Case Study Questions


Jordan is 8 years old and cries before going to school, saying that she does not want to go to school and that she is feeling sick. Jordan is an excellent student and has many friends. At first, Jordan’s parents allowed her to stay home because she acted sick and had no history to suggest anything other than illness. However, after repeated mornings saying she was sick, Jordan’s parents consulted with Jordan’s doctor who said that Jordan was healthy and suggested that Jordan’s problem may be psychological. Jordan’s parents chose a therapist who interviewed Jordan, Jordan’s parents, and Jordan’s teachers and administered standardized questionnaires.
Based on the assessment, the therapist decided that Jordan was anxious. Jordan identified fear of getting in trouble at school, having the teacher yell at her, and having to miss recess. According to Jordan and Jordan’s teacher, Jordan has never been in trouble and has never missed recess. Jordan reported that the teacher yells and says that if misbehavior continues, students will miss recess. The teacher reported that he intended the threats for the students in class who were misbehaving, not Jordan. Jordan also reported worry that she would do badly on a test or forget an assignment. Even though Jordan’s teacher assured Jordan that she is not likely to get in trouble, Jordan continues to say that she is sick, and Jordan’s parents pick her up from school and let her come home and watch TV and play. Jordan worries about more than school, including bad things happening to her and her family. Jordan’s parents repeatedly assure Jordan that they are all well and safe.
The therapist decided to use cognitive behavioral therapy with Jordan and began the Coping Cat program (Kendall & Hedtke, 2006). In addition, the therapist recommended that Jordan’s parents learn more effective parenting skills. The therapist explained that Jordan’s parents are rewarding Jordan’s worrying and lack of coping by allowing Jordan to come home from school and spending a lot of time with Jordan talking about Jordan’s fears. They often check with Jordan before planning activities to ask if Jordan would be comfortable or afraid of the activity. After Coping Cat and Jordan’s parents participating in a behavioral parenting program and rewarding Jordan for staying in school and coping with fears at home, as well as decreasing attention for acting sick and worrying, Jordan has attended school regularly and is much happier at home.
  1. What should you do if parents bring their child to sessions and attend parent sessions but continue to tell their child that everything will be all right when the child is scared (i.e., rescue their child) instead of asking their child to work through his anxiety?
  2. How would you approach a child who is not practicing the skills at home that she is learning in therapy?
  3. How would you address parent questions asking why they are being asked to attend treatment when their child has a problem, especially if they say that their other children are just fine?
  4. How would you address the problem of one parent attending therapy to improve parenting and reporting that his spouse or partner tells him that she does not believe in the skills they are learning and tells him he is wrong in front of the child?
  5. How would you approach parents who defend their child’s aggression by saying that they believe that children should stand up for themselves?
  6. How would you approach a parent of a child with PTSD when the parent was also a victim of the trauma?
  7. What would you say to a parent who dismisses her child’s sadness or anxiety or misbehavior as a normal but irritating stage?
  8. How would you work with a parent who is depressed and whose depression interferes with helping his child with the child’s therapy?
  9. How would you address a parent who tells you that her child just needs medication and who does not acknowledge or think that therapy will help her child?