The Petrakis Family
The Petrakis Family Helen Petrakis is a 52-year-old heterosexual married female of Greek descent who
says that she feels overwhelmed and “blue.” She came to our agency at the suggestion of a close friend
who thought Helen would benefit from having a person who could listen. Although she is uncomfortable
talking about her life with a stranger, Helen said that she decided to come for therapy because she
worries about burdening friends with her troubles. Helen and I have met four times, twice per month,
for individual therapy in 50-minute sessions. Helen consistently appears well-groomed. She speaks
clearly and in moderate tones and seems to have linear thought progression; her memory seems intact.
She claims no history of drug or alcohol abuse, and she does not identify a history of trauma. Helen says
that other than chronic back pain from an old injury, which she manages with acetaminophen as
needed, she is in good health. Helen has worked full time at a hospital in the billing department since
graduating from high school. Her husband, John (60), works full time managing a grocery store and
earns the larger portion of the family income. She and John live with their three adult children in a 4bedroom house. Helen voices a great deal of pride in the children. Alec, 27, is currently unemployed,
which Helen attributes to the poor economy. Dmitra, 23, whom Helen describes as smart, beautiful, and
hardworking, works as a sales consultant for a local department store. Athina, 18, is an honors student
at a local college and earns spending money as a hostess in a family friend’s restaurant; Helen describes
her as adorable and reliable. In our first session, I explained to Helen that I was an advanced year intern
completing my second field placement at the agency. I told her I worked closely with my field supervisor
to provide the best care possible. She said that was fine, congratulated me on advancing my career, and
then began talking. I listened for the reasons Helen came to speak with me. I asked Helen about her
community, which, she explained, centered on the activities of the Greek Orthodox Church. She and
John were married in that church and attend services weekly. She expects that her children will also
eventually wed there. Her children, she explained, are religious but do not regularly go to church
because they are very busy. She believes that the children are too busy to be expected to help around
the house. Helen shops, cooks, and cleans for the family, and John sees to yard care and maintains the
family’s cars. When I asked whether the children contributed to the finances of the home, Helen looked
shocked and said that John would find it deeply insulting to take money from his children. As Helen
described her life, I surmised that the Petrakis family holds strong family bonds within a large and
supportive community. Helen is responsible for the care of John’s 81-year-old widowed mother, Magda,
who lives in an apartment 30 minutes away. Until recently, Magda was self-sufficient, coming for weekly
family dinners and driving herself shopping and to church. But 6 months ago, she fell and broke her hip
and was also recently diagnosed with early signs of dementia. Through their church, Helen and John
hired a reliable and trusted woman to check in on Magda a couple of days each week. Helen goes to see
Magda on the other days, sometimes twice in one day, depending on Magda’s needs. She buys her food,
cleans her home, pays her bills, and keeps track of her medications. Helen says she would like to have
the helper come in more often, but she cannot afford it. The money to pay for help is coming out of the
couple’s vacations savings. Caring for Magda makes Helen feel as if she is failing as a wife and mother
because she no longer has time to spend with her husband and children. Helen sounded angry as she
described the amount of time she gave toward Magda’s care. She has stopped going shopping and out
to eat with friends because she can no longer find the time. Lately, John has expressed displeasure with
meals at home, as Helen has been cooking less often and brings home takeout. She sounded defeated
when she described an incident in which her son, Alec, expressed disappointment in her because she
could not provide him with clean laundry. When she cried in response, he offered to help care for his
grandmother. Alec proposed moving in with Magda. Helen wondered if asking Alec to stay with his
grandmother might be good for all of them. John and Alec had been arguing lately, and Alec and his
grandmother had always been very fond of each other. Helen thought she could offer Alec the money
she gave Magda’s helper. I responded that I thought Helen and Alec were using creative problem solving
and utilizing their resources well in crafting a plan. I said that Helen seemed to find good solutions
within her family and culture. Helen appeared concerned as I said this, and I surmised that she was
reluctant to impose on her son because she and her husband 20 SESSIONS: CASE HISTORIES • THE
PETRAKIS FAMILY seemed to value providing for their children’s needs rather than expecting them to
contribute resources. Helen ended the session agreeing to consider the solution we discussed to ease
the stress of caring for Magda. The Petrakis Family Magda Petrakis: mother of John Petrakis, 81 John
Petrakis: father, 60 Helen Petrakis: mother, 52 Alec Petrakis: son, 27 Dmitra Petrakis: daughter, 23
Athina Petrakis: daughter, 18 In our second session, Helen said that her son again mentioned that he
saw how overwhelmed she was and wanted to help care for Magda. While Helen was not sure this was
the best idea, she saw how it might be helpful for a short time. Nonetheless, her instincts were still
telling her that this could be a bad plan. Helen worried about changing the arrangements as they were
and seemed reluctant to step away from her integral role in Magda’s care, despite the pain it was
causing her. In this session, I helped Helen begin to explore her feelings and assumptions about her role
as a caretaker in the family. Helen did not seem able to identify her expectations of herself as a
caretaker. She did, however, resolve her ambivalence about Alec’s offer to care for Magda. By the end
of the session, Helen agreed to have Alec live with his grandmother. In our third session, Helen briskly
walked into the room and announced that Alec had moved in with Magda and it was a disaster. Since
the move, Helen had had to be at the apartment at least once daily to intervene with emergencies.
Magda called Helen at work the day after Alec moved in to ask Helen to pick up a refill of her
medications at the pharmacy. Helen asked to speak to Alec, and Magda said he had gone out with two
friends the night before and had not come home yet. Helen left work immediately and drove to Magda’s
home. Helen angrily told me that she assumed that Magda misplaced the medications, but then she
began to cry and said that the medications were not misplaced, they were really gone. When she
searched the apartment, Helen noticed that the cash box was empty and that Magda’s checkbook was
missing two checks. Helen determined that Magda was robbed, but because she did not want to
frighten her, she decided not to report the crime. Instead, Helen phoned the pharmacy and explained
that her mother-in-law, suffering from dementia, had accidently destroyed her medication and would
need refills. She called Magda’s bank and learned that the checks had been cashed. Helen cooked lunch
for her motherin-law and ate it with her. When a tired and disheveled Alec arrived back in the
apartment, Helen quietly told her son about the robbery and reinforced the importance of remaining in
the building with Magda at night. Helen said that the events in Magda’s apartment were repeated 2
days later. By this time in the session Helen was furious. With her face red with rage and her hands
shaking, she told me that all this was my fault for suggesting that Alec’s presence in the apartment
would benefit the family. Jewelry from Greece, which had been in the family for generations, was now
gone. Alec would never be in this trouble if I had not told Helen he should be permitted to live with his
grandmother. Helen said she should know better than to talk to a stranger about private matters. Helen
cried, and as I sat and listened to her sobs, I was not sure whether to let her cry, give her a tissue, or
interrupt her. As the session was nearing the end, Helen quickly told me that Alec has struggled with
maintaining sobriety since he was a teen. He is currently on 2 years’ probation for possession and had
recently completed a rehabilitation program. Helen said she now realized Alec was stealing from his
grandmother to support his drug habit. She could not possibly tell her husband because he would hurt
and humiliate Alec, and she would not consider telling the police. Helen’s solution was to remove the
valuables and medications from the apartment and to visit twice a day to bring supplies and medicine
and check on Alec and Magda. After this session, it was unclear how to proceed with Helen. I asked my
field instructor for help. I explained that I had offered support for a possible solution to Helen’s
difficulties and stress. In rereading the progress notes in Helen’s chart, I realized I had misinterpreted
Helen’s reluctance to ask Alec to move in with his grandmother. I felt terrible about pushing Helen into
acting outside of her own instincts. My field instructor reminded me that I had not forced Helen to act as
she had and that no one was responsible for the actions of another person. She told me that beginning
social workers do make mistakes and that my errors were part of a learning process and were not
irreparable. I was reminded that advising Helen, or any client, is ill-advised. My field instructor expressed
concern about my ethical and legal obligations to protect Magda. She suggested that I call the county
office on aging and adult services to research my duty to report, and to speak to the agency director
about my ethical and legal obligations in this case. In our fourth session, Helen apologized for missing a
previous appointment with me. She said she awoke the morning of the appointment with tightness in
her chest and a feeling that her heart was racing. John drove Helen to the emergency room at the
hospital in which she works. By the time Helen got to the hospital, she could not 21 SESSIONS: CASE
HISTORIES • THE PETRAKIS FAMILY catch her breath and thought she might pass out. The hospital ran
tests but found no conclusive organic reason to explain Helen’s symptoms. I asked Helen how she felt
now. She said that since her visit to the hospital, she continues to experience shortness of breath,
usually in the morning when she is getting ready to begin her day. She said she has trouble staying
asleep, waking two to four times each night, and she feels tired during the day. Working is hard because
she is more forgetful than she has ever been. Her back is giving her trouble, too. Helen said that she
feels like her body is one big tired knot. I suggested that her symptoms could indicate anxiety and she
might want to consider seeing a psychiatrist for an evaluation. I told Helen it would make sense, given
the pressures in her life, that she felt anxiety. I said that she and I could develop a treatment plan to
help her address the anxiety. Helen’s therapy goals include removing Alec from Magda’s apartment and
speaking to John about a safe and supported living arrangement for Magda.
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