PHIL Case Study upload - Phil is a 15-year-old Hispanic male who lives with his mother and three sisters. PDF

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Phil is a 15-year-old Hispanic male who lives with his mother and three sisters. Phil is a sophomore at the local public high school. He been struggling with feelings of sadness and angry outbursts over the last four months. His mother has brought him in for an assessment and treatment recommendati...

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COUC 546

PHIL CASE STUDY Phil is a 15-year-old Hispanic male who lives with his mother and three sisters. Phil is a sophomore at the local public high school. He been struggling with feelings of sadness and angry outbursts over the last four months. His mother has brought him in for an assessment and treatment recommendations at the urging of his school and per his mother “to help bring some peace in the family. It has been a very rough year and we all need some peace.” Phil stated that he swings from being sad to being angry and he does not like getting into trouble at school or with his mother. Phil is the second of four siblings. He has an older sister and two younger sisters who live in the home with Phil and his mother. Two and a half years ago Phil’s parents separated and a year ago the divorce was finalized. Phil reported that he was sad when his parents separated but since the divorce has been finalized and his father remarried four months ago, he has been “sad but mainly angry.” Phil stated “before my dad got remarried, I had hope that they would get back together… even after the divorce I hoped. But now he is remarried… there is no way they are getting back together. All my hope for my family to be normal again is gone.” Phil’s mother reported that prior to the separation, Phil had a good relationship with both parents and was close to all the members of the family. When the separation occurred, Phil cried a lot and according to his mother “he would beg his father and I to get back together. He always told me he missed his dad and wanted us to be a family again.” After the divorce was finalized Phil continued to ask his parents to reconcile, even after his father introduced him to his fiancé. Phil voiced several times to his mother and other family members that he believed his parents would sill reconcile. Shortly after his father’s wedding, which Phil refused to attend, he began stating that he knew it was hopeless now. Since the remarriage, Phil has been argumentative with his mother 3-5 times per week, daily with his sisters, and has refused to speak to his father. Phil and his mother both reported that Phil does not generally engage in verbal fights, and he has never engaged in a physical fight. Phil’s mother stated “I have had to find new consequences for this new Phil. It has been a very difficult change to manage… I never had to ground him or provide severe consequences. In the past I would only have to have a stern voice and let him know my expectation. It is like he is a different person… and I am not sure how to get my sweet son back.” In addition to feelings of anger and increased engagement in verbal arguments, Phil reported “I still feel sad about my family, and some nights I cry, and some days I get angry, and every night I have a hard time getting to sleep. I’m not interested in hanging out with my friends right now or playing sports. So, I wish my mom would stop pushing me to leave the house. Nothing seems fun and no one understands how much this all stinks!” Around the time of his father’s remarriage, Phil’s mother began getting calls from Phil’s teachers and principal about his verbally aggressive behavior at school. Until this time Phil has never had any behavioral problems. His mother stated, “I was so shocked; I could not believe that Phil was getting into verbal arguments with everyone… friends, teachers, the principal. He had always been so good at school, done well in his work, and got along with everyone.” Phil’s mother Page 1 of 2

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reported he has been reprimanded at school weekly for the last four months for fighting and speaking disrespectfully to teachers. He was given three days of in-school suspension two weeks ago, which prompted his mother to set the counseling appointment. Phil has also been struggling academically. His mother reported “Phil has always been a solid B student. His grades are now a few C’s but mainly D’s.” Phil stated, “I have had a really hard time concentrating in school since the divorce.” Phil reported that he has a large friend group at school and in his neighborhood. He normally plays every school sport he can but liked basketball the most. Phil stated that one of the things he was looking forward to the most was turning 16 so he could drive himself to sports practice and drive his friends around. Phil is eligible to start driver’s education but has not signed up for the course. He stated, “I just don’t care right now.” Phil and his mother agreed that his social life has been negatively affected by his change in mood, even though his closest friends continue to pursue engaging with him, and his many cousins who live in the area, who he is close to, drop by the house 3-4 times per week to attempt to engage with him. Phil stated “My family is trying to help me… but we are the first broken home in the family… they will never understand what is it like to be different and to know things will never go back to the way they were.” Phil’s mother is worried that if Phil’s refusal to engage continues, he will not have any friends. Phil reported that he has never been diagnosed with an illness and only takes vitamins. He broke his leg doing a skateboard stunt when he was 6 years old and broke his wrist two years ago playing basketball. Phil’s mother reported that she took Phil to the doctor last week for a check up to make sure there was not something physically wrong with him. She stated, “The doctor seemed to think he was a normal adolescent boy who was having a hard time with life being different. On one hand I agree, but his reaction just seems to be so much bigger than what his sisters’ and other kids’ reactions are.” Phil has no history of any past mental health issues. Phil’s mother reported “Phil has always been sensitive, and things seem to affect him more, good and bad. He has always been good about expressing his emotions instead of bottling them up… which might be why things are so hard right now.” Phil’s mother reported that Phil’s father has always been a bit unsure of how to manage Phil and his ability to express emotions. She stated “My ex-husband and I had very different ideas about how to raise children and what a family should look like. I encouraged Phil to be himself while my ex wanted Phil to be more macho and hide his feelings. Our differences in how to raise the kids and what it meant to be marriage partners were a big part of why I chose to divorce him.” Phil’s mother stated that she and her exhusband have maintained an amiable relationship so far. Phil’s sisters have continued to visit their father weekly while Phil has refused contact with him since the wedding. Phil and his family are involved in a local church and Phil’s mother reported that her faith is very important to her. She stated that the church has been a strong support for her through the divorce and as these issues with Phil have arisen. Phil reported that he used to enjoy going to church and he has a lot of friends there. He stated all the adults there were always kind to him. He stated he is not sure how important his faith is to him, even though he knows it should be. “I feel a bit guilty because my mom thinks faith is the center of life… but I am just not sure right now.”

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