In this assignment, you will be applying your knowledge of assessment in counseling to a specific scenario. Use the Resources provided and the Capella University Library to complete the following:Sele

Case Conceptualization and Behavior Plan for [Kiana Williams]

LaToya Baber

Capella University

COUN5420 – Child and Adolescent Psychopathology

Dr. Erickson

November 2018

Introduction

This paper will discuss a behavioral plan for Kiana Williams, a middle school student. The following behavioral plan will consist of the students’ personal & cultural background knowledge related to their strengths. By assessing Kiana this will further relate the student to classification/diagnosis and intervention planning. The assessment will provide a better understanding of the diagnosis implications and differential diagnosis of the student related to Kiana’s academic, developmental, social & emotional, college/career readiness.

Additionally, the role of a school counselor will be discussed to provide both legal and ethical implications related to the case of Kiana and her presenting concerns. From this information and working with additional stakeholders such as her parents, teachers and community partners, the school counselor will create an intervention plan that support her strengths in success specific to this Kiana’s case.

Case Conceptualization

Student and Case Description

Kiana Williams is an African American, eighth grade student at Madison Middle School. Her parents are not actively involved in her school studies. Due to the demand of her older star athlete siblings and the extra support needed to care for her younger sibling with a learning disability. However, Kiana is described by her history teacher Jenae Monroe-Keller as, “a very sweet kid, and an above-average student.” Despite the challenges of her home life.

Kiana’s history teacher Mrs. Keller has reported from another student along with her concerns of the changes in Kiana’s behavior over the past year. In which she notes that last year she was very quiet and she had to work hard to get her to participate in class. However, this year she’s opened up more, but she also seems to be much more concerned about her appearance and image in ways that aren’t healthy. Her grades have since been falling and she is now hanging out with a popular crowd instead of participating in film and choir. Due to these recent behavior changes, Mrs. Keller believes that Kiana is engaging in self-harm from the visible cuts she has seen on her arms.

Assessment

“Non-suicidal self-injury (NSSI), also called self-harm or self-mutilation, is the deliberate, self-inflicted destruction of body tissue, outside of cultural norms, and without suicidal intent (Cha & Nock, 2014; Yates, 2004) Although self-harming is considered to be a non-suicidal self-injury due to the ongoing change in behavior and additional reports of concern from Kiana’s friend and history teacher the school counselor would still access her for committing suicide, to ensure that the self-harm does not in fact lead to a potential real attempt to commit suicide.

According to American School Counselor Association when a school counselor is informed about a student self-harming themselves they should, “Inform parents/guardians and/or appropriate authorities when a student poses a serious and foreseeable risk of harm to self for others. When feasible, this is to be done after careful deliberation and consultation with other appropriate professionals.” (ASCA, 2016)

Therefore, in the case of Kiana the school counselor would initiate a general suicide risk assessment. The assessment would determine the likelihood of Kiana committing suicide based on the self-harm she has previously done. The SLAP assessment will assist in reviewing the situation with Kiana both in the home (internally) and school environment (externally). The lethality of the suicide plan will be reviewed on whether Kiana has an actual plan to commit suicide, based on the self-harm of cutting herself. Also, including the availability of time and actual means to carry out the suicide plan will be reviewed. Along with determining the timeline in which Kiana may act out the suicide plan.

Diagnostic Impressions and Implications

Diagnostic Impressions

Although school counselors typically do not diagnose students according to the American School Counselor Association as it can potentially affect the student’s academic success. In the case of Kiana who is considered to be nonsuicidal self-injury (NSSI), or known as participating in self-harming. Adolescents who display self-harm report different attitudes toward life and death and use different means of injury (e.g., cutting versus overdosing) from adolescents who exhibit parasuicidal behavior (Cha & Nock, 2014; see Box 12:2). (Parritz, 2018)

Variables related to identity, self-image, and self- esteem are also noteworthy contributors to increased risk, particularly with respect to lack of self-efficacy and hopelessness (Derbidge & Beauchaine, 2014; Rut- ter & Behrendt, 2004). Hopelessness is significant both for the development and maintenance of suicidality; shame and guilt, as well as a sense of being a burden to others, often exacerbate hopelessness (Joiner, Conwell, et al., 2005).

. However, in the case of Kiana the school counselor is still familiar with the process of diagnosis by applying standards from the DSM 5 to these cases. In this section, apply DSM 5 criteria to your case to determine diagnostic impressions for this case.

Differential Diagnosis

Counselors are often required to “rule out” similar conditions that could also be attributed to the presenting concerns. In this section, describe other related diagnoses you reviewed but ruled out and justify your reasons for excluding the diagnosis in favor of the one you selected.

Implications [Delete this: Carefully consider implications for your student related to the following. You may also create additional sub-headings, if you believe there are other areas of relevance to your case.]

Academic. Describe relevant academic implications of the presenting concern.

Developmental. Describe relevant developmental implications of the presenting concern.

College/career readiness (if applicable). Describe relevant college/career readiness implications of the presenting concern.

Cultural. Suicide rates decreased significantly for white children, whereas rates increased significantly for black children (Bridge et al., 2015). (Parritz, 2018)

Describe relevant cultural implications of the presenting concern.

Social/emotional. Describe relevant social/emotional implications of the presenting concern.

Legal and ethical. When faced with an ethical dilemma, school counselors use an ethical decision-making model such as Solutions to Ethical Problems in Schools (STEPS) (Stone, 2001): In which the school counselor will a. Define the problem emotionally and intellectually, which in the case is Kiana self-harming, lack of parental support, academically declining grades and the negative influence of her peers. b. Apply the ASCA Ethical Standards for School Counselors and the law, which in this case is to seek additional support from stakeholders including parents, teachers and community resources to avoid diagnosing Kiana. c. Consider the students’ chronological and developmental levels as Kiana is not receiving parental support due to the demand of her other siblings. Therefore, she is seeking acceptance from her peers with the change of her behavior. Developmentally she is more mature than her peers as she has been self-sufficient in seeking outlets previously in the school play and chorus. d. Consider the setting, parental rights and minors’ rights, in this case with Kiana the school counselor will need to Recognize that providing services to minors in a school setting requires school counselors to collaborate with students’ parents/ guardians as appropriate. (ASCA, 2016)

Therefore, Kiana will be informed that due to the act of self-harming there are both legal and ethical obligations to report the concern to the appropriate authorities unless it is appropriate to withhold this information to protect Kiana. e. Apply the ethical principles of beneficence, autonomy, nonmaleficence, loyalty and justice Kiana is the first priority in which the school counselor is loyal to. With confidentiality at the forefront of their professional relationship f. Determine potential courses of action and their consequences However, Kiana will be informed of the nature of confidentiality in the counseling relationship. In which School Counselors, keep information confidential unless legal requirements demand that confidential information be revealed or a breach is required to prevent serious and foreseeable harm to the student. Serious and foreseeable harm is different for each minor in schools and is determined by students’ developmental and chronological age, the setting, parental rights and the nature of the harm. (ASCA, 2016) g. Evaluate the selected action which is the notification of Kiana’s parents, consulting with additional stakeholders to assist in the academic, developmental, social & emotional, college/career readiness for her. Additionally consulting with a supervisor to obtain further direction on the case of Kiana by using a collaborative model of supervision that is on-going and includes, but is not limited to, the following activities: promoting professional growth, supporting best practices and ethical practice, assessing supervisee performance and developing plans for improvement, consulting on specific cases and assisting in the development of a course of action. (ASCA, 2016) i. Implement the course of action best fit for Kiana.

Student Strengths

Kiana is an above-average student who has been on the honor roll every semester in the previous year. She has also participated in school plays in the chorus. Even without the lack of parental support emotionally, physically and or academically Kiana has managed to previously stay focus on school. Therefore, her strength and developmental maturity places her at an advantage to begin refocusing on enhancing the skills and protective factors for Kiana. Rather than focusing on deficits, such as self-harming, peer pressure and lack of parental support due to the needs of her other siblings. The person-centered approach typifies the humanistic approach and focuses on the client and the world of the client as the center of therapeutic change. (Sheperis, ) Therefore, Kiana will be able to refocus on her strengths with the School Counselors’ use of the Person-Centered approach.

Intervention Planning

Role of the School Counselor

The role of a School Counselor in the case of Kiana Williams is to advocate and collaborate with Kiana to ensure that she remains safe at home and at school. A high standard of care includes determining what information is shared with parents/ guardians and when information creates an unsafe environment for students. While also, providing Kiana with a comprehensive school counseling program that ensures equitable academic, career and social/ emotional development opportunities for her. (ASCA, 2016)

Intervention Plan

Kiana’s intervention plan will consist of her participating in a group counseling program to assist with the pressure of her peers and the self-harming she has participated in. Young adolescents naturally look to their peers for affirmation and companionship, which makes group counseling particularly viable for this age group. Middle school counselors have the task of designing groups that can assist young adolescents in dealing with a variety of developmental tasks, providing an appropriate forum for promoting their personal and social development. (. ) Additional follow up personal counseling sessions will provide support to Kiana when she is feeling the need to self-harm and or not receiving support from her parents.

However, to assist Kiana’s parents with becoming more supportive to her developmental needs, the School Counselor will provide outside resources for family counseling. To assist with strategies on how to provide support to her and as well as her siblings on their individual developmental growth stages. As her parents have not previously always attended Kiana’s parent teacher conferences and or supported her in her participation in school plays in the chorus. Therefore, both mothers and fathers may be especially powerful agents of change (Schock, Gavazzi, Fristad, & Goldberg-Arnold, 2002; Sherrill & Kovacs, 2002), with parent advocacy a key factor in new research and treatment (Hellander, 2003). (Parritz, 2018)

Collaborative Support

According to the American School Counselor Association, School Counselors should collaborate with all relevant stakeholders, including students, educators and parents/guardians when student assistance is needed, including the identification of early warning signs of student distress. (ASCA, 2016) Therefore the School Counselor will work collaboratively with key stakeholders involved in Kiana’s case.

Parents(s) or guardian(s) Have been notified of Kiana’s behavioral changes of self-harming and peer pressure. The School Counselor will collaborate with the parents to find the best recovery and or support for Kiana’s case. In which the parents would like for Kiana to continue to receive short term personal counseling from the School Counselor, until she is seen by a medical physician to evaluate Kiana for a medication to help her with stress and stabilizing her mood, to avoid any further self-harming.

Teacher(s) and staff. The School Counselor will continue to communicate with Mrs. Keller, Kiana’s History teacher who is the original reporter of her behavioral changes within the last year. The collaboration with teachers and staff will be in providing additional support and strategies to use within the classroom. To help Kiana set an overall safe and positive environment for her to learn in.

Community resources. Will be provided for Kiana and her parents to seek long-term counseling if needed and family counseling. Additionally, third party community resources can provide awareness to students in the group counseling sessions on proper ways to handle peer pressure, stress and or self-harming.

Psychopharmacology. In collaborating with the physician the discussion on identifying common medication(s) in which will affect the learning and behavior of Kiana. Therefore the impact of .

Outcomes

How will you know when the intervention plan is successful? Include specific, operationally defined measures of success specific to this student’s case.

References

Hornik Parritz, R. & Troy, M. F. (2018). Disorders of childhood: Development and psychopathology (3rd ed.). Boston, MA: Cengage Learning.

NOTE ON GRAMMAR & MECHANICS [delete this section]:

Consult your APA manual for proper examples on citing and referencing APA style. The Capella Writing Center also has helpful tutorials. Below is a list of common errors. Please pay particular attention to the following:

• Subject-verb agreement.

• Indenting.

• Use of upper and lower case.

• Headings and seriation in APA format.

• Comma/semicolon/period placement.