Case Study
Patient Demographic: Client Age: 8 Sex: Female Gender: Female Grade: 3rd Ethnicity: African American Counseling Setting: School-based Type of Counseling: Individual and Family Presenting Problem: Defiance Diagnosis: Oppositional Defiant Disorder 313.81 (F91.3)
Mental Status Exam: Mental Status Exam: The client displays an angry affect and sits with her arms crossed. She is well dressed and well groomed. The client’s PGM repeatedly prompts her to say, “yes ma’am” and “no ma’am” when answering questions. The client sits slumped in her chair. She agrees to color in a feelings thermometer that reflects increased anger, sadness, and fear. Her insight is poor. The client often refuses to eat school lunch, and the PGM reports that the client is a picky ea
Presenting Problem: You are a school-based mental health counselor conducting an initial intake with an 8-year-old African American female in the 3rd grade. The client presents today with her paternal grandmother (PGM), the client’s legal guardian. The PGM states that the client is argumentative, refuses to take responsibility for her actions, and has a tantrum when she receives a consequence for her behavior. She reports that the client is restricted from “every single privilege indefinitely.” The client has been told she can regain privileges once she “learns to act her age.” The client states she is treated unfairly and “blamed for everything” at home and school. The client’s teacher reports that she has difficulty following directions, is easily annoyed by her classmates, and frequently loses her temper. The client’s grades are poor, and she is below grade level in reading. However, she enjoys art and proudly reports that one of her pictures came in 1st place and is hanging in the library.
Other Contexts: You are meeting with the client individually and providing parenting training with the client’s PGM. The client’s teacher has implemented a behavioral chart for the classroom, and you ensure the client is receiving appropriate reinforcement for targeted behaviors. The teacher believes the client’s behavior indicates ADHD, and you have agreed to conduct classroom observations. During the observation, you note that the client gets out of her seat multiple times to sharpen her pencil. While doing so, she glares at other students and is observed balling up her fists and threatening others. The teacher yells at the client to sit down and stop disrupting the classroom, which has little effect on the client’s behavior

Question: Which instrument would you select to further assess the client’s social and emotional problems, including DSM-specific disorders such as ADHD, ODD, and other conduct problems?
(A): The Brief Symptoms Inventory-18 (BSI-18)
(B): The Woodcock-Johnson IV (WJ IV)
(C): The Conners’ Third Edition (Conners 3)
(D): The Achenbach Child Behavior Checklist (CBCL)

Correct Answer: The Achenbach Child Behavior Checklist (CBCL)
Explanation: The Achenbach Child Behavior Checklist (CBCL) helps detect social and emotional problems, including disorders such as ADHD, ODD, and other conduct problems. The CBCL detects DSM-specific symptoms in the following six categories: affective problems, anxiety problems, somatic problems, ADHD, oppositional defiant problems, and conduct problems. The CBCL also provides information on eight syndrome scales, including aggressive behavior, social issues, and rule-breaking behavior. The Brief Symptoms Inventory-18 (BSI-18) is an 18-item assessment that provides information on three subscales: somatization, depression, and anxiety. The Woodcock-Johnson IV (WJ IV) is an intelligence test that evaluates a wide range of cognitive functions with three batteries: the WJ IV Tests of Cognitive Abilities, the WJ IV Tests of Oral Language, and the WJ IV Tests of Achievement. Therefore, the correct answer is (A)
Competency: intake, assessment, and diagnosis