“April”: A Quick Case Study (or more like a synopsis)

Every three months as part of my grant we have to do a report and in that report, besides asking for numbers to validate and show evidence of my value, we have to write about one client that has improved over those three months. I decided to share that client with you.

 “April”

April  (17 year old female) lives in a group home where she has been for about five years after being removed from her family because of neglect and ongoing sexual abuse.

When I met April she was having a hard time focusing in school, often walked off campus and ran away from her group home. Her grades were very poor and she was prone to emotional and angry outbursts. She was brought to me initially by another counselor after she had threatened to punch her school bus driver, walked off the school bus and went missing for twenty four hours and was later found by local authorities.

I begin working with April (using mostly cognitive behavioral therapy) on controlling her emotions as well as working with her group home and guidance counselor to make sure all of her needs were being reasonably met. I put her in a life skills group which initially she was reluctant to join because “I don’t get along with other people” and met with her once weekly in private sessions, often helping her process her anger and fear about her family and about her future. I encouraged her to keep a journal and to write down everything she wanted to say to her family (no communication with her family in almost five years was her biggest issue). I also worked with her teachers to make sure that when April was having a “bad day”, they knew how to appropriately handle the situation and not escalate it or send her out of class which usually led to her walking off campus.

As a result, within a few weeks April stopped walking off campus and running away from her group home as she learned how to self-regulate her emotions. Her attitude improved and the number of referrals for classroom disruptions fell to nearly zero. Her grades improved and her number of “emotional breakdowns” during class fell to zero, as she was able to express her emotions in private sessions with me. She became a very active member of her group and her number of group home infractions also fell. She begin getting positive attention and positive rewards from both her group home and school staff and is a much calmer person today than she was when I first met her.

Because she is much better at regulating her emotions, we are able to spend more of our private sessions processing her feelings of abandonment by her family and working on (in conjunction with her independent living counselor) becoming more self-sufficient in preparation for the day she will turn eighteen and transition out of the group home. In an individual education plan meeting I attended with April a couple of weeks ago, she was highly praised on her many improvements in both academics and behavior.

-April really is one of my favorite clients. She is labeled “emotionally disturbed”, and while she is 17 and functions more often like a 12 year old, she’s grown a lot since the first day she set across from me as a very angry young lady with no respect for authority. She could have been diagnosed at that time as oppositional defiant,  but she had enough labels and I didn’t see the need to label her any more and as she has improved, i’m glad I wrote her initial diagnosis as “deferred” despite the constant push by insurance companies that “everyone gets a diagnosis”. Oh gosh, that is another whole post for another time.

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