COUN5254 – Child and Adolescent Counseling
U3A1 - Case Conceptualization
2
BIOPSYCHOSOCIAL ASSESSMENT FORM
-Client Demographic Data
Name: Jared
Age: 5
Gender: Male
Race: African American
Ethnicity: Ghana
Religion: Great grandparents were raised Catholic, and Grandparents on mom’s side were also
raised with religion. Neither mom nor stepdad belong to any church or have any strong
affiliations in their household. They do believe in spirituality.
Other Relevant Information: Lives with his mom and stepdad since birth. (bio dad is not in
the picture left his mom when he found out she was pregnant.) Thinks of his stepdad as his dad.
Social-Cultural Information: lower middle class, spiritual family no strong religious ties,
English-speaking
-Presenting Problem
, Describe in detail the reason the client is seeking counseling, including behavioral, situational,
and environmental factors:
Jared is easily frustrated, when he gets frustrated he has been known to hit his teachers and
classmates. His school principal and teachers say that he is “a very angry little boy”
Within the past 2 months, Jared had had 2 physical outbursts of aggression by throwing a chair
across his classroom. After each incident, Jared has been very apologetic and broken down into
tears.
Teachers don’t know what to do with him when he gets physical at school, Jared won’t go to
the principal’s office he’s now afraid of her and thinks “she’s mean.”
One teacher did note that Jared seems most frustrated when he can’t accomplish the task at hand
by himself. Jared also doesn’t seem to be able to wait too long for help before getting upset and
hitting instead of using his words.
There is a teacher assistant who can sometimes get Jared to calm down before he gets physical,
Unfortunately, she’s not in the room all the time.
U3A1 - Case Conceptualization
2
BIOPSYCHOSOCIAL ASSESSMENT FORM
-Client Demographic Data
Name: Jared
Age: 5
Gender: Male
Race: African American
Ethnicity: Ghana
Religion: Great grandparents were raised Catholic, and Grandparents on mom’s side were also
raised with religion. Neither mom nor stepdad belong to any church or have any strong
affiliations in their household. They do believe in spirituality.
Other Relevant Information: Lives with his mom and stepdad since birth. (bio dad is not in
the picture left his mom when he found out she was pregnant.) Thinks of his stepdad as his dad.
Social-Cultural Information: lower middle class, spiritual family no strong religious ties,
English-speaking
-Presenting Problem
, Describe in detail the reason the client is seeking counseling, including behavioral, situational,
and environmental factors:
Jared is easily frustrated, when he gets frustrated he has been known to hit his teachers and
classmates. His school principal and teachers say that he is “a very angry little boy”
Within the past 2 months, Jared had had 2 physical outbursts of aggression by throwing a chair
across his classroom. After each incident, Jared has been very apologetic and broken down into
tears.
Teachers don’t know what to do with him when he gets physical at school, Jared won’t go to
the principal’s office he’s now afraid of her and thinks “she’s mean.”
One teacher did note that Jared seems most frustrated when he can’t accomplish the task at hand
by himself. Jared also doesn’t seem to be able to wait too long for help before getting upset and
hitting instead of using his words.
There is a teacher assistant who can sometimes get Jared to calm down before he gets physical,
Unfortunately, she’s not in the room all the time.
