts have been very tender and she has not had a period in a while. She knows she is jeopardizing the baby by continuing to do drugs, but does not think she can quit. She has had withdrawals before and knows that she cannot go through that again. She is not sure she wants to raise the baby but she is sure she will not have an abortion because it goes completely against her Catholic beliefs. She is almost positive the baby belongs to Billy because she uses condoms with all of her customers. He is encouraging her to keep their child. Communication Style: My communication style with Marie will be warm and friendly but non-evasive. My opening lines would go as follows. “Hello Marie. My name is Paula King and I am a counselor here. How can I help you? Could I get you anything to drink? Feel free to sit anywhere you like.” My goal is to make Marie feel as comfortable as possible. Most important, I will listen intently to Marie. I will encourage her to speak and I will be open and honest with her. Many times someone who is addicted is used to using manipulative techniques in conversations. He or she may tell us what we want to hear. It is important to be aware of body language. I will make myself available to conversation. Boundary Issues: Whereas it is important to develop a trusting relationship, it is also imperative to maintain a professional distance. If I get too involved I may lose focus and objectivity of the issues at hand. This does not mean that I will act cold and distant toward her, It means that I will not take on the personal responsibilities of her situation. “Boundaries are the framework within which the counselor/client relationship occurs. Boundaries make the relationship professional and safe for the client and set parameters within which services are delivered” (Dinfield, 1998, pg.1). As her counselor, I must make sure to aid Marie without stepping beyond the boundaries. Attending Behaviors and Help Techniques: My behaviors can possibly encourage Marie to open up and show her that I have an interest in what she is saying. I will make sure to have eye contact with Marie and face her at all times during the conversation. I will make certain not to perform another task while she is talking. My voice will remain calm and clear and I will speak with medium volume. I will ask Marie questions that require more than single word answers. Hopefully, using these techniques will allow Marie to feel at ease and comfortable during our session. Nonverbal Communication in the Client: The nonverbal communication I would look for in Marie would consist of eye contact, facial expressions, tension in the body, body position, gestures, space issues, crossed arms, crossed legs, the tone of her voice, voice volume, sweating, and pupil size. All of these nonverbal cues can help me determine the state of Marie’s mind as well as how responsive she is going to be to the help offered. “Research indicates that nonverbal communication accounts for approximately 70% of a communication episode” (Industry Collaboration Effort, 2010, pg.2). Cultural and Religious Sensitivities: Marie grew up in a household that was based on Puerto Rican culture. It is important not to criticize any part of Marie’s heritage. As most Puerto Rican Americans, Marie is Roman Catholic. Although she does not actively attend church services, she still holds her religious beliefs sacred. Marie chooses to adhere to the Catholic belief that abortion is unacceptable and she says she will have the baby. There is no other option for her. Knowing this information, I can format aid and solutions that can help Marie with her current situation. Rehabilitation and Therapy: Once a relationship is established between myself and Marie, my forst priority would be getting her the medical attention she needs. Our next step would be detoxification and rehabilitation. I believe Marie will continuously need individual and group therapy as well as education in family and child care.

References Catholic.Org. (2001). Catholic Facts and General Knowledge. Retrieved from http://www.catholic.org/prayers/beliefs.php

Catholic.Org. (2001). Catholic Facts and General Knowledge. Retrieved from http://www.catholic.org/prayers/beliefs.php

Dinfield MSW, RSW, Gary. Interaction Consultants. (1998). Professional boundaries in health care relationships. Retrieved from http://www.yoursocalworker.com_boundaries

Effort. (1997). Non-Verbal Communication and Patient Care. Retrieved from http://www.rihlp.org/pubs/nonverbal_comm_andpt_care.pdf. Industry Collaboration NCC,

Mashak, MS, NCC, Barbara, Active Listening Workbook. (2008). Learning to listen. Retrieved from http://www.ok.ngb.army.mil/jl/sarc/sarc_document.Active_Listening_Workbook_Learning_To_ Listen.pdf.

University of Phoenix. (2011). Interviewing in Action in a Multicultural World. Retrieved from University of Phoenix, HSBS322 website.

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