Patient’s Case Study Assessment

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The situation of the patient, Sophie, is a complicated case implying the presence of significant barriers to successful communication with peers and teachers. The factors resulting in the worsening of the client’s conduct were related to her inability to manage aggression and the consequent harm caused to other people and their belongings (Calub et al., 2021). As a result, the intervention of a therapist was needed. Therefore, this paper aims to assess in detail the actions of professionals in offering a solution to Sophie and her family.

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The Client’s Demographics and Family Dynamics

As follows from the case study, the overall family dynamics remained quite positive over the course of the issue development, and demographics did not contribute to any serious obstacles to treatment. The former was expressed by a healthy attitude towards parents and siblings and the absence of behavioral problems at home (Calub et al., 2021). In turn, the latter was connected to the limited presence of conditions among Sophie’s relatives. They included her mother’s temporary depression, alcoholism and substance abuse of her maternal uncle, and the sleep disruption of one of the grandparents (Calub et al., 2021). Since there was no direct connection between the specified health concerns and the girl’s behavior, the outcomes of these circumstances’ consideration allowed her to continue searching for the source of the difficulties in the external environment.

Identification of the Client and Family’s Presenting Problems

During the initial interviews with the client and her parents, the researchers managed to formulate the challenge’s nature adversely affecting socialization for the child. According to them, Sophie’s impairment in academic and interpersonal functioning was related to her sensitivity to criticism, the need to follow strict rules, and inability to accept others’ points of view (Calub et al., 2021). The case was exacerbated by the teachers’ policy who provided Sophie with one-on-one attention whenever she needed it and helped her escape situations in which the young student could learn to resolve conflicts (Calub et al., 2021). In this way, the scholars correctly defined the precondition of the girl’s aggressiveness to develop measures for educators and family members to teach the client how to behave in public places.

Evaluation of the Child’s Developmental Needs

The subsequent evaluation of Sophie’s developmental needs was performed through an individualized approach, allowing to readjust the existing instruments with regard to the patient’s age. The reports of her teachers and her parents’ opinion confirmed that the student’s progress corresponded to all major milestones, and her overall academic performance positively correlated with their expectations (Calub et al., 2021). These results led to the conclusion on the only problematic aspect of Sophie’s development, was social interaction with peers and adults. Therefore, the assessment of the client’s gaps in essential skills and abilities was adequately conducted, and the grounds for the therapist to propose a program for the elimination of these issues were created.

Cultural Considerations for the Case

Another critical area of the case study is the cultural specificities of Sophie’s family, and it was included in the stage of the selection of methods to help the client. Hence, a brief description of a healthy home environment and good relationships with relatives was presented by the parents’ opinions. In the beginning, they claimed that their daughter demonstrated no aggressive behavior, their communication could be viewed as warm and loving, and physical or sexual abuse was never a part of their conduct (Colub et al., 2021). However, this aspect of the study does not seem to be covered properly since the background of the family members, ethnicity, and important beliefs were not considered in any type of assessment conducted by professionals (Colub et al., 2021). Even though these circumstances might not play a significant role in the emergence of Sophie’s problems, the provision of therapeutic services would have been more effective if the specialists had paid attention to them.

Therapeutic Approach to Maintaining the Alliance with the Client

One of the most advantageous decisions of the clinic’s employees was the initiative to maintain the alliance with the client by separating her from their parents when asking questions and demonstrating an understanding of her struggles. The first condition allowed them to ensure the reliability of the family’s evidence by comparing their answers with the responses of Sophie (Colub et al., 2021). Meanwhile, the second task was performed when role-playing the cases of uncontrollable anger and the ways to deal with them without hurting other children or breaking their toys (Colub et al., 2021). Thus, the specialists managed to create a comfortable environment for Sophie to overcome her communication problems at school.

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Methods for Assessing Psychosocial, Cognitive, and Moral Development

The assessment of the patient’s psychosocial, cognitive, and moral development implied the use of a number of measures mostly connected to observations in the classroom setting. According to their outcomes, Sophie’s aggressive behavior was confirmed, and the corresponding circumstances were revealed. The video recordings received from the teacher demonstrated the willingness of the client to learn and interact with others but only on her terms (Colub et al., 2021). This behavior was indirectly encouraged by the educator, who paid attention to the student any time she required (Colub et al., 2021). Therefore, it was stated that Sophie was psychosocially and cognitively developed but experienced difficulties with moral norms.

Interview Questions to Ask the Client and Family

The principal questions included in the interviews with the client and her family covered all the possible aspects of the problem. Hence, their actions of Sophie were viewed through the lens of a variety of conditions, which might lead to the specified complications. They included the past and current episodes of psychopathology, internal and external issues triggering the emotional reaction, and other circumstances such as sleep patterns, anxiety, complaints, and many other factors (Colub et al., 2021). The attempts to reveal the mentioned circumstances were followed by evaluating the compliance of the girl’s actions with typical perceptions of adults regarding improper behavior.

Initial Diagnostic and Assessment Techniques to Use with the Client

The practical implementation of the program designed specifically for the client with a focus on her age and other personal characteristics was efficient due to the prior diagnostics and assessments of her problems. They were primarily conducted with the use of data received from the girl’s family and teachers. The main instruments contributing to this objective were comprehensive developmental and diagnostic interviews with Sophie’s parents conducted with the help of Kiddie Schedule for Affective Disorders and Schizophrenia – Present and Lifetime Version (Colub et al., 2021). This tool was complemented by the Caregiver-Teacher Report Form filled in by her educators (Colub et al., 2021). Thus, their combination allowed a conclusion on the lack of severe forms of illness in the patient and consider these results for further work.


To summarize, the conducted evaluation was efficient in terms of revealing the causes of Sophie’s difficulties and finding an optimal solution. The initial assessment of the client’s demographic situation, family dynamics, developmental needs, and overall state was performed in the best possible way. Nevertheless, the cultural aspect of the matter was insufficiently addressed compared to other tasks. Therefore, the program designed for Sophie was suitable but could be improved through the inclusion of this characteristic.

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Calub, C. A., Rapport, M. D., & Alexander, K. (2021). Reducing aggression using a multimodal cognitive-behavioral treatment approach: A case study of a preschooler with the oppositional defiant disorder. Clinical Case Studies 20(1), 39-55. Web.

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PsychologyWriting. (2022, June 13). Patient's Case Study Assessment.

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"Patient's Case Study Assessment." PsychologyWriting, 13 June 2022,


PsychologyWriting. (2022) 'Patient's Case Study Assessment'. 13 June.


PsychologyWriting. 2022. "Patient's Case Study Assessment." June 13, 2022.

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PsychologyWriting. "Patient's Case Study Assessment." June 13, 2022.