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.  You are working collaboratively with the client’s teacher and PGM to establish treatment plan goals

(A): SMART goal setting
(B): Goal Attainment Scaling (GAS)
(C): Functional Behavioral Assessment (FBA)
(D): Behavior Intervention Plan (BIP)

Correct Answer: Goal Attainment Scaling (GAS)
Explanation: Goal Attainment Scaling (GAS) is a criterion-referenced, collaborative goal setting method that allows participants to measure three targeted behaviors. The targeted behaviors can be transferred to the client’s treatment plan, with goals and objectives designed to measure incremental changes. For each targeted behavior, minimum, moderate, and significant improvement measures are used to determine the client’s progress. SMART goal setting uses the SMART acronym to guide goal setting. SMART goals are specific, measurable, achievable, relevant, and time sensitive. A Behavior Intervention Plan (BIP). is generally implemented as part of a student’s Individualized Education Plan (IEP). or 504 plan. The function of the BIP. is to identify problematic behaviors, determine their cause, and implement strategies that reward appropriate behavior. A Functional Behavioral Assessment (FBA). entails identifying problematic behavior, measuring the behavior, and determining the function of the behavior. Therefore, the correct answer is (C)
Competency: intake, assessment, and diagnosis