Case Study

Case 2: Luis

Luis was referred for evaluation and treatment by the Juvenile Court. He was charged with

Criminal Mischief, Criminal Possession of a Weapon with Intent to Use it, And Unlawful

Possession of Marijuana. He has pending charges of Assault and Possession of a Deadly

Weapon. He has been involved in the assault of one victim with a knife, causing injury requiring

stitches.

Luis is a 15-year old adolescent male of Peruvian and Guatemalan descent. According to Luis,

prior to his arrival at the juvenile residential program, he was living with his mother and his

younger sister, age 11, in Boston. According to Luis, he previously lived with a stepfather who is

now incarcerated. He also reported that his biological father visits him on weekends. Luis’ uncle

was reportedly killed by a gang. Luis’ denies gang involvement, but admitted that his uncles and

a cousin had been previously involved with a gang.

In the past year he has been arrested three times for Criminal Mischief and Criminal Possession

with Intent to Use. Eight months ago, at his school police report that Luis punched another

youth. Afterwards, two youth were assaulted by Luis with a knife, with one victim requiring 13

stitches in the head and the other 8 stitches in one finger. Luis stated that he had been attached in

his home by 8 people who followed him home. He stated that after he was involved in a small

fight at an afternoon basketball game, the boy he had fought got a group to beat him up. He was

prepared with a knife and that he stabbed and cut his attackers out of self-defense.

Luis describes having two groups of friends, a group of friends who work and are “good friends”

but are “boring” to spend time with, and a group of friends that drinks and hangs out with girls.

He reported that the latter group of friends was involved with the stabbing incident. He said that

this group of friends often got him in trouble and then did not back him up in any physical

altercations. Luis stated that he has been involved in many fights starting at age 11. He reported

that he was consistently jumped while living in another town from ages 11-13 because he was

“Spanish”. He also reported receiving counseling at this time because of his difficulties related to

managing his anger.

Luis reported a history of drug use. He admitted to using marijuana and alcohol regularly before

being admitted to the agency. Luis and his family have lived in Boston for one and a half years.

Previously, Luis lived and attended school in two other towns in the area. In the first school, he

had a history of school suspensions. He was suspended from school for a week for smelling of

marijuana and running from a teacher. He admitted to being high at the time of this event. He

was also suspended another time for arguing with a teacher. An academic evaluation was

performed last year, and special education was recommended, but he was unable to attend school

because of his arrest and placement in a residential program. Luis reported receiving counseling

from ages 11-12. He said he didn’t enjoy it.

Luis is a well-built boy of average height for his age with dark brown hair and eyes. He has

tattoos all over his body. During the initial interview with the clinician, he made appropriate eye

contact and was socially appropriate. He seemed slightly nervous and remained restless

throughout the sessions. He was engaging and cooperative, talkative and easily developed

rapport with interviewer. He displayed adequate frustration tolerance, and seemed motivated to

do well. He demonstrated adequate attention span and activity level and seemed to enjoy the

testing sessions.

He admitted using alcohol and marijuana. He said he used marijuana 2 times per week and

drinks alcohol on the weekends. He reported using marijuana in school. He began using

marijuana at age 12, and drinking at age 14. He did not acknowledge substance use were a

significant problem for him although he admitted that he fights more when he has been drinking.

He stated that he rarely drinks alcohol but when he does, he drinks to the point of intoxication,

and at times, the next day cannot remember what happened.

He reports he has never been the victim of physical or sexual abuse. He indicated he has been

sexually active and is aware of safe sex practices. He denied any suicidal or homicidal ideation.

He also denied having experienced hallucinations or delusions. He said he would like to return

home. He stated he had a history of getting into fights in his school and in the neighborhood.

There are indications that Luis has a tendency to solve problems with violence, socialize with

negative peers and that he feels the need for protection from a group. He seems to experience

difficulty managing and understanding his feelings of anger. He reports feeling better after fights

because he can get his anger out.

Luis’ mother is a 35 year old woman of Peruvian descent who has been in the United States

illegally since she was an adolescent. She works as a housekeeper for a wealthy family in

Boston and also works as a seamstress doing alterations for a local dry cleaning business to make

ends meet. She admits that she does not have much time to supervise her children because she

has to work all the time. Ms. P. speaks English with a heavy accent and at times did not seem to

fully understand the interviewers’ questions. She states that she was with Luis’ father for 3 years

until Luis was 2, but that she divorced him because of his womanizing, but that he has continued

to have some contact with Luis over the years with some visitation, and occasional gifts. She

states that Luis’ stepfather was who really raised him from age 3. She said that the stepfather was

a mechanic and that he spent more time with Luis than she did and that they are very close.

Eighteen months ago the stepfather was incarcerated for possession of marijuana with intent to

distribute. Ms. P. states that she was unaware that her husband was involved with drugs and that

she was very surprised when she found out he was. She blames him for Luis’ troubles. She

thinks it was his bad example that influenced Luis’ behaviors. She says she has never been a

disciplinarian and that she has never had good control of Luis’ behavior, which she says has

always been difficult. She states that in her culture that is “the father’s job.”

Testing results:

Wechsler Abbreviated Scale of Intelligence (WASI)

Scale IQ Percentile

Verbal 100 50

Performance 109 73

Full Scale 106 66

Wide Range Achievement Test – 4th Edition (WRAT-4)

Standard Score Percentile

Word reading 93 32

Sentence comprehension 92 30

Reading composite 91 27

Spelling 104 61

Math Computation 114 82

Youth Self Report Inventory

Results indicate that Luis responds to stress by externalizing negative behavior including using

drugs and alcohol, being truant from school, getting into altercations and socializing with

negative peers. He fell in the Clinical Range for Total Competence, for lack of involvement in

prosocial activities, groups, etc. He enjoys playing in sports teams. There’s an absence of

protective factors. His score on the Rule-breaking scale fell in the elevated range and his score

on the Withdrawn/Depressed scale was slightly elevated