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PRECIOUS Claireece “Precious” Jones was a 16-year-old African-American, obese, illiterate woman who was pregnant with her second incestuous child by her own father. Precious was severely physically, verbally, emotionally, and sexually abused at home by her mother, and occasionally her father, who would show up just to rape her. Precious copes with this by escaping into her own fantasy world she had made up in her head. Precious suffered from the trauma that she had been experiencing at home beginning at the age of 3 when her father first started sexually abusing her in front of her mother, who blamed and despised her for “stealing [her] man”. Since then, her mother had been abusing her as well, impeding her development as a person. After the birth of her second child, Precious finally left her mother with the support of her social network and has to raise both of her children alone, while also going to school and battling the HIV virus she contracted from her father (Daniels, Perry, & Winfrey, 2009).


HER PROBLEMS According to the DSM-IV-TR, events are considered traumatic if it involves a threat to one’s physical integrity, and that the person’s response to them involves “intense fear, helplessness, or horror” (Brown Reyes, Brown, Gonzenbach, 2013). Moreover, there are circumstances where the presenting problems are often masked by other disorders including “somatic complaints, somatoform disorders, anxiety, depression, phobias, panic attacks, drug and/or alcohol abuse, post-traumatic stress disorder, or dissociation,” instead of being seen as a reaction to the trauma (Brown, et al., 2013). In Precious’ case, she experiences dissociation, where she detaches herself from her harsh reality and escapes into her fantasy world.


Meet The Jones Family Claireece “Precious” Jones, 16 She was the daughter of Carl and Mary. She went to school and when she was home, she did all the chores around the house. Precious coped with all of the abuse by escaping to her fantasy world where she was white, skinny, and famous, and that she had a hot boyfriend and her mother loved her. She also overate under stress and often, Mary would also force her to eat fatty foods so “no one will want [her]”. When she found out about her second pregnancy, she got kicked out of her current school and got sent to an “alternative” one where she built her social support. After giving birth to Abdul, her second child, she left her current home to stay in a women’s shelter and receive welfare to support her family while she went to school. She later found out of her father’s death due to AIDS and then found out she, too, is HIV positive Mongoloid “Mongo” Jones, 3 She was Precious’ first born and she has Down Syndrome. She lives with her great grand mother and only visits Precious when the social worker came Abdul Jones, Newborn He was Precious’ second child. His birth was the catalyst to Precious’ liberation and because of him, Precious knew of her worth and that she had power over Mary. Mary Jones, 42 She was the mother of Precious. She was abusive to Precious verbally, emotionally, physically, and sexually. She was unemployed and was dependent on welfare and Precious’ services. She took all of Precious’ and Mongo’s welfare money to finance herself and continually lied to social workers about her living situation. She enjoyed sitting at home and watching TV and she had no friends. She refused to believe that she caught the HIV virus from Carl, but she is HIV positive as well.

Before Abdul’s birth the Jones are technically a nuclear family consisting of a mother, who is Mary, and estranged father, Carl, who is almost never home, Precious, their daughter because Mongo lived with her grandmother. So in that regard, they were in the “families with adolescent” stage where the family’s task is to allow Precious to establish her identity, think about her future, and increase her roles in the family (Kaakinen et al., 2015). However, their family would be considered “off-time” as Precious already had children, had a different role, and was not allowed to develop her identity. After Abdul’s birth, Precious left home and too Mongo with her and they lived in a woman’s shelter, making them a separate family being in the “children with infants” stage where their task as a family was to adjust to the infant and the new roles (Kaakinen et al., 2015). Still, this family would be considered “off-time” as Precious is only 16 and was not supposed to take on the roles that she had.

Carl Jones, Unspecified age, probably 40-50 He was the father of Precious and her children. He was sexually abusive to Precious and even promised to marry her, which left Mary vengeful. He eventually died of AIDS, which he gave to both Mary and Precious. Outside of occasionally visiting to rape Precious, he was otherwise absent from his family’s life.

. (Daniels et al., 2009)



VERBAL ▪ Mary was verbally abusive to Precious in that every time she felt Precious rebelling in some way, she would reiterate how Precious is fat, useless, dumb, undesirable by others, etc.

▪ Precious would give Mary short and vague responses ▪ Precious would talk to her children in a nurturing way, ensuring that her children knew she loved them NONVERBAL ▪ Mary would physically abuse Precious by beating her up and throwing things at her ▪ Mary appeared dominating and authoritative in front of Precious and her children

▪ Precious would resort to her imagination during stressful events to cope ▪ Precious always appeared tense and guarded in front of Mary

(Daniels et al., 2009).

The Jones lived in Harlem in the late 1980’s where poverty, drugs and racism were prevalent. At the time, HIV was thought to be a death sentence due to the lack of knowledge and resources. Technology was also limited for the Jones. Though not explicitly depicted, they were Christian because Precious would talk about God and after leaving Mary, she went to a Church and fantasized about singing and being a part of that community

Strengths ▪ Precious is determined to give herself and her children a better life ▪ Precious found support from her school, friends, and social worker ▪ Precious’ (unnamed) grandmother is willing to help her out

▪ ▪ ▪ ▪ ▪

Challenges Precious is impoverished Precious’ health is not optimal Precious is qualified for low-paying jobs due to her education level Precious is HIV positive Precious’ childhood trauma and its effects on her physical and mental health

(Daniels et al., 2009).


This theory is based off of the assumption that humans, as “biological and social entities,” interact and are interdependent with their environment. It combines a nature and nurture wherein the child’s biological predispositions and environment come together to shape his/her environment.

Microsystem- Precious’ family consist of her two children and they live in a women’s shelter in Queens, NY where she can stay until she can support herself financially. Precious’ childhood trauma would be this family’s challenge. Mesosystem- Precious’ peers that she met from her alternative school helped her securing a home after leaving her mother and continually support her throughout this process. Her unnamed grandmother also helps her with her children when she is at school. Her peers and her grandmother are resources Precious can use when her family is in need. Exosystem- The concerned social worker that helped Precious leave the abusive environment she was in helped her, too. Additionally, the country’s welfare system helps Precious to attain education and to financially support her family. Macrosystem- The rampant racism and the poverty-stricken neighborhood affects Precious and her family’s development as it takes away certain opportunities and makes life generally harder for them. Chronosystem- Overtime, the HIV virus, which was considered a “death-sentence” would affect Precious and her family as it will impede further development. This family’s challenge will then be to secure a (Kaakinen et al., 2015) future for Mongo and Abdul before Precious gets severely ill and die.


Precious is suffering from her childhood trauma as evidenced by the abuse she had to endure for most of her life, and her present behaviors that are indicative of dissociation such as fantasizing in times of stress. She has family of two to raise by herself and she needs to learn coping skills to better raise her family. To treat Precious’ family, is to teach Precious how to raise a family in a healthy manner free from abuse.

1. Establish a therapeutic relationship with Precious, Mongo, and Abdul and thoroughly assess their family dynamic. Perform a background interview on Precious and assess her attachment history as the attachment style tend to be transferred intergenerationally. Mindfully practice respectfulness, sensitivity, and empathy. Knowing the family’s dynamics as well as Precious’ attachment history will allow the nurse to personalize their plan of care (Ahlfors, 2016) 1. Outcome: By the end of the interview, the nurse will be able to identify Precious’ attachment history. 2.

Aim to establish attachment between Precious and her children by helping them to establish rituals and routines in their family such as making a schedule for eating, sleeping, and bathing, setting a day to go out to the park and eat together as a family, going to church together, etc. It has been shown that parents who were abused as children have attachment issues that can later lead to neglect. It is important to break that pattern (Ahlfors, 2016) 1.

Outcome: Precious and her children will agree upon a daily routine schedule and maintain it for a week.

3. Refer Precious to a group therapy. A study reveals that group therapy that involves psychoeducation, or informing the patients of the effects of their trauma and its associated symptoms, combined with the support from the group were powerful and effective in facilitating healing (Brown, et al., 2013). 1.

Outcome: Precious will verbalize a better understanding of the effects of her childhood trauma so that when he symptoms arise, she will be able to recognize it.


References Ahlfors, E. (2016). Nursing methods to support complexly traumatized children and their families: A Literature review. Bioecological Systems Theory [Online image]. (n.d.) Retrieved from Brown, D., Reyes, S., Brown, B., & Gonzenbach, M. (2013). The Effectiveness of Group Treatment for Female Adult Incest Survivors. Journal Of Child Sexual Abuse, 22(2), 143-152. doi:10.1080/10538712.2013.737442 Daniels, L. (Director); Perry, T., & Winfrey, O. (Producers). (2009). Precious: Based on the novel “Push� by Sapphire [Motion picture]. United States: Lionsgate Studio. Kaakinen, J., Duff-Gedaly, V., Hanson, S. & Coelho, D. (2015) Family health Care nursing: Theory, practice and research (5th ed.). F.A. Davis: Philadelphia. ISBN-13: 9780803639218 Nurse Clipart [Online image]. (n.d.) Retrieved from Precious [Online image]. (n.d.) Retrieved from Precious and Blu Rain [Online image]. (n.d.) Retrieved from Precious Looking Out [Online image]. (n.d.) Retrieved from novel-push-by-sapphire-19691231 Precious Movie Poster [Online image]. (n.d.) Retrieved from

N480 The Jones Family Assessment  
N480 The Jones Family Assessment  

From the movie: "Precious: Based on the Novel by Sapphire"