Academic journal article Journal of Multicultural Counseling and Development

Child Survivor of War: A Case Study

Academic journal article Journal of Multicultural Counseling and Development

Child Survivor of War: A Case Study

Article excerpt

The history of a Bosnian survivor of war living in the U.S. is examined using the extended case method. Clinical issues related to acculturative stress, posttraumatic stress disorder, and identity are analyzed. Suggested treatment includes existential therapy and its cognitive--behavioral applications, didactic education on trauma, client screening, and treatment effectiveness.

La historia de un sobreviente bosnio de guerra en los EE.UU. se examina utilzando el prolongado metodo del case. El tema clinico relacionado a estres de asimilacion, de trastorno de estres postraumatico, y la identidad se analiza. El tratamiento sugerido incluye la terapia existencial y sus applicaciones de conducta cognitiva, la educacion didactica en el trauma, en la investigacion de cliente, y en la eficacia del tratamiento.

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The purpose of the extended case method (Burawoy et al., 1991) is to present an interpretative framework that allows for the creative use of various techniques of data collection to understand complex relationships among variables that are not easily integrated into research designs but that can operate within traditional counseling practices. In contrast, case studies with a narrower focus limit the methodology used for developing a theoretical perspective. Extended case studies, because of the breadth of their content, allow the application of a large variety of methods in creating a theoretical framework. The access to diversity in methods allows for several different ways of analysis. This format provides multiple perspectives to case issues that ultimately result in an integrated and enriched theory. For example, an abbreviated case study might present a posttraumatic stress disorder (PTSD) case from the point of view of the PTSD literature (e.g., van der Kolk & McFarlane, 1996) and the Diagnostic Criteria From the DSM-IV-TR (American Psychiatric Association, 2000). In the extended case method, the clinician may include a cultural perspective to balance the interpretation of PTSD. The extended case method recognizes the value of a given theory while also acknowledging its limitations, thus rendering a theory as a work in progress.

The extended case method does not rule out using data grounded in the field to rework preexisting theories and scientifically exploring exceptions to the rule. The extended case method is a timely response to calls for an approach to science that can be used to improve empirically and theoretically informed practice interventions. It recognizes both the universal and idiosyncratic nature of human experiences, as well as privileging culture-specific emic perspectives in the development of theories to better understand the lived experiences of individuals that may be ignored or objectified. This article describes a young refugee's case history (historiography). Stephen, the name used to refer to him in this article, is a pseudonym, and informed consent was obtained from both Stephen and the therapist to write this case study.

case history

Stephen is 20 years old. His country of origin, which is now called Bosnia-Herzegovina, was part of the former Yugoslavia. He has lived in the United States for the past 5 years and is awaiting his U.S. citizenship. (Because the following story is Stephen's story, as he remembers it, some parts may not match the commonly accepted version of this region's recent history.) Stephen's homeland was ravaged by both ethnic cleansing resulting from religious intolerance and the history of political chaos that followed the fall of communism in the Balkan states. Approximately 1990, when Stephen was 10 years old, he and his family, who are Christians, lived in Kosovo. Here Christians and Muslims were fighting a civil war. For 2 years, Stephen witnessed constant fighting between organized militia as well as between Muslims and Christians. Stephen reported that nearly 80% of his classmates were killed in bombings, gunfire, and sniper shots as they walked to and from school. …

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