Read The Following Case Of Mike's Assignment Questions

Read The Following Case Of Mike The Assignment Questions Follow the C

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?

Paper For Above instruction

Introduction

The case of Mike presents a complex profile characterized by behavioral, emotional, and developmental challenges. To address these issues comprehensively, a diagnostic formulation based on DSM-5 criteria is necessary, along with an exploration of suitable interventions and consideration of potential disparities in treatment responses across different racial groups. This paper will provide a detailed analysis of Mike's diagnosis, differential diagnoses, appropriate treatment interventions, and the influence of cultural factors in clinical and judicial responses.

Diagnostic Impression

Based on the information provided, Mike’s behaviors and developmental history suggest a diagnosis of Conduct Disorder (CD), Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5; American Psychiatric Association, 2013). Conduct Disorder is characterized by a repetitive and persistent pattern of behavior that violates societal norms and the rights of others. Key criteria relevant to Mike include aggression toward people and animals, destruction of property, deceitfulness or theft, and serious violations of rules.

Specifically, Mike’s history of bullying, physical aggression, theft, truancy, and assault with a deadly weapon aligns with the core features of Conduct Disorder. His lack of remorse for his actions, as evidenced by his chuckling at the injury he inflicted and his rationalizations, further supports this diagnosis. The severity can be classified as “moderate” or “severe” given the significant harm caused, such as impaling another student and the long-term injury inflicted.

The diagnosis would be coded as:

- 312.81 (F91.9) Conduct Disorder, with a severity specifier of “severe” due to the high level of aggression, violence, and harm inflicted.

This severity level reflects the extensive behavioral problems, including physical violence, criminal behaviors, and the risk posed to others and himself.

Differential Diagnoses

Two potential differential diagnoses considered are Oppositional Defiant Disorder (ODD) and Antisocial Personality Disorder (ASPD). ODD is characterized by a pattern of angry/irritable mood, argumentative behavior, and defiance (American Psychiatric Association, 2013). However, Mike’s persistent pattern of violation of societal norms, criminal acts, and serious aggression beyond defiance, especially considering his age, makes CD a more fitting diagnosis, as ODD typically emerges earlier and is less severe.

The second differential, ASPD, involves a pervasive pattern of disregard for others’ rights since age 15 (American Psychiatric Association, 2013). However, ASPD diagnosis requires the individual to be at least 18 years old. Given Mike’s age (14), it is more appropriate to diagnose him with Conduct Disorder, which may later develop into ASPD if symptoms persist into adulthood.

Most Appropriate Treatment Interventions

In a juvenile detention setting, targeted interventions for Mike include cognitive-behavioral therapy (CBT) to modify maladaptive behaviors and improve emotional regulation. A mental health therapist’s role involves conducting individual therapy, facilitating behavioral management, and coordinating with juvenile justice staff to implement structured behavioral programs.

Cognitive-behavioral approaches can help Mike develop empathy, problem-solving skills, and impulse control. Additionally, family-based interventions, if feasible, can improve family communication and address dynamic contributors to his behavior (Kazdin, 2017). Considering his behavioral issues, skill-building for social and emotional regulation is essential.

Lacking consistent support, Mike is at risk for developing Antisocial Personality Disorder as an adult, characterized by persistent disregard for others, impulsivity, and criminality (American Psychiatric Association, 2013). Early intervention may prevent this progression.

Therapeutic Modality and Rationale

Given Mike’s presentation, cognitive-behavioral therapy (CBT) appears most suitable, as it directly targets problematic behaviors and thought patterns (Kazdin, 2017). CBT emphasizes skill development, self-control, and emotional regulation, which are critical for his behavioral issues.

If a different modality were chosen, a systems approach could be valuable to consider influences from his family environment, peer group, and social context. According to Greene (2014), a systems perspective recognizes the interconnectedness of individual and contextual factors and can guide comprehensive intervention planning.

Cultural Considerations and Systemic Responses

Research suggests that racial and cultural biases influence how treatment providers and the criminal justice system respond to youth with behavioral issues (Rogers et al., 2017). If Mike were a person of color, systemic biases might lead to more punitive responses and less culturally sensitive care, potentially exacerbating disparities in outcomes. Conversely, White youth might receive more rehabilitative support, reflecting implicit biases in decision-making (Hassan & Johns, 2020).

In conclusion, understanding the intersection of race, culture, and juvenile justice is crucial for equitable treatment and intervention. Culturally competent approaches are necessary to ensure that youth like Mike receive appropriate care that considers their social contexts and reduces disparities.

Conclusion

The case of Mike exemplifies the complexities of diagnosing and treating youth with pervasive behavioral problems. A DSM-5-based diagnosis of Conduct Disorder with severe features best captures his behavioral profile. Tailored interventions, including CBT and family support, are essential in addressing his needs and preventing future antisocial behaviors. Recognizing cultural and systemic factors influencing treatment is vital for promoting equity and effectiveness in intervention strategies.

References

• American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).
• Kazdin, A. E. (2017). Evidence-Based Parenting Interventions: Considerations for Practice and Future Research. Clinical Child and Family Psychology Review, 20(3), 239–261.
• Greene, R. W. (2014). Lost at School: Why Our Kids with Behavioral Challenges Are Falling Through the Cracks and How We Can Help Them. Scribner.
• Hassan, S., & Johns, R. (2020). Cultural Bias and Racial Disparities in Juvenile Justice. Journal of Youth and Adolescence, 49(7), 1444–1458.
• Rogers, B., et al. (2017). Racial Disparities in Diversion and Detention in Juvenile Justice. American Journal of Preventive Medicine, 52(2), S231–S239.