Welcome, I am a professional counselor, Behavioral-Consultant and relationship expert.
That is a wonderful, detailed narrative you provided. However, I'd like to better understand your question. Would you mind providing a more precise question for me to work with? When you say "sort this out" what are your specific goals?
I notice you are online but perhaps not at the computer. I'll check back for your response shortly. The most helpful thing here would be to "operationalize" specific goals, - for example, to prioritize 2 or 3 specific problem or target behaviors and desired changes or outcomes. Then I can put my clinical experience and research skills to work for you, much more effectively.
The chat window is showing that you are now offline. I'll check back periodically for your response, through out the day.
I need to know what resources are available for a 25 year old. I need a starting place. And now the thought comes to me that diagnosis of RJ's specific condition is the beginning. would that be correct.
My goal is for RJ to function as well as he can and gain independence.
There are both medical and behavioral issues here to disentangle. For example, internet addiction can be a very serious problem in it's own right. The questions on this issue alone are: to what extent is this behavior, life/work interfering and a root cause for other problems? (response continued)
I think a good starting point may be to facilitate having your grandson work with a well trained cognitive behavior therapist (CBT), who strongly implements the behavioral activation (BA) component of that treatment approach. Let me provide you with some links to further clarify what I mean by CBT and BA.
This is what I mean by CBT:
This is what I mean by BA:
This link explains why the behavioral activation component is so important in CBT:
With a well trained CBT therapist you may be able to avoid any stigmatizing mental health labels, while at the same time getting strong, evidence-based treatment for targeting and changing the behaviors of concern you mentioned. This would include time on the internet, social isolation, behavioral avoidance of prescribed medical treatments that may be contributing factors to his current behavioral presentation. CBT is skills based, so it teaches and trains new more healthy ways of thinking, feeling and acting in the world that your grandson can take with him through out the span of his life. It's also highly targeted and practical, getting lasting results in comparatively fewer sessions (i.e. 7-10 sessions) to less structured talking therapeutic approaches.
A well trained CBT therapist will also be trained to look for medical or psychiatric variables that may need more specialized supports or interventions. Yet, I also strongly recommend that your grandson get a full physical done simultaneously to starting CBT therapy so that the CBT therapist can be aware of your grandson's full health status in designing specific interventions and work tailored to his needs. Finally, a CBT intervention will provide very structured information to inform any further diagnostic work beyond the CBT itself.
Please let me know your thoughts about my preliminary answer to your question.
I'll check back shortly for your next response.
Your advise sounds very good to me. I appreciate your assistance. Thank you.