Case Study: Loretta

Loretta is a twenty-three-year-old African-American woman who is currently living with her mother and her six-year-old son.

Loretta’s son, Henry, was born when she was a senior in high school. Because Loretta’s mother, Regina, was willing to help out with Henry, Loretta was able to attend a community college. She was enrolled in a transfer program and intended to pursue a bachelor’s degree, possibly in education.

Unfortunately, Loretta’s education was interrupted when she got involved in an active social life that took a turn toward drug use. By this time she had broken up with her high school boyfriend and was seeing someone she saw as worldly and exciting. Loretta had not used drugs of any kind when she was in high school. In fact, she had abstained from alcohol as well. During her year at community college, Loretta’s newfound interest in drinking and drug use increased. She and her friends drank heavily on week-ends and had frequent get-togethers where marijuana was the drug of choice. She managed to stay focused enough to make it to her classes until she was introduced to cocaine by her new boyfriend. She became less and less able to participate in her son’s care, less and less likely to attend her classes, less and less involved in church. She dropped out of school to get a job but the job never materialized. Months went by. Finally, her family (her mother, aunts, older sister, and cousins) realized that she might keep drifting forever unless they did something about the situation. They confronted her and insisted that she go into treatment for drug and alcohol abuse.

Loretta did receive substance abuse treatment 1 ½ years ago. Her mother, really Henry’s sole caregiver, took care of Henry so that Loretta could stay in treatment and a transitional facility for six months. After this period in treatment, Loretta was able to get a placement in a training program for long-term unemployed people. She goes to this training program every day and receives a small stipend. She expects to get a job placement once the program is over.

After she finished treatment and got into the training program, Loretta felt that she was ready to care for Henry on her own. Her mother, however, felt differently about it. She didn’t feel that Loretta was ready to take care of Henry. Mother and daughter began having a lot of friction over this issue, with Loretta feeling that her mother was too distrustful and Regina feeling that Loretta was still too irresponsible. Because she has only a small stipend, Loretta doesn’t have enough money to live on her own. She moved back in with her mother. The problems between Loretta and Regina have gotten worse. Loretta knows that her mother is the one Henry listens to. She feels like an extra person who is not even part of the family.

Loretta has gotten bored with her life. She feels that she has nothing but the training program all day every day and then home in the evenings with a mother who doesn’t trust her and a son who doesn’t really know her. She drifted back to her old friends and quickly got involved with alcohol, marijuana, and cocaine again.

Things became so difficult at home that Loretta and Regina sought family counseling at a social service center in their neighborhood. The counseling began with a focus on family relationships, but it soon became clear that Loretta should have a substance abuse assessment as well. The social service center has a substance abuse program, so Loretta has been referred for an assessment.

Although at one point she says she has no alcohol or drug problems, Loretta winds up at the end saying that she is, in fact, moderately troubled by these problems. When asked how important it is to her to have treatment, she says that she can’t have treatment because she would not be able to continue in her job training program and she wouldn’t be able to get her son back. If you were Loretta, what do you think you might do in this situation?