Case Studies

I. Child Therapy: An Angry Boy Finds His Way

Situation:
Sam was eight years old when he was referred for help with his anger at home and his poor grades and bullying behavior at school. Sam's parents were divorced and not on good terms, and his mother had recently become involved in a serious new relationship. Sam was obstinate with both of his parents and had refused to talk with his previous therapist.

Intervention:
After a brief assessment of Sam and meetings with his parents, he began to attend weekly therapy sessions with Dr. Donahue, against his will at first. Despite their differences, Sam's mother and father agreed to commit to therapy and to make an attempt to reduce the intensity of their conflict in front of their kids. They took turns bringing Sam in for his weekly meetings.

Outcome:
Although initially brash and defiant, Sam quickly revealed another side of himself. He could be quite a friendly and respectful boy, and he spoke about wanting to restore his reputation with his teachers and to make amends with his friends. He also wanted more flexibility and consistency from his mother and father. After some positive negotiations between Sam and Dr. Donahue and his mother over bed time and his television privileges, Sam became more willing to compromise and less angry with his parents. As the next school year began Sam settled into a more comfortable routine and began to feel like a successful and capable student, and a more thoughtful and caring friend and son.

II. Worried Parents Learn to Do Less

Situation:
Anne, a medical professional, came in worried about her 6 year old daughter Sarah, who had recently been displaying signs of anxiety- biting her nails, twisting her hair, and weeping when she made mistakes. Anne told Dr. Donahue she was exasperated and could not understand why Sarah did not work to her full potential in school. In addition to her first grade work and religious school instruction, Sarah's weekly schedule included swimming, ballet, gymnastics and skating classes.

Intervention:
Anne came in for a series of parenting consultations with Dr. Donahue, sometimes alone and at others with her husband Ted. Although they were initially reluctant to scale back their daughter's commitments, they agreed to cut back to two activities per week, a change Sarah readily welcomed. At Dr. Donahue's suggestion, they also began to incorporate more alone time for Sarah, where she could play or think or read on her own. Anne and Ted also worked at helping Sarah feel a sense of pride in her work, and begin to praise her when she genuinely displayed effort and worked hard at a task.

Outcome:
With more downtime and a less hectic schedule, Sarah reported feeling less stress, and her anxiety symptoms gradually diminished. Although it was a difficult transition for Anne, she learned to pull back a little from her daughter and allowed Sarah to discover her own interests and work on the things she enjoyed. Anne observed that Sarah was gaining confidence, and she focused on helping Sarah recognize her accomplishments and to be more accepting when her work was less than perfect. Anne also discovered that focusing less intently on Sarah meant more time for her own interests, including cooking and reading, which she could in turn share with her daughter.

III. Executive Coaching: A Working Mother Excels in Both Roles

Situation:
Rachel worked for a large financial firm with offices in New York City, and was also developing a separate business venture that required much of her attention when she was at home. She sought a consultation to help her prioritize her goals and to manage her time effectively as she plotted her next career move. An extremely confident businesswoman, Rachel felt overwhelmed at managing the demands of her home life, particularly her six year old daughter Emma's moodiness and aggressive outbursts. Rachel was looking for strategies to calm her and to learn more effective ways of getting Emma and her younger brother to cooperate with her and her husband.

Intervention:
During an initial consultation with Dr. Donahue, Rachel was able to articulate her dilemma at home, and her wish for a more satisfying career that allowed for more control and more time with her children. In subsequent bi-weekly meetings, she was able to construct a time line for the next three years, during which she would maintain her current position and work part-time on her new venture, with the hope of transitioning to the latter full time when her children were both in elementary school. Dr. Donahue helped her establish effective routines at home and institute a behavioral system with Emma and her brother. He also helped Rachel to separate out work and family time at home, so that she could be more dedicated to and mindful of each of these pursuits.

Outcome:
After three to four months, Rachel reported that things had improved significantly at home. Both of her children were much more responsive to her rules, and Emma in particular was responding well to the behavioral system she and her husband had put in place. Rachel had learned how to more effectively divvy up her time, and how to be on task with both her work and her children. She was also more confident that her side business venture would become sustainable, and that she could leave her current position within the next year or two. Although still a tireless worker, Rachel was a little less hard on herself, and had adopted a longer term perspective that allowed her to tolerate some of the upsets and chaos of being a working mother with two young children.

IV. Workshops: Re-Energizing Parents in a Suburban School District

Situation:
The school board and administration of a small suburban school district were concerned that the academic and social pressures on both students and parents had increased to alarming levels in recent years, and that the reported stress levels of families had soared. Rather than schedule one-time speakers for parents, they contracted with Dr. Donahue to develop a comprehensive program of parenting workshops and support. The goal was to forge a more cohesive partnership with parents that supported healthy decision making at home and in school by students in the middle and high school.

Intervention:
Dr. Donahue developed a curriculum for parents with the following objectives:

  • To help parents create a climate that facilitates their children's independence and healthy decision making.
  • For parents to feel more comfortable with their authority at home and to be effective negotiators with their teens.
  • For students and parents to gain a mutual understanding and respect for each other's positions on wedge issues such as privacy, independence, social networking and risk-taking.
  • For parents to have a support network in the community to share their concerns and to develop benchmarks for acceptable behavior and reasonable limits for their children.
Workshop topics included Negotiating Responsibilities and Privileges, Encouraging Independence and Decision Making, Managing Technology and Media; Developing Healthy Social Relationships; Creating Realistic Parental Expectations and Reducing Stress at Home; Fostering Compassion, Competence and Resilience.

Outcome:
The series of workshops delivered proved to be lively forums for exchange of ideas and opinions between parents, school administrators and Dr. Donahue. A core group of parents emerged who were committed to challenging some of the local parenting norms, and re-capturing some of their authority and control over many aspects of their children's lives. They debated and sought solutions to a number of dilemmas facing their children, including outsized social pressures, the omnipresence of technology, unrelenting academic expectations and the rampant consumption of alcohol by teens in the community. Parents felt relieved and re-energized to see that many of their neighbors were struggling with the same issues, and the school administrators were particularly pleased that a large group of fathers were active participants in the discussions.

V. Child Development Consulting: A Nursery School Expands its Mission

Situation:
As it expanded, a large, suburban New York nursery school found itself facing an increasing array of child and family situations that were taxing the resources of its teachers and staff. More children were in need of language therapy, learning support and behavioral interventions. Parents valued the school as a welcoming community, and were apt to come to the director and teachers when struggling with separation or divorce, an illness or death in the family, or concerns with their older children. The recent terrorist attacks in New York City, damaging storms in the local community and the threat of an economic downturn had markedly increased the overall level of anxiety in the school.

Intervention:
After a series of meetings with the director, Dr. Donahue was contracted to spend several hours a week at the school throughout the year working with parents, children and staff. He held individual and group meeting with teachers and scheduled extended observations in each of the classrooms. He also set aside time each week to meet with parents individually and in groups. Dr. Donahue was available for ongoing consultation with teachers and team members around specific children they were concerned about. He also worked to include parents in classroom planning and behavioral interventions, at home and in school. When crises arose at the school, Dr Donahue was available for consultation, in person and by telephone.

Outcome:
Within the first year of working together, Dr. Donahue had become an established member of the school community. Parents were grateful to know they could consult with him on their concerns about their children and families and come away practical solutions, without incurring expense or inconvenience, or feeling any stigma about seeking psychological help. Likewise teachers began to value his input, and gained a new level of confidence when dealing with students with challenging behaviors or emotional struggles. Staff members were heartened to find they could speak with Dr. Donahue about personal issues, knowing they could do so in confidence during the school day. These sessions helped them manage their stress and reaffirm their commitment and loyalty to the school. The director of the school also valued her time with Dr. Donahue, and they forged a solid working relationship aimed at promoting their mutual goals: fostering the educational and psychological growth of the children, and promoting resilience and harmony in their families.