Conceptualization of the case
A critical analysis of the case of Alexandra reveals that she must be suffering from intermittent explosive disorder (IED). The case does not reveal much about the cultural background, but it provides detailed information about the family and the environment at school. The biological factors may help in conceptualizing this case.
The client is 10 years, which means that she is soon becoming a teenager. There is a possibility that other psychological problems may be the cause of her behavioral changes, but based on her age, it is more likely that teenage problems are setting in. According to Henderson and Thompson (2015), mood swings and changes in one’s behavior are common among teens that lack proper counseling. She may be experiencing some changes in her body that she may not clearly understand given the strained relationship with her mother, Dina. These developments may be the root cause of the mental torture that is making her behave abnormally. She feels that these developments may be abnormal, given that she cannot detect them in his brothers, Peter and Ricky.
Demographically, there is a clear lack of support from her parents who are keen on improving their socio-economic status. Maintaining an upper-middle-class status in the United States would require a lot of commitment to one’s work. Her father, Brian, works in the city for very long hours as a finance officer and this shows that he has limited time to spend with his family. Dina seems to be preoccupied with the issue of Ricky’s acting career to an extent that she has forgotten that Alexandra also needs her attention. This is demonstrated when she told Dina that she feels worthless.
When Dina tried to tell her that she was very pretty, she would not accept the compliment. This demonstrates that she rarely gets such compliments from her parents. She feels unappreciated, and the complement of Dina does very little to change this perception. According to Henderson and Thompson (2015), children below the age of 19 years need constant reassurance from people around them that they are wonderfully made. They need to feel that they are important to society and that they are destined for greatness. This must be what Alexandra lacks back at home hence she has very low self-esteem.
Dina reports that Alexandra was a child model, but this is no longer the case. A series of factors could have contributed to this change based on the case presented, making Alexandra have a complete change of perception about life. It is not easy for her to easily associate with other peers who feel appreciated. Her anger, outbursts, and violence are only means of self-defense against people she feels may be tempted to take advantage of her weaknesses.
Possible goals for Alexandra
At this stage, Alexandra is almost developing a sense of self-rejection. It will be necessary to set goals that would help change this mindset. As Bower observes, the stage of a mental problem and its nature may determine the ease with which it can be addressed (2008). In her case, the biggest advantage in addressing her problems is that she is still on good terms with Brian. The following are the specific goals that the client should achieve:
- To appreciate herself and believe that she is unique as a person
- To develop a positive relationship with her family members back at home
- To have two or three close friends at school
- To get active in a music club and playing drums
- To appreciate that she cannot be limited by her gender when it comes to pursuing her dreams.
Possible treatment methods
To address this problem, Cognitive Behavioral Therapy will be recommended for the client. The client will specifically need CRCST (Cognitive Relaxation and Coping skills Therapy) to help in fighting her outbursts, anger, and solitude nature (Bower, 2008). The problem will be considered a psychological problem that can fully be addressed using behavioral therapy.
Any psychotropic regimens through pharmaceutical products will be avoided because of the possible side effects they may have on the patient. This decision was informed by the need to avoid the possibility that she may have to rely on these drugs in the future.
How to implement a consultation/collaboration model with this client
The therapeutic model proposed above will help the client achieve the objectives set above. The implementation of the plan will need a collaborative approach that will involve the counselor, family members, and teachers. The cognitive-behavioral therapy will be administered in 12 sessions. Before starting the session, the client will be informed about the procedure and the overall aim of the process.
After that, she will be informed about the aims that should be achieved by the end of it all. It will be more fun if the therapy takes the approach of a game with two players. The first player will be the client while her opponent will be all the negative factors that make her lose self-esteem. The ultimate winner shall be determined after the 12 rounds.
Achievement of any of the goals set above will be a win for her against her opponent. The counselor will be her couch in the entire process and the referees will be the family members, teachers, and peers at school. After every session, the coach will rely on the feedback of the referees to determine the level of success of the client.
References
Bower, B. (2008). Study Evaluates Kids’ Therapies: Most Trauma Treatments Lack Scientific Support. Science News 174(7), 11-46.
Henderson, D., & Thompson, C. (2015). Counseling Children. Belmont: Thompson Brooks.