Phase 1

Carla Washburn Case Files

Carla Washburn

Photograph of Carla Washburn

Client History

Carla Washburn is a 76-year-old Black woman who has been widowed for twenty years. She lives alone in Plainville, a small town in the Northwest . Mrs. Washburn’s community is aging, both in physical housing stock and, especially, in demographics, as many young people have moved to larger cities closer to mountains and the coast. Mrs. Washburn worked for years as an administrative assistant in the school district in Plainville, but since her retirement, she has been saddened to see schools close as enrollments decline. Most of the working-age residents of the community today commute to larger cities for work, although there are some residents who moved to Plainville during the pandemic and work from home for larger companies located elsewhere. Carla’s husband spent his career working for paper mills in and around Plainville, all of which have closed. Carla receives a small pension from the school district and Social Security; however, as she spent several years only informally employed, while her son was young, her benefits are meager.

A few years ago, Mrs. Washburn lost her grandson, whom she had been raising since he was eight, to an active-duty military casualty. This loss followed earlier losses in Mrs. Washburn’s life—her husband, and then her son and daughter-in-law, who were killed in a car accident. While she was caring for her grandson, of whom she had full custody, Ms. Washburn was able to collect survivor benefits; however, the expenses of raising an active child consumed many of her physical, emotional, and financial resources for years.

During the time that Roland Jr. lived with her, Mrs. Washburn threw herself into his care and activities. She found that she had nothing much in common with her old friends, because they had raised all their children and had more freedom to socialize than she did. Eventually, these friends mostly dropped out of her life.

Roland Jr. decided to join the Army after his high school graduation, to get money to pay for college. Shortly after finishing basic training, he married a young woman, Alice, who he met while at the Army base in North Carolina. Carla traveled to North Carolina to attend the wedding. Although she liked her grandson's new bride, she really did not know her. And when Roland Jr. was killed, the Army focused its family outreach services on the young widow.

Although Carla and her sister spoke weekly by phone for the last fifteen years and have had a close relationship throughout their lives, Carla has made no attempt to contact Anna since Roland Jr.'s funeral eight months ago. When Anna called, Carla questioned over and over how it could be that both her son and grandson were no longer alive while she, an old woman, still lived. Anna has informed you that her sister told her of a recent fall she had had in her home that has made walking difficult, particularly as her diabetes also complicates her health.

When you contacted Ms. Washburn, she refused at first to have you visit and expressed irritation with her sister for contacting the AAA. However, when you explained how worried her sister had been and how Carla could ease her sister's concern if she would consent to a visit, Carla finally agreed to see you. However, she is adamant that she neither wants nor needs help.

Client Concerns

  • Carla insists that she has no concerns that you can help her with; she says little, initially, and seems somewhat annoyed at the intrusion. She does consent to a psychosocial history, however. From this history, you identify several concerns:
  • Fall risk: Mrs. Washburn does not remember much about the incident that led to her fall, and she has some concern that she could fall again.
  • Diabetes: Mrs. Washburn acknowledges that she missed some preventive medical appointments during the COVID-19 pandemic, and she wonders if her diabetes is currently managed as well as it could be.
  • Pain: Mrs. Washburn initially denies any pain, but you notice that she is walking with a limp, and she also has a brace on her arm.
  • Depression: Mrs. Washburn agrees to answer some questions for a depression screening. Although her grief reaction is normative, it is difficult for her to carry the considerable weight of her overwhelming sense of loss.
  • While Carla reports having enough money for food and utility expenses, she does express some concern about the cost of her required medications. You wonder if there are other resources she could access to stretch her limited budget further.
  • While many older adults, in particular, experienced significant isolation during the pandemic, Mrs. Washburn’s loss of social supports predates and outlives that global experience. She still has little contact with those who have been important to her earlier in her life, reports no real connections to her neighbors, and is not involved with organizations that many people find valuable resources.

Goals For Client

As a result of your great skills in relationship building, Carla agrees to continue to see you. She identifies the following goals for the work:

  • Help getting her diabetes under control
  • Connection to social supports to help her cope with her losses
  • Identification of resources to supplement her fixed income

Reverend James Smith

Photograph of Reverend James Smith

Client History

James Smith is the new pastor of the predominantly African-American Bethel AME Church. Relatively new to the region, he is very interested in meeting the membership and building church programming to accommodate their needs.

Client Concerns

  • Pastor Smith would like to see better attendance at church services on Sundays. It has been particularly difficult to rebuild active involvement following the move to online services during the COVID-19 pandemic, and he knows he may need some different approaches to engage the community.
  • He has not yet established relationships with many parishioners.
  • Pastor Smith is concerned about anti-Black racism in the community and wants the church to be a leading force for civil rights in the region.

Goals For Client

  • He would like church leaders to establish a capital campaign to raise funds for much-needed building expansion.
  • He would like to expand and diversify church programming.

Loretta Minor

Photograph of Loretta Minor

Client History

Like Mrs. Washburn, Loretta Minor has been widowed for many years. The two women initially met when their sons played football together. They have remained friends, and Mrs. Minor was very supportive through the deaths of Carla's husband, son, and grandson. They continue to see each other at church and in the grocery store, and occasionally Loretta drops in on Mrs. Washburn; however, they have not had as much contact in the past few years.

Client Concerns

  • Loretta knows that Carla is in deep grief but believes that there is no more that she or anyone else can do.
  • Mrs. Minor has her own health concerns, particularly as her eyesight has declined, making it unsafe for her to drive.

Goals For Client

  • Mrs. Minor wants transportation options that can help her connect to community resources and social interactions.
  • She would like to see her friend Carla re-engaged in life, and she wants to know how she can best help Carla cope with her losses.

The Jackson Family

Photograph of The Jackson Family

Client History

Like Mrs. Washburn, William and Luella Jackson are also serving as guardians to a grandchild (Lila). Lila is multiracial and often struggles to fit in at school and in the community. Lila's mother (their daughter) has been imprisoned for four years, having been convicted of drug possession and child endangerment. Both Mr. and Mrs. Jackson are frightened about Lila’s future and often struggle to understand the risks she faces in today’s society. To that end, they closely monitor her activities and her friends.

Client Concerns

  • Mr. and Mrs. Jackson both have jobs, but their incomes are seldom sufficient to take care of all Lila’s needs.
  • Both Mr. and Mrs. Jackson are concerned that they are working when school lets out, and they cannot be home for Lila. The period during the COVID-19 school closures was particularly difficult. Even today, there are few options for safe recreational or enrichment activities for teenagers in their small town.
  • A future concern is for Lila when their daughter is released from prison and wishes to resume her parenting role with Lila. They are uncomfortable with the uncertainty of their granddaughter's future.

Goals For Client

  • The Jacksons would like higher-paying jobs, as well as financial assistance available for a family in their position.
  • The Jackson family feels isolated in trying to raise an adolescent in the aging community, particularly with few resources to support Lila’s safe development.

The Johnson Family

Photograph of The Johnson Family

Client History

Paul and Toni Johnson moved into the neighborhood shortly after their youngest child was born, attracted by the relatively affordable housing market in the attractive, predominantly Black, neighborhood they chose. However, they are dissatisfied with the lack of activities and services for youth in the community. Mr. Johnson has a long commute to work, and Mrs. Johnson works fewer hours than they would like. They are also worried about their kids. They used to let their children walk to school with Lila Jackson, who was older. In the past few months, however, they have been worried about Lila’s influence on their son, so they have been looking for other options.

Client Concerns

  • While their home was affordable, they worry that it may be losing value; as a result, the Johnsons are unsure if they could afford to move to be closer to Mr. Johnson’s job, if they decided that was best.
  • Because both parents work, they are worried about after-school supervision, particularly for their eight-year-old daughter. Their son has done this in the past, but he is getting to an age where he is less likely to want to look after her.
  • Mr. Johnson is morbidly obese, a consequence of his sedentary job and poor eating habits. This makes him at higher risk of other health concerns, and he fears discrimination is also affecting his employment prospects.

Goals For Client

  • The children are in need of activities or supervision after school.
  • The Johnson family selected the Plainville community in part for its slower pace and the prospect of more time together; however, Mr. Johnson’s long commute and the lack of available supports means that they have more family stress and less quality time than they want.
  • Both Mr. and Mrs. Johnson would like to learn more about educational opportunities for Mr. Johnson that would lead to different job opportunities.


Review Ms. Washburn's support system, as shown on the ecomap.

Go to Ecomap

Critical Thinking Questions

These core questions, specific to each client, will help you better understand and assess your client. Refer back to your answers throughout your assessment.

View Carla Washburn's Questions