Question

What type of depression does this child have? Client Jacob Tooley Age: 10 years old Ethnicity: Caucasian lost his mother in the summer it is now January. he used to do well in school but now he is having emotional outbursts andTeacher comments share concerns that when Jacob was questioned about missing homework, or progress notes requiring parent signatures were beginning to not be returned, Jacob would grow unusually negative, telling his teacher that his mom was sick, his dad was working extra jobs and to stop trying to bother them. The comments also reflected a change in Jacob's demeanor with his classmates. Mrs. Simmons tells you that at the beginning of the school year, she had the class do a journal writing assignment about “What I did over the summer.” She shows you a copy of Jacob's journal entry. The picture showed Jacob, his brother, and his dad, all with sad faces. When the children were asked to share their assignments, Jacob refused. Mrs. Simmons explains that she set up a teacher-parent conference and found out that Jacob's mother had passed away over the summer. Mrs. Simmons explains that she and Mr. Tooley hoped that Jacob's behavior would improve if he had some time to mourn, but things have only gotten worse. You agree to meet with Jacob to find out more.    Jacob walks into your office with a sullen look on his face and flops onto a seat. You ask if he would like to play with any of the toys in your office and he glares at you.    “I don't even like any of these baby toys,” he says.    “Well, good thing I have some tough action figures for older boys,” you reply, pulling down a box from your shelf.    “I guess these are OK,” he grudgingly admits, “but my big brother says toys are for little wimps. He's right.”    “Do you spend a lot of time with your brother?”    “Maybe,” Jacob retorts, glancing at you from the corner of his eye with suspicion.    “What kind of stuff do you all do together?” you ask.    “None of your business!” Jacob retorts.    You try to engage Jacob a few more times, but he consistently refuses to give any detailed information about what's going on at home.    After finding that Jacob's home phone has been disconnected and hearing that Jacob's father drops him off at school, you decide to wait outside to quickly talk to Mr. Tooley in the morning. When Mr. Tooley drives up in the morning, . . . introducing yourself, you explain that you would love to sit down with him one day before or after school because of concerns about the changes in his son's mood. Mr. Tooley looks exhausted but concerned. He agrees to come in the next week, as long as it doesn't take too long because he has work.    Mr. Tooley looks equally exhausted the next week as he appears in your office doorway.    “I'm so glad you could come in today. I wanted to talk to you about some of the changes the teachers have noticed in Jacob's behavior,” you begin.    Mr. Tooley explains that life has been very hard since his wife died. You inquire about what this has meant for him and his family.    “Because of all the bills that have piled up, I started working a second job. Jacob's 15-year-old brother, Brandon, has been looking after Jacob most of the time. It's just how it has to be for right now.”    You mention that Jacob seems to think that toys are for babies, which confused you for a child his age. Mr. Tooley shifts in his seat uncomfortably and clears his throat. After a moment, he tells you that the other issue with all the debt is they could not afford rent and were evicted from their home.    “Jacob has been sad for a while. I get that—he's a kid who lost his mom. What I don't understand are these angry outbursts. They're about the most minor things. I took Jacob for his physical in the fall, and asked the doctor about him acting up. The doctor said he could not find any sort of problem that would explain Jacob's outbursts. He just told me to be patient. I didn't know it was getting so bad at school. Working two jobs, I have a hard time keeping up.”    You ask Mr. Tooley to tell you a little more about his son's behavior at home.    He shares that Brandon complains constantly about having to care for Jacob, and that it has only gotten worse.    “He'll start screaming if I don't make his breakfast just the way his mom did, for example,” Mr. Tooley explains. You ask how Brandon handles caring for Jacob, and Mr. Tooley shakes his head.    “Brandon has struggled ever since his mom died. He's pretty hard on Jacob, but then again Jacob is so difficult. I wouldn't leave Jacob with him if I had any options. I just can't afford any of these after school programs.”    After hearing about all of Mr. Tooley's experiences, you tell him, “It sounds like you care about your children very much and are doing what you can to provide for them. Because Jacob seems to be in a difficult spot right now, I want to make sure I support you in getting him what he needs. Do you think that you'd be interested in taking him to a place that can give him weekly counseling to help resolve some of these complications from losing his mother?”    Mr. Tooley nods his head. “I didn't even know there were places for kids to get special help like that. I think I'd almost given up because life is just so impossible this last year. I'm worried about the costs and my work schedule, but I'll do whatever I can to get him there.”    You assure that the Children's Guidance Center has a sliding scale. He wonders how referrals like this work. “If you give me permission and sign this form, I can contact a social worker at the Child's Guidance Center and give her your name.”

Answer 1

Jacob is going through situational depression.

Reasons:

1. This pattern of behaviour started after his mother's death which is a traumatic event and Avery big change in his life.

2. Another stressful factor that lead to this behaviour was him and family getting evicted due to lock of funds. For a child all of 10 years, these two events are enough to elicit the response of a depressed mood.

3. There is evidence that his brother is also projecting his anger which stems through his sadness over losing his mother on Jacob. The child cannot understand the reason of the same and since both of them are spending time together (as father has to work two jobs) it is becoming increasingly ddifficult for Jacob to get a ray of anything positive.

4. Because of all of this at home, he is acting out in school and depreciating in his performance which is getting him a negrive feedback at school as well.