Clinical Assessment: Clara
Mr. and Mrs. Lawson brought their 4-year-old daughter, Clara, to see Dr. Mason, a psychiatrist. Clara was polite in greeting Dr. Mason, but did not smile and kept her gaze down as she took a seat. Mr. and Mrs. Lawson sat next to Clara and began explaining their concerns. They described Clara as a quiet child who has recently begun throwing temper tantrums, during which she is inconsolable. Her sleep and eating patterns have changed, and she no longer wants to go to preschool.
1. What other information would you like to learn during the interview with the family? What questions would you ask?
The first thing I would do is find out as much about Clara as possible. The sudden onset of temper tantrums can be caused by numerous things such as a life changing event like loss of a family member. I would ask if there has been a recent death in the family, be it a person or a pet, as in most cases when a pet dies there is just as much grief as there is when a loved person passes. Since Clara no longer wants to go to preschool, to me this indicates that at one point she enjoyed attending. I would ask when she stopped wanting to go. What was her performance and behavior at preschool like before the tantrums started? Most of the time there is something that sets a child off, something that someone says or does. Have the parents noticed anything in particular that throws Clara into her tantrums? Is Clara violent or verbally offensive during her tantrums? Or does she just scream, cry, and stomp? Since children are very easily stressed out by negative environments, I would ask the parents about their relationship. Every couple argues, but do they scream, yell, use offensive language, or get physically violent in front of Clara or where she can hear it? Sometimes children will act out to get attention. Are the parents working long hours, or odd hours? How much time do they spend with Clara. Another important thing to ask would be how they...