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TREATMENT PLAN
Diagnosis:
Axis I: 312.89 Conduct Disorder, Severe, Unspecified onset
300.13 Dissociative Fugue (Rule Out)
315.31 Expressive Language Disorder
Axis II: V71.09 No Diagnosis on Axis II
Axis III: Deferred to medical personnel
Axis IV: Problems related to the social environment, Exposure to frequent conflict
Client-stated Desired Outcome
(Client remained silent)
Treatment Goal(s)
Based on his diagnosis and history, it is anticipated that Link may want to:
(1) be arrested less often. He would also probably like to
(2) find some way to express himself so that he no longer feels obligated to complete undesirable tasks, including this treatment plan.
Client Strengths in Meeting Goals
(1) Despite his behavioral issues, Link appears to be highly motivated to help others and engage in selfless tasks.
(2) Though he does not speak, Link has managed to function well throughout his life. He appears to have the capacity for social skills, as he is highly regarded in his community.
Barriers to Meeting Goals
(1) Link has resulted to violence (with deadly weapons) as a way to manage conflict, and has done so for many years.
(2) Link is well past the developmental age to begin speaking. The etiology of his speech disorder is unknown.
(Other) Due to the nature of his apparent fugue states, it is possible that progress made in therapy may simply be forgotten in the future.
Interventions
(1) A characteristic of Conduct Disorder is disregard for others. Link has displayed this behavior over a long period of time. However, he has also displayed many acts of selfless service, often at great expense to himself. It is possible that he simply lacks an awareness of what is and is not socially appropriate. In other words, Link does not appear to have deep animosity for others, but rather is unaware of how to resolve conflict without violence. Link would likely benefit from some empathy exercises, such as writing a letter from the perspective of one of his victims. This may help him gain insight into how his behavior affects others, and will in turn likely decrease incidents where he is likely to be arrested.
(2) With regard to Expressive Language Disorder, it appears that Link is not able to speak at all. However, it appears Link is able to understand others but simply does not respond verbally. The therapist that works with him will need to be flexible in working with Link in this regard. Before moving forward with this goal, the therapist should process with Link how much he would like to work on this issue. It is possible Link does not care about whether or not he speaks, but rather that he would like to increase his assertiveness so that he no longer gets "trapped" into completing tasks for others.
Due to Link's passivity, it is important for his therapist to be patient and express empathy. A therapist may feel a tendency to speak on behalf of Link or set goals for him, but this will be anti-therapeutic. His assertiveness will be increased when he is given an environment where this is possible. When Link is able to better assert himself, this treatment plan should be revised with his input.
It is anticipated that Link would meet weekly for individual therapy for 8 to 12 weeks.
Termination
As always, termination will occur at the discretion of the client with input from the therapist. A strong indication for the end of therapy will (frankly) be whenever Link is capable of asserting himself to the point where he would request this. It would also be considered significant progress if Link is able to avoid serious violation of others' rights for two months.