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Listen to thisSarah will be 18 in four months. For the past few months she has been living in a foster home where she was placed after being picked up in a police drug raid. She couldn’t go home because her father disappeared a number of years ago and her mother is unable to care for anyone.
She hasn’t been to school since she was 15 and educational testing reveals that she functions at a grade three to four level with severe learning problems. Her overall I.Q. places her in the dull-normal range but there are so many discrepancies in the sub-test that the test validity is in question.
She demonstrates very limited self-care skills, a low self-esteem and unrealistic fantasies about what she’s going to do with the rest of her life. Most of the time she talks about being a movie star.
Yesterday she went to the doctor who confirmed that she is two months pregnant. Last night she had the following conversation with her case worker, Maria:
Sarah: I’m pregnant.
Maria: So, Sarah, how do you feel about that?
Sarah: It’s wonderful, I’m going to get married.
Maria: To whom?
Sarah: To John. I met him a few months ago.
Maria: Where is John? What does he do?
Sarah: I don’t know. I met him in the place I was staying. He’s really nice.
Maria: But do you know where he is now?
Sarah: I don’t know. Maybe he’s in the place I was staying. Or maybe he went back to Toronto. I have to go and look for him.
Maria: Do you know his last name?
Sarah: No.
Maria to herself: Where do I go from here?
Situation response
As I ponder Sarah and her plight I am very centred on the fact that she is four months away from being considered an “adult” legally, if not emotionally, developmentally or behaviourally. It is always such a quandary when a young person is clearly not ready for “emancipation,” but is legally entitled to it, and sometimes actually pushed toward it. The “system” has its hands full with minors, and seems reluctant to remain involved with “kids” over 18! But Sarah definitely is not prepared to deal with her pregnancy and independent living. I’m not sure I can convince the agency to continue to pay for foster care for Sarah after she becomes 18, but this is certainly an issue I’m going to pursue immediately. Any kind of “extended care” option should be considered. We need more time with Sarah to help her make realistic plans for herself and her baby. A complicating factor, of course, is that Sarah uses drugs. This drug use presents at least two major issues: Should she be counselled against continuing the pregnancy given the potential harm to the fetus? Could this substance abuse be a factor in her “dull-normal” intelligence diagnosis?
Since Sarah has been out of school for almost three years, an educational intervention probably is not indicated. Sarah and I will have to review her realistic options, which include:
making a decision about continuing the pregnancy, given her lack of practical support and her drug abuse,
arranging a re-test of Sarah’s aptitude and vocational potential since the previous results are suspect, and
formulating a “plan” for Sarah, depending on her decisions and test results.
If Sarah decides to keep her baby she will need to be urged to become involved in an addiction program, at least during the pregnancy. Membership in a group such as A.A. will not only provide help for her substance abuse, but will provide her with practical support away from the agency, which will be crucial when she is on her own. In addition, we will also have to help Sarah become involved with the Public Welfare system to get support for herself and the baby.
If Sarah decides to terminate the pregnancy, we’ll have to get her involved in a vocational training program in preparation for her release from the child welfare system.
You'll notice that I am not concentrating discussion on Sarah’s fantasies. This can be dealt with casually, since a direct confrontation might drive Sarah away. For example, we can deal with the fact that “movie stars” always have to support themselves while they are waiting for their big break. Using marketable skills in this way can provide motivation for Sarah, whereas, if she sees a job as a substitution for her dream she could well resist.
We can make our decisions about the pregnancy now, without John, since she will have to act quickly. After these decisions are made, and plans are put into effect, she can decide how she will find him, perhaps by putting an ad in the personal section in a Toronto newspaper. In other words, we don’t have to ask Sarah to give up her fantasies while working on other concrete plans for her life. (It isn’t even clear that John is the father of the baby!) We want, instead, to keep Sarah around so that she can be monitored and assisted. If we can arrange to continue service to Sarah for a while we can refer her for counselling, which will provide a place for her to deal with her wishes and fantasies, and which will also provide an additional supportive link for her life away from the child welfare system. A direct confrontation by me, at this time, about her unrealistic thinking might cause her to “split,” thus putting both her and her baby in danger.
This feature: Fox, L.E. (1992). Situations in Child and Youth Care. Journal of Child and Youth Care, 7, 4. pp. 109-111.
