What Do We Do With Jim Case Study

April 3, 2008 1. It is appropriate and helpful for Frieda to lend her classroom to be used as  a “time out” for other teachers to send their students because it allows the  kid’s one last chance before the Principal’s office to allow them to “cool  down” and rethink their actions and the consequences those actions would  and could bring. This is a better option rather than keeping the student  from attending school or punishing them. This will correct their behavior.  One of the procedures that is currently wrapped in controversy over the  discipline of students with assorted disabilities is the thought of  “developing positive, proactive behavior (and) intervention plans”. In the  case of Frieda, her classroom was used as an intervention to encourage  positive behavior in children rather than send them to the principals and  simply punish for negative, disruptive behavior. She would ask them to sit  quietly and think about why they had been sent to see her, and she would  often talk with them for a little bit about why they were there. She acted  very similar to a child’s guilty conscious after the fact. She understood that  at the point when those kids entered her class, they knew that they had 

Jim, a 33 year old male, had the classic symptoms for AD/HD (ADD, ADHD) such as difficulty sustaining focused attention, restlessness, trouble getting started on projects, and impulsivity. He also had significant anxiety, addictive behavior and mood issues. According to his REI intake form he described himself as:

laid back personality, good sense of humor, creative, spiritually inclined, can have a hot temper, high energy, symptoms of difficulty falling asleep, restlessness, and problems focusing when reading, distractible, impulsivity, difficulty starting tasks, difficulty stopping activities, procrastination and delay, addictive behavior, and overall anxiety.

Due to his symptom make-up, age and gender Jim's REI Custom Program consisted of 16 progressively-created REI Audio Tracks with each track scheduled to change every seven days.

In his first week on track one he found that he had a more stable energy and mood throughout week. He still had some anxiety and depressed negative thinking (due to circumstances and life changes). But he was less impulsive in his decisions and was able to refrain from addictive behavior (internet use and playing music loudly). He also found some improvement in focus, but still some difficulty focusing in meditation and schoolwork. He did not see any improvement in his ability to fall asleep.

Week two, on track two, Jim saw improved focus when reading, but still had some focusing problems when practicing meditation and contemplation. He found improved focus when writing. He was able to start assignments and work on them without frustration. He had fewer feelings of anxiety this week and found it easier to redirect himself and refrain from addictive behavior (internet and listening to music). Still, there was occasional difficulty falling asleep at night.

Week 3's track three provided less anxiety and better focus when reading and in meditation. Yet he struggled a bit with some impulsive decisions that drew him into addictive behavior. His sleep was still so-so.

Week 4 offered JIm some improvement in sleep. For a few nights this week he did not feel stuck in a tired state of being unable to fall asleep. He continued with better focus when reading. And had fewer addictive thoughts and actions compared to the previous week. He seemed to be less anxious overall, but noticed some anxiety over the weekend.

His negative Response: "Still some anxiety. Experienced some intense anger, frustration moods and thoughts with resentment and bitterness with highly charged emotions to the point of physical movement. Some depression as well. Still some impulsive, addictive behaviors - internet and loud music, but not as bad as last week."

As is common with the REI Custom Program, Jim seemed to really make headway in his symptomatic improvement in week 5.

Week 5 Jim continued the gains from last week. Not many addictive thoughts and he was able to redirect. By the end of the week, it was easier for him to refrain from impulsive, addictive behavior. He said it was "easier to redirect my mind". He had less anxiety overall but it was still present. He stated that "I realized this week that I have had long term anxiety problems in addition to ADHD (my father also has had anxiety problems). Intense feelings of frustration, anger and resentment earlier in the week, was significantly reduced by the end of this week." His focus when meditating and reading has improved, but he stated that there was still room for improvement. He also stated that he feels, "my mind has slowed down, with less racing thoughts and intense moods." He was able to fall asleep this week.

Week 6 he had an improved ability to fall asleep and was waking up at a good time. He also had better focus when reading and meditating.
His thoughts and feelings of resentment and anger did return this week, but not with as much intensity as the previous week. His feelings of anxiety were most often in the morning. He had some restlessness and frustrated moods and some difficulty concentrating. And he was more inclined to impulsive and addictive behavior this week.

Week 7 Jim had significant improvements in anxiety and mood. And he had no harsh feelings and thoughts of resentment. He found it much easier to get to sleep - no restlessness or rampant thinking when lying in bed to go to sleep. He also had a better overall and more stable mood throughout the day and week. (During this time he moved and registered for school, which resolved some problems.)
There were addictive thoughts this week, but not as frequent or intense as earlier weeks where it was a problem. Still had some restlessness and hyperactivity -- and listening to music with headphones at night and during the day when he wanted to be doing other things.

Week 8 Jim noticed he was better able to focus when reading. He also experienced far less fear based anxiety. He did find it harder to get to sleep at night this week, even though he had just listened to the audio. He also had a bit of regression for restlessness and frustration. This week also included a lot of time spent with addictive music listening (to relieve anxiety or restlessness?). This seemed to be triggered by a "difficult relationship incident" that he experienced at the beginning of this track. In spite of this incident he described having, "better moods upon realizing what I need to do and responding. But there was some negative imagination and frustration going on..."

Week 9 Jim saw continued improvement in focus and also noticed improvements in sleep. He also saw some changing moods this week: frustration with negative thoughts and charged feelings. He stated he is "Probably still experiencing anxiety."

In week 10 Jim reported, "Significant improvement in mood this week compared to before. Very little anger, frustration, and resentment. More stable mood and energy throughout week. Improved sleep and rest. No problems waking too early and getting back to sleep."

He still experienced some impulsive decisions into addictive behavior at night after work, still listening to music with headphones but with less frequency and duration.

Week 11 Jim reported, "Starting to see an overall consistency in all areas. Less anxiety, more solid sleep, more stable moods, better focus, and attention. Almost no feelings of anger, resentment, and frustration compared to a few weeks ago. Did not see any clear regression in any areas. Still having some problems with impulsivity towards addictive behavior (listening to music and internet activity). A couple of nights it was harder to fall asleep. Better focus when reading, but my mind will wander off. Focus could be better in meditation."

He also reported a drastic shift in routine: He moved out of state and enrolled in a graduate program, which brought about a resolution to a long difficult period of change.

Week 12 Jim wrote, "Less restlessness and anxiety. Saw less of an impact from consuming sugar in juice and cookies over holidays. Stable moods and energy. No frustration or angry moods. Felt more "centered" emotionally and mentally over the week, even though in new environments. More overall focus and calmness."

He did have some difficulty with attention when reading and some impulsivity. He still exhibited some impulsive behavior to addiction (listening to music w/ earphones and internet). And he saw some difficulty focusing in mediation/contemplation. During this time he traveled for the holidays.

Week 13 Jim reported, "No anxiety this week. Pretty stable moods for the most part. I have noticed better ability to learn and focus when reading. I can move through the text at a slower, more concentrated pace. However, my mind may still wander off. Some impulsive decisions towards addictive behavior. A few nights it was harder to fall asleep. No problems waking early and getting back to sleep. Some difficulty focusing in meditation/contemplation. Routine Change: No, but still adjusting to change and being at home where I grew up which has had an impact on mood and behavior."

Week 14 Jim wrote, "Really the first major test of my focusing abilities this week, being in a classroom and studying afterwards. Able to remain calm and focused during work and class. A very noticeable difference and change from earlier time periods doing school work. I do not recall any anxiety and my moods were quite stable overall. Generally more calm and centered."

From Jim's Week 15 notes: "Some improvements in impulsivity. No anxiety from what I recall. Overall much more centered and focused mind, stable moods and energy compared to the beginning of the program. Ability to fall asleep easily on nights when audio was not played too loud."

Throughout his entire Program, his daily feedback consistently states that his current track "calmed me down and helped me focus" while it played.

At the 15 week point Jim had progressed well enough that it was determined that he should use each track for a 4 week period to help with his long-term focusing and to solidify the changes he had achieved so far.

At this point he has had 2 further adjustments and is progressing along well with the improvements he has seen and is seeing progressively better long-term focusing effects.

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