Case Conceptualization

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Rational Emotive Behavioral Therapy
Case Conceptualization of Michael
Noelle Pauling
Liberty University

Abstract
This is a case conceptualization of a client referred to a Residential Treatment Facility by Family Court for treatment and evaluation of intellectual, academic, and behavioral performance. The client presents with several issues. In the client interview, the counselor hypothesizes that client has difficulty with anger, aggression, and low frustration tolerance. The client’s current behaviors are affecting his home and educational environments. The client’s early experiences will be explored only as it relates to current behavior and beliefs. During the therapeutic process, the client and the counselor will explore his inability to respond appropriately when frustrations occur. Exploration would include disputing irrational thoughts and beliefs, and exercising more appropriate positive replacement behaviors. This case conceptualization will create a hypothesis of the client’s aggressive behavior. Using Rational Emotive Behavior Therapy framework, the counselor will explore the client’s issues and create a treatment plan with goals that pertain to the client’s presenting issues. This conceptualization will also include support that will show the benefits the client should gain with application of this theory.

Rational Emotive Behavior Therapy Case Conceptualization of Michael
Michael is a 14-year-old African American male. He has been referred to a Residential Treatment Facility (RTF) for an evaluation of intellectual, academic, and behavioral assessment. While in the treatment facility, Michael must undergo therapy to address his presenting problems. Michael presents himself as a very well dressed and engaged young man. Despite the fact that he is court-ordered to be in a treatment facility for an undetermined length of time, he was cooperative during the interview. During the interview, the counselor speaks with Michael and his adoptive family about the details of the court documents, the responsibility of the client (Michael) and the facility. The counselor, Michael, and the adoptive parents have completed the intake process and the time was scheduled for his first session. Biological and Environmental Factors

Michael’s biological parents are reported to have been heavily addicted to drugs and alcohol. His mother reportedly abused multiple prescription drugs and cocaine during her pregnancies. It is also reported that the mother was Schizophrenic. Both parents have lengthy criminal records. Michael did not experience a nurturing environment. At age four, Michael and his younger brother were removed from the biological parents by child protective services. The brothers were placed in separate foster homes. Michael has had four foster care placements in two years prior to going to his adoptive parents. During his placements, it is suspected that Michael experienced neglect and sexual abuse.

His maternal aunt and her husband adopted Michael. They also adopted his younger brother. They have two biological children. Michael did not adjust well to the new environment. He became more aggressive and exhibited hoarding behaviors. By age seven, he had been placed in a psychiatric hospital and other RTFs to receive treatment. Michael and his adoptive parents have sought counseling services through their church and local mental health agencies. Michael had been diagnosed with Reactive Attachment Disorder, ADHD, and ODD. He has poor sleep patterns and is on several medications that have little effect. Michael has self-harmed for attention, but denied suicidal thoughts. Michael has a history of violent and aggressive behaviors in school and home. Michael has very weak and superficial relationships with peers. Case Conceptualization

Michael’s presenting issues and previous history is suitable for Rational Emotive Behavior (REBT). REBT focuses on environmental and...
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