Sarah evidenced social skill deficits as well as problems in self-soothing and emotional regulation. Work on social skills in therapy included role plays to develop skills in conversation, listening, emotional expression and friendship-making. Sarah also practised these skills in therapy through the use of structured games to learn rules, frustration tolerance and turn taking. During the course of therapy, Sarah's mother was advised to enrol Sarah in preschool, camps and dance classes to provide further practice in and exposure to social relationships.
Problems in self-soothing were approached by providing Sarah with a ‘toolkit’ to assist her in utilising tactile means of soothing and reducing stress. This included fabric pieces of different texture, koosh and stress balls. These were placed in a small bag that Sarah could take with her. She was encouraged to use these both in session and during the week when feeling frustrated and having difficulties regulating her behaviour.