Cognitive Behavioral Therapy for Teenagers Responses

Respond to two of your colleague’s postings in one or more of the following ways:

• Ask a probing question.
• Share an insight gained from having read your colleague’s posting.
• Offer and support an opinion.
• Make a suggestion.
• Expand on your colleague’s posting.
• Be sure to use reference in your response

DB1—Tiffany

A brief description of the presenting symptoms of the child or adolescent in the case study you selected.

Monte is a 9-year-old white male referred by the school for behaviors that impact his and his classmates’ ability to learn. Specific behaviors noted include verbal aggression toward teachers, verbal aggression toward peers, and reports that Monte feels like the teachers are picking on him. When one on one with a teacher, Monte appears clingy with teachers and seeks their approval. Monte reports at home that his sisters are mean to him. Other presenting symptoms include Monte having very low self-esteem, difficulty concentrating, negative thought processes and cognitive framing, overeating, frequent headaches, and infrequent school attendance. There is no evidence of abuse in the family. The frequency of the maladaptive behaviors exhibited has increased over the past two years.

One possible reason the child’s or adolescent’s problem exists and why.

One possible reason the child’s problems exist is that Monte is reported to live in a chaotic family, and his primary caretakers are his two older sisters. Monte displays symptoms closely aligned with Disruptive Mood Dysregulation Disorder (DMDD), such as irritability in his negative comments, explosiveness in his exhibiting behaviors, and dysregulation, as noted in his low self-esteem. Risk factors may include low socioeconomic status as his parents are not home, chaotic household, and other potential family patterns (Stebbins, & Corcoran, 2016). Monte displays anxious attachment in being clingy with teachers when he is one on one but displays behaviors that may protect himself from abandonment and rejection when around peers. Addressing Monte’s relationship with his parents and the home’s stress level creates conditions where Monte is experiencing a lot of emotions and is struggling with emotion regulation and feeling secure in his relationships (Hallab & Covic, 2010).

Explain one evidence-based intervention you might use to address the child/adolescent in this case study and how it will be used.

One evidence-based intervention I might use to address the child-adolescent in the case study would be a cognitive-behavioral approach that would involve Monte and his parents. Before beginning the intervention, I would contact Monte’s parents to understand better the barriers they face to being home with Monte. I could provide support to reduce those barriers, such as child care assistance, food assistance, or rental assistance. If parents are out of the home often for work, this will allow them the flexibility to meet as a family when completing sessions. Once family needs were met, I would then schedule sessions to work together. In the study I found, the therapist utilized a group approach to services for the children exhibiting the symptoms and then tailored family approaches with the child. Skills worked on individually and as a family included relaxation, mindfulness, and cognitive restructuring. Parents were taught about the skills the children learned and then had sessions together. The sessions force on building coping sequences of when there is distress, identify the emotion being felt, use an emotion-focus coping strategy, reflect on and challenge any negative thoughts, and then regulate and solve the problem. These skills were learned through video modeling and role-play before trialing in real situations within the family (Drella et al., 2020).

References

Derella, O. J., Burke, J. B., Romano-Verthelyi, A. M., Butler, E. J., & Johnston, O. G. (2020). Feasibility and acceptability of a brief cognitive-behavioral group intervention for chronic irritability in youth. Clinical Child Psychology and Psychiatry, 25(4), p. 778-789.

Hallab, L., Covic, T. (2010). Deliberate self-harm: The interplay between attachment and stress. Behaviour Change, 27(2), 93-103.

Stebbins, M. B., & Corcoran, J. (2016). Pediatric bipolar disorder: the child psychiatrist perspective. Child and Adolescent Social Work Journal, 33(2), 115-122.