At six years old, James was diagnosed with ADHD and was prescribed a stimulant medication for a short few months. There was some concern from his teachers that he also should be assessed for a learning disability. James lived with his mother Karen, father Rick, and two younger sisters. Meanwhile, there was child abuse occurring in the household. The vicious cycle was repeating itself; Karen was abused by her parents, and she allowed the cycle to continue. Taking James’s case into consideration that he suffers from three core concepts, physical violation, living on the edge of not knowing what his father’s mood or action would be from minute to minute, constantly living in the state of fear or the unexpected.
Verbal prompts, redirection to remain focused on a given task, minimize outdoor play, reduced iPad games and parent meeting. The results of interventions are diverse. Adriel would respond to previous intervention such as less outdoor play and parent meeting by behaving in class and follow directions for outdoor play for the first two days of the week and then the behavior occurs again. Verbal prompting often works for the first 2 minutes and then the behavior occurs again. The support and one-to-one attention given from the staff during transitions decreased the incidents of noncompliance, pushing and yelling. The staff will model, role play, practice and discuss all these intervention strategies to support Adriel. He will be given attention when he shows replacement behaviors.
Intervention: Ms. Smalls (MHP), Santonias and Ms. Givens (MHS) discussed Santonias complying with the rules of the home. MHP and Santonias had a discussing about his NFL football team as a way to build rapport. MHP requests feedback on possible goals from Santonias and MHS for Individual Plan of Care. MHP, Santonias and MHS discuss and process an incident that happened at the school’s gym.
Lester is a 40-year-old man referred to me for counselling by his doctor. He is currently married and lives with his wife, Carolyn, and their 16-year-old daughter Jane. He is employed as a fast food attendant (Cohen, Jinks & Mendes, 1999). At the initial examination Lester dresses untidily and unshaven, and avoids eye contact. Lester reports an overall feeling of unhappiness (Cohen, Jinks & Mendes, 1999). He stated that he has become reckless and self-destructive and worried about some of his recent life decisions.
Per report from mother pt have demonstrated erratic behaviors and unstable emotions since the change in living arrangments. Per report from mother the Pt have been demonstrated violent behaviors (e.g. kicking, hitting, spitting, throwing items) towards mother and (13) sister. Per report from mother pt have been demonstrating self injurious behaviors (hitting self in the head, pulling hair out). Per report from ther pt have been demonstrated property destruction in the home where she has thrown items and taken them apart. Per report from mother pt does not have any triggers for maldaptive behaviors or mood swings. Pt reports her anger
Pt mother describes the pt seems to be in a “trance state” when he is in an anger episode. Pt mother stated that the pt have punched holes in the walls. Pt mother stated pt became assaultive towards pregnant sister who has M.S. Pt mother stated she feels unsafe with the pt in home due to is impulsive anger outburst.
Intervention: CSP, MHS and the youth discussed weekly improvement in the home and community. CSP and Miasia review the youth’s feelings and thoughts for the past week in the home and school. CSP, MHS and Miasia discussed ways to improve mornings and keeping on task. CSP and MHS praised Miasia for her progress on this goal. The youth had zero incidents of disrespecting others belongings. CSP provided reinforcement interventions for respecting boundaries in diverse settings. CSP discussed medication management concerns with MHS.
Discussion with the child’s mother gave me insight into his favorite activity at home, which was incorporated into his social story. Additional discussions with the extended care staff were essential to support the methods designed replace unwanted behavior with positive behavior. The afternoon staff used visual prompts to help the child recognize when he was exhibiting unwanted behavior. This extended collaboration ensured he expected to exhibit this behavior throughout his day.
Intervention: MHS reintroduced herself to the client as him counselor. MHS facilitated a family session in the home. MHS explained her role, the purpose of the program, and allowed the client to speak freely about things he wants help with. MHS allowed the client discuss some of his behavioral issues. The client reports that he fights a lot with his siblings. The client shared why he fights with his sibling, the client said they take his things and they are not nice to him. The client and his sibling began to yell and blame each other for all the fighting in the home. MHS asked the mother to shared with the MHS some concerns she has with the client behavior.
Tracy was the only child for the first 2.5 years of her life, and then a baby brother, Anthony (not his real name) was introduced to the family. Per Tracy’s mother’s report, Tracy was on track psychologically until her baby brother became sick and then she appeared to regress somewhat. Tracy’s response to her brother’s illness will be discussed in greater details in a subsequent section of the case assessment. Examples of Tracy’s regression include development of sleeping problems, and also a backslide in toilet training. Tracy has also exhibited some emotional changes during the months since her brother became sick which may be the result of ineffective coping and changing parenting styles.
William responded well to the intervention to the intervention. William is making progress towards his goals. William stated, dropping out of high school, drinking smoking, running away for home, and being none compliant with the house rules. William stated, not being trusted, being question by the police, losing parent trust, losing privileges, not being allowed to have friends over, and losing his job. William responded yes, anger and other emotions. William stated no, because he now knows how he has cause hurt and paint to his parent and the consequences thought him how to make better choices, in his life. William responded yes. William stated that he was encouraged by his friend to stay with them even though he knew it was wrong. William
Lanesha is a 12 year old girl that has been having trouble with her temper and her anger in almost every aspect of her daily life. Her medicine and compliance to her treatment plan are no different. As a teenager, she does not want to continually be hassled and bothered. So to avoid this she constantly is telling the providers lies, or in her mind, “what they want to hear.” (http://support.mchtraining.net/national_ccce/case1/Flash/activity1.html). Lanesha has a sense of neglect from her grandmother because she states that she want to act like everything is fine as to appease her Grandmothers temperament. Marietta, also shares in frustration but also has a great deal of added stress as she also cares for her 10 year old grandchild and also her older ailing mother. Marietta exudes many of the qualities spoken by Dr. Horky in her presentation; her own age is taking a toll on her ability to care for Lanesha, she is worried about Lanesha. Due to Lanesha’s age and behavior however, Marietta is experiencing depression and grief. Almost portrays a sense that she has given up, like she has done all that she can. (Horky, n.d.). Other socioeconomic issues are in Marietta’s forefront.
Emily is a 6-year-old girl referred by her pediatric psychologist because of behavioral issues. Emily’s parents have informed the analyst that her problems first arose when she
Chris had an overall well-groomed appearance. His hair was combed, his facial hair was shaved, and it look as though he had showered. He maintained good eye contact through the whole conversation even when the questions became very personal. Chris expressed a euthymic attitude. He verbalized that he had come to terms with his failed suicide attempt. He said that he was now glad that it didn’t work and it has opened a new chapter in his life. Chris was very engaging and gave us a ton of personal information about his life. His motor activity was a tad decreased. He mentioned that he has some trouble walking. His thought content was appropriate and he was oriented to time, place, and person. Presently Chris stated no longer having any suicidal