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Solution Focused Brief Therapy for Adolescent in Crisis (Case Study)

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The Case of Emma You have just been appointed as a counsellor at a high school in Gauteng (South Africa). The high school is situated in an urban area and is reasonably well resourced. The school has 1400 learners and 23 teachers. The school offers a range of academic subjects as well as various sporting codes and extra-curricular activities. The school’s student wellness policy states that learners have access to six sessions with a counsellor. As and when necessary, the counsellor is required to refer a client on to a more experienced practitioner (e.g. psychologist, doctor, social worker, etc.). A concerned teacher referred Emma to you. Emma is 16 years old, in Grade 10 and is generally a below-average school achiever (she just passes). The recent onset of sadness, unexplained tearfulness, difficulty concentrating, and struggles with sleeping is part of the presenting complaint. These are the reasons the teacher has referred Emma to you. You have a small private office on the school premises and Emma comes to you after her last class of the day. You have a one-and-a-half-hour session with her. You begin your session and Emma confirms her sleepless nights, difficulties with concentration, and appears sad and tearful. Emma then starts talking and shares with you – in a rather soft voice - that she feels ashamed of her body, is rapidly gaining weight, and adds that she does not feel like going to school in the mornings and would rather sit at home in front of the TV. She also mentions she is behind with her schoolwork, and considering that it is September, preparations for the final exams will soon commence. She tells you that her mother works as a bookkeeper and that her mother and father separated a year ago. Her father seldom makes contact with her and forgot to phone her on her birthday. She has no idea whether divorce proceedings are underway but indicated that her father is cohabiting with his new girlfriend, who Emma has met on two occasions and seemingly dislikes. Emma’s boyfriend of over a year, who is in matric at the same school, has also recently stopped contacting her and has not responded to her messages. She also thinks he has defriended her on Facebook. She thinks it is because of her weight gain, adding that her gym teacher recently told her in the gym class “she was getting too fat” in front of the other learners. Two nights’ ago, her mother came to her and asked her to try to get a part-time evening and weekend job (as a restaurant server) to help with the finances, as her father was defaulting on his financial maintenance. Emma has a younger brother who is in Grade 5. She takes care of him during the afternoon, helps with his homework, and walks him to the soccer field for practice every evening. She is very close to her brother. She complained that she feels like a burden to everyone and that for the last few days she wishes she could go to sleep and never wake up. She tells you that she is unable to talk to her mother, who returns home in the late evening, often grumpy, and has her own problems. Emma says that her mother is depressed. During her session with you, Emma says, “I would just like to go to sleep and never wake up. I am a burden to everyone, and no one seems to like me”. Her eyes brimming with tears she looks up at you and says “I’m not sure how you can help me, can you?. Instructions: -Based on your exposure to the content of this module, discuss how you would go about managing the case of Emma. -Your answer should include the following:  The definition of and types of crises that might apply to Emma; - How you might assess and identify Emma’s emotional state e.g. possible levels of self and/or other harm;  - Emma’s coping mechanisms within the context of anxiety and loss; - What principles/theories/models of crisis intervention would assist you in managing Emma’s case; - How you might convey some techniques of crisis intervention that demonstrate your ability to contain her; - How you feel about the layers of crisis presented, and your feelings of countertransference; and - Write a one-page referral letter to the school psychologist, expressing your concerns and summarising your intervention plan with Emma. The letter should be a clear summary of your opinion, based on your identifying the elements/dynamics/themes of crisis and distress that have emerged between Emma and yourself.

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1




Crisis Intervention Using Solution-Focused Therapy



Kelsey Nairn

South African College of Applied Psychology (Pty) Ltd.

Trauma and Crisis Counselling

Samuel Hill

10th August 2020

CRISIS AND TRAUMA - CASE STUDY ASSESSMENT RUBRIC

STUDENT NAME: KELSEY NAIRN MARK: 96%
Please note: where the section of the grid is in red, these are the key areas you need to pay attention to,
either continue to do or correct errors.
CRITERIA NOT YET SOMEWHAT COMPETENT ACCOMPLISHED HIGHLY MARK
COMPETENT COMPETEN ACCOMPLISHED
T
ENGAGEMENT No evidence Some Theory and Theory and Outstanding
WITH of evidence of literature is literature is engagement
LITERATURE engagement engagement engaged engaged with and
AND THEORY with but not with and and understanding
literature sufficient or well incorporated of theory and 34
and theory not very incorporated very well literature
/ 35 or irrelevant pertinent to
engagement the case
with theory study
and
literature

APPLICATION The Adequate Includes In-depth Outstanding
OF THEORY TO application application essential application of application of
THE CASE does not of theory to application theory with the theory to
STUDY pertain to the case of theory to pertinent and the case study
the case study but the case up-to-date and excellent
study or is some study information attention to

, 2


irrelevant to aspects clearly and detail and deep
/ 50 the case unclear compellingly engagement
study portrayed 48




APA Many Several Few errors, Very well Outstanding
ACADEMIC obtrusive errors Unobtrusive represented error-free
CONVENTION errors apparent in errors in and near presentation
S including references, references, perfect and technical 10
[STRUCTURE, referencing citation and citation and references, aspects
REFERENCING, and citation presentation presentation citation etc.
ETC.]



/ 10

STYLE / Wrong Some Awareness Strong audience Outstanding
AUDIENCE register for evidence but of audience engagement engagement
ENGAGEMENT audience not is evident throughout the with the given 4
sufficient or document audience in
/5 not mind
consistent

TOTAL: 96
ADDITIONAL SPECIFIC COMMENTS:
Dear Kelsey, I cannot even begin to tell you what a pleasure it is to have you as a student. Your work is of
an exceptional high quality – thank you! At this point your APA is basically faultless, you know how to use
theory and integrate into the challenges of everyday practice and you show skill in the step-by -step
application of your modality and the justification of your modality using theory! In terms of your reference
letter, so far you are the only student who actually created their own letter head! Well done, as this is
where all your relevant information is, so that you do not need to ‘introduce’ yourself to the referral
practitioner.
To improve mark: the only places I can ‘fault’ you is in the countertransference section [if you had included
it this would have given me a clearer indication of your empathy levels], and in terms of the referral letter –
rather ask for feedback directly then ‘Feel free to get back to me regarding your thoughts on this matter’ –
as they [in my experience] probably won’t take the hint that you really want to have feedback. Also rather
than ‘closing’ thoughts have a definite ‘Conclusion’ section.
Please also remember that I encourage you to continue developing your favourite theory and then to read
10 books a year on that theory, so that at the end of your graduate studies you should have read a
minimum of 30 books [cover-to-cover] on your favourite theory – this will give and expand your excellent
grounding in theory and the application thereof.
SAM 😊

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Type
Case
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