As you listen to the assessment session in Chapters 1 and 2, take notes on what you would capture about Nelson. You can compare your notes to the example provided after Chapter 2.
You greet Nelson and his mother at your office door and warmly guide them inside. “It is really nice to see you! And Ms. Hernández!” you exclaim as you shake her hand. They both take a seat in the cushioned chairs across from you.
Nelson has already made himself comfortable. He checks to see that his mother is settled, too, before brightly telling you, “Hello!”
Nelson’s mother sits with her legs crossed at the ankle and purse clutched in her lap. “Thank you! It is nice to see you, too.”
“Today I’m going to gather some history and background from both of you so that I can find out what your main concerns are and how I can best help you.”
Through a veneer of confidence, Nelson asks, “What kind of questions are you going to ask?”
You cross your legs and lean forward. “The idea is just to get to know more about you. The reason that you’re here is because you have had some difficult experiences that are impacting your life right now. I want to find out just how much it is impacting your life, what exactly is getting in your way, and how it is making you feel, think, and behave.”
“Sounds good,” Nelson shrugs. “Is it me who answers these questions?”
“Yes, I will first ask you, and mom can help us, also. And if there is anything you would prefer to discuss with your mom waiting outside that’s okay, too.”
“Oh okay, no problem. Yeah, I’m okay that my mom is here with me.” He pauses and then nonchalantly asks, “Are you going to ask about my accident?”
“I know that it can be hard sometimes to talk about difficult experiences and it might seem that some of these questions are sort of probing. But the reason I ask them is that I really want to get the big picture of who you are, how this experience has impacted different areas in your life, and how it is getting in the way of how you are doing now.”
“So, you are going to talk with Nelson and myself,” Nelson’s mother restates. “Can I talk with you separately as well?”
“Yes, absolutely,” you nod vigorously. “Let’s set some time to meet separately to make sure that you feel fully heard and that we are addressing all of your concerns.”
“What if I don’t want to answer a question?” Nelson declares this more like a statement, rather than a question.
“If there is any question that you feel uncomfortable answering, you can let me know. But again, it would be good if you try to be as open as possible.”
He crosses his arms over his chest and leans to the side. He announces, “Honestly, I don’t really want to be here at all.”
You maintain your posture and look him directly in the eyes. “I can totally understand why you might feel like you don’t want to be here. It is kind of difficult, right? You are meeting me for the first time and it’s not easy to talk about these experiences. I wonder, do you have an idea of why you are coming to see me?”
“Because my mom wants me to see you.” He kicks out his left leg and scuffs his heel back into the ground. He winces a little as this jostles his injured leg.
“Why do you think your mom wants you to be here?”
Nelson scoffs, “I don’t know. Because of my leg? Or my headaches?”
“Well, yes…one of the reasons you’re here is because it sounds like you went through some difficult experiences in life. These experiences seem to be affecting how you feel and how you are doing right now. They also affect how you feel in your body, for example, the leg that hurts and your headaches.”
He bites his lip and then states dismissively, “But everyone has difficult experiences—I’m no different from anyone else.”
“You are right that everyone has stressful experiences from time to time, and we are all affected by these experiences” you begin, “and it sounds like you have been through a lot of stress, which might be causing some problems for you now. Really, the whole reason you are here is for us to figure out and hear how these experiences have impacted you, and that’s why we want not just your mom here, but you as well so we can hear your opinion. Then, we will figure out together what might be the best approach for us to take in order to help you.”
You take a moment to let that sink in and cross your legs. Then you continue, “So, what are your main concerns that bring you here today?”
“Well…I guess…that bad things happen to me…and my leg and my headaches. And sometimes, also, I can’t sleep.”
Nelson’s hands are in his lap and he alternates clenching and unclenching his fists. “When I think about the accident, I feel very upset and mad.”
Nelson’s mother elaborates, “Lots of bad things have happened to us. Most recently, Nelson had an accident. It happened six months ago. Nelson was riding his bike to school when the car hit him. He suffered a contusion, but there were no major injuries.”
“I am very sorry to hear about that. What concerns you most about the accident?”
“The accident itself wasn’t that bad,” she explains. “However, he still feels pain in his leg. And now he has headaches. But what worries me the most is that he seems not to be interested in school anymore.”
“Is he normally interested in school?”
Nelson’s mother clutches her purse in even closer and pleads, “Normally, he is a good boy, an ‘A’ student. He really liked school in the U.S. and immediately had lots of friends. He plays soccer really well and was chosen for the school team. But now, he is skipping school, he doesn’t do his assignments, and he sleeps in. He even stopped going to soccer tournaments. He is hiding from his friends.”
“And before that, when he was a child?”
“Nelson has always been a lovely boy. He has always been a good student.” She beams at him and starts to reach towards him to smooth a lock of hair but then changes her mind. He doesn’t notice, and she goes on, “Even after he first experienced bad things, he was still a happy child. And later when he stayed with my mother back home, she was always talking about how he was helping her with chores, going to school, and had lots of friends. We were all proud of him.”
You check your notes to make sure you don’t miss anything and ask Nelson’s mother, “So, you think that after the accident his school performance has decreased, he has less interest in activities that he normally enjoys, and he avoids being with friends?”
She nods, “Yes, that is correct. He is not the same boy anymore…”
You turn to look at Nelson. “Nelson, what do you think about that?”
He furrows his brow and then shrugs. “Yeah, I guess that it is true. I’m just not up to it anymore…It’s…hard to focus on anything when I always have pain in my leg.”
“Yes, it must be very hard for you, Nelson,” you agree gently. “Can you tell me more about your leg pain?”
“Ummm…it just…hurts. Especially when I think about the accident. Or when I’m in the neighborhood where it happened. So, I just try to stay at home. It hurts less when I am at home.” He folds his arms across his chest.
“So, your leg hurts when you think about the accident. Or when you are in the neighborhood where it happened. Can you tell me more about the accident?”
“I guess. I was riding my bike to school. And some guy in a pickup truck didn’t stop at the red light. The car hit me and I fell on the ground. I guess I lost consciousness for a couple of minutes because the next thing I remember I was in the ambulance. At the hospital they examined me and did some tests…took a picture of my head. I was there for a couple of hours, but then they sent me home.”
“Do you remember who it was that caused the accident?”
Nelson looks at you and purses his lips, deciding whether or not to tell you this, and then goes for it. “It was this guy…he reminded me of one of the men in the gangs back home that did the bad things—the one with a bandana. After my mom left for the U.S., he came to our house looking for her many times. It was so scary.”
“When did it happen, the accident?”
“It was six months ago.”
“And the ‘bad things’?” you ask.
“It was like 2–3 years ago, back home.”