Case histories

• Counsellor speaks with class teacher about the nature of the problems in class.
• Counsellor meets with Julie’s mother prior to meeting Julie to explain the counselling process and gain some insight of life at home. Mother appears anxious and weary and is quite defensive of Julie and of her home circumstances. She is happy for Julie to meet with the counsellor and wants to remain involved in the process, if possible. Julie’s mum shares that she has a current boyfriend who her three children don’t like and who is planning to move in to the family home. Julie has two older brothers who see their own father but Julie does not see her father who is in prison.
• Counsellor has a brief first session with Julie to explain why they are meeting and what they might do. Julie is invited to tell her story and say why she thinks she is coming to see the counsellor. They agree to meet for the next few weeks to talk some more.

Counsellor decides to engage a variety of play therapy methods alongside talking therapy. A sand tray, some drawing materials and puppets are available in each session.

The counsellor uses a range of methods: observation; active listening; awareness raising. She also talks about bullying; and covers self concept and destructive beliefs, to help Julie to understand her story and behaviour.

The issues which emerge in the first session are around Julie being bullied at home by her two older brothers which appears to be left unchallenged by her mother, who is spending increasing time with her boyfriend. Julie and her brothers are struggling to accept a new male influence in their lives following unhappy memories of Julie’s father who was violent with their mother and the children.

Julie has not made the link herself between being a victim of violence and bullying to her own behaviour, of being a perpetrator of bullying. Through talk and play the counsellor is able to explore Julie’s feelings as a victim and perpetrator and talk about her negative feelings about herself and others.

With Julie’s knowledge the counsellor takes time to talk with Julie’s mother and teacher and their role in supporting Julie and to look at ways of better supporting her. There is some immediate decline in her acting out behaviour in class. As she is listened to and encouraged her negative beliefs about herself, being bullied by two older brothers, and some thoughts of her being partly responsible for her daddy being in prison for GBH and assault, emerge.

As Julie learns not to bully others and that she should not be bullied herself she fairly quickly sees herself gaining new friends and gaining approval by her teacher and she decides she doesn’t want to come to counselling any more. Mum has taken control of the older boys bullying Julie and they are waiting to attend CAMHS together as a referral from their GP. The counsellor suggests they meet for one last session.

Despite a complex home situation, this brief counselling arrangement has finished with some positive results within 6 sessions. There is clearly more long-term work to do, but not at the moment.

There has been good co-operation between home and school, bullying in school and at home has been addressed and Julie has been able to talk about and explore some difficult feelings and issues.

It is likely that, given her mother’s future relationship, things may develop further and that Julie may need to attend further sessions. However, it may be that the planned family sessions will help here, too, and the counsellor may be able to share relevant information with CAMHS.

In the final session the counsellor helps Julie to see how much progress she has made by talking and how things have changed. They end on a positive note by doing some sand play and the opportunity of returning sometime is made clear.

In the six sessions that Julie had with the counsellor, and in consultation with her mum and teacher, it was possible to establish the root cause of her bullying behaviour and look at alternative ways of managing this. Julie is no longer being bullied at home and has been helped to understand that bullying behaviour is unacceptable, both towards her and others. Julie has begun to explore some negative feelings about her father’s behaviour in the past and her feelings about him being in prison and this will be explored further with CAMHS and even in further sessions when she is ready.

Max agreed reluctantly to meet with the counsellor as an alternative to his mother being invited into school to discuss his recent absences and behavioural changes.

Counsellor invites Max to tell his story. He recounts that he has found his parents’ recent separation devastating and difficult to manage. He often feels unmotivated to attend school and when he does he finds himself feeling angry or depressed by lessons and the pressure of work.

Counsellor reflects on Max’s situation and is able to contract with him to meet for six sessions to explore:

• Feelings of loss and anger at parents’ decisions
• Strategies for identifying mood and seeking support
• Alternative ways of expressing strong feelings
• Ways of managing lessons and exams
• Ways of negotiating with his form teacher to avoid conflict and get through GCSEs
• The future and how to relate to both parents with minimal conflict

Counsellor meets weekly with Max in a 40-minute session to explore the above issues which they identified together in the first session. The work is done mainly through talking therapy with the addition of some negotiation with teaching staff to agree time out when Max experiences low mood or anger. Some help is also sought from staff with writing letters to both parents to express some of what he is feeling.

Half way through the sessions the counsellor and Max do an evaluation of the work so far to re-prioritise their remaining sessions. Max is able to recognise some changes in how he is feeling more in control of both his home and school life. His teacher is able to confirm a reduction in angry outbursts and an increase in attendance.

After six sessions Max feels he is able to face his exams ahead and whilst his parents are progressing on to divorce he feels they have listened to him via his letters and are avoiding using him as a weapon in their differences.

The counsellor looks back with Max at the agenda they set in the initial session and he is able to see how far he has moved as well as talk about how he may use some new skills he has learned when facing similar pressure to that stemming from his parents’ divorce and how to manage his feelings around this.

Max has been able to make the link between his anger at his parents and his disruptive behaviour in school and non attendance. He has also seen the value in asking for time out or writing down his strong feelings.

The counsellor summarises the work they have done and encourages Max to continue talking with his parents and his teacher in addressing issues as they arise. Max is left with the offer to meet in the future should he feel the need.

Max came to counselling in a time of crisis in his family which he struggled to manage. A previously ‘model student’ it was recognised that he was struggling and through counselling he was able to express strong feelings which were impacting on his thoughts and behaviours at home and in school. In just a few sessions, Max and those around him were able to see a distinct change in his mood and behaviour and he has been empowered to take action which has helped him to face his loss and manage his school and home life more easily. He knew that he had support around him and had the offer of further support, if needed.