Peter's case study evaluation
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Case Study Evaluation: Peter
College of Humanities and Social Sciences, Grand Canyon University
PCN-671: Psychopathology and Treatment of Children and Adolescents
DR Christy Land
November 22, 2023
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Case Study Evaluation: Peter
Pre-teenagers undergo so many changes through their development. There are so many
factors to consider when a child is plagued with mental illness. First and foremost, the parents
undergo so much stress trying to cope with the child’s behavior on top of all the household
responsibilities they already carry. For the most part not, all parents are educated to pick up signs
of mental illness on their child and others simply ignore the signs completely. The earlier the
child is treated the better relationship the child will have with the entire family. In the case of 12-
year-old Peter the signs of mental disparity are evident. The child displays cruelty behaviors
towards animals and his siblings. Peters displays behaviors pertaining to those that identify with
conduct and child-onset disorders. The following analysis of Peters case study is necessary to
fully understand the root of his behaviors, the diagnosis, his family situation, and how will
mental health support will help repair all the broken relationships.
Peter and his family do not have the best relationship. The aggressive behavior peter has
towards everyone in the family has everyone on their toes. Peter’s siblings have learned to keep
their distance from him, and his mother is terrified. Like in every intake session the therapist
must ask all necessary questions to get to know the client, his needs, his triggers, and his fears.
So far, we know what Peter does to the rest of the family and there is still more information that
was not given in the intake.
What type of parenting was performed during the first years of Peters life?
In your ethnic background, did you explore parenting styles, if so did you ever try
attachment parenting?
How close was Peter’s father to you while you were pregnant?
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During the toddler years what were some behaviors displayed by Peter that gave
you some kind of warning for future behavior issues.
How do you and your husband get along?
How do you and your husband resolve conflict?
How do Peter and his father interact with one another? Is there any special game
they both enjoy playing together?
When mom was hospitalized how were Peter’s behaviors at home?
Was there any special care arranged for Peter’s care while mom was in the
hospital and dad worked?
Did the behavior change for Peter after mom’s release from the hospital? Was he
more aggressive?
The aggressive behavior towards the younger sibling, did it start immediately
after birth?
How was bonding divided between each sibling with individual parent or both
parents?
Has any form of intervention ever been done with Peter as to where is the
behavior coming from?
Peter, are you mad at your parents? Do you feel that your anger is what separates
you from them?
How do you feel about your siblings? Would you wish to be an only child?
It is imperative to ask all the necessary questions to get to know the family situation in depth.
Peter’s family’s cultural and sociocultural background is unknown, and it is necessary to identify
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key aspects of it for a good evaluation (Anonymous, 2014). Peter has history of mental illness in
his family. His mother suffers from depression and has had to be hospitalized from it. Peter has
become more of a threat that makes his mother anxious. It is obvious that father is not around
much and is not as understanding as a child with Peter’s symptoms needs.
In Peter’s case, conduct disorder is what fits all his symptoms. Conduct disorder in teens
is expressed in different patterns that include tantrums, continuous disobedience, delinquent
behavior such as theft, destruction of property, violent attacks, and rape (NLM, 2005).
Adolescents with CD are also very aggressive towards humans and animals and continuously
violate social norms and other people’s property (APA, 2013). The DSM-5 denotes that the
behaviors displayed by Peter are consistent with CD and the ages where Peter began to show
symptoms. For instance, in childhood-onset conduct disorder the child begins to display
symptoms before age ten. Peter has a hard time with engaging in relationship with his siblings
and his peers at school as well. Peter has also smoked cigarettes before and parents report that
they fear he has engaged in substance abuse. It is not uncommon that adolescents engage into
some sort of substance abuse (Steiner, 1997). It does not help Peter that there is conflict with the
parents due to the absence of the father.
The father given his background on law enforcement
and his authoritarian parenting style may be one of the triggers for Peter’s behavior. What Peter
is not experiencing is attention deficit hyperactivity disorder even though at first glance that is
what may be what his symptoms display. ADHD is displayed with symptoms of inattention,
impulsive and hyperactive problems. While Peter may display some, they are not at all close to
all the violent behaviors Peter engages in. ADHD can be ruled out by using the behavior
assessment system for children (Skogli, 2013). One other assessment that is imperative for
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Peter’s evaluation is the Vanderbilt assessment scales along with rigorous observation of
behaviors displayed at home and school.
Family support is one of the best ways to aide a child who is plagued by a mental illness.
Peter’s family system is not well put together with mom having her own issues with mental
health and father not on board with a diagnosis for Peter rather just being authoritative possibly
thinking that Peter’s behaviors will be fixed with discipline. Adolescence is already a hard
developmental stage to deal with, let alone when it is plagued by a disorder. The whole family
suffers until they understand what is behind the child’s behavior. Adolescents need their families
to navigate around their social environments and gain autonomy and independence. In the case
of Peter, he needs his family to support him, and they are not a united front. Peter’s parents do
not understand each other as his mother has mental health issues of her own and the father is
gone most of the day at work. Peter has little to no bonding with the parents and his aggression
only escalates due to not understanding why he behaves the way he does.
In the case of Peter’s family, the interventions they have tried have to do with basic
discipline. At his age and with his behavior discipline does not help. There are rules put in place
by the father as he is authoritarian, but those rules are not followed by Peter (Anonymous 2004).
Not because Peter does not want to follow rules, but due to the lack of his understanding of them
as he is not a normal twelve-year-old. In peter’s case the interventions that will be most effective
are therapy, psychiatric evaluations, and medical treatments.
Behavior coaching will also be
handy as Peter needs to navigate the correct ways to behave in his social and family
environments. Another approach is family therapy where all the members engage in evidence-
based therapy sessions that will aid in the members of the family to understand where Peter’s
behavior stems from.
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References
American Psychiatric Association (2013) Diagnostic and Statistical Manual of Mental
Disorder (DSM-5), fifth edition. Washing DC, American Psychiatric Association
Effective discipline for children. (2004).
Paediatrics & child health
,
9
(1), 37–50.
https://doi.org/10.1093/pch/9.1.37
King, V., & Boyd, L. M. (2016). Factors Associated With Perceptions of Family Belonging
Among Adolescents.
Journal of marriage and the family
,
78
(4), 1114–1130.
https://doi.org/10.1111/jomf.12322
National Library of Medicine. (2014). Culturally responsive evaluation and treatment planning.
Retrieved from
https://www.ncbi.nlm.nih.gov/books/NBK248423/
National Library of Medicine. (2005). Conduct: Disorder in children and adolescents. Retrieved
from
https://www.ncbi.nlm.nih.gov/books/NBK7133/
Skogli, E. W., Teicher, M. H., Andersen, P. N., Hovik, K. T., & Øie, M. (2013). ADHD in girls
and boys--gender differences in co-existing symptoms and executive function
measures.
BMC psychiatry
,
13
, 298.
https://doi.org/10.1186/1471-244X-13-298
Steiner, H. (1997). Practice parameters for the assessment and treatment of children and
adolescents with conduct disorder. Vol 36. Issue 10.
https://doi.org/10.1097/00004583-
199710001-00008
.
6
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