Life-threatening disability in adolescence: Adjusting to a limited future

This paper describes a medical social worker's efforts over one and a half years to help a client adjust to a neurological disorder. Prior to social work services, the young woman had never discussed her disability, which began in adolescence, with anyone outside the family, and communication within the family was seriously compromised by their perception of disability as a stigma. Lacking the opportunity to mourn the loss of her physical abilities, she became isolated and depressed, and acted out aggressive thoughts and fantasies within the family system. Social work intervention helped the client to re-work the original trauma of diagnosis, which led to the development of a healthier defensive structure and new coping mechanisms.