Vlad Is A 17-Year-Old White Male Court Mandated To Attend

Vlad Is A 17 Year Old White Male Court Mandated To Attend A 6 Month Re

Vlad is a 17-year-old white male who is court-mandated to participate in a six-month residential treatment program at a juvenile detention center due to criminal behaviors including breaking and entering with a firearm possession. He has experienced multiple failed placements and ongoing substance use, particularly marijuana, which has contributed to his legal and behavioral issues. Vlad’s early life was marked by institutional care in Russia following his biological parents' history of alcoholism and abuse, with physical abuse and neglect shaping his early childhood experiences. His adoption by a U.S. military family at age seven and subsequent family dynamics, including strained parental relationships, influence his current psychosocial functioning. Vlad exhibits symptoms of anger, impulsivity, and substance dependence, with history indicating difficulty regulating emotions and forming stable attachments. His mental health background includes unsuccessful treatment efforts for ADHD and substance use, and his developmental history suggests potential underlying attachment disruptions and emotional regulation deficits. These factors, combined with ongoing environmental stressors, contribute to a complex case requiring an integrated biopsychosocial understanding to inform treatment planning.

Case Formulation Chart

Biological

• History of ADHD (aged 11, untreated currently)
• Genetics: familial alcoholism
• Physically healthy, some sinus/allergy issues
• Early malnutrition and frostbite (Russian orphanage)

Psychological

• History of mental health treatment (unsuccessful)
• Anger, impulsivity, poor emotion regulation
• Substance dependence (marijuana, alcohol, PCP)
• Lack of guilt/empathy for victims; superficial remorse
• Early developmental trauma—possible attachment issues

Social

• Adopted from Russia, estranged from biological family
• Family dynamics—resentment toward mother, improving relationship with father
• Peer Influence—association with delinquent peers
• Previous placement disruptions and limited consistent social attachments
• Religious involvement and community ties (Catholic church)

Case Formulation Narrative

Introduction and Diagnosis

Vlad’s comprehensive biopsychosocial assessment points toward a Diagnosis of Conduct Disorder (DSM-5 312.81, with unspecified rule-breaking behaviors), compounded by mild ADHD ( inattentive presentation), substance use disorder, and possible underlying attachment disturbances. He exhibits persistent pattern of rule violations, aggression, and deceitful behaviors, with evidence of substance dependence, particularly marijuana use since early adolescence, and episodes of impulsivity. His criminal behaviors, including breaking and entering, firearm possession, and domestic violence, underscore a pattern of youth with difficulties in emotional regulation and impulse control.

Predisposing Factors

Genetic predisposition plays a significant role, as familial history of alcoholism suggests a biological vulnerability toward substance dependence. Early childhood trauma—including parental neglect, abuse, and exposure to violence—likely contributed to insecure attachment styles and emotional dysregulation. Vlad’s early experiences in the orphanage, coupled with physical illness and malnutrition, further compromised his developmental trajectory. Temperamentally, Vlad demonstrates traits associated with impulsivity and sensation-seeking, aligning with his ADHD diagnosis and substance use behaviors.

Precipitating Factors

The precipitating event was Vlad’s recent involvement in theft and firearm possession—behaviors precipitated by association with delinquent peers, family conflict, and substance use. His ongoing struggles with anger, boredom, and peer influence coupled with family disapproval and limited emotional outlets triggered recent criminal behaviors. Peer reinforcement and the thrill-seeking element of juvenile delinquency provided immediate reinforcement for his rule-breaking acts.

Perpetuating Factors

Current environmental context perpetuates his problematic behaviors: association with deviant peers, ongoing substance dependence, family strained relationships, and limited coping skills for managing anger and stress. His poor emotion regulation and difficulty developing secure attachments hinder positive social integration, leading to repetitive antisocial behaviors. The lack of consistent, effective intervention has contributed to entrenched patterns of maladaptive coping and rule violations.

Protective Factors

Vlad demonstrates motivation for change in his expressed desire to repair family relationships, his artistic talents, and his interest in trade skills. Support from his adoptive family, especially his supportive stepfather, provides a foundation for therapeutic engagement. His religious background and participation in faith-based communities also serve as potential assets for moral development and resilience.

Prediction of Response to Treatment and Interventions

Vlad’s prognosis for positive change hinges on addressing his emotional regulation deficits, substance dependence, and attachment issues simultaneously. Motivational interviewing could enhance his readiness for change, focusing on his expressed goals for a stable family relationship, educational achievement, and vocational aspirations. Cognitive-behavioral therapy (CBT) tailored to impulse control, anger management, and substance abuse is likely to be effective given his history and temperament. Incorporating family therapy could help repair relational ruptures and improve communication, leveraging his desire to connect with his family. Addressing underlying trauma through trauma-informed care, possibly using EMDR or other approaches, could facilitate emotional processing. Engagement with peer support groups and skill-building activities such as sports or vocational training may reduce boredom and improve social competence. Barriers may include his entrenched substance use, resistance to authority, and possible emotional dysregulation—necessitating a phased, motivational approach to treatment that recognizes his ambivalence and strengths.

Theory Application

Applying attachment theory elucidates Vlad’s difficulty forming stable close relationships, rooted in early neglect and inconsistent caregiving. His reported preference for solitude and difficulty with physical affection are consistent with insecure attachment styles, which may underpin his lack of empathy and affect regulation issues. Cognitive-behavioral models explain his maladaptive coping strategies—such as substance use and aggression—as learned behaviors reinforced by environmental reinforcement cycles. The social learning perspective underscores the influence of peer modeling and reinforcement of delinquent behaviors. Developmental trauma theories suggest that early abandonment and physical neglect have created a vulnerability to maladaptive behavioral patterns, including impulsivity and emotional dysregulation, which persist into adolescence. Addressing these underlying developmental issues within a systemic and trauma-informed framework will be crucial in fostering recovery and resilience in Vlad.

References

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