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Lahee An
CSP 624A
11/ 27/23
Case Study: CM
Anaheim Unified School District

COUNSELING INTERVENTION REPORT

Name: CM Age: 15
School: John F. Kennedy High School Dates of Intervention: 9/10/23- 12/3/23
Grade: 10th LPCC Trainee: Lahee An

Introduction:

CM was referred by her first-period teacher after she was seen crying and having
a difficult time focusing in class. The counselor met up with her, and CM was able to
share her struggles. Her teacher is concerned about her emotional well-being, given her
recent behaviors in class. From the teacher’s observation, CM has been crying and
having difficulty focusing in class. These behaviors are negatively impacting her ability
to engage in learning. CM’s emotional distress has led to concerns about her social
interactions. She is seen withdrawing from her peers and exhibiting signs of distress in
group work.
CM’s parents are divorced and are currently going through a custody battle. She
resides with her father and has expressed a strong preference not to return to her
mother’s home. Her perception is that her parent’s divorce and custody battle are
negatively affecting her mental and emotional health. CM has also indicated that she
has difficulty communicating her needs and lacks coping skills.

Assessment and Case Formulation:

CM reported that her living arrangements have been shaped by the recent
divorce of her parents, which occurred last year. Currently, she resides with her father,
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while her older brother lives with her mother. Her mother has initiated a custody battle
this year, introducing additional emotional challenges into CM's life.
Upon reviewing CM's cumulative file, it revealed that she had a strong academic trend;
however, a noticeable decline in her grades occurred in 8th grade. CM disclosed that
her experience in middle school was particularly challenging due to her parents'
constant fighting and the preparation for their divorce. This emotional stress made it
difficult for her to concentrate on her studies as she grappled with the impending
separation of her family.
During a phone interview with CM's father, it became evident that CM is a
thoughtful and kind-hearted individual. She conceals her struggles out of fear of
disappointing her father, a sentiment he deeply appreciates but finds heart-wrenching.
He recognizes the pain inflicted by the divorce on his children, although CM shields her
emotions from him. Her father noticed the gradual decline in her grades but refrained
from asking her about it, as he felt guilty for the difficulties the family situation had
imposed. Despite this, he has made sincere efforts to provide emotional support by
consistently checking in on his children and assuring them that the divorce was not their
fault.
This year, with the added stress of the custody battle, CM is burdened by anxiety
about having to live with her mother. Her relationship with her mother is strained, and
she perceives the move as being forcibly separated from her father. CM believes that
her mother is attempting to use her declining grades as leverage in the custody battle,
attempting to prove her father's incompetence as a parent. When asked if she has ever
received therapy, she shared that due to cultural norms in the Asian community, she has
never received therapy despite her evident emotional struggles.
Goals:
● Goal 1: By December 15, 2023, CM will improve utilizing “I-Statements” to
express her thoughts and feelings in at least two different situations per
week.
○ Intervention: Learning how to effectively communicate her feelings
and needs through “I-Statements.
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○ Goal Monitoring: Weekly self-report utilizing Likert scale-type

questions
● Goal 2: CM will improve regulation by exploring different coping skills (i.e.,
journaling, breathing exercises, asking for breaks) to effectively manage
stress and emotional distress by the end of 12/15/2023.
○ Intervention: Provide psychoeducation to CM about the importance
of identifying coping skills that work for her in managing her
emotions and stress. Explain that coping strategies are effective
tools she can use to navigate challenging situations when she feels
like nothing is within her control.
○ Goal monitoring: Weekly self-report/ self-tracking along with Likert
scale-type questions
● Goal 3: By 12/15/2023, CM will improve mood by reducing incidents of at
least two negative thoughts per week (i.e., guilt/ blame, worries about the
future, etc.) as reported by the student.
○ Intervention: CM will learn and apply cognitive behavioral therapy
(CBT) strategies to recognize thinking traps and help her challenge
those negative thoughts by asking simple questions like, “Is it true?”
○ Goal monitoring: Children’s Automatic Thought Scale. The full scale
was used during the first and last sessions. Modified scale (choosing
some questions) during each session

Based on CM’s symptomology, areas of concern, and proposed goals, it seems

appropriate to employ a therapeutic approach that combines Cognitive-
Cognitive-Behavioral Therapy (CBT) with the use of Solution-Focused Brief Therapy
(SFBT) techniques. Although CM has not received a formal anxiety diagnosis, she
shared that she experiences strong worries about the future, feelings of irritability and
nervousness, difficulties concentrating in class, and restlessness. To better support her,
given her symptoms, the first-line psychological treatment for adolescents struggling
with anxiety disorder is, in fact, cognitive behavioral therapy (Kendall & Perman, 2017).
CBT serves as an effective intervention by providing psychoeducation about anxiety,
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teaching skills for managing fears (e.g., relaxation, coping thoughts, problem-solving
externalization), and facilitating gradual exposure to fears, thereby reducing avoidance
behaviors (Kendall & Perman, 2017). School-based CBT has been reported to improve
outcomes for adolescents compared to no treatment.
Solution-focused brief counseling is one of the most post-modern counseling
intervention approaches that can help improve psychological symptoms/ disorders that
range from trauma to aggressive behavior, anxiety, academic stress, and more
(Naraswari et al., 2021). This will be helpful for CM because the primary purpose of
SFBT is not to identify the cause of the problem, but the problem is used to understand
the current situation (Naraswari et al., 2021). At our initial meeting, she felt like nothing
was within her control; however, through SFBT, she will be able to shift her focus from
dwelling on the problem to actively seeking and utilizing her existing resources and
strengths. This approach empowers her to explore practical solutions, regain a sense of
control over her life, and develop effective coping strategies to overcome guilty feelings
facing the custody battle.

Analysis of Outcome Data

CM and I were able to establish a strong therapeutic relationship early on in the

session. After each session, I was able to monitor and evaluate CM’s progress towards
her goals. The following chart outlines CM’s responses on the check-in sheet that she
completed each session. This weekly check-in sheet corresponds to her first and
second goals.
Goal #1:
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The data demonstrates a positive trend in CM’s self-assessed progress regarding

effective communication. In the initial meeting, she reported challenges in
communicating her needs and identifying her emotions. To address these concerns, I
provided further psychoeducation and practical examples. The increasing scores in her
self-assessment indicate that she is gaining proficiency in this communication method,
suggesting the effectiveness of the intervention.

Goal #2:

The data highlights a notable increase in CM’s stress levels and a progressive
elevation in her feelings of anxiety and nervousness. It’s important to note that on
October 24, she was quite stressed out because, based on her Quarter 1 progress
report, she was flagged as ‘at-promise’ due to failing some of her classes. This
circumstance also added to additional stress. However, despite these challenges, CM
consistently reported a satisfactory level of overall satisfaction with her overall coping
skills.
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Goal #3:

The chart above reflects CM's scores on the Children's Automatic Thought Scale
(CATS), a self-report questionnaire that prompts students to rate how frequently specific
thoughts occurred in their minds over the past week, using a scale where 0 indicates
'not at all,' 1 indicates 'sometimes,' 2 indicates 'fairly often,' and 4 indicates 'all the time.'
It is important to note that for questions not included in the chart, CM responded
with a rating of 0, signifying that those particular thoughts did not occur at all. Based on
her responses, a pattern emerges, indicating that CM may be experiencing low
self-esteem and grappling with feelings of guilt. This is particularly significant in light of
her parents' ongoing custody battle, as she carries a sense of self-blame for the
situation. Much of her emotional distress appears to be linked to her worries about the
future. Therefore, during our sessions, we continued to address automatic thinking
traps, working to reframe and test CM’s thoughts for accuracy.

Reflection:

Upon reflection on my experience working with this client, I have learned the
importance of building rapport and practicing active listening. Initially, I found myself
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feeling apprehensive, given the vulnerable state in which my student approached me,
particularly amidst her ongoing custody battle and the looming possibility of separation
from her father. I was acutely aware of the need to set aside my own biases and simply
provide a space for her to express her hardships.
Throughout this process, I gained a profound understanding of the power and
significance of active listening. By employing active listening as a therapeutic tool, I
created an environment where she felt comfortable opening up. It became evident to
her that our interactions were a safe space, fostering an atmosphere of empathy and
validation for her feelings. This allowed her to share more freely and enabled me to
provide the support and understanding that she needed during this challenging period.
After our first session, she shared with me how much it meant to her to feel listened to
and understood. She admitted that she was not sure whom to reach out to initially, but
she felt this overwhelming urge to share her feelings with someone, and our
conversation provided her with that outlet.
CM demonstrated remarkable receptiveness in our sessions, actively engaging
with the skills we practiced and learned, such as ‘I-statements,’ coping strategies, and
reframing negative thoughts. Since our sessions began, she has successfully utilized
‘I-statement’ to communicate her needs to her mother, feeling truly heard without her
mom getting defensive. She also identified coping strategies to manage stress and
emotional distress. For her, journaling became a safe space where she could be honest
and express her thoughts, feelings, and struggles without fear of judgment.
Witnessing the client’s progress in challenging her own thoughts and seeking
accuracy has been deeply rewarding. This experience reiterated the therapeutic
importance of validating my client’s emotions and concerns while learning the
significance of asking clarifying questions to guide and support her effectively. Over
time, I noticed remarkable progress. She reported feeling less anxious about the
custody battle, recognizing the importance of focusing only on what she can control.
She realized that for matters beyond her control, letting go of negative emotions and
feelings was crucial for her well-being. Overall, it has been a rewarding experience
working with my client, and I am proud of the progress she has made thus far. It is nice
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to see her dedication to learning these skills to enhance her relationship with her mother
and making positive changes in her life.

References

Kendall, P. C., & Peterman, J. S. (2017). CBT for adolescents with anxiety: Mature yet
still developing. FOCUS, 15(2), 227–239.
https://doi.org/10.1176/appi.focus.15206

Naraswari, I., Suranata, K., Suarni, N., & Gading, I. (2021). Solution-focused brief
counseling in educational setting: A Systematic Literature Review.
Konselor, 10(3), 86-91. doi:https://doi.org/10.24036/02021103120291-0-00
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