Case Study
Patient Demographic: Name: Luna Clinical Issues: Developmental processes/tasks/issues Diagnostic Category: Neurodevelopmental Disorders Provisional Diagnosis: F81.0 Specific Learning Disorder, with Impairment in Reading Age: 13 Sex Assigned at Birth: Female Gender and Sexual Orientation: Female, Heterosexual Ethnicity: Hispanic Marital Status: Not Applicable Modality: Individual Therapy Location of Therapy : School  
Mental Status Exam: The client is an average-built individual who is alert. The client is casually dressed and adequately groomed. Speech volume is quiet, and speech flow is slow. She has difficulty maintaining eye contact for extended periods and often looks down at her feet. She demonstrates irritability at times during the interview and sighs several times. Her thought process is logical. Her estimated level of intelligence is in the low average range, with limited abstract thinking. Concentration is intact. The client shows no problems with memory impairment.
Presenting Problem: First session As the mental health therapist working in a school setting, you welcomed your new client and her parents into your office. They explained their daughter's struggle with reading and how it caused her to freeze when faced with a spelling or math test. After listening to them closely, you asked the client why she did not enjoy reading. She said that words confused her and made no sense, so she found it difficult to remember what she read.    You consider possible solutions for your client, who was having difficulty with schooling due to a lack of literacy skills. You proposed an idea: "Let's try incorporating creative activities as part of our therapy sessions." Doing so, we can develop strategies for improving written language comprehension and expression while making learning fun for your daughter."    The parents were hesitant but agreed to try it after seeing their daughter's enthusiasm about trying something different than traditional methods like instruction books or worksheets, as those have not been effective in the past. During the session, you brainstormed ideas around stories, role-playing games, and drawing activities focusing on using everyday experiences as inspiration for creating unique narratives within each session – not only reinforcing literacy skills but also providing an opportunity for emotional growth through storytelling exercises.  Fourth session The client came to her weekly session with you feeling discouraged and embarrassed about what happened in school earlier that day. She had been called on to read a paragraph from the science textbook in front of the whole class, and she could not get through it. Her classmates, who she usually gets along with, began to laugh at her, and she quickly excused herself to the clinic, saying she had a stomachache. It was the worst experience she had ever encountered, making her feel even more vulnerable.    You offered comfort as you discussed strategies for the client's reading struggles. You also encourage the client not to give up and assure her that no matter what happens tomorrow, next week, or next month, she can reframe the fear and embarrassment she felt with being surrounded by support and people that will help her through these challenging times.    After the client leaves, you talk with her parents over the phone. You suggest they meet at school with everyone involved with their daughter to discuss how best to implement an Individualized Education Plan (IEP). Your objective with this meeting is to review the areas where improvements and support could be given and determine if any changes need to occur for your client.  Ninth session The client's parents were elated to see their daughter make significant progress in her reading at school. After careful consideration and collaboration between you, the client, her teachers, and the paraprofessional, the team has all devised a treatment plan tailored specifically to her needs. Incorporating a small group setting provided the client with the individualized attention she needed to become successful in her reading skills.    As the session came to an end today, it was clear that both the client and her parents were satisfied with the results of their hard work. To ensure that they felt comfortable moving forward and everybody was on the same page, you asked them, "What I hear you saying is that you feel as though your daughter has met her educational goals and has the support to continue to succeed? Is that correct?" Both of them smiled knowingly and nodded affirmatively.    With a sense of closure now achieved by this family team, the parents left feeling confident about continuing on this path towards helping their daughter reach success with reading deficits. Together they had created a practical plan which could be adapted as necessary along the way, one which would pave a brighter future for the client.
Other Contexts:  The client says she is only poor at reading and "good at everything else." She says that she feels stressed when she has to read. The client's IQ is 89. A reading specialist assessed her, and her reading skills are abnormally low. Throughout elementary school, teachers noted the client has difficulty reading and that, in turn, it has adversely affected the client's academic achievement. As a result, special needs are implemented in the client's school setting. The client has an active Individualized Education Plan (IEP). Pre-existing Conditions: The client has also been diagnosed with epilepsy and is on medication for seizures. The client had frequent seizures for many years until a medication that lessened the occurrence of her symptoms was prescribed. The client fell when she was eight, hit her head, and fractured her skull. She was not diagnosed with any traumatic brain injury, but she did need stitches. Additional Characteristics: The client portrays positive interactions with both staff and peers at school. The client does state she feels she is "stupid" when it comes to reading and wishes she could get better. The client's family is supportive and values education. They are hands-on in supporting the client in any way they can. 

Question: What action would be irrelevant as part of the termination process?
(A): Ensuring the IEP is effective for the student
(B): Check-in frequently with the client's parents
(C): Discussing the client's progress with the principal
(D): Following up with the client's teachers

Correct Answer: Discussing the client's progress with the principal
Explanation: Connecting with the principal to discuss students' academic success is irrelevant as part of the termination process. Instead, you would discuss the client's progress with teachers, parents, and school psychologists. Therefore, the correct answer is (D)
Competency: professional practice and ethics