A Defiant Personality; A Case of Shy and Insecure School-Going Girl

Hamda Mahmood Bazmi *¹, Kiran Akbar Khan ²

Corresponding Author: Hamda Mahmood Bazmi, GC University Lahore, Pakistan.

Copy Right: © 2022 Hamda Mahmood Bazmi, This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Received Date: August 30, 2022

Published Date: September 05, 2022

This case revolves around a 11 years old school-going girl referred for facing difficulty in understanding Science subject, low confidence, difficulty in making new friends and facing adjustment problems in new school and for the purpose of psychological assessment and Low self-esteem management. The psychological assessment tools (behavioral observation, semi- structured interviews, subjective ratings, portfolio assessment and self-esteem scale) also confirmed the problem of her low self-esteem at school. Management plan included were Supportive therapy was used in rapport building, Psycho-education was used to teach her regarding her current situation and how to cope up with different difficulties in life, Chunking was used for learning Science lessons, deep breathing exercise was used to overcome her anxiousness, Mirror Technique was used for confidence-building in client herself, Situation exposure hierarchy technique was used to overcome her fear and social skills training was used in order to make social relationships and friends. Nine therapeutic sessions were conducted. There was noticeable improvement in the client’s problems by pre and post assessment on subjective-rating scale.

Keywords: shyness, low-confidence, low self-esteem

Self-esteem is a very important construct of a personality. How a person believes about himself, it matters a lot in life. Higher the self-esteem, higher rates of achieving great things in life and able to grow and prosper. There are several factors behind the low self-esteem of a person, it could be the physical appearance, emotional issues, mental issues, environmental factors, bullying or any other kind of pressure results in lower self- esteem. Self-esteem is mainly boosted by our society, parents, teachers. The purpose of reporting this case study is to show how parents and teachers and environmental factors can play vital role in shattering the self-esteem of a child. And most importantly, the children need support from family, friends and teachers, lack of social relationship also results in a shy and insecure child as this is the very sensitive age. In this case study report, the extensive case formulation is done on the basis of client’s history, the psychological assessment of client and a successful therapeutic plan is also discussed.

M.I, an 11-year-old girl, student of sixth grade was referred was referred to the school counsellor for the purpose of her psychological assessment and management of behavioral problems. The semi- structured interviews were done with the client produced the presenting problems of the semi-structured interviews were done with the client produced the presenting problems of facing difficulty in understanding Science subject, low confidence, difficulty in making new friends and facing adjustment problems in new school. The client had a very reserved and shy nature. According to the client, these all problems started two months back, when she shifted to this school about two months ago. She also reported that in this school, she didn’t have any friends. The client also reported her problem with learning difficulties with Science subject, she reported that because it had short questions which were very hard to learn and had some difficult terminologies to understand. The client’s teacher reported that client had very low  confidence that whenever she was being pointed out in to read aloud the lesson in front of whole class, she become very anxious.

To access and to devise a treatment plan for her presenting problems, client’s psychological assessment was done by Behavioral observation, Semi-structured interviews (Anderson, 2005). Subjective Ratings Scale (Scalzi, 2013), Portfolio Assessment (Dimmit, Carey & Hatch, 2007) and Self-esteem Scale (Saleem & Mehmood, 2011).

The client was very shy, and she found very difficult to respond in front of whole class. according to Muqadus Butt & Samra Moosa 2011, the shyness plays a vital role in the self-esteem of students. Higher the levels of shyness in a student, lower the self-esteem in students. In the client’s case, her parents remained busy most of the time, and client was the only child, she couldn’t talk to her siblings as well as her parents and there was a huge communication gap in family members. According to Jingyu Shi, & Lu Wang, 2017, if there is a free and frank way of expression at homes, it can boost up self-esteem. The sharing of things with family members also builds up a sense of self-awareness in a person. As the client lack social relationship, as well as friendships. So according to Michelle A & Ulrich O, 2019, self-esteem leads to improvements in a person’s social relationships. Social relationships and self-esteem are reciprocal, across the person’s life span.

Clinical observations of the client also supported her presenting problems as she did not maintain eye contact throughout the initial sessions. The portfolio assessment of the client was also done, which showed that client was performing good in every subject except Science subject, she didn’t know the conceptualization of topics. The score SESC also indicated low self-esteem of client.

The information generated by the client’s history and psychological assessment were compatible with each other and provided a very understandable picture of client’s presenting problems. M.I’s prognosis was good. She was willful and in favor of resolving her problems. she wanted to make friends and participate in class like others.

Therapy

Rapport building (Tanner, 2006) was done by using Supportive therapy. Attentively listening to her, empathizing with her to understand her situation completely. Psychoeducation (Brand & Bergsman, 2006) was given during semi- structured interviews to the client so she could be well psycho educated about her problems, their severity and also the management     plan.    Chunking (Miltenberger, 1997) was used with the client to teach her how to memorize question/answers of Science subject. Deep Breathing (Cully, & Teten, 2008) was used with the client to facilitate relaxation and make her calm in anxious states. Mirror Technique (Pam N, 2013) was used for confidence-building in client herself. Situation exposure hierarchy (Leahy, 2003) was used with the client in order to help her overcome her fear and anxiousness and to motivate her to respond in class. Social Skills Training Alex Kopelowicz, 2006 was used for increasing resilience, social affiliation, interpersonal supports and improved quality of life.

Outcome

The pre and post subjective ratings of client’s presenting problems showed a measured decline, which indicated that she had been able to control her anxiety in front of whole class during participation and also learned the concept of chunking for memorizing the Science question/answers. Figure 1 shows the client’s scores of pre and post subjective ratings.

The client’s presenting problems were decreased to some extent, the client quickly learnt the concept of chunking which helped in memorizing Science lessons. The client also learnt to initiate a conversation with class-fellows. She also leant to practice deep breathing exercises in state of anxiousness whenever she had to participate in her class. This case study report investigated the anticipated etiology of low-self-esteem in a young school-going girl while narrating the treatment plan for the client, which showed notable improvements in the client having low-self- esteem. The present case outlines that by using the techniques of cognitive behavioral therapy, the therapeutic outcomes can be upgraded to manage the clients with low-self-esteem.

References

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