Jeremy occasionally attends youth group at your church. He is 15 years old, lives with his mother and two younger sisters, and sees his father infrequently. Jeremy’s mother is bringing him to counseling; he is not interested. He presents as apathetic though not unpleasant.
Jeremy’s mother reports that his behavior is ‘out of control,’ giving examples of him repeatedly coming home after curfew, talking disrespectfully to her, skipping school on several occasions, lying to her about whom he is with, and getting caught setting fire to garbage cans at a local park. His grades have dropped from honor roll to C’s and D’s this year.
The family moved to this town 2 years ago to be nearer to extended family. Jeremy’s father is reportedly an alcoholic and very unstable. Jeremy gets along fairly well with his sisters, mostly limiting interactions to games or watching TV together. He reports lately not feeling like ‘hanging out’ at home, wanting instead to be with friends. He does not feel closely connected to the youth group, though he does not mind attending “if nothing else’s going on.”
He sleeps a great deal when he is home in the afternoons and on weekends; never feeling rested, has a large appetite, and spends his free time with his friends. He denies drug use, but admits drinking beer on occasion.
Please respond (short answer is fine) to all of the following questions:
In your diagnosis, please use DSM IV-TR diagnoses when appropriate (found in your powerpoint presentations)
What are the client’s most prominent ‘presenting issues’ (that is, what seems to take priority as being wrong)?
What else do you feel you need to know (or, what might be some areas you may ask about in order to determine what is going on and how severe the problem may be)?
What do you think may be your ‘initial diagnosis’ based on the information given in the case study? Why?
What, if any, psychospiritual factors might be present and maintaining the presenting issue?
What are possible methods of treatment or referral?