On a scale of 0 – 3, being Need is

On a scale of 0 – 3, being Need is dangerous rate this ansa vignette Rate Stacys story Stacy is a 20-year-old mother of two children, aged 2 and 3. She presented for treatment as a referral from a vocational rehabilitation program where she applied for assistance with paying for school to be a physical therapist. She reports she is ready and willing for any treatment or support they can provide. Stacy is a high school graduate who has held many brief jobs, but has never been able to sustain employment, always quitting out of boredom or being fired for conflicts with supervisors or co-workers. Stacy wants to go to school, but is worried she will quit again as she has in the past.Stacy was hospitalized twice as an adolescent for suicide attempts. She also engaged in some brief cutting behaviors as an adolescent, and even though she still has urges, she has resisted them for the past two years because she does not want to have any permanent scars.Stacy says she feels emotionally out-of-control much of the time. She reports feeling down and irritable most days and frequently becomes explosive with those around her. She has been fighting with her husband, whom she sees as unhelpful and unsympathetic to her problems. In the past two weeks she assaulted her husband with a broomstick and he responded by hitting her back and punching holes in the wall. She has called the police on him twice, but then regretted the call because she believes she is responsible for the fights. She reports a sense of emotional release when she provokes her husband to hurt her and states that she does this impulsively. Stacy is aware of her problems, but is not aware of the implications that come with these problems.Stacy reports a history of multiple sexual assaults by strangers and acquaintances as an adolescent. She reports flashbacks, difficulty developing sexual intimacy with her husband, and intrusive thoughts. She reports being terrified those around her will abandon her, but admits that she pushes people away with her verbal and physical aggression. Stacy recognizes that her fears interfere with her ability to get close to people, and probably contributed to her problems at work when she was employed. Stacy has regular contact with her parents, but she feels very ambivalent towards them. She blames them for not protecting her from abuse. She frequently asks for their support and then becomes angry and blaming when they do not provide what she feels she needs. Stacy perceives her mother as especially judgmental and critical and says she is unwilling to help when Stacy feels overwhelmed. She responds to her mother’s reluctance to help by screaming at her or withdrawing. In her previous hospitalization, Stacy was diagnosed with borderline personality disorder. Stacy cares greatly for her children; she takes great pride in them and has high hopes for their futures. Stacy is currently able to manage her responsibilities as a parent. She is a regular member of a church where she volunteers teaching Sunday school. She says she feels guilty about her hypocritical behavior when she is at Sunday school and then behaves abusively at home. She has some friends in the church who sometimes help her with childcare, but she says she cannot always be herself around them because she worries they will judge her and think she is a bad person. Stacy reports feeling peaceful and happy while at church; when at home, drawing and painting help calm her down when she is feeling out-of-control.Stacy wants to be a good parent and a good Christian, but is fearful that she is inherently a bad person and may never be able to control her behavior and temper. She is hopeful about making progress by being accepted into the physical therapy program. Suicide Risk 2. Danger to Self or Others 3. Self-Injurious Behavior 4. Other Self-Harm 5. Exploitation 6. Gambling 7. Sexual Aggression 8. Criminal Behavior

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