Possible one-on-one interventions may include the following retention of pharmacology
Introduction of cognitive behavioral therapy where Brian is shown how to deal with and manage his thoughts as well as how to be responsible for his own behavior rather than attempting to control that of others. This is particularly helpful with Brian's self-imposed isolation
Eclectic Rogerain counseling where counselor practices empathy, non-judgmental tolerance towards client, active listening, and encouraging client to formulate his own solutions
Insight into the conduct and feelings of Brian's mother as well as specific suggestion for how to deal with the mother's seeming apathy to Brian. Understanding can revolve around previous marital concerns, as well as her present medical concerns
Insight into the behavior of his biological father and strategies that may be effective in dealing with his father's abusive behavior and/or keeping away form his father.
Strategies for dealing with his disease and insight into its cause.
Social relationship skills that he can use to make friends and break out of his isolation. (Felson, 1983)
Predictably, any one of these actions will have a rebounding effect where positive influence will be witnessed in various other elements of Brian's life.
The brunt of this stage is to formulate specific tasks / projects that will be directed to dealing with the problems.
Phase 3: Early Development and Pilot Testing
Brian's progress will be tested in order to assess whether change / improvement has been noted. This may be done with the involvement of Brian's family, his school, and/or other people involved in Brian's life aside form the counselor's own observations of Brian's behavior. Other means of assessment that may be used may involve Brian keeping a journal or some other appraisal techniques such as a daily chart as well as weekly reporting frequency and intensity of his conflict with siblings or other client progress notes. However, Brian needs to be independently motiaveted to voluntarily implement and complete these as well as honest and interested, and given Brian's case study it seems doubtful that this is the case.
Evaluation and Advanced Development
The earlier phase of pilot testing leads onto continuous evaluation of client progress and determination of whether or not to modify Brian's program and, if so, in which ways. The SSE/s as well as feedback from people who are most involved with Brian's life (such as parents, family, school etc.), and Brian's progress notes themselves would serve as reports for whether or not to proceed.
The counselor need not always wait for these intervals of evaluation and feedback, rather plan can be modified as she sees fit if necessity would call for it (for instance if Brian's behavior improves or worsens).
A chart can be kept to assist with tracking frequency and severity of behavior and to assess whether improvement has, indeed, been noted.
Phase 5. Dissemination
In this, the final phase, Brian's plan and practitioner's notes of progress are made available to other's involved with Brian's life such as his family, school, medical practitioners so that thtey too can employ it to their advantage aside form providing their own feedback and evaluation of how plan can be modified / improved and their personal observations of Brian's progress.
Source
Caspi, J (2008). Building a Sibling Aggression Treatment Model: Design and Development Research in Action, Research on Social Work Practice, 18: 575
Felson, R. (1983, December). Aggression and violence between siblings.Social Psychology Quarterly, 46(4), 271-285.
Graham-Bermann, S.A., Cutler, S.E., Litzenberger, B.W., & Schwartz, W. E. (1994). Perceived conflict and violence in childhood sibling relationships and later emotional adjustment. Journal of Family Psychology, 8, 85-97.
Means-Burleson, a.M. (2002). Aggression: Family and sibling correlates. Dissertation Abstracts International, 68(6B), 3015. (UMI
No. 3058213)
Minuchin, S. (1974). Families and family therapy. Cambridge, MA: Harvard University Press.
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