Lydia's Transition Case Study

Lydia’s presenting problem is her reaction to her transition to fourth grade and her onset of puberty. When Lydia graduated to fourth grade, she began attending a new school. While this event is normally stressful, Lydia also had to cope with her body beginning to change. She began to develop breasts, which none of her friends had developed yet. This change amplified the stress she was feeling from being at a new school. Fifth graders noticed how developmentally different Lydia was from other fourth graders and began to bully her. Since Lydia was visibly Asian, the bullies targeted this quality when teasing her. Lydia became anxious about how she looked. This body image anxiety coupled with her school transition stress made her uncomfortable

and upset. Since she did not feel confident and comfortable, Lydia struggled approaching other children to make friends. As she watched other children make friends and play together, she began to feel worse about herself and worried her old friends would not like her or make fun of her because of how different she looked. Lydia’s hesitation to make new friends and worry about her old friendships amplify a negative self-image, and she withdraws from social activities. Since she is not having a positive experience with school or with her body’s growth, she continues to feel anxious about school and herself, which continues the vicious cycle of negative self-image and withdrawal.
When coming home from school, Lydia would say hello to Lisa, but then she would go and play alone in her room. When her neighborhood friends would come by to visit her, Lydia would tell Lisa that she wasn’t feeling well or had homework to work on, so she could avoid seeing them. At dinner time, Lydia would not offer to help Lisa cooking and would quietly eat her food. When Lisa would try to ask her about school, Lydia would vaguely answer before continuing to eat. By the end of dinner some nights, she would only have eaten half of her food but would eat full meals other nights. When Filipino women would have gatherings or birthday parties, Lydia would protest going but would eventually relent. At these events, Lydia would play by herself or sit quietly with Lisa.