This case study examines a five-year-old girl referred for counseling following her parents' separation and the mother's subsequent arrest for substance abuse. The paper documents the intake process, developmental assessment, and therapeutic sessions, applying Piaget's preoperational stage, Erikson's psychosocial theory, and DSM-IV-TR multiaxial diagnosis. The counselor explores the child's emotional understanding, her relationship with her father, and her adjustment to a single-parent household. Key themes include the effects of parental conflict on young children, the role of the father-child relationship in post-divorce adjustment, and the use of play-based therapeutic activities to assess and support the child's emotional development.
The client is a five-year-old Caucasian female currently in kindergarten. She is living with her father and great-grandfather, next door to her paternal grandparents. The client came to live in this arrangement following her parents' separation and divorce. Her father requested that she receive counseling as a result of the parental separation.
In a study discussed by Bryner, researchers Wallerstein and Blakeslee conducted a longitudinal study over ten years, following a total of 116 children from divorced homes. What they found was that divorce was not an isolated event but rather one step in a series of family transitions that affect both the family and the child. Those transitions range from life in the family before divorce, to life in a suddenly single-parent household, to possible future changes in parental relationships (Bryner, 2001).
How fathers maintain a relationship with their child after a divorce may significantly affect the child's adjustment. "Empirical findings suggest a wide array of interrelated, entangled factors that predict father involvement and link father involvement to child adjustment" (Kelly & Emrey, 2003). In this client's situation, she is being raised by her father and their relationship is flourishing. This raises the question of whether her adjustment to the divorce is influenced by that relationship and by the way her father has explained her mother's illness to her.
During the intake session, I met with the father to gain a better understanding of the presenting problem. When I first met him, he smelled of cigarette smoke and seemed very nervous, possibly unsure of what to expect. When asked why he wanted his daughter to receive counseling, he described the situation between himself and his soon-to-be ex-wife. He explained that his wife struggled with substance abuse and would constantly argue with him in front of their daughter.
He described one incident in which he came home from work for lunch and found his daughter and her cousin playing outside unsupervised. When he went inside, his wife was still in bed. He asked where their daughter was, and she replied, "In her room, probably." He told her the child was outside playing and that she needed to be watching her. His wife argued that she was exhausted. He was unable to return to work that afternoon because there was no one available to supervise their daughter.
The father also described a night when he and his wife were arguing because she was under the influence. He told her she needed to leave and locked her out of the house. Shortly afterward, his wife broke through the window of their daughter's bedroom and told the child they needed to leave together. The father heard his daughter crying and the sound of breaking glass. When he opened the bedroom door, he found his wife there, bleeding, in the child's room. He immediately called the authorities, who arrived and arrested his wife. Following this incident, she was issued a restraining order and jailed for a period of time due to substance abuse. The father was granted sole custody of his daughter.
After the incident, the father moved them out of their home, fearing his wife might violate the restraining order. He relocated with his grandfather, who lives next door to the paternal grandparents. He noted that his daughter had already spent some weekends with her grandparents and felt this environment would be good for her. As noted by Forman, "children from homes characterized by high levels of parental conflict are at increased risk for developing psychological problems" (2002). The father appeared to have taken the necessary steps to protect his daughter from that type of environment.
The father described his daughter as doing very well in school, with no major behavioral problems, though she occasionally gets into a bad mood that affects the rest of her school day. He also mentioned that she sometimes talks too much and gets her behavior card flipped to yellow.
The client had previously received counseling due to her parents' separation. Her father had taken her, noting that she had difficulty speaking about her mother. He worried that she might one day resent him for separating her from her mother, and he also feared she might follow in her mother's footsteps and not finish school. The previous counselor had indicated that the client seemed to be doing well and advised the father to return if further concerns arose.
Shortly after, the father began dating a woman with a two-year-old child, and they all moved in together. The girlfriend scheduled an appointment at the counseling center for her child, and the father then decided to schedule his daughter as well. In January 2012, during my practicum, this client was assigned to me. The father explained that at first the living situation went well, though at times his daughter and his girlfriend did not get along. He described his daughter as sometimes being "hardheaded."
It was not until our second session that I met with my client and her father together for a full session. During that session, my client opened up considerably and was very talkative, sharing details about school. We played "Go Fish" with Disney princess playing cards and then moved into a planned activity focused on emotional awareness. Since my client was only five years of age, I wanted to gain a better understanding of how she recognized different emotions.
I printed out pictures of children expressing various emotions. Each picture was accompanied by two questions: "What emotion is this person showing?" and "Has there ever been a time you felt this way?" The emotions depicted included happy, sad, upset, very angry, scared, and surprised, among others. When we discussed sadness, she said she felt sad about two siblings. Her father stepped in and explained that she would have had two older siblings, but they had passed away as infants.
A relevant study examined children's understanding of their parents' emotions. The researcher showed photographs depicting sadness, anger, happiness, and fear to children between the ages of 4 and 11 and asked them what emotion was shown and what would cause their mother or father to feel that way. Results showed that 85% of children identified themselves as the cause of their parents' anger, 65% as the cause of parental happiness, 49% of parental sadness, and 41% of parental fear (Covell & Abramovitch, 1987). I came to realize that my client associated sadness with her deceased siblings because she had observed her parents expressing sadness when looking at photographs of those children, and she was mirroring that emotional association.
"Formal five-axis diagnostic assessment of the client"
"Piaget and Erikson frameworks applied to client behavior"
"Magic key activity and letter-writing therapeutic work"
Children who go through divorce experience stages similar to those of patients facing a terminal illness, including denial, anger, bargaining, depression, and acceptance. During our six sessions together, I have yet to see my client express any of these stages. Children express these stages differently from adults — through fantasizing, acting out behaviorally, attempting to modify their own behavior in hopes of reuniting their parents, feeling sad and fatigued, and eventually reaching acceptance as they gain emotional experience and distance to process outcomes (Bryner, 2001).
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