I Don't Want to Be a Handicapped Child: The Case of Marie


Marie was eleven and in sixth grade at the time of the first collaborative team intervention session. She had been underachieving, distractible, and a general pest for all of her elementary school career. Complaints about Marie went all the way back to her private preschool teacher. The sixth-grade teacher was regarded as an excellent motivator and had tried everything she knew to motivate Marie. In addition, she had called and met with Marie's parents on several occasions and had consulted with the school psychologist on the management of Marie.

Marie had one older sister, thirteen years old and in eighth grade, who was reported to be achieving and behaving appropriately. Marie's parents were both middleclass and high-achieving. They had been separated for one year, and were still actively in conflict over parenting and other issues. The consultant had heard through the grapevine prior to the first session that the father had questioned one of the town's school administrators about the advisability of participating in the collaboration program. The father had, in addition, called several acquaintances in an attempt to get more information about it. As is often the case with parents of problem children, there was substantial resistance to facing the problem, and months passed before the parents agreed to the meeting. The first session was held in the last quarter of the school year.

Assessment And Intervention

The first collaborative session was attended by the whole family, that is, the parents and their two children, and by the school psychologist, the sixth-grade teacher, the school principal, and the ecosystems consultant. The session began with the usual recounting by all present of the history of the problem and of individual perceptions and judgments regarding its cause and solution. The parents reported advice from various professionals and others attributing Marie's problems to laziness, hyperactivity, being "young for her age," and other causes. During this stage the disagreements among the session participants began to emerge. From the beginning of the session, the mother and father were observed to relate differently to Marie. Though they sat on either side of Marie in the circle, the father sat close to Marie and appeared to be protective of her, intercepting and interpreting remarks about her or to her. His arm was on the back of her chair. In response to direct questions, Marie talked in a somewhat disorganized fashion, in a voice like that of a child of perhaps five. She talked nervously and alternated between smiling and looking confused.

Sensing the familiar disagreements between parents about parenting and the overprotectiveness of the father, the consultant chose to attack the problem by provoking Marie. He asked her what she thought about the situation and how capable she thought she was. She replied that she thought she could do better, but that she was lazy and that the work was becoming more difficult. The consultant noted that she had been having problems since preschool. He asked her if she realized she was becoming a "handicapped" child and if she wanted to continue on the "road to being handicapped." At this point, the father angrily intervened and accused the consultant of cruel and unprofessional conduct. He increased his closeness to his daughter and she began to cry. The level of tension was great, and the father began to get up to leave. The consultant asked the father how frustrated he was with the problem and how much he wanted to solve it. The father agreed that things were serious and began to sit back down.

After everyone calmed down a bit, the consultant proceeded to give his analysis of the situation. He said he thought that Marie's problem was motivational, and that it was inadvertently, but primarily, caused by the parents' disagreements and the father's protectiveness of Marie against the expectations of the "cruel" school. He said the mother's and father's attitudes no doubt came from their upbringing and perhaps other factors. He said that the answer to the problem was for the parents to ask Marie to "shape up" and do her work, and to provide negative consequences, like time on the bed, if she didn't. He asked Marie whether she thought his ideas were fair. Marie said she agreed with the consultant and that his recommendations were fair.

After some additional processing, the consultant suggested a one- or two-week experiment during which Marie would take home a daily report card containing grades on specific behaviors expected of her in school, for example, paying attention and handing in homework. The grades were to result in home consequences, either positive (free time) or negative (time on the bed). Each of five grades was to have a one-hour consequence at home. All parties were advised to keep in touch with one another and to "sound the alarm" if the agreement was breaking down for any reason-for example, if the father was getting scared and was neglecting to impose consequences. Everyone agreed to the experiment, and a follow-up meeting was scheduled two weeks hence.


The results of the one-session collaborative intervention with Marie were dramatic. Because Marie was upset at the meeting, her parents took her home from school after the meeting. On the way home, Marie told her parents that she didn't want to be "handicapped" anymore. The next day in school, the teacher observed her to be what he called "completely different." The teacher characterized her behavior as "a 180-degree turnaround." She was polite, age-appropriate, and productive. She was, in all respects, "a completely different child."

At the second, and last, collaboration meeting, the teacher reported the excellent results to the assembled group. The participants were the same. The "news" was not news to anyone except the consultant because everyone had been communicating with each other. The parents were delighted and reported significant changes in home behavior as well. Marie was more polite at home, more compliant, more cooperative with her siblings, and was even initiating work around the house. Marie's teacher asked Marie to explain her "turnaround," and she was extremely articulate. In the session as well, she was a completely different person. The change was truly inspiring. It was agreed by all that this would be our last session, but that we would keep in touch and reassemble if things began to deteriorate.


Marie's underachievement, behavior problems, and general immaturity had been caused and maintained by her father's overprotectiveness and the marital problem. Shifting the diagnosis from intrapsychic causes, like hyperactivity, to interactional causes was crucial to the solution of the problem. The school-based ecosystemic collaborative format increased the clarity and intensity of the school personnel's feedback to the family and the likelihood that the parents would listen and act on the information. The ecosystems consultant provided-the expertise in interactional diagnosis and the courage and skill to confront issues in a manner that was direct and forceful, though respectful. In two sessions of work, approximately four hours in duration, the consultant was able, with help from all collaborators involved, to lead the way in restructuring a situation into more positive and functional sequences and interactions. An additional benefit of the session was teacher training. As a result of one session of collaboration, Marie's teacher spontaneously took charge of conducting session two as if she were a veteran systems therapist. This she did well and with no formal training. A middle school follow-up with Marie and her family the following year revealed that Marie was still doing well.

Reprinted with permission from "School-Based Collaboration With Families" by Dr. J.B. O'Callaghan, 1993, Jossey-Bass Publishers.

More case studies:

Greg | Melanie | Jared | Samantha | Jeremy | Marie | Linda | Michael | Jonathan

For appointments and scheduled consultations, please contact Dr. J. Brien O'Callaghan at DRBRIEN@JBOCALLAGHAN.com or write to him at J. Brien O'Callaghan, Ph.D., 246 Federal Road, C-32, Brookfield, CT 06804