Case Presentation: E. T. Counseling Intern: Kathy Parker 10/29/12 1. 2. 3. Client/Student: E.

is a 15 year-old Caucasian male who attends Ingraham High School as a freshman. He is the son of two teachers who advocate well for him. Date session occurred: 10/11/12 : session number: #5 ; length of session: 19.26 min. S.O.A.P. (Subjective, Objective, Assessment, Plan) Notes:

Subjective: Es presenting issue is he struggles to turn in his work on time. For example, E says: its actually me just being absent minded, having it in by notebook and not turning it in. Sometimes I completely forget to hand my stuff in Sometimes E mentions having trouble focusing in class and attributes this to being diagnosed with ADHD. Objective: E is well groomed and has a good affect. He smiles, asks questions, and appears to be eager to get good grades. In the last session he pointed out with joy that he had 104% in one class. E has good attendance and has relayed to his mom he enjoys our sessions. Sometimes Es eyes look tired and have dark circles under them. E is on medication for ADHD and talks openly about how the affects of the medicine run out around 5th or 6th period. Assessment: Es presenting problem seems to encompass the following: (1) Biological: E is diagnosed with ADHD and is currently on medication. He demonstrates an inability to keep focused at times and has trouble remembering to turn in his homework. He has a 504 plan that includes accommodations such as extra time, special seating and modified tests. (2) Psychological: E refers to his diagnosis of ADHD frequently. When he is missing assignments he relies on his 504 plan quite a bit and uses the extra time for assignments. While this is appropriate, I wonder if he is standing behind his diagnosis of ADHD too much and this is preventing him from working to his full potential. I think E could utilize strategies and coping skills more, instead of relying on his parents threats to take things away if he doesnt turn in homework. He is not becoming self-sufficient when he relies on others actions to motivate him to do a task. Plan: E is having trouble focusing in class and following through on turning in his homework. The plan is to help E become self-sufficient and manage his homework using some strategies. My hope is that he can head to college with some strong self-management skills. A variety of strategies will be tried to see what is realistic and a good fit for E. Some of the cognitive/behavioral strategies are as follows: (a) Sensory triggers to condition a response (ex. sandpaper on pencil pouch to remind Eric to turn in homework), (b) Twenty minutes of exercise in the morning to increase focus, (c) Cognitive approach (view identity outside of ADHD diagnosis). I have collected data from E regarding his focus in class. After a week of exercise in the morning more data will be collected again, using scaling questions. We will also be keeping track of the number of missing assignments over the next few weeks to see if there is any change.

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What multicultural factors influence the client-counselor relationship? No issues have surfaced at this point. Gender may be an issue, as I can not fully relate to E on that level. What counseling theories are you using in this session and what evidence do you have to support this? I am mainly using solution focused brief therapy. I asked E what has worked before the help him turn in his homework on time. He replied that some a kind of reward like skiing was motivating for him to get his work in on time. In his plan we are trying some behavioral/cognitive interventions as well. List three things that you did well in the session with the client. 1. Connected students desire to have a safety net to turning in homework 2. Kept the focus on the client 3. Provided a comfortable environment for student List three things that you can improve on in your session with the client. 1. Giving too much advice before student can give input. 2. Looking at the computer too much while talking to the student. 3. Often say so.

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7. ACA Advocacy Competencies: Client/Student Level: What are you doing to empower the client in the session? Working with student to develop coping skills that work for increasing focus and remembering to turn in his work on time. Empowering him to move beyond the ADHD label and set up systems and strategies that allow him to function well and to his full potential at school.

School/Community Level: What systemic barriers impede the clients ability to achieve her/his academic, career, and personal/social goals? The amount of homework required is difficult for Eric. Alternative ways to show what he knows would be helpful. How would involving school and community members help the client with her/his presenting concern? Consulting with other professionals in the field has been helpful, such as a speech therapist and a biofeedback therapist. I learn techniques and strategies from them that incorporate the mind and body connections. Public Arena Level: How would the clients life change for the better by being involved at the political level? A greater awareness of what these students experience may alleviate the belief that they are just not trying enough. How do you take the clients issue and bring it to the public eye? Educating teachers on the struggles students with ADHD has and giving them tools to modify and accommodate their teaching styles to support these students.