Conceptualizing A Case Makala

Running head: CONCEPTUALIZING A CASE 1

Conceptualizing a Case: Makala

Student

University

CONCEPTUALIZING A CASE 2

Conceptualizing a Case: Makala

Case description

Identification of the Problem: Makala is a 15-year-old African American girl in ninth

grade. She attends Euclid Heights High School. She was referred to our agency by her math

teacher and family physician for skipping school and excessive weight loss.

Individual and Background Information

Academic: Makala is friendly and outgoing, and is the president of the student council at her

high school. Her active role in the school is visible in her participation in the student council. She

has skipped school recently.

Family and Culture: Makala has four sisters and a brother. She is the youngest of her siblings.

She lives with her aunt following her grandmother’s death six months ago. Makala’s mother is in

a rehabilitation institution and her father lives in another state. Makala’s brother attends college

far away. Her other siblings are much older and live with their own families. She is a Christian

and has made many friends from her church. Christianity, therefore, has a significant bearing on

her life.

Physical: Medical records show that Makala was a plus-size girl, weighing 201 three months

ago. She now weighs 142 pounds. She has started working out more intensively recently, leading

her trainer to notice the unusual change.

Social: Makala has many friends at her school and church. She has an outgoing personality and

enjoys singing and dancing. Her wide social network indicates her willingness to share her life

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experiences with others. She has, however, skipped school and student council meetings

recently. This recent behavior is a notable change from her past.

Analysis

Developmental Analysis

Developmentally, Makala’s progress is mixed. The environment around her is playing a

role in her cognitive development. At her age, according to Piaget’s theory of cognitive

development, Makala is at the formal operational stage (Ribaupierre, 2001). This stage is the

final stage in cognitive development as per Piaget’s theory and is shaped by experience and the

environment. An individual’s development at this stage involves accumulating knowledge which

is constantly informing and drawing upon their experiences and surrounding. Makala is

conscious of the role of her surrounding on her own life. Her decisions draw upon complex

interrelated issues affecting her school, family, and personality. This observation points to

rationality in her thinking, a phenomenon that is a central element of the formal operational stage

in Piaget’s theory. She has grown uncomfortable with her plus-size weight as seen in her desire

to lose excessive weight. Moreover, her increased level of intensity and frequency as regards

physical exercise resonates with her recent excessive weight loss.

Cultural Analysis

Makala’s African American and American identity at large suggest some unique

experiences underpinning her life. Her active lifestyle as indicated by her role in the student

council and her work out routine suggests her desire to stay fit. This objective is particularly

common in the United States amid concerns over high levels of obesity in the country.

According to Wang, Beydoun, Liang, Caballero, and Kumanyik, (2008), obesity in the US has

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raised alarm across various domains of the society, driving many Americans to adjust their

lifestyles in attempts to address this burden. Such adjustments often place unnecessary burdens

on people’s lives as they strive to obtain unrealistic targets. Makala’s role as leader of the student

council is reminiscent of the spirit of the wider American society grounded in individualism.

Williams (2006) noted that in individualistic societies like America, people tend to put loyalty to

themselves first (p. 183). This attribute is visible in Makala’s recent behavior involving skipping

school and leadership meetings. Her culture is also defined by her church activities. She has

many friends in church, pointing to her active involvement in religious gatherings. Her

involvement in the church also indicates that she is a Christian. Makala seems to have also

deviated from her Christian values as her deviant behavior involves disregarding her

responsibilities and the expectations of her community and the society.

Assessment of Stressors and Supports

The main stressors for Makala arise from her family, community, as well as the American

culture and society. Her father lives in another state, reducing the likelihood that he performs his

parental responsibilities effectively. She is also detached from her siblings and has recently faced

her grandmother’s death. The leadership responsibility implies that she is expected to be a role

model for others in her school and the wider community. Her plus-size appearance is also a

stressor keeping in mind the portrayals of the desired appearance in the American society.

According to Voelker, Reel, and Greenleaf (2015), one’s weight status ad media portrayals of the

supposed ideal image represents a major stress factor in adolescents. This observation is

consistent with the descriptions defining her stage in Piaget’s model. She is at a point where she

operationalizes the knowledge acquired from her environment and life experiences, including the

media and society.

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There are also several supports in Makala’s life. Her aunt is currently her guardian and

gives her both material and other support. Her school is also another important support for the

student as she has been elevated to a leadership position. The fact that the school has not

removed her from this position despite her recent behavior indicates the confidence the school

community has in Makala. Her teacher and physical trainer are also life supports as they are keen

to help her keep her development on the right track. Despite the support offered to Makala, she

misses out on important interventions such as counseling that specifically aim to address her

recent behavior. As a Christian, the church serves as an important support factor in Makala’s life.

According to Battey (2009), spirituality is important for the overall well-being of an individual.

The church represents an important dimension for Makala’s spiritual development, boosting her

development. It is, therefore, important to establish whether she has been skipping church

recently as has been the case for school. This information would help towards developing a

comprehensive treatment for Makala.

Legal and Ethical Issues

One of the key legal issues surrounding Makala’s case is the absence of her father amid

her change in behavior. Her father has the legal obligation to perform his parental obligations.

He has instead left Makala’s aunt to perform all the parental duties, raising the ethical issue of

whether his actions are in conformity with the expectations of the American society. Although

the health information about Makala was obtained in accordance with the legal requirements of

the HIPAA Privacy Rule code, the important ethical question of whether Makala should have

been involved in the process remains unsolved (English & Ford, 2004). Another ethical issue is

whether the school has been fair to Makala by failing to offer her more support in the form of

counseling. Recent events, including the death of her grandmother, suggest that the girl is

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undergoing a troubled period and needs personal attention. Makala’s aunt also seems to ignore

the emotional needs of her niece as it is the teachers who reported the change in behavior.

Careful consideration should be given to the possibility that both Makala’s father and aunt are

negligence as regards taking good care of the adolescent girl.

Treatment Plan

Problem Identification

Makala, a 15-year-old African American high school student is experiencing a behavioral

disorder that has seen her behavior change drastically to the alarm of those around her.

Problem Definition

Makala is an adolescent minor currently living with her aunt while her father lives in

another state. Her weight is a source of concern for her and has seen her undertake physical

exercise with unusual intensity and frequency. Her breakdown in behavior has also undermined

her education and social life as she skips school and student council meetings.

Goal Development

To develop an intervention that restores good behavior in Makala

Measurable Outcomes

- Makala will attend all her classes

- Makala will attend all her student council meetings

- She will normalize her intense workout regime

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- She will learn life skills and gain coping skills, motivation, and a positive view of life that

does not focus on achieving unrealistic physical appearances often depicted in the

American media

- She will become confident in her appearance

Creating Interventions

- Makala will attend one therapy session per week

- She will attend one family therapy session every fortnight.

Diagnosing

The therapist will monitor progress and receive reports from Makala’s teacher, fitness

trainer, and aunt.

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References

English, A., & Ford, C. (2004). The HIPAA Privacy Rule and Adolescents: Legal Questions and

Clinical Challenges. PERSPECTIVES ON SEXUAL AND REPRODUCTIVE HEALTH,

36(2), 80 - 86.

Ribaupierre, A. (2001). Piaget's Theory of Child Development. International Encyclopedia of the

Social & Behavioral Sciences, 2001, 11434–11437.

Voelker, D. K., Reel, J., & Greenleaf, C. (2015). Weight status and body image perceptions in

adolescents: current perspectives. Adolesc Health Medicine and Therapeutics, 2015(6),

149–158.

Wang, Y., Beydoun, M. A., Liang, L., Caballero, B., & Kumanyika, S. K. (2008). Will All

Americans Become Overweight or Obese? Estimating the Progression and Cost of the US

Obesity Epidemic. Obesity 16(10), 2323-2330.

Williams, C. (2006). Effective Management. New York: Thomson/South-Western.

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