EDDIE: An attention-getting child

A third-grade teacher seeks your professional help with an 8-year-old boy in her class. She tells you that Eddie’s
behavior is highly disruptive because he is continually acting out his problems in a hostile or aggressive manner. He
punches other children for no apparent reason, tears up others’ work, rarely follows instructions, continually talks at
times that are disruptive, and draws attention to himself through negative behavior. He seems to take delight in
seeing other children get angry.

The teacher tells you that she is at a loss to know how to deal with Eddie’s behavior. She considered asking that he
be removed from her classroom, but she hesitated because she believes that he has many pressing conflicts and is a
deeply troubled child. She asks you to see him for a session and give her some guidance in dealing with his
behavior.

You see Eddie for an individual session, during which you discover that his father is both verbally and physically
abusive. Without provocation his father calls him names and beats him up. One time, Eddie was beaten so badly that
he had severe cuts and bruises, and his father threatened him with a “real beating” if he did not agree to say that he
had had a bicycle accident. You also discover that Eddie comes from a single-parent family. His father has had
custody since his parents divorced when he was in preschool. Eddie tells you that he would feel really lost if he
didn’t have his father. He thinks that maybe he has done many wrong things to deserve the treatment he gets.

Working within a behavioral framework, show how you would proceed in this session with Eddie so that you might
be in a better position to make recommendations to his teacher and might offer him some direct help yourself.

1. What goals would you have in mind during this session? How would you attempt to meet them? What questions
would you ask of Eddie? How might you approach the issue of his disruptive behavior in class? What might
you want to tell him? What would you tell his teacher?

2. What speculations can you offer about the reasons for Eddie’s disruptive behavior? Where might he have
learned his aggressive behaviors?

3. How do you expect that you would handle the issue of Eddie’s beatings by his father? How would you deal with
Eddie on this matter? Might you approach his father? If so, what would you say, and what would you hope to
accomplish? Might you consult the authorities? What are your legal obligations in this case?

4. During your session, what behaviors would you most want to observe? What would you do with your
observations as far as Eddie is concerned? How much would you share with him of what you know from his
teacher and of what you actually observe?

5. Would the fact that Eddie comes from a single-parent home influence your interventions? How would you deal
with him when he told you that he would be lost without his father?

6. If you were to continue working with Eddie as his counselor, what specific behavioral procedures might you
employ, and toward what end?
KATHRINA: Learning to cope with anxiety

Kathrina, a Native American in her early 20s, comes to the clinic where you work as a behaviorally oriented
therapist. Assume that this is your initial meeting with her and that you know nothing else about her. Also assume
that she would very much like to become involved in short-term behavioral counseling, mainly to deal with chronic
anxiety that is getting in the way of her personal and professional life.

Some Background Data:

During the initial interview Kathrina tells you:

“I’ve just got to learn how to cope with stress. I feel as if there’s a dark cloud over my head – a constant feeling of
apprehension. I’m so worked up during the day that when I try to go to sleep, I just toss and turn most of the night,
ruminating over everything that happened to me that day. I keep telling myself that I’ve got to get to sleep or I won’t
be worth a damn the next day. I just lie there and can’t seem to stop thinking of what I did or will do the next day.
When I do get up the next morning, I’m a basket case. I sell real estate, and lately I’m getting more anxious about
my future. I’m fearful of contacting people because I might say the wrong thing and blow the potential sale, and I’m
afraid they’ll notice my anxiety. I just don’t seem to be able to relax at any time. And what’s even worse is that I
feel less able to cope with stress now than I used to. Stress is getting the best of me, and I’m afraid that unless I can
learn to recognize and deal with the situations I’m in, my anxiety will do me in.”

Kathrina also tells you that she is experiencing many problems in leaving home and feeling that she can make it on
her own. She says that she is not following the family “program” and lets you know that her parents are disappointed
with some of the ways in which she is living. She does not want to cut herself off from her family, yet she has
trouble in being everything her parents expect of her.

Assume that you and Kathrina agree to several counseling sessions to help her deal with her anxieties. Specifically,
she wants guidance in learning coping skills that she can use on her own. Show how you would view her as a
behaviorally oriented counselor and how you might proceed for several sessions.

Questions for Reflection:

1. How do you view Kathrina’s anxiety? How will your answer to this question have a direct bearing on the
manner in which you work with her in your sessions?

2. What cultural themes would you pay attention to, if any? To what extent would you focus on her alienation
from her family? Would you be inclined to focus more on her anxiety? her stress? her concerns over not living
up to the expectations of her family?

3. What might you want to know from Kathrina about the ways in which her cultural experiences have affected
her? If you are from a different background, would you expect any difficulties in understanding and working
with her?

4. What specific behavioral procedures might you employ during your sessions? What suggestions would you
make to Kathrina for work she can do by herself outside of the sessions?

5. What ways can you think of to teach her how to cope with stress? What self-help or self-management
techniques could you suggest?

6. How might you deal with Kathrina’s insomnia? How might you design a program for her that would help her
relax and sleep at night?