Procedure
Evaluation
In the first week
of the intervention plan if treatment was assessed. The evaluation was
conducted considering pretreatment measurements (pretest) and after treatment (posttest),
and we had the combination of the following assessment tools:
- The
interview: through she gained valuable and detailed information about the
student's problem, recognizing its components in different response systems (cognitive,
psychophysiological, emotional / sentimental, and behavioral), and academic
anxiety before exams. In this way they could appreciate the situations
perceived as relevant (threat, danger), the strategies used in coping, and the
consequences they produce (see Table 2 and 3).
- Also
collected data on timing and course of the disorder, and therapeutic attempts
were made to solve the case, with their results.
- In
addition, interviews were held separately from the parents of the student, the
tutor and the school psychologist.
- Self-reports:
is used to quantify the extent of the student's symptoms and assess the change
that occurred with the action of the intervention. Self-reports have been used
here are:
- Inventory
of school fears (IME), Mendez, 1988.
- Inventory
of Situations and Responses of Anxiety (ISRA), of
Vindel Tobal &
Cano, 1994.
- The social
reserve scale (SRS), and Russell Jones, 1982.
- The self
reported test Multifactor Adaptation (TAMAI) Hernandez.
- The test
of intelligence Progressive Matrices (Raven), Raven.
- The self-reports:
they are practical and accessible techniques that have been used to assess and
collect information about the components of the anxiety response, and possible
maintenance or factors.
treatment
Techniques
Several techniques
have been employed within the therapeutic intervention program in order to
modify the student's behavior (see Table 5).
Of all these
highlights their importance: exposing live phobia and social skills training.
Intervention
Program
Analyzed self-report
information (pretest) found that patients expressing high levels of anxiety
regarding their assistance to the Institute, before exams and social
interaction with peers. Subgroup analysis showed a negative assessment of his
own image (low self esteem). The intellectual assessment made within normal
limits.
Also, it was felt
that their anxiety symptoms had manifested over eight months. Assessed all this
information and taking into account the recommendations of the DSM-IV
diagnostic-TR, the patient was diagnosed: academic anxiety before exams as
situational type specific phobia, accompanied by deficits in social skills and
self-esteem school.
Then he got up
your medical records containing the following information headings: 1) personal
identification data, 2) identification data psychologist, 3) The reason for the
consultation, 4) The family and sociocultural situation, 5) History previous
treatments of the problem and, 6) The symptomatology (Cognitive, Psychophysiological,
Emotional / Sentimental, Behavioral, Motivational), 7) The areas evaluated and
results, 8) The diagnosis, 9) The treatment and / or recommendations, and 10) The
genogram.
After the patient
was informed of the disorder and their parents suffering. At the same time, a
therapeutic contract was negotiated in which the patient agreed to continue treatment
designed for it, attend therapy sessions and perform the tasks entrusted to
home. It was also suggested to parents the importance of their cooperation and
support in the therapeutic action.
Days after the
clinical psychologist contacted the institute director, tutor and psychologist
to inform the diagnosis and treatment plan with the patient to continue
soliciting participation with the teacher and special education specialist
bandmates - class. All were given and worked positively, giving emotional
support. Thus was formed a social network and educational therapy.
In interviews it
was found that the patient was open to collaborating, and agreed with him
recovering overdue homework to be done at home. To this end, put a support
teacher.
It was also found
that parents ran the consequences of a non-contingent on the behavior expressed
by the adolescent. For example, one day the father punished his son not buying
a laptop I wanted, the reason was that he left his room to fix daily. But after
a few days it was purchased for her birthday, even though it had not changed
their behavior at all.
For this reason, we
developed a contingency plan that was intended to extinguish the complaints of
child and materially and socially reinforce target behaviors. These should be
expressed in a simple, realistic and observable. Examples of them were studying
at the desk, meet the assigned schedule of school work, attend classes at
certain times, etc..
All therapeutic
techniques used in interventional treatment were necessary, but among all these,
the most important was, in vivo exposure (EV).
For the patient to
overcome anxiety school phobic situations, he carefully explained the
mechanisms that enable the acquisition and maintenance of anxiety behaviors. At
the same time, he noted the importance of confronting feared situations to
overcome the lingering fear, excessive and irrational they produce.
After phasing was
scheduled to classes during the first three days. This was a binding contract
in which the patient agreed to attend several hours of class a day.
The psychologist
accompanied the patient to school the first day for the art exhibition. Support
also used deep breathing and self-instructions.
He taught learning
techniques and strategies of how to study how to deal with the tests, indicating
that in the case of failing any of them could recover. Also he trained in
social skills.
In many of the
activities involved support intervention and emotional support center
educational psychologist, specialist teacher in special education. They were
also extremely useful the faculty and classmates.
Meanwhile, parents
participated from home positively supporting the therapeutic treatment of his
son. Which promptly sought from attending the institute, slept properly, desayunase
every day, did the exercises both therapeutic school, etc.
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