Sarah Cisneros is a 7-year-old Hispanic female whohas just started the second grade at Hutto Elemen-tary School. She is a friendly and engaging child, although she has had numerous problems at school.Last year, the teacher reported that Sarah had dif-culty following directions and staying in her seatand talked incessantly. She often got into disagree-ments with other children on the playground whenshe couldn't seem to follow the rules of a gamethey were playing. Her teacher also stated that shehad difculty learning the alphabet and writingletters and numbers. Sarah often reversed words, saying "tac" instead of "cat" and "kool" insteadof "look." Although she had a difcult time in rstgrade, her teacher felt that Sarah was just an activechild who would "settle down" when she enteredsecond grade.At the beginning of second grade, Sarah's par-ents separated. Sarah stayed with her mother,Regina, age 27. Regina moved back to Sarah'sgrandmother's home and went to work as an ad-ministrative assistant at a law rm in town. Sarah'sfather, Don, age 32, moved in with a girlfriend hehad been seeing for several months prior to theseparation. Don travels extensively in his job as aninternational computer sales representative. He isoften out of the country for 3-4 weeks at a time.Sarah told her grandmother, "My heart won't hurtanymore when my daddy comes back to live withme." Regina and Don have told Sarah that they arejust living in separate places for a little while.When Regina discovered that Don was seeinganother woman, she became very angry and de-pressed. She began working overtime, sometimes 12hours a day, as a way of coping with the upheavalin her marriage. Sarah often sees her mother onlyearly in the morning when Sarah is getting ready for school. Sarah's grandmother takes care of herafter school. She complains to Regina that Sarahis "headstrong" and "can't seem to follow direc-tions." She also tells Regina that if Sarah weregiven a good spanking she would "straighten up."Regina just doesn't feel she has the energy to dealwith Sarah's behavior and told her mother, "I justcan't deal with everything, Mom. You need to helpme with the discipline. I can't be mother and father,hold down a job, and deal with Don. It's just toomuch for me right now."Regina's mother told Sarah that if she didn't fol-low directions, she would get a spanking. Sarahscreamed, "If my Daddy was here, he'd give you aspanking," and ran to her room, slamming the door.Regina decided to enroll Sarah in Brownie Scoutsfor one afternoon a week after school. The BrownieScout leader is a friend of Regina's who lives downthe street and said she'd bring Sarah home after theScout meeting. Although Sarah was very excitedabout being a Brownie, she had difculty gettingalong with the other girls. She couldn't sit quietlyand work on projects; she often interrupted theleader with silly outbursts; she got bored easily andbegan running around the room; and she disruptedthe meetings with her constant chatter.After several weeks, the Brownie leader called Regina and told her that perhaps Sarah needs an-other year before she's mature enough to be inBrownie Scouts. Regina was so frustrated thatwhen she got home from work, she screamed atSarah, gave her a spanking, and sent her to herroom. Sarah slammed her door and began throw-ing all her toys off the shelves. She screamed for 2 hours until she was so exhausted that she laydown on the oor and went to sleep.After this incident, Regina, feeling very guilty,sought the advice of the counselor at school. Thecounselor suggested that Sarah may need an out-let for all her energysomething that involvesphysical activity. Regina decided to enroll Sarahin a ballet class on Saturday mornings at the local dance company. Once again, Sarah wasvery excited about being in the ballet class. Shewent shopping with Regina and bought a pink leotard with matching ballet slippers. Sarah dancedaround the house all day in her leotard in anticipa-tion of the class. CengageUnfortunately, when Sarah began the dance les-sons, the ballet teacher had the same complaintsthe Brownie leader had about Sarah's inability tofollow directions and pay attention in the class.Regina felt at her wit's end about what to do next.She called Don and told him the problems she hasbeen having with Sarah, and he told her, "You justlet her get away with murder. When I was that ageand I didn't obey my parents, I got a whipping andit never happened again. I'll take her for a weekendand teach her a lesson or two."Regina angrily told him, "Don't bother," andhung up the phone.Late one night shortly after this altercation withher husband, Regina was sitting by herself in theliving room of the dark house watching the newson television. During a public announcement com-mercial for a Fun Run, she noticed that one of thesponsors was the Family Mental Health Center, aprivate nonprot organization. Regina wrote downthe phone number, and the next day at work, shemade an appointment to go talk to a counselorabout Sarah. The intake worker told Regina thatthe counselor would like to talk to Regina at therst appointment before she brought Sarah to theagency.Initial Interview with ReginaThe counselor introduces herself as Peggy Ross, aclinical social work practitioner who works withchildren and families. Peggy tells Regina about theagency and what her role as a counselor is. Reginatells Peggy about the problems she has been havingwith Sarah since her separation from her husband.She states that she just can't do anything with Sarahanymore and she just doesn't know what to do.She states that it is difcult living with her mother;however, her mother does provide child care sothat Regina can work.Peggy asks Regina whether the behaviors thatSarah has been displaying are new behaviors orones that were present before the separation."Come to think of it," says Regina, "Sarah hashad trouble ever since she started school. Evenin kindergarten, she didn't seem to listen to theteacher. She's not a dumb child. In fact, I thinkshe's very smart, above average. But when it comesto completing her homework, she's a mess. Sheloses things she needs for assignments. She seemscompletely disorganized; she spreads all her stuffaround and then can't nd anything. She's alwaysexcited when she starts projects, but then it's likepulling teeth to get her to nish."Peggy asks Regina about her and Don's child-hood experiences. Although Regina doesn't knowwhy that's important, she tells Peggy that she hadno problems in school and, in fact, excelled in allher classes. "I was a classic good little girl. I knewif I wasn't, I'd get in big trouble at home," Reginatold the counselor.Peggy asked about Don's childhood experien-ces. Regina stated that Don's experience was verydifferent. He was constantly getting into troubleand was very active as a little boy. He once toldRegina that he was considered the "class clown"all through elementary school. Although he at-tempted a variety of sports, he was never very goodat anything except soccer. He said he could runlonger than most kids his age. He was a skinny,high-strung child. Regina tells the counselor thatDon recently told her that he got whipped all thetime for his bad behavior. She says that she doesn'treally think spanking helps Sarah. She relatesthe incident of the night she spanked Sarah outof frustration and the tantrum that Sarah threw afterward.After obtaining information about Regina, Don,and Sarah's present difculties, Peggy suggests thatRegina bring Sarah with her for the next interview.She states that she has some ideas about what isgoing on with Sarah but would like to talk withher before making any assessment. In the mean-time, she gives Regina a form to ll out on Sarah'sbehavior as she observes it over the next week. Shealso asks her to sign a form giving Peggy permis-sion to talk to Sarah's teacher at school. The fol-lowing week, Regina brings Sarah to the agency totalk with Peggy.Interview with SarahPeggy meets Sarah in the waiting room of theagency. She readily goes with Peggy to her ofce.Peggy gives Sarah a few choices of some things theycan do together while they talk, including drawing,puppets, and a board game. Sarah has a hard timedeciding what to do and after making a choice, shequickly grows bored with drawing a picture andwants to do something else.When Peggy suggests they can do something elseonce they have nished their pictures, Sarah getsirritable and keeps jumping up from the table andwandering around the room. She says that she haslots of friends at school. She likes recreation timethe best because she likes to jump rope. She alsotells Peggy that she doesn't like her teacher, whois always mean to her. When Peggy asks her whyshe is mean, Sarah states, "She makes me sit in mychair and do my letters over and over again. It'sboring."While Sarah is easy to engage, she talks con-stantly and has difculty focusing her attention onany one task. She wants to play with all the itemson Peggy's desk, and when Peggy says she can'tplay with those things, Sarah stomps her feet andsays, "If my daddy were here, he'd let me." Peggyfeels very tired after 30 minutes with Sarah.Peggy invites Don to come in for an interview,but Don states that he has to be out of town fora month and thinks that the problem is simply Regina's problem with lack of discipline withSarah. Peggy tells Don that she'll call him when hereturns from his trip.After talking to Sarah's teacher at school andthe school counselor, Peggy is ready to make aninitial assessment of Sarah. The teacher told Peggythat Sarah often makes careless mistakes, has dif-culty nishing her work, is two grade levels belowin math and often gets in trouble for irritating otherchildren. Peggy asks herself the following ques-tions. How would you answer them?

can i get a Case Conceptualization Explaining the issues, symptoms, and diagnosis of the case through the lens of a theoretical perspective please

and a diagnosis title and code