(Information was disguised to protect confidentiality)
Like many children in our system of care, “Sonny” was referred to mental health services for disruptive behaviors, anger outbursts, aggression, and marijuana abuse. He is a latency age (6-12) male in the sixth grade and is at risk of probation removing him from the home. He was refusing to take medication, the parents were suspected to be abusing alcohol, and the family felt that traditional behavior therapy was not working. Mental Health held a meeting with the supports in the child’s life to brainstorm his needs and what services may be most helpful to this child and family.
At the meeting, the therapist decided to give Solution Focused Brief Therapy (SFBT) a try. Knowing that SFBT focuses on the client strengths and looks for exceptions to the negative behaviors, it is important to get a baseline rating of the behavior first. The first question to the team was to rate the child’s behaviors on a scale from 1-10. It was interesting to see how each person rated the child. The therapist followed up with, “what would be the first signs that are going to tell you we’re helping him?” The group came up with 1) he would not leave the house without permission, 2) he would be more calm, 3) he would not get physical with anyone, and 4) he would no longer use marijuana. The therapist asked the treatment team to look for exceptions, “Are you already seeing any of these things on occasion?” The treatment team sat quietly thinking about the question when the parent interjected, “At home, when he gets angry, if I sit and talk to him he can calm down. So that tells me he can do it. I also notice that he is creative and can calm down when he draws, or plays his video games.” His probation officer shared, “If I make frequent unannounced visits and don’t make threats about drug tests, then he seems to do better.” The therapist also pointed out that the child seemed to be doing better while mother was in co-occurring treatment of her own. Out of these exceptions to the problem, the therapist was able to help the team refine a plan they could initiate at home, while using the exceptions they noted. By the end of the meeting, the plan was to: 1) talk to Sonny about alternative activities that he finds calming and encourage those in times of stress, 2) the probation officer was going to offer no drug tests while child was able to appear to “try” and control himself, and 3) mother was willing to reengage with her own co-occurring services.
Out of this meeting came a launching point for the treatment and a consensus of what the team expected of client. Sonny began to notice that his anger was related to his mother’s use, the intensity was related to his drug use, which helped him make better choices. Over time, he started using the coping skills that worked for him in the past to avoid physical aggression and escalated anger. Mother began her own treatment and achieved four months of clean time. As they both worked on themselves, their relationship with each other improved.
Submitted by: Joshua Stuart, MFT Intern
Written by: Laura Diaz-Winterset, Psy.D.