Case Study TV Show Atypical PDF

Preview

Summary

Download Case Study TV Show Atypical PDF

Description

Case Study: TV Show Atypical CHYS 3P43 Kiana Nichols 5563879

Identifying Information Sam Gardner is an 18-year-old boy who is on the Autism Spectrum. He is obsessed with the South Pole, Antarctica and Penguins. During our sessions, he is always dressed well and tends to get off topic to talk about how much he wants to visit Antarctica. He lives with his father Doug, his mother Elsa, and older sister Casey who are all very affectionate and caring towards him. Presenting Problem Sam came to counseling because of an incident that occurred with his old therapist Julia, his “practice girlfriend” Paige and a lady at Casey’s track meet. Sam announces that he wants to start dating and begins to develop a crush on his therapist, Julia. Sam has been seeing Julia ever since he was diagnosed. When he was younger, he developed appropriately and knew how to walk and talk at the appropriate age. But he always got upset or stressed and would hit, bang, or yell. These behaviours occurred due to having trouble understanding what is happening around him, unable to communicate his own wants and needs, or in the most care, want to escape from stressful situations and activities. Sam appreciates Julia as his therapist because she allows him to talk about his feelings, thoughts and situations that occur throughout life. Sam has once crossed the streets with his eyes closed, had a freak-out at the mall and once hit a police officer. These incidents occur when he is in a loud and unfamiliar place and causes him to not be able to think, listen and freeze. Julia is an important foundation for Sam and his family because she actively listens, reflects his feeling and asks open-ended questions. As Sam’s father quickly pulls Sam away from his crush, he ends up finding a “practice girlfriend” of his own age who also has the same interest. Paige has always noticed Sam at school and never had the courage to approach him until she complemented his dolphin shirt. After a couple days of studying together and

getting to know each other, Sam created a pros and cons list of Paige and confessed his love to his therapist. Paige eventually found the list and was very heartbroken towards it and didn’t realize why Sam does and/or say the things he does. When Julia found out that his client Sam had a crush on her, she burst out towards Sam and told him the truth about their relationships. This caused Sam to have a meltdown on the bus and leaving Julia fired. Another incident occurred at Casey’s track meet where Sam pulled a lady’s pony tail because it was too distracting for him. Due to these situations, it brought it to Sam and his families attention to bring them into counseling. Sam has clearly identified his long-term goals, as well as prioritized them. He stated that; 1) He first wanted to better understand what is happening around him 2) Be able to communicate his own wants and needs 3) Want to be able to escape from stressful situations and activities To prevent meltdowns, everyone in the family emphasized the importance of revolving these issues before Casey leaves for College and Sam is left independently at school. Relevant History Sam and Casey have recently found out that their father had left their family for 8 months when Sam was 4 and Casey was 6 years old. When Sam was born and diagnosed with Autism, Doug did not know how to handle the situation and/or handle the long-term effects that would cause their family. He could not understand why or how Sam was diagnosed with Autism and was not mentally prepared to raise a child with a disorder. When Doug decided to rejoin his family and Sam forgave him, he slowly started to connect and form a bond with Sam by bringing him to his weekly sessions.

Sam’s mother Elsa, is a stay at home mother who devotes her life to her kids and bakes lemon bars for the Autism Support Group she attends with other parents. She is very protected of Sam and doesn’t allow much freedom which annoys Sam. However, now that Sam is 18 years old and forming and strong bond with his sister and father, she believes that she is no longer needed and wants more independence. She realizes that she needs to spend more time on herself and figure out what her interests are in life. After a night out with the girls, Elsa meets a bartender name Nick and has an affair with him. After feelings of shame and guilt, Elsa can’t help herself but to secretly continue the affair. Without knowing, she is caught by her daughter, Casey, who was going for a run and spotted her and Nick kissing. Interpersonal Style and Environmental Factors Sam is brought to school daily by his sister Casey who monitors him throughout the day and gives him his lunch money at his locker. Ever since Sam was diagnosed, she has been very protective of him. Most of the stressors that Sam faces are normal to the world of any 18-yearold. Sam faces stress from school, peers and family. Many people at school don’t usually notice him and when they do they say that Sam is weird. He never understood what or why people have said that about him which makes him feel alone even when there are other people in the room. Sam is an intelligent student who always completed his homework and maintained a good average. He also developed a very good socialization skill with the staff and teachers but has little tolerance for building relationships with students. Since he performed aggressive behaviours towards himself and other children as a kid, he had a hard time making friends. But as he got older and changed some behaviour ways, he progressively made a friend named Zahid and met his “practice girlfriend” Paige. Sam’s family is a huge support to him. His mom and dad are attentive and caring, displaying genuine interest in him and his problems. Casey has always

put herself and her dreams aside to make sure that Sam has a regular life. Casey has been training to earn an athletic scholarship to a prestigious but distant high school for many years. Not only does it mean that she gets the dream of her life, but she is nervous about what leaving will mean for Sam. Personal Dynamics As Sam possesses above average intelligence. He can handle both concrete and abstract thinking. Sam has a piercing mind that seems to catch on to things quickly and remembers them. Sam’s level of fantasy life seems appropriate for his age, manifesting in goals and desires. Sam has realistic, but hopeful goals for himself. For instance, visiting Antarctica and meeting a penguin. During most sessions, Sam displays a more serious and stern attitude where he actively listens and is attentive to the conversation. When Sam is upset or stressed, his mind becomes over-run with negative thoughts. For instance, Sam will sometimes repeat the same word or sentence continuously in his head or out loud. A phrase such as adelie, chinstrap, emperor, gentoo. These situations occur when Sam is usually stressed or feels pressure from his family, especially his mother and “practice girlfriend”. Because his mother has always put so much pressure on herself to be a good mother and a good caretaker, Sam has learned that he must do the same. When he is angry, he becomes much more quiet and distant from everyone and myself. He becomes less expressive and is less attentive to conversations. Sam seems to have a strong leaning towards these negative thoughts, especially in times of stress. For instance, with the situation with his “practice girlfriend”, Paige did not understand why Sam would write a pros and cons list about her and told him that he is not supposed to do that because it’s a rule and rude. He acknowledges her support by saying that now that he knows it’s a rule, he will not do it

again. In this situation, he was able to expression his rational, but did not respond well to challenges to his flawed logic. This is not having that Sam is entirely negative. Treatment Plans To address Sam’s problems, my goals would be to help Sam recognize and correct irrational thinking in problems he is facing currently, but also apply skills to problems he may face in the future. In order to accomplish this, I would be using the Rational Emotive Behavioral Therapy and address the cognitive, behavioural and emotional aspects of Sam’s situation. I would make Sam write down his goals he had outlined at the beginning of our meetings and address these needs. As he stated that he wanted to better understand what is happening around him and be able to communicate his own wants and needs, I would teach Sam how to recognize his own body cues when he gets anxious, frustrated or angry. I would ask him to identity how his head, body and stomach is feeling. Along that, I would teach him relaxation techniques to use when he is feeling anxious or frustrated to avoid creaming, yelling or having a meltdown in public. For instance, when Sam was feeling anxious when his therapist told him the truth about their relationship, he panicked and had a meltdown. By knowing what his body is doing, Sam can recognize what is happening around him and calm himself down. Another intervention I would use is role play using the Reality Therapy. As he stated that he wanted to be able to escape from stressful situations and activities, I would teach Sam the appropriate ways to interact and talk with others. Looking back at his incident at Casey’s track meet, I will mimic the behaviour he did and have him describe his behavior. Then I would help Sam brainstorm other alternatives he could’ve used in the situation. I would make this a homework and have Casey do something that would bother Sam at home and have him try and think of an alternative. At our next session I would have Sam describe to me how his alternative worked and look at whether he kept his

commitment. If he fails and does not keep his commitment, then we will start from the beginning of our sessions until he success. By doing this, we would note observable changes in Sam’s behaviour when he is at different levels of anxious. Using these techniques will allow Sam to become more confident in his ability to make good decisions and to feel good about himself, even when things to not go as planned. I do not believe that there will be any concerns that may arise as treatment progresses. This progression and success will result in an increase in communication between himself and his peers and his ability to control his emotions. After reviewing the treatment plan with Sam and myself, he agreed to come back in two weeks with his family to review the plan....