Activity 5

A Case Study of a School Child with Emotional and Behavior Problems treated using
Cognitive Behavioral Therapy

Background:

N.P., a 12-year-old girl, was referred for psychological assessment by her class teacher due to
concerns about her emotional and behavioral problems at school. The referral highlighted
issues such as lack of concentration, adjustment problems, low mood, disinterest in school
activities, and conflicts with classmates. She tried to challenge the role and responsibilities of
class monitors and always ended up with fight. These behaviors opted her teacher to refer
her for psychological assessment and management of presenting problems.

FBA Process:

1. Initial Meeting (Referral):

 The classroom teacher initiates the process by referring her for psychological
assessment. A counselor conducted an initial meeting with N.P. to gather information
about her challenges and experiences at school.

2. Define the Behavior:

 The target behaviors were identified as lack of concentration, adjustment problems,

low mood, disinterest in school activities, and conflicts with classmates.

3. Data Collection:

• Baseline data was collected through interviews with N.P., behavioral observation, and
subjective distress scale ratings to understand the intensity of her problematic
behaviors.

4. Antecedent Analysis:

• Antecedents such as interactions with classmates, encounters with class monitors, and
academic challenges were analyzed to identify triggers for N.P.'s emotional and
behavioral problems.

5. Consequence Analysis:

• Consequences include expressing anger, and displacing it to younger siblings. This

displacement of anger served as a stimulator for the child, because the class monitors
 had authority to hit her. Also, the attitude of teachers and monitors towards her made
other class fellows against her and they started treating her wrongly. As a result, she
isolated herself and started displacing her anger on younger siblings.

6. Develop Hypotheses:

• Hypothesis 1: N.P.'s disruptive behavior is a result of feeling rejected and isolated in

the new school environment, leading her to seek attention and approval from her
peers and teachers through disruptive actions.
• Hypothesis 2: N.P. engages in disruptive behavior as a way to express her frustration
and anxiety related to the challenges of adjusting to a new school, particularly when
faced with academic tasks and interactions with classmates and teachers.

7. Functional Analysis (Optional):

 An eight-session therapeutic intervention using cognitive-behavioral experiments,

assertiveness techniques, coping statements to build confidence, and problem-solving
techniques is implemented to help the child manage her emotional and behavioral
problems, specifically related to anger management

8. Behavior Support Plan (BSP):

Based on the findings, a Behavior Support Plan is developed:

 Identifying and avoiding triggering situations and behaviors that lead to aggressive
outbursts and emotional instability.
 Using cognitive-behavioral experiments to assist with anger management,
assertiveness techniques to improve social competence, and problem-solving
techniques to find solutions to the reported problems.
 Teaching N.P. to use assertive skills training to learn how to handle pressuring
situations in a polite manner.
 Involving the family in the therapeutic intervention and providing motivation
developing techniques to handle challenging situations.

9. Implementation and Monitoring:

 The therapeutic intervention plan was implemented over eight counseling sessions,
with a focus on addressing N.P.'s emotional and behavioral symptoms. Techniques
such as deep breathing, distraction, and cognitive restructuring were utilized to
manage her emotional responses. With the help of her teacher and other support
staff, the therapy, including the counselling sessions and psychoeducation, was done
consistently,
 10. Review and Adjust:

 Regular reviews of N.P.'s progress were conducted, and the intervention plan was
adjusted based on her responses and improvements over the course of the counseling
sessions. Overall, the therapeutic interventional plan was effective as the child showed
consistency and compliance throughout counselling sessions.

Outcome: Through the conduct of series of counselling sessions that are focused on
cognitive-behavioral experiments, anger management, assertiveness techniques, coping
statements, and problem-solving techniques, the N.P was able to manage her emotional and
behavioral problems effectively. She was also able to identify and evaluate the problems
related to her instability of emotions and behavior, and to develop strategies for addressing
them. As a result, the she showed consistency and compliance throughout counseling
sessions, and she started taking an interest in class activities and felt less sad, anxious, and
angry. Overall, the FBA process, particularly the cognitive-behavioral therapy has been
effective in providing interventions for addressing the emotional and behavioral problems
that affects N.P.’s academic performance.

Ref:
Sana, F., & Subhan, S. (2022). A Case Study of a School Child with Emotional and Behavior Problems Treated Using Cognitive Behavioral Therapy. Research
Article. School of Professional Psychology. DOI: https://doi.org/10.21203/rs.3.rs-1970357/v1.