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Elliott, LPCC, NCC
Elliott, LPCC, NCC, Psychotherapist
Category: Mental Health
Satisfied Customers: 7664
Experience:  35 years of experience as a Licensed Professional Clinical Counselor, National Certified Counselor and a college professor.
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I have a client who has some severe medical issues, speech

Resolved Question:

I have a client who has some severe medical issues, speech issues, missing digits on his hand, he is currently being brought up on charges for writing a threat on a school bathroom wall. He states that he was constantly bullied and only wrote on the wall out of frustration instead of "punching someone" what would be some treatment options for this young man
Submitted: 5 years ago.
Category: Mental Health
Expert:  Elliott, LPCC, NCC replied 5 years ago.
Seeking expert counseling is a sign of strength. A personal relationship with a caring professional is proven clinically effective.

Dear colleague,

Your client appears to have two issues, the second a consequence of the first.

From the scant information that you presented, because you have not done a long-term intake with him, since he is a new client, I would say that he was probably born with certain conditions (perhaps the missing digits are part of that syndrome).

He seems to have a Pervasive Developmental Disorder. Since you cannot say if it is Autism or Asperger's Disorder, then you would best give him a preliminary Axis I diagnosis of 299.80 Pervasive Developmental Disorder Not Otherwise Specifiied

He needs to have a second Axis I diagnosis of 309.3 Adjustment Disorder With Disturbance of Conduct.

The Short Term Objectives of the first diagnosis is to identify the exact nature of clients PDD. The therapeutic intervention is to have client tested by child development expert for the type of PDD to see if it cannot be further refined.

The Short Term Objectives for the Ajustment Disorder are to: Identifuy the symptoms of his his pulsivity (defacing prooperty, anger, etc.) and to help him understand the connection between his impusive acts and his life's difficulties. The Therapeutic Interventions is to monitor, encourage, redirect, and give feedback to client relating to control over compulsive reactions, helping client increase his abiltity to observe himself, and teach him to implement these control techniques in his everyday life.

This should get you a good solid, and authentic DX and treatment plan.

Warm regards,

Elliott Sewell, LPCC, NCC, CCMHC
Customer: replied 5 years ago.
He was in fact born with Poland's Syndrome and Pierre Robin Syndrome both of which are rare. On his past WISC-IV he scored a full scale IQ of 86, and was in the low average range in perceptual reasoning and processing speed. I work at a mainly CBT focused non-profit I could try some of these techniques, possibly suggest that when he feels these impulses to direct his energy elsewhere (drawing, etc...). Also some work with the school to change his current IEP is what my plan is.
Thanks again
Expert:  Elliott, LPCC, NCC replied 5 years ago.
Dear colleague,

Thank you for the additioanl information even if it did come after your original question. His congenital deformities make him the object of fear and ridicule among his peers. This is his primary stressor.

I do appreciate your thanks. I enjoy helping others. This is what I do for a living and would appreciate if you accpet my answer so that JustAnswer can acknowledge my expertise and time. Thank you so much.

Warm regards,

Elliott Sewell, LPCC, NCC, CCMHC
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