Target Problem: – Lou

Assess level of grief and function of hallucinations about mother

 

What are the limitations of your design? – Lou

Single System Design Proposal

Date Due: 11/8/22

Group Members: Desiree Edwards, Jennifer Messina, Lou Sorrells, Aminat Adebayo-Lateef, Jonathan Pritchard

Stated Problems – Jennifer

Jennifer-

1. mom died when patient was three, grief issues, trauma, ACE indicator,

2. Patient hallucinating, -child, female age 10, “sees her mother”

3. experience fear (alone a lot), sees things

4. Home alone unsupervised

5. Thinks brother also sees mom some

Target Problem: – Lou

Assess level of grief and function of hallucinations about mother

How did you prioritize? – Desiree

Of Sakura’s stated problems, she does not understand why she is seeing her mom; her mom is not real; she stated her mom is a ghost. The problem can be measured by using Cognitive behavior therapy to help her identify ways to manage emotions (

https://www.mayoclinic.org
.

· Hogan bereavement short form for adolescents

· https://pedpsych.org/fact_sheets/grief-children-and-adolescents/

Target Goal: – Aminat

Discover function of hallucinations

What dimensions will you measure? (Circle: behaviors, thoughts,

feelings
, attitudes, intensity,

frequency
, duration) – Jonathan

Choosing what dimensions to measure and how to measure them is difficult given the fact that Sakura is so young (10 years old) and is alone so much of the day, particularly when has the hallucinations of her mother. Behavior observation would be ideal by her father or brother, but we have chosen to create a kid-friendly measurement tool for Sakura to do on her own. Additionally, Sakura did not really report significant gaps in functioning, quality of life (for herself; there were concerning issues in her family life, namely how much she is left alone at home), or persistent troubling feelings, so really, we are still very much in the assessment phase.

We will begin by measuring the intervals in which Sakura feels that she sees her mother (this is a type of frequency recording, which we chose in order to try to make the measurement tool age-appropriate) and the feelings Sakura has when she sees her mother. We are asking Sakura to report each day whether she saw her mother during the morning, afternoon, and/or evening, and whether she felt happy, sad, angry, and/or scared when she saw her mother. Hopefully, this will help us see if there are any patterns to see what behavioral function the hallucinations may serve and what interventions are necessary, in addition to or instead of those spelled out below.

Intervention (Describe Briefly): – Jennifer

The recommendations for intervention with the patient, Sakura, age 10 would be to process grief through play therapy and cbt. At this point, the therapist is more concerned with dealing with the hallucinations and identifying outside support strengths of the patient with includes her family unit. The patient expresses that she is happy, and enjoys schools and her activities. The therapist would like to build on her strengths in order to build resilience within the patient. Family therapy will be essential for the patient as she works through her hallucinations. Changing a few routines in the home

Attachment based family therapy-check if evidence based cbt for restructuring any thought patterns that are maladaptive (working with a child)

What forces, other than the intervention, could cause change in the client system’s goal? – Desiree, Aminat

1. Sakura may decide she wants to stop recording her responses on bereavement short form of how many times she sees her mom in a day.

2. Sakura may feel overwhelmed having to circle her thoughts, feelings, and behaviors

Single System Design: Please provide a visual of your study design using notation and time intervals. – Jonathan

When during the day? (circle all that apply)

How did you feel? (circle all that apply)

Monday

Morning

☀️ Afternoon

Evening/Nighttime

Happy Sad

Scared Angry

Tuesday

Morning

☀️ Afternoon

Evening/Nighttime

Happy Sad

Scared Angry

Wednesday

Morning

☀️ Afternoon

Evening/Nighttime

Happy Sad

Scared Angry

Thursday

Morning

☀️ Afternoon

Evening/Nighttime

Happy Sad

Scared Angry

Friday

Morning

☀️ Afternoon

Evening/Nighttime

Happy Sad

Scared Angry

Saturday

Morning

☀️ Afternoon

Evening/Nighttime

Happy Sad

Scared Angry

Sunday

Morning

☀️ Afternoon

Evening/Nighttime

Happy Sad

Scared Angry

What are the limitations of your design? – Lou