Running head: CASE STUDY: THE INFLUENCE OF FAMILY

Case Study: The Influence of Family on a Young Boy

Rachel Kwan
San Diego State University

CASE STUDY: THE INFLUENCE OF FAMILY

Abstract
A case study was conducted to examine a fifth grade, special education, Native American male
student at Mueller Charter School, who was referred by teachers for reported rude and disruptive
behaviour. Information about the student was collected from his cumulative file, group
counseling observation, his grandmother, his teachers, and the student himself. The initial
hypothesis was that he was socially awkward, however, this hypothesis changed upon review of
his cumulative file and interviews with his teachers and grandmother. A new hypothesis was
synthesized to incorporate his unstable relationship with his parents and the burden of
grandmothers illness. Solution Focused Brief Therapy was chosen as an intervention, due to its
brief nature and efficacy as an early intervention for behavioural problems in children.
Insufficient data was available to reach a conclusive result about the effectiveness of the
intervention, though progress was perceived by both the student and his teachers. Other possible
interventions to use with this student include the Big Sisters and Big Brothers of America, and
Cognitive Behavioural Therapy.
Keywords: case study, behavioural problems, elementary, familial dysfunction

CASE STUDY: THE INFLUENCE OF FAMILY

Case Study: The Influence of Family on a Young Boy

The case study student (hereby to be referred to as B.U.) is a ten year old enrolled in fifth
grade at Mueller Charter School, located in Chula Vista, California. B.U. has attended Mueller
Charter School for two years, where teachers have recommended him for counseling due to
classroom disruption and rude behaviour. Since then, he has participated in counseling groups
targeted towards disruptive behaviours and social skills. B.U. has an Individualized Education
Plan (IEP) for a multiple step processing disorder, qualifying him for special education services.
Background Information
Demographic Characteristics and Family
B.U.s parents are both Native American, but he does not live with either of them. He has
two older brothers, the oldest (21 years old) who lives in Arizona with his mother, and B.U. and
his middle brother (15 years old) living with his paternal grandmother. His grandma has had
custody of B.U. and his brother since 2010, due to his parents divorce and history of substance
abuse. B.U.s grandmother has cancer, which makes it difficult for her to be as active in B.U.s
life. However, in March, B.U.s grandmother finished chemotherapy treatment for her cancer.
The relationships between B.U., his grandmother, and his middle brother are strong. B.U.
reported that his brother has defended him from bullies in the past, and that his grandmother is
always there to support and encourage him. B.U.s relationship with his mother and oldest
brother appeared stable, though he reported not being able to see them often. B.U.s relationship
with his father is strained. Although his father lives in Chula Vista, B.U. does not visit him often.
Diagnoses and Individualized Education Plan
In addition to the processing disorder, B.U. has also been diagnosed with adjustment
disorder, mixed disturbances and emotions, conduct disorder, and attention deficit hyperactivity

CASE STUDY: THE INFLUENCE OF FAMILY

disorder. He receives weekly counseling sessions at Nueva Vista, but is not taking medication for
any of these diagnoses (nor has he taken any in the past).
As a special education student, part of B.U.s IEP is served by being a part of the
Resource Specialist Program (RSP). In this program, B.U. receives individual instruction for 90
minutes, four times a week. He also participates in Occupational Therapy at Mueller Charter,
which helps students develop strategies to succeed to the best of their ability in school.
Impact on Educational Outcomes
When diagnosed with his processing disorder, a note was made that B.U.s learning
problems stemmed from the disorder, not the result of cultural, environmental, language, or
economic disadvantage. Although this may be true for his academic problems, his other life
factors can be said to influence his behaviour. Considering B.U.s relocation of schools, his
turbulent family life, and his grandmothers cancer, it is unsurprising that B.U. sometimes
displays disruptive behaviours, rudeness, or sometimes has trouble concentrating in class.
Hypothesis
In order to avoid bias, Individual and group sessions were held with B.U. before
cumulative files were examined. In the initial interactions and of observations of B.U., it
appeared that he was shy, enthusiastic about counseling, and unwilling to compromise about
certain topics. Overall, B.U. seemed to be pleasant and intelligent, albeit socially awkward.
After reviewing his cumulative file, interviewing his teachers and grandmother, and
spending more time with the student, the hypothesis about B.U. shifted to one not focused solely
on him, but on how ecosystemic factors were influencing his behaviour and performance in
school. The new hypothesis about B.U. is that he is still learning how to control and express

CASE STUDY: THE INFLUENCE OF FAMILY

strong emotions in less aggressive ways; his tempestuous family life and anxiety around his
grandmothers cancer causes him to act out from fear and frustration.
Data Analysis
Behavioural Observations
B.U. was observed during a group counseling session. During this session, the students
played a bingo game with emotional facial expressions instead of traditional numbers. During
this time, B.U. remained attentive and on-task. At one point, he was unsure whether one of the
pictures on his bingo card matched the emotion called out. He looked at his group members
cards for guidance, but seemed hesitant to ask for help. When one of the boys next to him
noticed, they helped him name his picture. B.U. thanked him, then continued playing the game.
This event was significant because in other group sessions, B.U. was more willing to interact
with the adult facilitators rather than his group members. It was observed that aside from this
help, B.U. spent most of his time looking at his own card or at one of the facilitators. This
observation was consistent with the way he distances himself from classmates, supporting the
initial hypothesis of social awkwardness with peers.
Records Review
B.U.s previous report cards and cumulative file were reviewed for more information. His
cumulative file held information about previous teachers, school history, test scores, absences,
health conditions, behavioural problems, and IEP information (B.U. cumulative file, accessed
February 27, 2014). It was in this cumulative file that the extent of his academic and behavioural
problems were first discovered. B.U. has made vast improvements in his school work, now
proficient in English and basic in math. This is a marked improvement from his performance
when he first arrived at Mueller Charter School. The cumulative file also revealed other

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diagnoses and behavioural outbursts that he has had in the past. Reports contained mostly
aggressive behaviour, such as ripping a poster off the wall and storming out of the classroom.
Interviews
Interviews were conducted with B.U.s grandmother and two of his teachers. Both of
B.U.s teachers expressed that he is a kind boy, but that he can be rude yet overly sensitive, and
inconsistent with his work. Mr. Treter, his main teacher, said that B.U. has made improvements
in his academics and behaviour. Mr. Treter noted that when B.U. has a creative outlet, he is
calmer and focused in class. When asked how B.U. gets along with other classmates, Mr. Treter
said that B.U.s sensitivity and shyness was a challenge at the beginning of the year, but that he
has made friends with a few of his classmates that he sticks close to (J. Treter, personal
communication, February 20, 2014).
The interview with B.U.s grandmother gave the most information about his family
history and relationships, and how those events impact him now. Until four years ago his, life
was even more hectic with custody switching between his parents and his grandmother. Now his
grandmother is his primary guardian, and he has started making improvements in school. His
grandmother expressed concerns that B.U. can be rude to her, but stated that he always
apologizes after he calms down (A. Umada, personal communication, March 20, 2014). This
report of rude behaviour is consistent with notes in his cumulative file, as well as comments that
other teachers have made. These interviews support the new hypothesis that factors in his
environment such as his relationships with family influence B.U.s behaviour at school.
Counseling Interventions
Counseling goals were chosen by B.U. himself, with guidance from the counselor. The
goals were to improve his grades and to help his grandmother with more chores. B.U. chose

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these goals to focus on the academic and social aspects of his life, although the improvement in
grades was chosen more to impress his grandmother rather than for his own educational gain
(B.U., personal communication, March 13, 2014).
The primary counseling intervention used was Solutions Focused Brief-Therapy (SFBT).
This method of counseling focuses on creating goals and discussing how to achieve them based
on exploring the history of the problem (Skalre, 2005). This method of counseling was picked
because of its brief nature and focus on the present and future. Since there was a limited amount
of time able to be spent with B.U., SFBT was able to quickly target improvements that could be
made in B.U.s life without dwelling on past family problems.
SFBT has been proven to be an effective form of counseling, especially with children.
Bond, Woods, Humphrey, Symes, and Green (2013) conducted a systematic and critical
evaluation on the effectiveness of SFBT with children and families. 44 databases were searched
for SFBT studies published between 1990 and 2010. Studies were then screened for qualitative
and quantitative assessment, resulting in the 38 studies used in this review. When comparing the
results of the studies, Bond et al. found that the use of SFBT is supported, especially in changing
the behaviour of children. In addition, it is particularly effective when used as an early
intervention for problems that are not severe.
SFBT techniques used included the miracle question, scaling, exceptions, and asking,
what else?. The miracle question was used to help B.U. come up with ways to achieve his goal
and identify unnoticed successes. For example, when B.U. was having a hard time thinking of
ways to help his grandmother around the house, I asked what it would look like if he was already
doing so. In conjunction with asking, what else?, he was able to come up with four more ways
that he could help her (clearing his belongings off the kitchen table, hanging his jacket up,

CASE STUDY: THE INFLUENCE OF FAMILY

carrying in the groceries, and putting away the dishes). He also realized that he was already
helping her around the house by taking his dishes to the sink after eating and taking out garbage
(B.U., personal communication, March 20, 2014).
Scaling was used to measure how B.U. felt he was progressing, as well as to cheer him on
and show room for even more improvement. For example, in the first session B.U. gave himself
a four out of ten in helping his grandmother with chores. When the counselor expressed
excitement about being at a four rather than a one or two, B.U. realized that he was already doing
some things to help him towards his goal. By the last session, B.U. was at an eight (B.U.,
personal communication, March 20 and April 24, 2014). This helped him keep track of his own
progress, as well as identify the things he was doing to increase his number.
Effectiveness of the Intervention
When asked whether he reached his goals, B.U. indicated that he thought he reached his
goal of helping his grandmother around the house more, but that he did not think he had fully
met his goal of improving his grades. He stated that although he had made progress on doing
things that would improve his grades in the long run, he had not been doing them long enough to
see a significant effect (B.U., personal communication, April 24, 2014).
Ideally, counseling would have been held over a longer period of time in order to gauge a
quantitative difference in B.U.s grades. However, due to the limited time frame of three weeks,
the assignments he completed in this time did not make a significant impact on his overall grade.
Additionally, B.U.s grandmother was unable to be contacted for a second interview regarding
whether B.U. was doing more chores at home. Because of the short time frame available to
counsel B.U. individually, personal scaling and post-meetings with B.U.s teachers were the only
data collected. Within three sessions, B.U. moved from a four to an eight for his goal in helping

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his grandmother. For this other goal in increasing his grades, B.U.s rating increased from a four
to a six. His teachers were unable to speak about his first goal, however, Mr. Treter informed me
that while B.U. would generally fail to turn in his homework twice a week, in the past three
weeks he had only failed to turn two assignments (J. Treter, personal communication, April 24,
2014). Since completing his homework was one of the ways B.U. came up with to increase his
grades, it could be said that this area of the intervention was effective.
B.U.s personal ratings and feedback from his teachers make this intervention appear
effective, but in reality there was not enough data collected to determine it was truly significant.
Ecosystemic factors that could impact the possible effectiveness of this intervention are B.U.s
interaction with his father, or further illness of his grandmother. According to B.U.s
grandmother, his rude and disruptive behaviour seems to surface after negative meetings with his
father. If B.U. were to have another negative meeting with his father, it could impair his ability to
make progress on his goals, since he would likely deal with his emotions in a maladaptive way
by lashing out on others. Lastly, a decline in his grandmothers health could negatively impact
his ability to concentrate on his school work. B.U. did not report having a harder time in school
when his grandmother was going through chemotherapy, but since she is his primary caregiver, it
would be natural to feel anxious if she were to experience a decline in health.
Recommendations
The counseling recommendations for B.U. extend over home, school, and community. At
home, it is recommended that B.U. continues his goal to help his grandmother, tracking his own
progress with ratings and communication with his grandmother. At school, B.U. is encouraged to
continue working on raising his grades and to reach out to other classmates to expand his support
network. Social support contributes to resiliency, which is important in children whose family

CASE STUDY: THE INFLUENCE OF FAMILY

10

life is as turbulent as B.U.s (Ozbay, Johnson, Dimoulas, Morgan, Charney, & Southwick, 2007).
By having a larger network of support, B.U. may feel less stress, resulting in less disruptive
outbursts of emotions. In the community, B.U. is encouraged to be involved in more activities
that foster his creative talents. As creating art is a way to release his emotions in a positive way,
community opportunities should be further explored.
Another intervention that could help B.U. is Big Brothers Big Sisters of America. This
program matches adult mentors with at-risk children to grow a supportive relationship. The pair
is matched on common goals, then meet three to five hours a week for at least a year. This
program show promise in reducing drug and alcohol initiation, physical violence, and truancy
(De Wit, Lipman, Manzano-Munguia, Bisanz, Offord, ONeill, Pepler, & Shaver, 2007). This
program could alleviate B.U.s lack of adult guidance in his life. Although his grandmother
serves as a role model, the question of her health leaves B.U. with backup adult to rely on.
Another intervention that could be beneficial for B.U. is Cognitive Behavioural Therapy
(CBT). CBT involves altering maladaptive thoughts by identifying irrational beliefs and creating
specific strategies to overcome problems (Corey, 2013). Since CBT involves the complexity of
understanding personal cognitions, it is not generally associated with use with children.
However, Heyne, Sauter, Van Widenfelt, and Westenberg (2010) conducted a study using a
developmentally adapted version of CBT with adolescents ages 10-18, finding it effective in
reducing school anxiety. CBT could be beneficial for B.U. because many of the troubling parts of
his life are out of his control. B.U. is unable to change these events, but through CBT it would be
possible to change the way he interprets these events. Ultimately, this could lead to calmer
emotions surrounding his family life.

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11

References
Bond, C., Woods, K., Humphrey, N., Symes, W., & Green, L. (2013). Practitioner review: The
effectiveness of solution focused brief therapy with children and families: A systematic
and critical evaluation of the literature from 19902010. Journal of Child Psychology
and Psychiatry, 54(7), 707-723.
Corey, G. (2013). Theory and Practice of Counseling and Psychotherapy. 9th Edition. Belmont,
CA: Brooks/Cole.
Sklare, G. B. (2005). Brief counseling that works: A solution-focused approach for school
counselors and administrators (2nd ed.). Thousand Oaks, CA: Corwin Press.
Ozbay, F., Johnson, D.C., Dimoulas, E., Morgan, C.A., Charney, D., & Southwick, S. (2007).
Social support and resilience to stress: From neurobiology to clinical practice. Psychiatry,
4(5), 35-40.
De Wit, D., Lipman, E., Manzano-Munguia, M., Bisanz, J., Graham, K., Offord, D.R., ONeill,
E., Pepler, D., & Shaver, K. (2007). Feasibility of a randomized controlled trial for
evaluating the effectiveness of the big brothers and big sisters community match program
at the national level. Children and Youth Services Review, 29(3), 383-404.
Heyne, D., Sauter, F. M., Van Widenfelt, B. M., Vermeiren, R., & Westenberg, P. (2011). School
refusal and anxiety in adolescence: Non-randomized trial of a developmentally sensitive
cognitive behavioral therapy. Journal of Anxiety Disorders, 25(7), 870-878.