| Client Service Plan – Noah and his Family |
| Problems |
Goals |
Objectives |
Intervention/Model/ Theory |
Clinical Skill/Practice Strategy |
Outcomes |
| Depression, grief, stress-related symptoms resuting from the death of his cousin |
Provide a normative degree of resolutin for grief, resolve acute symptoms related to deth, cognitive appraisal of the death and further sense of danger |
Carefully review child’s understanding of circumstances of cousin’s death and exaggerated fears of his own danger, review time with Damon and develop a scrapbook together |
Cognitive therapy focused on resolving fears related to death and facilitiating grief: Introduce emotion identification and scaling, explore cognitive distortions Behavioral activation |
Mindful listening Engagement |
Decrease score on index of suicidal ideation and index of hopelessness |
| Shyness, social anxiety with kids at school |
Increase comfort level and improve socializiation skills to play after school for at least one hour |
Graduated objectives: measured from a few minutes up to 60 minutes in after school program; instructors record number of minutes |
Coping Skills to enhance relaxation through imagery and muscle relaxation, modeling and role playing of conversation and play; graduated exposure, contingency management with rewards for more playtime in afterschool program Explore core beliefs that trigger avoidant behavior |
Therapeutic alliance Mutual agreement Systems collaboration (school) Reframing |
Increase number of minutes playing with others in after school program from 0 to 10 to 20 to 40 then 60. Increase number of times he initiates conversation druing play from 0 to 4 Decrease SUDS (subjective units of distress scale) to below 5 when approaching other children |
| Moderate OCD symptoms, perfectionism, excessive organizing to get things just right, feelings of responsibility for external events |
Reduce expectations to be perfect: tolerate messiness with reduced anxiety and compulsive behaviors |
Graduated objectives: to reduce level of perfectionism with regard to tidying up room, homework, prayer by reducing amount of organizing to 1-2 mintues daily at the end of each task. |
In addition to coping skills, EXRP (exposure with response prevention) exercised early on until he can leave it alone, dailiy rewards for reducing organizing time Mindfulness – relabeling, reattributing, refocusing, revaluing |
Exploration Feedback Reinforcement |
Decrease number of minutes organizing at home and school from current rate to 5 then to 1-2 Level of subjective anxiety experienced if things are not perfect to under 5 |
