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TREATMENT PLAN
Diagnosis:
Axis I: 313.89 Reactive Attachment Disorder of Infancy or Early Childhood, Inhibited Type (Rule Out)
Axis II: V71.09 No Diagnosis on Axis II
Axis III: Deferred to medical personnel
Axis IV: Child Abuse, Child Neglect, Parent-Child Relational Problem
Client-stated Desired Outcome
(client did not speak, but was extremely tearful throughout the initial meeting; no parents escorted him to the session)
Treatment Goal(s)
Isaac did not speak during the initial session. Due to his history and diagnosis, he would likely benefit from decreased anxiety and a greater sense of security with his primary caregiver.
Client Strengths in Meeting Goals
Isaac has experienced some times in his life without abuse and neglect. He has also demonstrated assertiveness and strong survival instinct during traumatic situations.
Barriers to Meeting Goals
Isaac experienced neglect and an attempted murder by his primary caregiver. This experience was likely very traumatic and memorable. Isaac also cannot speak, so traditional talk therapy is not recommended.
Interventions
Isaac's age is undisclosed, but it is clear he is very young. The therapeutic intervention of choice for children with experiences like Isaac's is Play Therapy. The basic idea of Play Therapy is that the language children speak naturally is play, and thus play is a better venue than talk therapy as a means to help children resolve psychological issues. Play Therapy involves allowing children to play in an unstructured way, but with a very specific therapeutic interaction with the therapist - that is, Play Therapy is not merely a child playing with toys and an adult watching. To a trained professional, play enacted by children with significant psychological issues appears markedly different from typical child play. Isaac would likely manifest his processing of his traumatic experiences through play, and it would not be surprising if the nature of his play mirrored the gameplay of "The Binding of Isaac," inasmuch as this appears to be how Isaac is processing his emotions. He would play in a self-directed manner and work through his issues at his own pace.
Ideally, Isaac and a caregiver would engage in Filial Therapy, which is essentially teaching the caregiver how to conduct play therapy and having the experience of Play Therapy happen regularly at home. This increases bonding and attachment between the adult and child. Isaac will need to process his trauma and have numerous positive interactions with his primary caregivers. This will likely be very helpful in alleviating the effects of his traumatic experience.
Though not directly related to therapy interventions, Isaac would definitely benefit from having a caregiver who is capable of assisting him with his needs. His mother appears unable to do this.
It is anticipated that Isaac would receive Play Therapy every week for anywhere between 20 to 100 weeks.
Termination
As always, termination will occur at the discretion of the client with input from the therapist. As Isaac is a child, input from his caregiver is necessary. In Play Therapy, a good indication that termination is imminent is when Isaac begins to get bored during the sessions. This indicates that he is no longer working through his trauma.
