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Read the following case of Mike. The assignment questions follow the case information.
Mike grew up in a small town where he lived with his two adoptive parents, who were both women. His moms had decided to adopt in order to be “equal parents” by neither of them having more of a biological connection to the child than the other. Mikey was adopted at 18 months of age, and no information about his birth or early development is known other than he was premature.
While growing up, Mike enjoyed playing with the neighborhood kids. He became tall for his age and he became known as Big Mike, which he really liked. By age 11 he began to take advantage of his size to fight and bully the other neighborhood children. When his mothers found out about his behavior from the other neighborhood parents and confronted Mike on it, he did not seem to feel guilty about having injured other children. He would also lie to his moms by saying that he had hurt the other children because they had made fun of his moms for being lesbians. His mothers, who had endured a great deal of discrimination during their lives due to their sexual orientation, were reluctant to punish him given his stated reason for his behavior.
Mike was an average student in school. He would typically do as little work as possible in order to pass to the next grade. While he did not generally have academic problems, at times he had behavioral problems. Once in the fifth grade at age 11 he stole money from a teacher’s purse during recess. During lunchtime at school in the sixth grade at age 12, Mike would initiate gambling games in the bathroom where he used fake dice to win and take money from other boys. He explained his incredible luck by saying, “Never gamble with the son of a gambler,” even though neither of his mothers gambled. He was eventually caught and suspended from school for a week.
In the seventh grade at age 13 Mike would often leave school shortly after entering the building in the morning and go to the house of a friend who also skipped school. During one such time, Mike and his friend decided to consume large quantities of the alcohol of his friend’s parents. When his friend’s mom came home from work early and saw the two of them drunk, Mike told her that his parents would beat him if they found out, even though his mothers did not use corporal punishment. Stricter monitoring of Mike’s attendance at school had some impact but did not curtail his truancy entirely. Other times when Mike was at school he received one or two day suspensions for behavioral issues such as carrying a knife or for stealing other kids lunch money. Any time a behavioral incident happened in school, Mike would account for it as stemming from other children not liking him due to his mothers’ sexual orientation.
For the eighth grade at age 14 Mike was transferred to a specialized school for children with behavioral difficulties. Nonetheless, one day Mike got into a fight with another student in the locker room during which he impaled his stomach and rectum with a large pocket knife. The other student suffered long-term damage to his liver and bowel functions. Mike was charged with assault with a deadly weapon and sent to a juvenile detention facility as a result. At his court appearance he chuckled to himself when he learned that his victim had to permanently use a colostomy bag.
By this time Mike’s mothers had three younger foster children living in the home with them and were told by Child Protective Services that the other children might need to be removed if Mike was returned home to live with them. So they were actually relieved when Mike was sent to the juvenile detention facility.
Use the DSM-5 and information from the case to respond to the following questions for this written assignment.
- Formulate a diagnostic impression for Mike with coding and specifiers from the DSM-5, making sure to clarify if his condition is mild, moderate, or severe. Explain your answer in terms of how he meets diagnostic criteria.
- What are one or two differential diagnoses that you considered for Mike and what helped you to rule them out?
- What treatment interventions would be most appropriate for Mike in the juvenile detention facility? Include in your answer the specific role of a mental health therapist on his treatment team.
- What adult disorder is Mike at risk of acquiring if he does not receive adequate support and intervention as an adolescent?
- If you were a therapist in this case, what therapeutic modality would you use to treat their disorder, psychodynamic, cognitive, behavioral, cognitive-behavioral, systems, person-centered? Use 1-2 scholarly sources to support your answer. If you have not taken a theories course, choose one theory from the above list and summary the articles.
- Using 1-2 scholarly sources, how might Mike’s treatment providers and the criminal justice system respond differently to him if he is a person of color rather than if he is European American/White?
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