1. Case of Anxiety Disorder
Sinem Batum

2. Complaining Reject going to school
Somatic symptoms like crying, vomiting
Reject being alone
Does not want to be separated from caregivers

3. Demographic
Information is obtained from parents and teacher
Lives with parents
Mother is 45 and father is 48 years old
Mother has a high school and father has a college degree
Goes to a private school

4. History of the present problem
Problem came out this year both at home and school
’99 earthquake as stress factor
Somatic symptoms hinder daily functioning and relationships with peers

5. Social and Developmental History of the Case Relationships with Parents
Parents’ desire to have a child for a long time (pregnancy period)
Sleep with parents until ’99 earthquake
Not differentiating parental roles
Close family ties and dinners every weekend
Physical and behavioral similarities with mother

6. School and Peer context
Ambitious teacher and exam anxiety
Successful as a student but high expectations and pressure
Doesn’t like teacher, afraid of her shouting
Doesn’t have many friends, only two friends
Complaints about school

7. Medical History of Case and Parents
Mother cannot go out alone
According to school advisor’s report mother takes drugs because of anxiety problems
No medical problems of the child

8. Assessment Methods Draw a Child
Louisa Duss Psychoanalytic Stories Test
Play with Toy House
Kinetic Family Drawing
CAT

9. Developmental Perspective
Equifinality
Biological and psychosocial factors
Environment (school, peer context, neighborhood)
Parenting
Temperament
Results as anxiety disorder especially separation anxiety and school refusal

10. Facts to be considered Demanding teacher, exam anxiety and pressure
Parents’ overprotection: cannot perform age appropriate social skills
Peer context: not so many friends around
Problem about self-efficacy belief
Mother’s anxiety problems
Guilt induction
Parents as a role model
Cannot form intimate relationships with others

11. Literature and Theories
Transactional model
Parenting as control : behavioral and psychological control
overprotection, guilt induction: poor self-worth
Emotional bonds & parent-child attachment
Tripartiate model: cognitive representational models, level of monitoring, affect management skills
Temperament : emotional fit hypothesis, interaction between socialization and temperament, experiential canalization, goodness of fit
Peer context: only vertical relationships, withdrawn
Modeling

12. Recommendations & Approach
Try to form self-efficacy belief
Social and emotional role model
Try to differentiate role models
Suggestion of family therapist
Behavioral or cognitive-behavioral approach?