answered: A Minor (?) Client Tommy, age 17, is brought by his parents

  

A Minor (?) Client
Tommy, age 17, is brought by his parents to see Ben, a counselor in private practice. During the
intake session with the parents and Tommy, the parents tell Ben that they are concerned about
Tommy’s performance in high school as well as his overall social adjustment. Tommy had been an
athlete throughout middle and high school, but about 6 months ago he was dismissed from the
baseball team by the coach and school administrators. The situation that led to the dismissal
involved an incident during a practice in which Tommy had an argument with a teammate. After
practice, he got into a fight with the same teammate and another player in the locker room.
Tommy was viewed by the coaching staff as the instigator of the argument, and observers
supported this view. Tommy believed the coach did not like him and was singling him out, as
other players had argued and scuffled without serious consequences. Within a few days of the
fight, Tommy got into a verbal altercation with a teacher over a grade. These combined events led
to him being dismissed from the team and suspended from school for a week.
Tommy’s school performance has declined from grades of A and B to failing or barely passing most
classes. He also has changed his group of friends, spending his time with individuals his parents
view as troublemakers and drug users. In fact, his parents have caught Tommy drinking and
smoking marijuana several times, and they suspect additional drug use. He has become
increasingly defiant with his parents by withdrawing from his family, staying out far beyond his
curfew, and hanging out in dangerous areas of town.
Ben meets with Tommy individually after completing the intake with the parents present. Tommy
denies that he is using any drugs except marijuana and states that he believes his parents are
overreacting. He describes his drug use as “normal high school stuff.” He says that he plans to
return to school, pull up his grades, and graduate on time and that he hopes to play baseball at a
college or university. When Ben asks Tommy if he wants to continue in counseling, Tommy says
that he does. When Ben gently questions whether Tommy’s response is motivated more by a desire
to avoid further dissention with his parents than by a sincere desire to receive counseling, Tommy
denies this.
During the next six weekly sessions, Tommy remains marginally engaged in the counseling process:
He answers questions and carries on a conversation but will not actively explore his internal
struggles, feelings, or actions that led to his current situation. Ben structures some sessions as
family sessions and sometimes sees Tommy individually. In both situations, Tommy maintains the
same stance: “I’m fine, my parents are simply overreacting.” By contrast, Tommy’s parents believe
his substance abuse is more serious than he admits. They have removed all alcohol from the house
to prevent him from drinking it and report that they discovered he has used Xanax recreationally.
Also, they state that Tommy was once involved in a situation in which someone pulled a gun on
him and friends when (the parents assumed) they were at a house to purchase drugs. Taking into
account the parents’ report, Ben diagnoses Tommy with a substance use disorder and submits
paperwork for reimbursement to the family insurance company. Ben also includes a diagnosis of
an adjustment disorder with conduct disturbance.
When the family receives notification from their insurance company about the claim, they are
upset to learn that a diagnosis of a substance use disorder was given. They are concerned that such
a label will follow Tommy and negatively affect his future. Tommy, also, is very concerned, fearing
that such a diagnosis might prevent him from being able to play baseball at a college or university.
Tommy is particularly upset because he disagrees with the diagnosis, maintaining that his
substance use is “normal” and that he isn’t “stupid enough to get into trouble with drugs.”
A complicating factor in the case is that Tommy turned 18 during the 6 weeks he was in
counseling, making him legally responsible for remaining in counseling and confounding the
question of who gives consent for treatment. Initially, Tommy’s parents had reviewed and signed
the consent for treatment documents, and Tommy had given his assent. The parents had paid for
counseling services. Ben was unaware of the birthday, although the information was in the client
file
Source
https://www.amhca.org/events/publications/practiceguidelines
https://www.counseling.org/knowledge-center/ethics
https://www.counseling.org/knowledge-center/vistas
https://schoolhouseconnection.org/wp-content/uploads/2021/05/Statemedicallaws.pdf
Please note that the sources should be refer to New York. The sources should also be peer review articles. if you need anything please email me thank you.