AODS 255 Final Exam TIMED TEST-4 HOURS TO COMPLETE. MAKE SURE YOU SET ASIDE ENOUGH TIME TO FINISH OR DON'T START IT UNTIL YOU HAVE A LARGE TIME SLOT.

 Final Reflection on Learning

AODS 255 Final Exam

          First, let me say how proud I am of your efforts throughout this course. I have enjoyed interacting with all of you and hope to have a chance to work with you again in the future. This is a very "practical" exam, meaning it requires you to put into practice the information you have taken in all semester. Good luck and I wish you all the very best in your future endeavors.  

Instructions: You will use the following scenario to complete this exam. As you read through the Case of Jose, take a pencil and paper and make notes as you read. Jot down all the relevant facts of the case "as if" you are his Case Manager and Counselor. You work at the Center for Recovery, an adolescent treatment facility in Tierrasanta that has both residential care and an out-patient program. You have 4 hours from the time you opened this exam to finish it. If you have done your preparation, you should not need that much time.

The Center For Recovery has been providing behavioral health and substance abuse treatment since 1997. The Center offers a full continuum of care specializing in the unique and specific needs associated with mental health and substance abuse treatment. The treatment locations offer "a warm and engaging environment that fosters long-term recovery." Each program treats a small number of clients at a time, allowing for truly individualized care that is focused on healing both the client and their family. Each of the Center's programs is led by licensed and expert clinicians in their area of clinical specialty. The Center for Recovery specializes in treating mental health disorders and substance abuse issues along with the underlying causes that accompanied them.  The adolescent transitions program is an intensive residential treatment program for children and adolescents, ages 11 to 18, dealing with issues co-occurring substance abuse and trauma, depression, anxiety, self-harming behavior.  "We empower our clients to self-reflect, gain deeper insight, accept difficult truths when necessary and identify areas for greater overall functioning. Our goal is to help our clients become healthier individuals and functioning members of their family systems". The program provides residential treatment for children and adolescents, ages 10 to 19, who are struggling with alcohol abuse, prescription drug abuse, methamphetamine or heroin addiction or other substance abuse related issues. Treatment is personalized to meet the needs of each individual resident. The Center advertised that it has expertise in identifying and addressing the substance abuse cycle and the underlying issues for our clients.

DO NOT ASSUME FACTS NOT PRESENTED IN THE CASE!

   The Case of Jose

Community and Culture

Jose is a 15-year-old Hispanic male of above-average intelligence. He is of average size and weight and currently in good physical health. Jose is bilingual, equally fluent in both English and Spanish; Spanish is primarily spoken at home. He presents as charming, easy-going, and articulate. He lives on the east side of Oceanside which is nicknamed Posole after a Mexican soup. Varrio Posole (VP) is the name of the street gang in Jose’s neighborhood. Of the 30 documented gangs in North County, about half of those gangs are in Oceanside. Some of these gangs were formed years ago to protect certain ethnic groups. Others are transplants from Los Angeles. Jose was born into a gang family. He says most of the gangs in North County are Hispanic, Samoan and black. He doesn't seem to fear getting injured or killed.

“When you're going to do your stuff, you got a chance of dying,” Jose said. “You got to accept that because you're doing it for your cause -- our community. We don't want people coming over and chasing down a Mexican and beating him up because he's a Mexican.”

Jose and gang specialists say gangs are now more about protecting their money, not their turf. Some of these North County gangs are criminal enterprises, helping to smuggle weapons, push prostitutes, and deal drugs all over the country. Jose says older gang members, who are often strung-out on drugs, are recruiting kids at younger ages to do their dirty work in North County, whether it’s a stabbing, shooting or robbing someone. He says some are as young as 12 or 13 years old. “There is saying, ‘Get them while they're young,” Jose said. “(Older gangsters say) you can still brainwash them. Get them used to juvenile hall. Get them used to the system.”

Family Composition and History

Jose comes from a large Hispanic family. His parents Maria and Joseph, have been married for 25 years. They are undocumented, having entered the US illegally some 20 years ago. All the children were born in the US and live with their parents in a modest Oceanside home. Jose is the middle child, with two older sisters (Betty, age 19 and Alma, age 18) and three younger siblings (twin boys, Marco and Miguel, age 12, and a sister, Mary, age 10). He had another brother who would be 17 now if he were still alive; he died two years ago from a heroin overdose while in Jose's presence.  "We don’t even speak his name in the home anymore—we just pretend he never existed," Jose stated that when they would talk about Joseph (Junior), his mother would cry uncontrollably. Jose said, “What good would it do to talk about him? It won’t bring him back.”

Aside from taking care of her family, his mother cleans 4 houses every week for extra cash. He said his mom is a great cook and loving mother. "She is a 'Madonna' among women and has been through a lot. She just doesn't smile much anymore." His mother is a devout Catholic and an active member of the parish at the Mission San Luis Rey.  His father, while raised Catholic, attends only on occasion, primarily on holidays at his mother’s urging. Jose said they were all forced to go to Mass on Sundays, holidays, and holy days until they reached their teens. His mother says, “I can’t force them to go.”  His older sisters and the younger kids still go to Sunday Mass most weekends. They all received their sacraments and the three youngest kids attend Catholic school. When asked if he attends church services, Jose said: “Men don’t need to go to church.” 

Jose says, ‘My older sisters are good girls, they help my mom a lot. They take care of the younger kids when she is cleaning homes.”  Betty will be starting at Palomar College in 2018, hoping to get some classes completed so she can apply for the nursing program. Alma goes to Oceanside High and will graduate this next June. Alma thinks she would like to go into early childhood education so she can teach preschool someday. His little sister, Mary is everyone’s favorite. Jose said, “Mary is just such a pretty little thing. She’s momma’s little helper. She’s so loving and sweet, we all adore her. If anyone ever touches her, I’ll kill them.”

As to his brothers, he said, “The twins are wild and won’t listen to anyone. They are good boys but don’t think before they do something or say something and they don't like school.  Someday their mouths are going to get them in trouble around here.” He worries about them becoming recruits for the gang.

Joseph, Sr., Jose’s father is still a gang member but stays out of “gang business” if he can and has managed to avoid any run-ins with the law. He stays busy with his Auto Repair business in Fallbrook. He told Jose to stay away from the gang but it didn’t seem to help. Jose's uncles in Los Angeles are deep into the gang culture. Jose’s been in the gang since his brother died two years ago. He said, “Everything changed when Joe died. I didn't just lose my brother. It's like my family dies too.”

Jose was an honor student until his brother’s death. After that, his grades started to slip and he lost interest in school. He hooked up with the gang and started cutting school. He got into a few fights and showed up high a few times. Before his brother died, they would sneak into the garage and steal beers from his dad’s outside refrigerator.  His dad drinks a lot of beer on the weekends so he never noticed any missing. Now his dad drinks every day after work as well as on weekends. He drinks until he passes out. Jose denied any family history of domestic violence or child abuse.

Legal and Substance Use Issues

Jose stole a car in Carlsbad for a ‘joy ride’ and was arrested within 12 hours of the theft. The car belonged to a friend's parents and no charges were pressed for the car theft. This was his first run-in with law enforcement with the exception of “words” with campus police at his high school. He and a friend were under the influence of alcohol and marijuana when they were arrested. They were also in possession of cocaine at the time. Jose said he was holding it for a friend. After the death of his brother, he began getting high on weed on his way to school.  Lately, he has experimented with smoking meth and spice.

Joe spent a few days in Juvenile Hall awaiting his arraignment/hearing. While in JH, he was on his best behavior. The judge was moved by Jose’s parents advocating for their son and decided to give Jose a chance to get his life back in order. Jose has been ordered by the Court to participate in a minimum six-month substance use program. Jose agreed to give treatment a chance. His parents and siblings are willing to participate in any services required of them. The first 90 days will be in a residential treatment program followed by outpatient treatment for at least 3 months.  When he has successfully finished up the required 6-month program, he will remain on probation until he turns 18, provided he has no more arrests or ‘dirty tests.’ He cannot have any gang associations. He has to make up any missing credits for school and graduate on-time. He must meet with his probation officer every month and has to complete 150 hours of community service over the next 6 months.