MST Incorporates CBT to Help Mom and Daughter

Posted by Tom Havrilak

Apr 30, 2015 11:34:00 AM

A mom was ready to place her child. Nothing was working until she found MST.

Jackie was referred to MST in December 2014. I called her mother’s cell four or five times without any contact. I drove to their home one day. Jackie and her mother lived in rural Southwest Pennsylvania. No one was home. I left a note.

 

I hadn’t heard anything for nearly two weeks after multiple attempts. The referral information noted that Jackie was a truant, leaving home without permission (she once left for two months), and verbal and physical aggression. Records showed she had a negative peer group. On top of which, she was failing in school having missed around 60 unexcused days.

I finally received a call from my mother and scheduled the first session.

Immediately upon arriving, mother said I was wasting my time, and she didn’t want our service. She declared “nothing will work” and was willing to have her daughter placed outside the home. As we talked, Jackie paced around the house, approaching her mother several times yelling, “Why are you telling this man our business?”

I stayed focused on engaging mother. I explained how MST worked and what she could expect. Mother changed her mind. She said since MST could help her develop improved tools to increase her authority at home and help change Jackie’s behaviors, she would try the service. She agreed to permit me to return and start sessions.

Jackie continued to resist, but this lessened over time. Mother started focusing on Jackie and became less overwhelmed with her job and other duties. Child-focused issues and boundaries were addressed. Cognitive Behavioral Therapy was used to help change mother’s faulty thinking that she was not a good parent. She set limits and improved rules, rewards, and consequences. Jackie soon started changing her behaviors, particularly after I attended a magistrate’s hearing and reported that she had been attending school and her behaviors were improved. He said Jackie could return in a month or so, and if she had good attendance and grades, he would dismiss her truancy charges.

Jackie and her mother became distraught in late January 2015, believing that the girl was going to be placed outside the home. I helped mother prepare statements, consulted with mother’s and Jackie’s attorneys, and testified in court. Jackie had not missed a day of school since early January. She hadn’t violated curfew, often coming home early. She stopped going out with friends to stay home, do her schoolwork and help mother around the house. Her grades improved, including one C and As. She had not have any more unexcused days. Mother advocated keeping Jackie in the home, something she didn’t think she could do. The judge dismissed charges and did not place Jackie due to the progress reported. Both mother and Jackie were able to articulate their feelings well in court about Jackie’s progress. Mother felt empowered and saw that she has a voice.

After court, I observed Jackie having much anxiety as she raced for the exit complaining about not being able to breathe. After further assessment, I realized Jackie was having panic attacks. Mother concurred that she had them, particularly in the car. Further inquiry suggested that Jackie was experiencing social phobia due to her perception that others would ridicule her because of her amblyopia (lazy eye). She also was having anxiety in small classrooms, interfering with her learning.

It hit me that what the school thought was a student who was defiant and refusing to come to school was really one who was experiencing much failure and stress from her anxiety and inattention. It was emotionally easier for her to stay home. Much of the previous fighting at home was caused by her refusal to go to school.

I made arrangements for Jackie to be evaluated by a local psychiatrist, who diagnosed her with anxiety and prescribed medications. I informed the referral source and the school of the situation and started transferring collaboration skills to mother so she could continue to make sure Jackie was receiving the correct support in school.

Jackie improved to the point that she was able to work at a local Dairy Queen several nights a week and on weekends. She quickly excelled there and received social rewards from working in public. This success also had a positive impact on her school performance. With sustainability plans and aftercare in place, her case will soon be closed.

 

Mother says that MST saved her daughter and her relationship with Jackie. Mother displayed improved confidence in herself as a mom and an adult. She started training as an assistant manager at work and is going to church. Mother said she enjoys just sitting down and having long conversations with Jackie now.

Mother was so moved by the progress, she made arrangements for me to have a session with her at Jackie’s work. Little did I know that she planned to buy my dinner that night knowing I enjoyed good fish sandwiches. (Daily Queen has one of the best.) I couldn’t refuse her offer to know that she worked two jobs, sometimes 60 hours a week at one, to make ends meet. Having dinner with mother and Jackie was one of the best rewards I ever experienced because I knew what it meant for them.

Sometimes it’s hard to let go and close a case when so much progress is made and you receive such satisfying rewards.

 MST Therapist Tom Havrilak works for Adelphoi Village. 

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Topics: MST Success Stories