Presenting Concerns

Nick is an eleven year old boy presenting with difficult to manage behavior in multiple settings. He disobeys his mother and grandparents and is consistently argumentative regardless of the scenario. He has bouts of temper when he can't get something he wants and wil kick and scream and sometimes do mild property damage until his caretakers "give in" and he gets what he wanted in the first place. He is insulting and defiant to the authority figures in his life. His family "walks on eggshells" around him, trying to avoid setting him off in one of these fits of anger.

Risk and Protective Factors

Risk Factors - Nick's father left the family several years ago so Nick does not have a relationship with any type of father figure. He also had no opportunity for closure or understanding. There is a history of clinically significant depression among male members of his family going back several generations. Nick is in danger of being expelled from school, according to his mother. He has been receiving very inconsistent discipline at home, changing methodologies trying "everything". Regardless of the punishment chosen, Nick often ends up getting what he wants. Physical punishment (spanking) has been used and is ineffective leading his mother admittedly to increasing the severity of the spanking. The problem behaviors have been going on now for four years. There is also some degree of financial struggle since Nick's father left the family.

Protective Factors - Nick has a mother and grandparents who care very much for him. He is now going ot receive professional help. Despite his family's financial situation he has a stable, safe place to live.