I believe that Marky should remain in the home with his parents. It would be great if the in-home counseling included showing Judy how to properly maintain a clean environment. I feel that Judy definitely needs referrals for counseling and psychiatry for her mental illness. Marky might do well to get involved in either a sport or some activity so he can “learn to be a kid again”. Also, Roy needs to go to Gamblers Anonymous or another addiction support group (I like SMART Recovery, it’s CBT-based and covers all addictions) so the family would be able to afford food, clothing, cleaning products, treatment, medications.