Psychology

In beginning a psychological case study, it is first essential to explain the conceptual framework involved regarding the theoretical dynamics of healing.  In this study, the methods of psychoanalysis, holistic psychotherapy, child therapy, fitness, economics, and nutrition will be utilized in aiming to understand the client and develop a reasonable treatment plan.  Through psychodynamic and holistic psychotherapy, it will be demonstrated how the relationship between parent and child can be negatively affected and lead to attachment disorder.  There is significant evidence that maternal depression and child behavior problems are related.  In regard to the client being studied, it is believed that as a result of a severely depressed mother, the client is now emotionally disturbed.  It will be demonstrated how psychological theory was translated into clinical application, and how the therapist asserted a positive effect on the patient.  This model includes the introduction of a dynamic and holistic approach, including Bowlbys attachment theory and Anna Freuds model of psychoanalytic parentinfant psychotherapy, as well as integration of the practice of yoga, play therapy, fitness, and nutrition into the parent and child relationship.  The combination of a good understanding and application of these psychological theories and holistic approaches will help the child to reduce frustration, anxiety, and stress, alleviate depression, improve concentration and balance, promote emotional health, and increase mental clarity.

Literature Review
By reviewing modern literature centering on the case of a child who is suffering from mother child attachment issues and being treated by reattachment focused and family centered techniques and holistic remedies involving economics, fitness, nutrition, socialization, and relaxation, it is clear that a wide array of research has been conducted in this area.  Modern researchers place much of their focus on describing the dynamics between mother and child, how the relationship suffers under mental, physical, social, and economic stress, and offer suggestions for how to help remediate the mother child relationship (Augustyn, Beeghly, Cabral, Frank, Grant-Knight, MacDonald, et al., 2008), (Bakermans-Kranenburg, Benoit, Madigani, Moran, Pederson,  Van Ijzendoorn, 2006), (Bakermans-Kranenburg, Bolkhorst, Fearon, Fonagy, Schuengel,  Van Ijzendoorn, 2003), (Beebe, 2005), (Belsky, Vandell, Burchinal, Clarke-Stewart, McCartney, Owen, 2007), (Blatt, Diamond,  Lichtenberg, 2007), (Bgels  Brechman-Toussaint, 2006), (Bowlby, 2005), (Britton, Britton,  Gronwaldt, 2006).  By placing significance on the vital importance of the mother child bond, modern researchers explain how the relationship is able to be damaged under the influence of negative personal and environmental situations which serve to undermine mother child attachment and also highlight the ways in which mothers and their children can be helped by applicable mental health interventions (Bronte-Tinkew, Capps, Horowitz, Moore, Weinstein  Zaslow, 2008), (Brumariu  Kerns, 2008), (Cicchetti, Rogosch, Sturge-Apple,  Toth, 2009), (Cooper, Murray, Romaniuk,  Wilson, 2003), (Coosene  Van Ijzendoorn, 1990), (Engstroem  Neander, 2009), (Grienenberger, Kelly,  Slade, 2005), (Van Lange, 2006).  It is also of great importance to note the ways in which the therapist is able to provide support to the family in the area of discussions surrounding healthy finances, nutrition, fitness, socialization, and relaxation (Ajaya, 2008), (Armstrong  Edwards, 2003), (Brown, Gerbarg,  Muskin, 2009), (Caspi, Melchior, Milne, Moffitt, Poulton, 2007), (Castillo, Ortega, Ruiz,  Sjostrom, 2008), (Engle, 2009), (Gillen  Gillen, 2008), (Wachs, 2009).  In considering the case of a child suffering from mental and emotional disturbances, it is essential to pay close attention to the family unit and the level of security in mother child attachment as well as other lifestyle factors including how money is obtained and utilized in the family, how the family perceives nutritional choices, how the family attends to appropriate exercise, how family members make accommodations for healthy socialization, and how the family values time for relaxation.

Case Presentation
The selected client is an eight year old African American male, who was referred to the clinic on February 18, 2009.  His presenting symptoms indicate the following DSM-IV Axis 1 Diagnoses Emotionally Disturbed, Mood Disorder NOS, Disruptive Behavior NOS, Reactive Attachment Disorder of Early Childhood, Mixed Type, and possible Attention DeficitHyperactivity Disorder.  This client was selected due to the nature of his behavioral symptoms and the presence of trauma symptoms, including the fact that he suddenly cries hysterically (e.g. , when he thought a project was too difficult), his mood changes abruptly and there is no reasoning with him during these periods, he takes off his clothes in the time out room and plays with his penis, urinates in the time out room, makes himself vomit, throws food in the classroom, tried to strangle a peer, hurt a teacher, exhibits defiance, swearing, restlessness, aggression, speech difficulties, and low self esteem, and has nightmares and poor eating patterns.  His mother openly expresses how she cried everyday while pregnant due to the murder of the clients father, and she becomes sad and does not want to deal with anything when mourning the loss.  The client lives with his mother and older brother, and his mother works as a nurses aid.  The mother reports that she has had some emotional difficulties and the clients father had behavioral difficulties.  The client attended a head start program five days a week from 7AM to 7PM, and the mother reported that he had many tantrums in preschool.  In school, he has had significant difficulties with following routines and teachers directions.  His open court results show significant deficits in reading, writing, and spelling.  He has had tantrums and crying episodes in response to the most minor redirections or corrections.  The mother reports that her son refuses to listen, is hyper active, and difficult to control.  The client disrupts family functioning and causes impairment in his relationships with others and in his daily living skills. His symptoms and behaviors impair his interactions with his peers, resulting in disruption of his ability to form age appropriate peer relationships and social well being.  The mother also reports that her son is sweet and loving as well as moody and sensitive.

TreatmentDiscussion
The most appropriate treatment plan for the patient requires a full scale lifestyle readjustment in order to promote relational connectivity between the client and his mother, support social skills, and center on holistic health improvement in the area of emotional and mental stability.  This includes the family as a whole, as a supportive economic and social unit, as well as the more specific needs of the client.  Client needs may not be met in a general education setting and may need special education services, either in the school setting or by being home schooled.  The repair of the relationship between mother and child and developing a trusting and loving bond between mother and child is crucial.  It is important to place interest in the socioeconomic status of the family as well as other needs related to mental and emotional stability.  Yoga, sports, movement, exercise, diet, breathing techniques, meditation, and play therapy are also some highly important elements of a well rounded lifestyle.  It is vital that the client be provided with praise of his efforts and encouragement to verbalize his feelings and frustrations rather than act out.  By creating a behavior contract involving the parent, client, therapist, and any teachers and school administers regarding what is expected of the student and what are the potential rewards if these expectations are met, there can be complete clarity in knowing acceptable behaviors, boundaries, and unacceptable behaviors.  It is important for the client that there be accommodation and modification of instruction according to clients present level of ability.  Implementation a positive behavior support plan with place praise and rewards on positive behavior and draw attention away from negative behavior.  It is recommended that the client be monitored for suicidal ideation on a regular basis and for the therapist and other support systems to create a safety plan when the client experiences these intensely sad feelings.  Client participation in a peer activity such as fitness or sports may help to bolster the learning and practice of pro-social behavior and appropriate boundaries.  A family advocate may be helpful in obtaining a referral list of positive after school activities which would assist in building social skills.  The utilization of play therapy techniques provides psycho-education about emotions through age appropriate and creative play and expression.  By teaching age appropriate anger management techniques, the client will be able to have increased awareness of raging emotions and implement self help measures of self control.  The therapist will provide psycho-education regarding labeling emotions and will encourage verbalization of emotions, teach coping skills, and explore underlying causes of anger, anxiety, and sadness.

Conclusion
It is very important that all aspects of this case be explored in all of its complex dimensions involving mental, emotional, physical, and economic security.  The family is the center of help and reliance in what can be a very tumultuous world, and it is essential that the therapist act as an aid of help in striving to mend and restructure the family in positive ways depending on the needs of the family, especially the client.  The needs of the client are the precise point of concern for the therapist, and all theoretical knowledge and technical interventions should be put into use regarding the mental and emotional state of the client within the center of his family.  The therapist alone cannot work miracles, however, with a wide array of background research, a competent and positive attitude when dealing with the client and his family, and a sincere desire to help the lives of the people in treatment, it is possible for the therapist to act as a catalyst in helping the client and his family members to help themselves and one another as part of a dynamic and intertwined system of love and interdependence.