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© 2021 Walden University, LLC. Adapted from Plummer, S. -B., Makris, S., & Brocksen, S. M. (Eds.). (2014). Social

work case studies: Foundation year. Laureate International Universities Publishing.

Brandon

Brandon is a 12-year-old, Caucasian male who currently resides with his mother and

her boyfriend. Six years ago, Brandon disclosed that his father had repeatedly sexually

abused him between the ages of 4 and 6. Brandon’s mother called law enforcement

immediately after the disclosure, and his father has been incarcerated since. Brandon

has previously participated in therapy to address challenging behaviors, including

physical aggression, difficulty following rules at home and school, and using

inappropriate language with sexual overtones toward female peers. Brandon and his

mother report that they ceased participating in therapy in the past after there was no

change in Brandon’s behavior. Brandon’s teachers have suggested that his behaviors

are similar to those of peers with attention deficit hyperactivity disorder (ADHD), but his

mother has declined educational or psychological testing because she does not want

her son to be labeled and is unsure if she agrees with the use of psychotropic

medication with children.

Brandon began attending trauma-focused treatment after demonstrating an increase in

argumentative behavior and minor property destruction at home. His mother reported

that the majority of undesired behaviors were initiated during interactions with her

boyfriend during lockdown due to the COVID-19 pandemic, when all three people were

confined to home. Brandon’s use of physical aggression has not increased since

returning to in-person school; however, a female peer recently reported him for using

sexually explicit language toward her. Brandon admitted to using inappropriate

language toward the female peer but appeared to have a limited understanding of what

the phrases used meant. Brandon’s mother noted during intake that she is concerned

that her son will become a violent sexual offender or a pedophile and noted that his use

of sexual language was likely the start of sexual behavior problems.

At the beginning of treatment, Brandon reported that he frequently feared for his

physical safety but often could not pinpoint what made him feel unsafe. He had

searched the Internet to find registered sexual offenders in his neighborhood, and he

had begun sleeping with a loaded BB gun under his pillow in case someone entered the

home to assault him again. Brandon had flashbacks when trying to fall asleep and

described feeling like he was floating outside of his body when he thought of his abuse.

He had seen a television show where victims spoke at the parole hearings of their

perpetrators, and he spent many hours thinking about what he would say if he went to

his father’s parole hearing in 3 years. Brandon felt like he loved his father very much

and that his father was a great father except for when he hurt him. Brandon identified

wanting to feel less worried, sleep better, and fight less with his mother as primary

treatment goals.

Individual and Family Sessions

Brandon’s Sessions

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© 2021 Walden University, LLC. Adapted from Plummer, S. -B., Makris, S., & Brocksen, S. M. (Eds.). (2014). Social

work case studies: Foundation year. Laureate International Universities Publishing.

I worked with Brandon in both individual and family sessions to address his symptoms

of depression and post-traumatic stress disorder (PTSD). Utilizing the trauma-focused

cognitive behavioral therapy approach, early sessions focused on coping skills and

emotional regulation. As Brandon became more comfortable with expressing feelings

and utilizing coping skills, he began discussing his sexual abuse history and the

ongoing effect of this experience on his life.

Mother’s Sessions

I met with Brandon’s mother for collateral sessions in order to help her identify and

process her own feelings about his abuse and to develop skills to support Brandon

through his treatment. Brandon’s mother was provided with psychoeducation regarding

childhood sexual abuse, and her belief that her son would become a violent sexual

offender as a result of his experience was challenged through cognitive behavioral

therapy.

Medication

Brandon’s mother agreed to meet the agency psychiatrist, and after the initial

consultation, she agreed to have Brandon meet with the doctor. After a psychiatric

evaluation, Brandon was prescribed a low dose of antidepressant medication.

Trauma Narrative

Brandon completed a trauma narrative that addressed the details of his sexual abuse

experience, his disclosure of the abuse, and the trial and subsequent imprisonment of

his father. Brandon included a description of his feelings at each point in his narrative,

as well as what he learned in treatment about childhood sexual abuse and coping skills

to deal with uncomfortable feelings and impulsivity. Brandon shared his trauma

narrative with his mother, who provided a safe and supportive space during this

experience through the use of skills learned and practiced during collateral parent

sessions.

Brandon’s symptoms of depression and PTSD decreased steadily during the course of

treatment. After 8 months of sessions and the successful completion of his trauma

narrative, the family and I agreed that Brandon was ready to terminate trauma-focused

treatment. Brandon continued receiving medication management with a psychiatrist and

transitioned into home- and community-based treatment that focused on his ongoing

impulsive behaviors.