Case Conceptualization, Research Paper Example

Introduction

C.H. is an 11 year old Caucasian male who was referred to Alternatives to Violence (ATV) by a family friend.   The client and his mother presented at  thefirst session stating that they wanted to explore the trauma, which C.H. encountered.The counselor held just two sessions with him

Presenting Concern:

C.H.’s mother brought him in seeking to work through his trauma and manage his “mood swings.”  C.H.’s mother states that he can go from being calm and collective to so angry that he cannot stop shaking.  C.H’s mother also revealed that he cries very easily. Often he expresses hopelessness verbally.

Background Information:

During the initial session I met with both C.H. and his mother separately.  His mother stated that he was physically abused by his paternal grandfather.  She stated it was an isolated incident and due to grandfather’s medication he was taking at the time.  C.H. currently does not have any contact with this grandfather, who is in counselling too. C. H’s Mother also informed me that she was divorced from his father for approximately 1 ½ years. Custody of C.H was split 50/50 between them.  C.H. does not have any siblings.

The mother also reported that C.H. would be calm/ collective and then suddenly becoming extremely angry and upset over minor issues. For example, if I forgot to tell him ‘Good morning’ upon’ getting up in the morning he would begin by shouting, ‘you did not say morning, did we sleep together?’ If I did not respond he would continue his tantrum for a while until I say, good morning to him

It was also related by C.H’s mother how C.H would frantically begin crying and saying how he had no friends, mother, father, sisters and job. Subsequently, he would blurt out, ‘why am I living? I cannot go to school, get a wife and children, I do not have any body?’ This sobbing would continue for hours and it seemed to be the same issues every time in his day dreaming stages. Further, C.H‘s mother explained that on one occasion when he was angry and upset that he said “I shouldn’t be here.” This was the first time he showed signs of having suicidal thoughts or ideation. It was also reported that C.H. is often bullied at school.

Mother reported that C.H. “leaks” so he still wears pull-ups. This experience he finds extremely embarrassing. So far the counselor has yet addressed this subject with  theclient.  Mother also stated that C.H. spends nights at father’s house because she will not allow him to sleep in the same bed with her due to his bedwetting.  Father allows C.H. to sleep in the same bed with him despite wetting the bed.  Mother also reported that she feels father humiliates C.H. because he is not athletic as he was.

Client Strengths

C.H. Has many strength as an 11 year old. For example, he likes music, especially singing and learning to play the guitar.  Heenjoys attending counseling sessions and communicated this feeling to his counsellor.  C.H. informed the counselor that he also participates in four different after school activities, which has helped him form some new friendly relationships. Besides, C.H. enjoys playing video games and reading comic books, which facilitates use of his imagination and sharpens the memory. A huge strength quality is C.H’s strong relationship with his parents even though they are. Splitting up his time between them has become one of his greatest pleasures.

Hypotheses:

It seems that throughout C.H.’s life experiences he has developed both adaptive and maladaptive thoughts/assumptions/beliefs about himself, others and the world.Anxietyand depression are two major personality issues facing C.H in his childhood. Erroneous thoughts/assumptions/beliefsaffect his emotional regulation. They could possibly be easily triggered in the process of everyday interactions and working through his physical abuse. C.H.’s maladaptive thoughts may contain a number of distortions that create the confusion in his behavior and speaking.

Counselor Observations

During our two sessions together, C.H. was nervous and uncomfortable at the beginning of eachsessions. There was minimal eye contact and he frequently adjusted himself in his seat   However, about halfway through the session, I could see him relax as his eye contact became more pronouncedhe developed comfort being seated in the chair.  Importantly, C.H. was at ease when answering questions about school, his after school activities, and his dog.

During our conversations C.H cited multiple times when he got the impression that his father did not like not like him much because he is not an athlete. C.H even talked about two very close friends with whom he and participated in extracurricular activities after school. This very articulate young man also talked about how bullying at school forced him to inhibit his feels about many situations he was encountering at home and in the community

C.H.’s psychosocial development appears is consistent with Erickson’s model of industry versus inferiority whereby at one stage he is confident, industrious and brilliant yet at another he feels incapable and worthless.C.H. appears to be in need of validation in the form of praise and recognition for his achievements.His father, who is expected to play a significant role in rewarding his accomplishments seems insensitive to his desire for validation to build self-confidence and develop self-esteem.

Overall Conceptualization

From observations and assessment, C.H. would benefit the greatest by working to overcome low self-esteem/self-worthless ness issues in his rowing up years, However as a child it requires astute parenting and adequate supportive measure. The situation of being judged and ridiculed byfatherneeds to be resolved within him. The experinces with his father is a learning culture, teaching him how to cope with ridicule and antagonism from other people. While it could be traumatic during childhood, the interaction has its positive influences later in life building resilience.His “leaking” difficulty may be the only reason some compassion may flow from his father. However, this is a medical dysfunction, which must be addressed.  The frequent shifts in emotions may be due to bullying encountered at school and from his grandfather at home.