The Case of Jace

Respond with appropriate Behavioral, CBT and DBT interventions.

The only time I lose it is when other people get on me about what I should or shouldn’t do.
That teacher deserved to hear it from me, and I’m glad I threw my book at him. He gave me an F
last semester, and he’s always been after me. He told me that I needed to go to class even though
I told him I was getting something from my locker. He is the one who pushed it with me. The
teachers at school are on me about everything, just like stupid mom. My little brother hates it
when I go off on Mom and we fight, but she’s always all over me. I don’t need to be in counseling
– everything just needs to leave me alone.
Jace appears to have conflicts with authority and demonstrates noncompliance for
authority figures. My hypothesis is that Jace may have oppositional defiance disorder as
evidenced by these conflicts with authority figures as well as his blaming of others and his
angry/irritable mood.
Some appropriate behavior interventions that might work for Jace are operant conditioning and
positive reinforcement. Working to reinforce his positive behaviors and distinguish his negative
behaviors by using rewards can be effective. One has to understand the motivation for the
youth's behavior first and know what problem behaviors they are addressing. Counselors can
work with parents and teacher and teach them how to use behavior interventions for problem
behaviors. I might implement these interventions by using a check-in check-out process. Jace
could come check-in with me at the beginning of the day and we would go over how we can
have a good day today. If Jace was able to manage his behavior effectively he would receive a
reward at the end of the day during check-out.
Cognitive behavior interventions that might be helpful are cognitive restructuring, socratic
questioning, and problem-solving skills training. Jace appears to have some irrational thoughts
(that his teachers are out to get him) and helping him identify and replace these thoughts with
rational ones could give him insight to how his thoughts are affecting his behavior. Socratic
questioning could also help Jace see the connection between his thoughts and feelings. It's
important to be encouraging, validating, and use reflections during this process. I also believe
problem solving skills training would be beneficial for Jace. It would help him identify the
consequences of his actions and generate alternative solutions to his problems. It would also
help him meet his needs in a way that is respectful to others.
DBT would be helpful to help regulate his emotions. Counselors could help him recognize his
triggers and then develop healthy emotional regulation skills. This would help with his emotional
outburst and impulsivity. He could learn to self-sooth with his six senses as well as explore pros
and cons of his actions. By being able to identify one-thing in the moment, he could become
more aware of his emotional outburst and ground himself to come back to the present.