Presenting Problem: Kwalon is currently residing in the home with his grandmother and receiving outpatient services. He is no-compliant in school and probation rules. Kwalon has engaged in negative and delinquent behaviors. He endorses continued problems with fragility of affect, frequent tearfulness, explosive frustration, and intrusive negative thoughts. He describes a sense of hopelessness about his environments. He denies any perceptive abnormalities are delusional thought content, but he does demonstrate some impaired reality testing.
Psychiatric Hx: Kwalon was under the care of CSB from 2010-2011 where he was already provided the diagnosis of ADHD and mood disorder with conduct problems, for which he has been prescribed a combination of Abilify and Concerta. He has a history of assaultive, aggressive and disorderly behaviors. These medications were at that time continued with sporadic compliance. After several no show appointments in 2011 his medication management was transferred back over to his PCP. His medication regimens reported remain the same during this time, although compliance remained sporadic. According to Kwalon, he is now taking no medication. He struggled with behavioral and social difficulties most of his youth. He started smoking marijuana at age
…show more content…
Riopel’s accounts, he spent in 2012 in juvenile detention after a fight a school. He was than enrolled in an alternate education program Hampton Roads 2012 to 2015. He returned to the Eastern shore last year and has been attending Northampton High school while residing with his grandmother. Kwalon resides with his grandmother and shared legal guardian. There relationship fluctuates. There times of tension as the guardian are old and unable to supervise him adequately. The given psychiatric family history is minimal, but there is suggestion that affective and substance use disorders are on both sides of his family