Childhood Onset Disorders: Applying the T/C Model of Case Conceptualization

The Case of Bill

Sixteen-year-old Bill was brought to the office by his mother because of several incidents at school. The last incident was so severe that Bill is required to have a mental health evaluation and letter before he is able to return to school. Bill was suspended indefinitely for bringing a weapon to school. Bill has also been suspended in the past for marijuana possession, fighting with peers, assaulting a teacher, and misconduct in a bathroom. Mom reports that Bill leaves the apartment for days at a time, does not listen to anything she says or asks him to do, and has stolen money from her purse. She is “at her wits end,” and does not know what to do with him.

Bill says that everything that he does is blown out of proportion. He leaves the house for days at a time after what he calls a “blow out” fight with his mother. Bill’s father is incarcerated and he has no recollection of any significant relationship with him. Bill complains that his mother regularly works at night and on the weekends and leaves him in charge of his two younger siblings.