Summary of the Case Mary, a 31-year-old single mother of three children (ages 9, 5, and 3) has been seeing Annabelle, a mental health counselor at a community mental health center for about 4 months. She has become increasingly anxious over past few weeks and reports that she feels frightened all the time, is unable to sleep through the night, and worries that “something horrible is going to happen.” She also admits to having a “couple of drinks” during the evening several times a week. Mary shared during her last session with Annabelle that she is very worried that she is a horrible mother and is afraid that her children will be taken away and placed in foster care. Mary has also met with the social worker at the clinic, Jane on two occasions to help her secure food stamps and get her children appointments at the local dental clinic. Her children Jane, age 9, Johnny, age 5, and Emma, age 3 have met with the child therapist at the clinic, Amy for play therapy during the last 3 of Mary’s sessions. Another counselor at the clinic reported Mary showed up during the last week thinking she has an appointment with Annabelle. The counselor spoke to her about 20 minutes. She reported that Mary was very anxious about some things a neighbor had said to her but calmed down during the meeting. The client appeared to have been drinking. The counselor stated that she told Mary that she would let Annabelle know she had been there. Jane, the social worker reported that when she last spoke to Mary, she sounded disoriented and that she is considering calling child protective services. She would like Annabelle opinion about this call. Amy, the child therapist shared with Annabelle about her third session with the children, with permission of Mary. She stated that the children were dressed in clean clothing, but Johnny was missing his socks and Emma’s shoes were falling apart. She stated that they
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