• Join over 1.2 million students every month
  • Accelerate your learning by 29%
  • Unlimited access from just £6.99 per month

Case study of a five-year old girl with school refusal behaviour

Extracts from this document...


Case study of a five-year old girl with school refusal behaviour 0638141 Case description Mary, a five year old girl, had been attending her local nursery school successfully for several months. However, for the last four weeks she found it difficult to separate from her mother and refused to attend school so her case was referred to the school psychologist. Her mother and her nursery teacher agreed that her problem began when she had a disturbing dream during nap-time and became agitated when she woke up and realized her mother was not present. Everyday before going to school she began crying and requested not to attend. Subsequently, Mary was forced to attend school and when her mother dropped her to school her teacher had to hold on to her so her mother could leave the classroom. Although she was calm at times through the day she very often started crying and asked for her mother. At home, Mary did not separate from her mother and did not sleep in her own bed. Mary was described by school staff as a quiet child who liked to play alone. ...read more.


Mary's social and emotional functioning was assessed using the Devereux Behaviour rating Scales-School Form (Naglieri, LeBuffe & Pfeiffer, 1993), which was completed by her mother. This scale includes sub-scales for depression, physical symptoms or fears, interpersonal problems and inappropriate behaviours or feelings. Mary's Total Scale Score was in the "Very Significant" range. Mary was diagnosed with Separation Anxiety Disorder (SAD). She met the criteria for SAD described by the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 2000). The school psychologist made the diagnosis based on data collected from interviews with the mother and the school teacher. In addition, the data collected suggested that Mary's school refusal behaviour was motivated by attention-seeking purposes. Shaping, positive reinforcement and extinction were the selected approaches to treat Mary's school refusing behaviour associated with SAD. Mary's mother was taught a muscle relaxation technique with deep breathing that was to be practiced by Mary at bedtime to help her sleep and also to relax when she felt distressed during the day. They were also shown how to separate at the classroom door using adequate phrasing. ...read more.


The mother reported during weekly phone calls the greatest time intervals that Mary could be apart from her during the treatment period. The shaping procedure was considered successful when Mary was able to remain separated from her mother for intervals of twenty minutes as the perception of being away from a parent during this time was comparable to being away for longer periods for a five year old child. The treatment finished after three weeks of successful school attendance. Interviews with the mother and the teacher were conducted for the follow up at four months and twelve months after treatment. The mother reported that Mary was no longer shadowing her or becoming distress when separating at school and that she was also sleeping in her own bed. The teacher confirmed Mary was successfully attending school and was no longer asking for her mother or becoming distressed through the day. She also confirmed Mary and her mother separated in the way reported above. The mother also completed the DSF scale at four and twelve month follow-up and Mary obtain a Total Scale Score in the "normal" range. In addition, Mary did not meet the DSM criteria for SAD at both follow-up points. ...read more.

The above preview is unformatted text

This student written piece of work is one of many that can be found in our University Degree Clinical Psychology section.

Found what you're looking for?

  • Start learning 29% faster today
  • 150,000+ documents available
  • Just £6.99 a month

Not the one? Search for your essay title...
  • Join over 1.2 million students every month
  • Accelerate your learning by 29%
  • Unlimited access from just £6.99 per month

See related essaysSee related essays

Related University Degree Clinical Psychology essays

  1. The purpose of this essay is to consider different systemic issues in a counselling ...

    family and Andy's role within it, it may help the other members to understand all points of view and how they are feeling. Andy then may understand why Mandy wants to look after him and her fears of him doing too much and returning to drugs.

  2. The assessment and treatment of children and adolescents with sexually abusive behavior.

    erotization of the ag gression; and the history of sexual victimization, physical abuse, and emotional neglect. It is necessary to discriminate between compulsive sexual behaviors and paraphiliac compulsive sexual behaviors. Is there a history of prior nonsexual delinquent behavior or a history of arrests, convictions, incarcerations, use of weapons, or cruelty to animals?

  1. Depression in Old Age. From an uncritical viewpoint, it would be reasonable to associate ...

    does have a different profile which the current classification systems do not take into account. It has been found that elderly people who have clinically signi?cant depressive symptoms do not meet the rigorous diagnostic criteria for major depressive disorder (MDD)

  2. Efficacy and safety of SSRIs in the treatment of childhood depression

    in the placebo group. These authors also published no statistical analysis of this outcome or details of the adverse effects, but the difference in withdrawal rates was significant (Pearson's 2 = 6.62, df = 1, P = 0.01). Wagner et al reported seven adverse effects that occurred in at least

  1. Abnormal Psychology Case Study - A joint diagnosis of Generalised Anxiety Disorder and Social ...

    With the proposed DSM-V getting closer to completion, the definition and features of GAD and other disorders are being updated and changed. Thus, as an extension, theories attempting to explain Generalised Anxiety Disorder (GAD) are also being changed with the emergence of many different theories to try and explain the disorder.

  2. Cocaine Addiction: Literature Review, Modalities, and Improved Treatment Plan

    Therefore, as this information shows, cocaine is still the most commonly abused drug in America's current society. Rights, Diversity, and Legal/Ethical Issues In today's society, human rights are being violated because of the misuse and misunderstanding of drugs, not because some are addicted to drugs.

  1. Theories of Human Behaviour: Psychodynamics, Behaviourism and Cognitive Psychology

    Within the social work and foster care settings, behaviourism provides useful mechanisms for undoing previously-established patterns of expectations and behaviour, such as in connection with child abuse and neglect. By repetitively reinforcing positive experiences and associations, the behaviourist approach can change existing negative patterns and replace them with positive patterns and expectations (Gross, 2010).

  2. Couples Analysis and Case Study. ...

    These complaints will be discussed in more detail in Patrick's section. Patrick Patrick believes Kerri is too picky about how clean the house has to be and he does not understand why it's so important to keep their apartment meticulously clean.

  • Over 160,000 pieces
    of student written work
  • Annotated by
    experienced teachers
  • Ideas and feedback to
    improve your own work