Running Head: CASE STUDT: PARENTING AND BOUNDARIES 1

Case Study: Parenting and Boundaries with a Gifted Child

Shanna D Krausman

University of South Carolina

CASE STUDY: PARENTING AND BOUNDARIES 2

CLIENT PRESENTATION:

The client presented herself as a put-together middle-aged woman and was ready to begin the
session. The client informed the counselor that she had completed her homework right away. She
was a bit disorganized and fidgety, but overall comfortable with the counselor. The client is a
single mother who struggles with Post-Traumatic Stress Disorder and anxiety due to previous
time served in army as well as abuse encountered as a child from her father. Due to her PTSD,
the client had reservations about showing affection to her own daughter and has been working
past those issues. The client had been investigated by the Department of Social Services due to
an incident between her and her daughter where she struck her with a broom. The client claimed
the daughter attacked first, and the daughter remained in the mothers custody. Since this
incident, there has been no further act of corporal punishment. The clients daughter is extremely
gifted and will be graduating high school at sixteen years old. The client has trouble dealing
with such a special child and has trouble setting boundaries because the daughters friends are
all older. The client is working with the counselor to learn to make appropriate rules for her
daughter and to explain reasons to her daughter in order to gain trust and respect. The client
described an incident of scheming on her daughters part when she asked the client if she could
go to a seniors beach weekend while the client was under the influence of her anti-anxiety
medication, and therefore would be more lenient about the issue. The client is now working on a
compromise with her daughter for the weekend that the counselor supports. The counselor
reminded the client of the progress she has made with her daughter. The client confirmed this
assertion when she stated that last year she couldn't even find her daughter half of the time, but
now she works at Zaxbys and has become more responsible. The client is working through
preparing her daughter to graduate high school in the spring and go to college or join the army in
the fall. The client seems to be ready to have the daughter on her own and states that she will
not cry when her daughter leaves because she will be free. The counselor asked the client,
would you consider what you've done with your daughter to be phenomenal? The client
responded, I would consider it normal even though other people say it was and I am a good
mother, but to me I had no other choice. If she does not succeed in what she wants, I would see
myself as a failure. After this assertion, the counselor complimented the client and agreed that
her work with her daughter was and is phenomenal. The counselor gave the client new
worksheets as homework. Her assignments include a broken rule assignment, the three
things worksheet, and a goals worksheet for both the client and her daughter. This is the clients
second to last session with the counselor.

DSM-5 CODE WITH RATIONAL:

995.53 (T74.22XA) Initial encounter of Child Sexual Abuse, Confirmed: (American Psychiatric
Association, 2013)
Child sexual abuse encompasses any sexual act involving a child that is intended to provide
sexual gratification to a parent, caregiver, or over individual who has responsibility for the child.
Sexual abuse includes activities such as fondling a childs genitals, penetration, incest, rape,
sodomy, and indecent exposure. Sexual abuse also includes noncontact exploitation of a child by
a parent or caregiver for example, forcing, tricking, enticing, threatening, or pressuring a child
to participate in acts for the sexual gratification of others, without direct physical contact
CASE STUDY: PARENTING AND BOUNDARIES 3

between child and abuser. (American Psychiatric Association 2013) This client experiences
sexual abuse from her father and witnessed her mother experiencing the same type of abuse.

309.81 (F43.10) Post Traumatic Stress Disorder: (American Psychiatric Association 2013)
The client presents with Post Traumatic Stress Disorder related to her own abuse encountered as
a child as well as her time serving in the military. The client experienced exposure to sexual
violence by 1. directly experiencing the traumatic events and 2. learning that the traumatic events
occurred close to a family member (American Psychiatric Association 2013). The client also
experiences marked alterations in arousal and reactivity associated with the traumatic events
such as hypervigilance when she had to learn to allow her daughter to hug her and still has
problems with being that close to someone. (American Psychiatric Association 2013).

300.02 (F41.1) Generalized Anxiety Disorder: (American Psychiatric Association 2013)

The client presents generalized anxiety disorder, which can be attributed in part to her Post
Traumatic Stress Disorder. The client has excessive anxiety and worry that causes clinically
significant distress or impairment in social, occupational, or other important areas of functioning
and these disturbances are not better explained by another medical disorder (American
Psychiatric Association 2013).

CORE PRINCIPLES:

The core principles are empowerment, strength, and boundaries. The client needs to feel
empowerment over her daughter in order to feel that she is doing her job of being a mother. With
empowerment, the client needs to realize and revel in her own strengths. By showing strength as
a mother, she will gain respect from her daughter and teach her strength and empowerment as
well. As a single, working mother, strength and empowerment are two of the most important
principles in her life. The client also needs to establish appropriate boundaries. She needs to set
boundaries with her daughter to ensure she is not disrespected. The client also needs to realize
that the daughters boundaries need to be edited and tailored to her specific situation and she
needs to respect the work her daughter has done to finish school early.

POSSIBLE ASSESSMENTS:

Assessment of Parenting Values: (Passini, Pihet, & Favez, 2014)

-Do you believe physical punishment is necessary when disciplining your children?
-What do you expect from your children? What do you expect from yourself?
-Do you ever feel disappointed with your children? Do you feel disappointed with yourself?
This assessment will help the client think about punishment and discipline from her
perspective and her childs perspective. Although this particular client only used physical
punishment once, it is important for her to realize when it is okay to use physical
punishment and if that past instance was necessary. The client can also make a list of
things she expects from her child and tailor it to her gifted daughter.

Assessment of Parenting Issues: (Gerald, 1994)

-When you tell your child no, do you usually explain why?
-Do you feel you have trouble disciplining your child?
CASE STUDY: PARENTING AND BOUNDARIES 4

This assessment will allow the client to reflect on her past experiences with disciplining
and realize when there needs to be a change in the way she implements punishments.

WHAT INTERVENTIONS WOULD YOU IMPLEMENT:

Pyschoeducation for appropriate parenting techniques and expectations: According to Baumrind

(1966), too much control can provoke rebellion or generate passivity and dependence. On the
other hand, permissive parenting frees the child of authority and allows approval for misbehavior
(Baumrind, 1966). Authoritative parenting attempts to shape, control, and evaluate the behavior
and attitudes of the child in accordance with a set standard of conduct, usually an absolute
standard, theologically motivated and formulated by a higher authority (Baumrind, 1966). The
permissive parent attempts to behave in a nonpunitive, acceptant, and affirmative manner toward
the childs impulses, desires, and actions (Baumrind, 1966). It is important for this client to
understand the boundaries she needs to make as an authoritative parent. It is her natural
inclination to take on the authoritative persona, but the client needs to find a balance between
that and the permissive style.

LONG-TERM GOALS WITH SHORT-TERM OBJECTIVES:

Long-term Goals: Achieve a level of competent, effective parenting and reach a realistic view
and approach to parenting, given the childs development level. (Jongsma, Peterson, & Bruce
2014).
Short-term Objectives: Verbalize a commitment to learning and using alternative ways to think
about and manage anger and misbehavior. Develop skills to talk openly and effectively with the
children. Identify unresolved childhood issues that affect parenting and work toward their
resolution. (Jongsma, Peterson, & Bruce 2014).

PERSONAL REACTIONS:

The client seemed to be relaxed and outgoing during the session. The client clearly trusts the
counselor and values her opinions. To me, it seemed like a venting session and not as structured
as some sessions with other clients. In this specific case, it may be exactly what the client needs
in order to work through her issues with her daughter. Talking through specific instances and
reviewing her past rules and conversations with her daughter helped the client review the
mistakes she has made in the past and the things she can change to benefit her and her daughter.
The client seems strong-willed and sure of herself. These strong characteristics make me wonder
if they are part of the reason her daughter and her butt-heads because her daughter probably
shares some of these characteristics. I believe the client is making positive changes and growing
as a parent as her daughter grows.

OBSERVATIONS MADE DURING SESSION:

CASE STUDY: PARENTING AND BOUNDARIES 5

I noticed that the counselor seemed to treat the client more as a friend than a client. This is
important because the counselor and client seem to be around the same age and both have
teenage children. The counselor did not ask as many questions during this session as she had
with other clients, but let the client lead the session and bring up topics. When the client
discussed her daughters attitude, it struck me as an attitude of a typical sixteen year old and I
wonder if the client is overreacting to her daughters emotions. The client had a hard childhood
and is not able to relate herself at sixteen to her daughter now, but the counselor was able to
relate herself to the clients daughter. This was important because it made the client realize her
daughter is not so different that it is an issue. For the clients final session, I would review
everything covered over the course of treatment and make sure the client notices her progress. I
would also allow the session to be similarly informal to ensure the client receives all of the final
answers and advice she needs to continue a healthy relationship with her daughter.
References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental

disorders: DSM-5 (5th ed.). Arlington, VA: American Psychiatric Publishing.

Baumrind, D. (1966). Effects of authoritative parental control on child behavior. Child

Development, 37(4), 887-907. doi:10.2307/1126611

Gerald, A. B. (1994). Parent-child relationship inventory (PCRI): manual. Los Angeles, CA:

Western Psychological Services.

Jongsma, A. E., Peterson, L. M., & Bruce, T. J. (2014). The complete adult psychotherapy

treatment planner. Hoboken, NJ: John Wiley & Sons, Inc.

Passini, M. C., Pihet, S., & Favez, N. (2014). Assessing specific discipline

techniques: A mixed- methods approach. Journal Of Child And Family

Studies, 23(8), 1389-1402. doi:10.1007/s10826-013-9796-0