Counseling Intervention Report

Name: KH Grade: 7

Age: 12 LPCC Trainee: Brittany Corbo

School: Santiago Charter Middle School

Introduction

This student is a female, white seventh-grade student. The student is twelve years old. The
student was referred to the counselor because she is a foster youth. The counselors were
checking in with all students who were identified as foster youth. During the brief check-in with
the student, it was determined by the counselor that the student would benefit from ongoing
counseling services to help with anxiety. During the initial interview with the student, it was
explained that the student struggles with panic attacks and has general anxiety symptoms. The
anxious symptoms impact the student’s daily tasks and functioning causing the student to miss
class time.

Assessment and Case Formulation

The student currently lives in Orange County California with her grandmother, grandfather,
younger brother, and younger sister. She was separated from her biological parents last year due
to an unsafe living environment. She currently has monthly supervised visits with her mother and
father. The student has seen an outside therapist in the past to help with anxiety and develop
coping skills.

Per student report, the student has also explained that they have some difficulty developing
relationships and friendships with their peers due to anxiety. Surrounding peer relationships, the
student has reported having reoccurring negative thoughts. Per the student interview, anxious
symptoms arose and became more frequent after being separated from their parents. The student
noted that their mother is diagnosed with schizophrenia and their father is an addict. However,
currently both the parents are seeking treatment. The student has a strong relationship with their
grandparents and aunt. The student utilizes these relationships as a system of support. Per the
student’s guardian, the student self-isolates at home—stays in her room—but is comfortable
talking about her feelings and emotions when asked or if she needs support. The guardian noted
that anxious symptoms have seemed to always be present however increased in the last year
following separation from her parents.

Upon interview with the student, it has been seen that the student struggles with self-esteem,
confidence, and anxiety. The student has difficulty speaking to teachers to ask for
accommodations relating to anxiety while in class (asking to take a break/step out of class).
Although the student is comfortable speaking to the counselor and explaining the
accommodations that are needed and when they may be needed. Upon review of the student’s
record, the student is also doing well academically.

The student frequents the counseling office while at school when anxious symptoms arise. The
student is visiting the counseling office on average three out of five days of the school week. The
anxious symptoms include increased heart rate, inability to focus, shortened breathing, and
trembling hands. Per the student, she is not currently utilizing any coping skills to manage
anxious symptoms.

Goals to Address

 The student will improve emotional regulation by utilizing coping skills from “never” to
“often.”
o Interventions: Will model and rehearse coping skills with the student.
o Goal Monitoring: There will be a weekly self-report check-in with the student.
Provide student with a journal to log when they have utilized their coping skills
and why.
 The student will improve self-esteem by decreasing instances of negative thinking related
to self from “all the time” to “sometimes”
o Interventions: CBT strategies to identify negative thoughts and learn how to
challenge/reframe negative thinking, thought records, positive self-affirmations
o Goal Monitoring: Weekly self-report check-ins with the student utilizing the
Children’s Automatic Thoughts Scale (CATS)

 Reduce the overall frequency and intensity of the anxiety response so that the daily
functioning is not impacted.
o Interventions: CBT techniques to challenge and reframe negative thoughts and
utilize coping skills.
o Goal Monitoring: Monitor the number of times the student is in the counselor’s
office instead of being in the classroom. Weekly student self-report as noted in the
student’s thought record journal.

The student displays signs of anxiety and shares negative thoughts. This student would
benefit from CBT. For this student, I will utilize CBT techniques to help manage the student’s
anxiety and recognize and challenge their negative thoughts. The CBT techniques that I will
utilize during treatment are cognitive restructuring, relaxation training, and exposure therapy to
build coping skills and self-confidence for the student.

CBT is a psychological treatment proven to be effective in treating anxiety and other related
mental health concerns for children and adults (APA, 2017). CBT treatment includes teaching
clients to change their thinking patterns by recognizing unhelpful patterns, utilizing problem-
solving to cope with difficult situations, and developing a greater sense of their abilities (APA,
2017). In treating anxiety, CBT involves repeated and gradual exposure to fears and reframing
negative thoughts (Pegg et al., 2022). CBT works to replace, recognize, and understand where
negative thoughts are coming from, halting anxiety-inducing thoughts (Pegg et al., 2022).

The counselor will meet with the student in weekly meetings to discuss coping skills,
practice challenging negative thoughts, and build self-confidence. The counselor will also
administer the Children’s Automatic Thoughts Scale to the student during weekly meetings to
assess the student’s progress. The counselor will utilize goal setting and planning to meet the
goals for the student.

Analysis of Outcome Data

The following chart shows a record of how the student reported utilizing coping skills throughout
the week as anxious symptoms arose and corresponds to goal one. During each counseling
session, the student was asked whether she used coping skills never, rarely, sometimes, often, or
always when anxious feelings were present. The initial interview with the student indicated that
the student was not using any coping skills to manage anxiety. Throughout treatment, it is
apparent that the student began to utilize coping skills when anxious feelings were present. The
student reported utilizing coping skills never, rarely, and sometimes. However, the goal of the
student changing from “never” to “often” was not achieved.

Below is a record of the student’s scores on the Children’s Automatic Thoughts Scale for the
past 5 weeks corresponding with goal two. A lower score indicates fewer negative thoughts have
been present throughout the week. During the beginning of each counseling session, the student
was asked to complete the Children’s Automatic Thoughts Scale. Overall, throughout treatment,
there has been a downward trend in the student’s score. Aside from week 4 when the student’s
score was heightened. The downward trend can indicate a positive response to treatment.
Below is a record of the number of times the student visited the wellness center due to anxious
feelings instead of being in the classroom throughout the past six weeks. This chart corresponds
with goal three. Overall, throughout treatment, the number of times that the student visits the
wellness center has remained somewhat consistent. From week five to six there was an increase
due to a change in the student's schedule. It is important to monitor whether the student’s daily
tasks and functioning are not being impacted regularly.

Reflection

The experience of working with this student presented a valuable opportunity to address anxiety-
related symptoms. Throughout each session, I was able to learn more about the student and
understand where some of her anxiety may have been stemming from.

One takeaway from this experience is the importance of personalized interventions. Ensuring
that the interventions that are being utilized are applicable and relevant to the person that you are
helping is a crucial component of counseling. Some of the outlined goals were not achieved
which highlights the importance of adjusting interventions based on the client's needs.
Overall, utilizing CBT techniques showed positive outcomes in various areas. The Children's
Automatic Thoughts Scale displayed a downward trend in negative thoughts which explains a
positive response to treatment. Also, the student reported using coping skills more frequently
than before treatment although the goal of "often" was not achieved. This could be attributed to
not teaching coping skills that applied to the student. There could have been more time in
sessions dedicated to discovering a coping skill that worked well for the student.

The consistency of wellness center visits remained somewhat unchanged throughout treatment.
This highlights the need to understand whether the interventions that are being utilized
effectively address the impact that the student’s anxiety has on daily functioning and class
attendance.

Moving forward, I am going to continue working with this student. During weekly meetings, we
will continue to discuss how to utilize coping skills, challenge negative thoughts, and build self-
confidence. As I continue to work with the student, some adjustments to the interventions will be
necessary to encourage the frequency of utilizing coping skills and reducing symptoms of
anxiety.

In future sessions, a more in-depth exploration of the factors contributing to the student's
consistent wellness center visits will be needed. Looking into understanding the underlying
triggers and adjusting interventions accordingly will help lead to more improvements.
Additionally, collaboration with teachers and other school staff to implement accommodations
while in the classroom could help with supporting the student. I may also want to implement
more regular communication with the student's guardians to have a more holistic understanding
of her progress and the type of support she may need.
 References

American Psychological Association. (2017, July). What is cognitive behavioral therapy?.

American Psychological Association. https://www.apa.org/ptsd-guideline/patients-and-
families/cognitive-behavioral

Pegg, S., Hill, K., Argiros, A., Olatunji, B. O., & Kujawa, A. (2022). Cognitive behavioral
therapy for anxiety disorders in youth: Efficacy, moderators, and new advances in
predicting outcomes. Current Psychiatry Reports, 24(12). https://doi.org/10.1007/s11920-
022-01384-7