External issues Ms. Malcom faces are the strenuous relationships that she has with Irene’s school, the hospital, the juvenile justice system and her the counseling relationship is has with Ms. Kaplan. Ms. Malcom tried utilizing these services to address Irene’s behavior but they all were unsuccessful and now Ms. Malcom is left torn between her American beliefs of there is something mentally or medically wrong with Irene versus her Haitian beliefs of Irene is victim of a curse. Ms. Malcom’s relationship with her family is close and they have been supports to her thus far as a single working mother of three and she feels torn and seeks professional advices from Ms. Kaplan. This places Ms. Kaplan in an ethical dilemma, as she is intrigued by
