Andrew is a 15 year-old male who was diagnosed with ADHD in 2nd grade and was put on Ritalin. He was the fourth child to a mother and father and his siblings do not have ADHD. The mother began drinking 1-2 drinks when Andrew was 6 years old and would be in her bedroom from 6:30pm on throughout each evening. In 2nd grade Andrew remembers feeling sad at school and asking to see his older sister in the 6th grade classroom, not his mother who worked at the school. Andrew is a superior athlete and plays basketball and baseball but has trouble keeping his grades up because of his ADHD and due to some of his classroom behaviors. He’s known as a class clown in peer groups. He doesn’t have close friends and has a reputation for antagonizing children at times. His father often sets up parent/teacher conferences to try to solve the academic problem and the teachers and father conclude to enforce more consequences and punishments for Andrew’s behavior. He already gets grounded regularly and this doesn’t seem to affect him. He fights often with his siblings and father and doesn’t have much of a relationship with his mother. He recently was caught selling his Ritalin at school and is presenting to you for therapy. He has an above average IQ but only a 2.4 GPA in high school. He reportedly loves basketball and baseball but can become ruminative and ritualistic when he doesn’t perform well. He watches videos on basketball players and practices his sports in all of his spare time.
Answer the following 5 questions: thoroughly and thoughtfully using your own language clearly indicating that you not only can recite what you watched but that you understand it and can integrate your knowledge of it in your response. The lengthier the answer does not equate to a better answer. Showing you understand the material and have thought about it critically is key. A point or several points will be lost if your answer is too brief, not fully answered or doesn’t exemplify thoughtful understanding
1.What further questions would you need to have answered in order to work effectively with Andrew?
2. From the information given, what are his core issues and possible additional diagnoses?
3. What are the goals of treatment? What modalities of treatment are necessary?
4. From a multipath model conceptualization, what aspects of Andrew might be at play? Think about biological and genetic contributions, psychological contributions (attachment, temperament, personality, etc.), social contributions (family and peers), gender and cultural considerations?
5. Describe how a single issue that goes undiagnosed and untreated can become multiple mental health issues over time?