Resistant Client Vignette

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Vanessa Million: Changing Millions of Lives, One Relationship at a Time.

Resistant Client Vignette

Thomas is a 10 year-old white male, born in Texas. His mother and father divorced

when he was 5 years-old and he is now being reared by his mother who has not

remarried. Thomas rarely sees his father or has communication with him. Additionally

he has one younger sibling, a 6 year-old sister who is the biological child of both of his

parents.

Thomas has been referred to me due to his extreme violent outburst towards his

family; for example, he slaps, hits, pulls hair, bites, spits, and also starts fires. His

aggression has escalated toward his mother and recently he has begun to behave this was

towards his younger sister. Thomas’s mother is daily utilizing full body restraints, and

has taken away all of his privileges such as the television, radio, and going out for dinner.

His mother is the main focus of Thomas outburst. Until recently, he never hit or

utilized inappropriate language towards anyone except his mother. Thomas is now

lashing out at his 6 year-old sister; he is pulling her hair and burned with a curling iron.
Thomas’s teacher report he “is a cooperative student whom is a pleasure to have in

class.”

Thomas observed his father physically abusing his mother. The mother reports that

he saw his father slap, punch, kick and pull her hair. Thomas’ father also was extremely

verbally abusive towards the mother and taught Thomas to swear at his mother.

Reportedly, the father also told him to hit his mother when she did not follow the fathers’

instructions. The abuse took place almost daily.

Observation of Thomas, he is well mannered, utilized words such as “please and

thank you” he is well dressed and has good hygiene. He does not exhibit any violent

behaviors or use inappropriate language, he is quite charming. When I asked him why he

thought his mother and teachers referred him to me, he continued to color in his coloring

book.

In my opinion, Thomas and his family need to start family therapy; his outbursts

are only a symptom of a family in crisis. If his violent outbursts continue he may need

hospitalization and drug therapy may be appropriate. Furthermore, now that Thomas’s is

exhibiting violent behaviors towards his younger sister, he may need to be removed from

the home and placed with DCF; his sisters’ safety is vitally important. I would also put

his mother in contact with a mobile mental health program so they would have

community support in their home 24 hours a day seven days a week. Additionally I

would suggest to the mother to take parenting classes so that she can improve her

parenting skills. I also would also refer him for a neural-psych evaluation to rule out

possible neurological issues.

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