Corey is an 8-year-old boy who was brought into the emergency department where you work, by EMS personnel after he was hit by a softball during physical education class at school. Corey lost consciousness for several minutes. During the physical exam, you note that he has bilateral bruises to his shoulders, arms and abdomen. Crying, Corey reports that he was "beaten up" by classmates. When his father arrives at the ER, Corey becomes visibly fearful and stops crying. The father is clearly angry; he begins to shout at Corey about having to leave work early during an important business meeting; he was shouting at Corey about not paying attention to the game, about being a lousy ball player and acting like a baby. As the physician in the ER you note the dad's behavior and how Corey is responding to it.

You are a family nurse practitioner working in a primary care office. Juanita's mother comes to the office in follow-up to the hypertension noted at the last visit. She brings 9-year old Juanita with her to the appointment, as she usually does. Today you note that Juanita is withdrawn and has bruises on her face and arms. She looks like she's been crying. Juanita is typically a chatty girl who usually engages you in talking about her love of dancing, often showing off her latest moves for the staff. Her mother appears irritable and distracted. You ask her what's wrong and she says she's fine. You mention that Juanita is so quiet and looks upset today, to which she replies that Juanita has been "bad". What would you do if you were the nurse practitioner this situation?

Twelve-year-old Sam comes to school wearing only a short sleeved t-shirt and jeans on days when the temperature is in the 30s. Sam is a quiet, slender young man. He often seems nervous; he is easily startled. Sam is a C student. He never seems to be paying much attention during class; he looks preoccupied. Sam doesn't make much eye contact. He spends most of his time alone; he doesn't really have any friends at school. Indeed, often Sam is the focus of harassment and teasing from his classmates. About 2 weeks ago Sam came to class limping. He said he sprained his left ankle. The ankle didn't get better after a week, so you sent a note home to have Sam's family get medical attention for Sam. That was last week and there has been no change. As the teacher in this 7th grade classroom you wonder if Sam might be really injured.

As a clinical social worker, you are Leah's therapist. Leah is stepmother to 5-year-old Tisha, having been married to Tisha's father, Michael, for the last 6 months. The whirlwind relationship has been the frequent topic of your sessions. Leah has also talked about her role as a stepmother and her discomfort with it. She thinks that Michael and Tisha are too close; it makes her uncomfortable. Leah reports that she thinks Michael is too protective of Tisha, not really allowing her to play with other children when she is staying at their house, even limiting her contact and relationship with Tisha. In the last session with Leah, she told you that she fears that Michael is sexually abusing Tisha: she saw him leave Tisha's room early in the morning, when he thought she was sleeping; she saw him toss a condom in the trash. As the therapist, what should you do?