Proposed Case Vignette

Presentation of the Problem

Janice Ferrara, a 29-year-old European American, has been arrested for reckless endangerment and driving while under the influence, with a blood alcohol level of 0.10%.Police were called to the scene when she missed a curve and ran her car into a tree, seriously injuring her 8-year-old daughter Francesca.Her daughter was being loaded unconscious into an ambulance when officers arrived.

Janice had also hit her head on the steering wheel.She had some whiplash injuries in her neck and back, as well as other bruises and strains.She was dizzy and somewhat disoriented when officers arrived.She was crying hard, screaming at times, and rambling tangentially from one topic to another.Officers had difficulty following what she was saying, but some elements were terror over the injuries to her daughter, fear of facing her husband, and agreement that her boss was right about her incompetence.The officers had difficulty getting her to focus on their questions about the accident.

By the time you met with Janice two weeks later, Francesca was awake, and had been found to have some brain injury.She had some trouble accessing words, and weakness in her left arm and leg.As a result, she was walking with difficulty, and was in physical therapy. It was not yet certain the extent to which these difficulties might improve with time.

Psychosocial History

Janice was brought up by both biological parents.She has an older sister and younger brother.All of these family members are still living.She says that there were no serious financial problems or arguments in the household.She and her siblings all did well academically.When asked about a joyful memory, she said that they got a kitten once.She did not remember other happy times, and said that there were not unhappy times either.

Janice was brought up Catholic and met her husband Marco through church functions.Marco is two years older than Janice.When asked what attracted her to him, she said that they share the same values, both being Catholic.She had once thought about becoming a teacher, but she and Marco decided to get married and raise a family instead.She became pregnant with her daughter soon after they married.She expressed strong beliefs that she should stay home with her daughter, just as her mother did.

Once her daughter started school, Janice took a part time job at the local grocery store during school hours.However, lately her boss told her she will have to improve at her cashiering job if she wants to keep it, and told her she is generally incompetent.

Janice says that she “hardly drinks,” “a couple of glasses of wine in the evening,” “maybe a little more if she worked that day.”

Behavioral Observations

When you met Janice, she was appropriately dressed and groomed in a simple blouse and jeans, with no jewelry or make-up.She was quiet-spoken, a little slow to respond, and cried easily.Her answers made sense and were not rambling, but sometimes she forgot what the question was, and had to be reminded before she could answer.Her answers were usually the bare minimum needed to respond to your questions, with no embellishments.She made little eye contact and instead looked mostly at your shoes.

When asked about her family relations, she had little to say except that they were OK.Then, contradicting herself, she said that, even though she perceives Marco as a “good person,” she has always been unhappy.From this, she reasoned that she “probably can’t be happy married to any man.”She could not name a specific problem between them, and said that he should have married someone else.She explained that Marco and Francesca would be better off with a different wife and mother.

When asked about her legal charges, she first said she had no opinion, and expressed a willingness to just accept whatever the outcome might be.She then added that she, “did a terrible thing and should be punished.”

Task Identification

You are a forensic mental health evaluator being asked to evaluate Ms. Ferrara and make service recommendations.You are working closely with the Forensic Psychologist who will be evaluating her competence to proceed, and mental status at the time of the offense. You are to produce a written case report addressing the questions below.The report will be submitted to the appropriate supervisor and may be presented to the court.

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