Client Is a Four-Year-Old Caucasian Female Currently Case Study

Excerpt from Case Study :

client is a four-year-old, Caucasian female, currently in kindergarten. She is living with her father, and great-grandfather, and next door to her father's parents. The client is currently living with her father and great-grandfather due to her parents separating/divorcing. Client was asked by the father to receive counseling due to parent's separation/divorce.

In an article I read by Bryner, he wrote about a study done by Wallerstein and Blakeslee, whom did a longitudinal study for 10 years, they followed for those 10 years a total of 116 children who had come from a divorced home. What they found was that divorce was not something isolated but yet just one step of a series of family transitions that affect the family and the child. Those series of events range from life in the family before a divorce, life in a sudden single-parent household, and possible future marital changes (Bryner, 2001).

During our intake session I met with the father in order to get a better understanding as to what the presenting problem was. When I first met with the father, he smelled of cigarette smoke, and seemed to be very nervous, possibly not know what to expect. When asking the father why he wants his daughter to receive counseling, he went on to describe the situation between him and soon to be ex-wife. The father described having problems with his substance abusing wife, who would constantly argue with him in front of his daughter. He described one day coming home from work for lunch and his daughter along with her cousin were outside playing, as he walked into the house his wife was still sleeping in bed and hadn't started her day yet. He began telling me he asked her where their daughter was and she stated "in her room probably." He became upset and told her "no she's outside playing; you need to be watching her!" His wife argued with him about being exhausted. He explained how he couldn't go back to work that afternoon because there was no one to watch his daughter.

My client's father was describing to me that one night, he and his wife were having an argument, because his wife was under the influence. He told her she needed to leave the house and he locked her out. A little while after his wife broke through the window of their daughter's bedroom was telling my client that they needed to go. My client's fathers described him going into the room because he heard my client crying and shatter of glass. When he opened the door to the room he found his wife there bleeding in their daughter's bedroom. He immediately called authorities to come and arrest his wife. Soon authorities arrived and arrested his wife. Soon after the incident she was given a restraining order and was put in jail for a period of time, due to substance abuse. My client's father was given sole custody of her.

Since then he had moved them out of their home for fear his wife would violate her restraint and come back to the house. He decided to move with his grandfather, whom lives next door to his parents. He stated how my client would spend some weekends with her grandparents before, and figured this would be good for her. In an article written by Davies and Forman, it states "children from homes characterized by high levels of parental conflict are at increased risk for developing psychological problems" (2002). It seems as though the father had taken the necessary steps in order to protect his daughter from that type of environment.

How fathers maintain a relationship with their child after a divorce may affect the child adjustment after divorce. "Empirical findings suggest a wide array of interrelated, entangled factors that predict father involvement and link father involvement to child adjustment" (Kelly & Emrey, 2003). In my client's situation she is being raised with her father and the relationship is flourishing, so I'm wondering if her adjustment to the divorce is due to this relationship with her father and how he has explained to her about her mother being ill.

During our intake the father described to me that his daughter does very well in school, she has not had any major problems in school, other than sometimes she gets in a bad mood and it affects the rest of her school day. He also described that at times she talks too much and gets her behavior card flipped to yellow.

My client has had previous counseling at Riverwood, due to her parent's separation. Her father had taken her. He stated that my client had difficulties speaking about her mother and he worried that one day she will grow up and resent him for him taking her away from her mother. He is also fearful of his daughter taking after her mother in not finishing school. He explained that her previous counselor had stated she seemed to be okay and if he had any further problems or concerns to bring her back.

My client's father soon after was dating a woman with a two-year-old child, and soon they all moved in together. Father's girlfriend scheduled an appointment with the Andrews Community Counseling Center to see her child, and my client's father was then interested in scheduling his daughter as well. In January of 2012 during my practicum was when this client was assigned to me. During the time my client lived with father and girlfriend, father explained at first it was going well, however there were times when his girlfriend and his daughter would sometimes not get along, he explained his daughter as sometimes being "hardheaded."

It was not until our second session that I had met with my client and her father during the full session. During the session, my client opened up more and was very talkative; telling me a little about school. We played "go fish" with Disney princess playing cards, and soon moved into the activity I had planned for the session. Since my client is only five years of age I wanted to get a better understanding as to what she understood about different emotions.

I had printed out pictures of children expressing different emotions, with the picture there were two different questions one asking, "what emotion is this person showing?" And then "Has there ever been a time you felt his way?" The different emotions that were displayed were as followed: happy, sad, upset, very angry, scared, and surprised, amongst a few others. When discussing if she had ever felt sad about something, she stated she was sad about two siblings. When she stated this her father jumped in and explained that she would have had two older siblings but they had passed away as babies.

A study was done on children's understanding of their parents emotions. The researcher showed several photographs of emotions such as sad, angry, happy, and scared, to children ages 4-11 years of age. The researcher would then ask the children what emotion was depicted on the photograph and what would make their father and mother feel that way. The results showed that 85% of children referred to themselves as the result of their parents' anger, 65% of parental happiness, 49% of parental sadness, and 41% of parental fear (Covell & Abramovitch, 1987). I soon realized that my client was stating that she was sad solely because that was an emotion she saw her father or mother feel when looking at a picture of her deceased siblings.

My client seemed to have an outgoing personality, very talkative and easy to connect with. She seems to easily reflect the feelings of those around her. It showed that she liked to please others; during our first session together she was always looking to father for confirmation. The relationship between her and her father seem to be very close.

Using the DSM-IV-TR, Axis I; Clinical disorders, you are to "report any various disorders or conditions in the Classification except for the Personality Disorders and Mental Retardation" (DSM-IV-TR, 2000).Under this Axis I gave my client a V71.09 which is no diagnosis of any clinical disorders. Axis II; Personality disorders, reports any personality disorders and mental retardation, in this section she has another V71.09 which is also no diagnosis. My client has no general medical conditions so under Axis III on my intake interview I wrote none. On Axis IV; psychosocial and environmental problems, which could be any negative life event, an environmental difficulty or deficiency, a familial or other interpersonal stress etc.… (DSM-IV-TR, 2000) my client is experiencing divorce within her primary support group, which was the reason for counseling. Under Axis V, counselors are to "report their judgment of the clients overall level of functioning" (DSM-IV-TR, 2000). I gave my client a GAF score of 80 which states, "If symptoms are present, they are transient and expectable reactions to psychosocial stressors."

My client speaks well; you can clearly understand what…

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