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BHS 450 Topic 4 Billy Case Study

Billy Case Study

Billy has been acting aggressively at home with his siblings and at the academy with classmates and authority numbers. He has been reported to display recalcitrant and aggressive actions with any form of authority figure in any setting when approached and given instructions. Parents report that Billy purposefully goes out of his way to upset his siblings, and preceptors report the same with classmates. Billy is described as perverse, recalcitrant, vengeful, and a bully to any and everyone around him. Parents also report having set up marijuana in Billy’s effects a sprinkle of times over the once six months. When they brazened Billy, he became argumentative and aggressive.

Position/ Terrain

Billy and their parents have agreed to meet in my office rather than at home or the academy. Parents believed this was the stylish option as well due to my office being a better-controlled terrain. Due to the nimbus contagion epidemic, the option of telehealth services being handed via drone was offered and is still an option if parents or Billy feel more comfortable with virtual meetings.

BHS 450 Topic 4 Billy Case Study

Demographic Information

Billy is a fifteen- time-old, manly, in the tenth grade at El Camino High Academy. He lives at home with both parents and two siblings- Family( 14) and family( 10). Billy’s parents report having some fiscal strain that begins over the last many times. They had to move from a five-bedroom house in an upper-class neighborhood to a three-bedroom house in a lower-middle-class neighborhood. In the morning, Billy participated a room with his family, but his actions increased, and he began being targeted by his family. Parents dislocated the youngish son to partake in a room with their family in order to drop Billy’s actions.

Presenting Symptoms

Presenting symptoms include aggression, perversity, argumentativeness, vindictiveness, frequent issues with authority numbers, and deliberate defiance. Preceptors and parents agree that the onset of Billy’s problematic actions passed roughly three times agone (at age 11) but that they weren’t as extreme until roughly six months a gone. Billy has been reported to have occurrences of oral and physical bullying towards classmates and siblings, as well as verbal altercations with authority numbers and both verbal and physical altercations with their parents.

BHS 450 Topic 4 Billy Case Study

Parents and preceptors explain that Billy is fluently bothered and irked by peers and, indeed, more so, by grown-ups and authority numbers. In the academy, Billy has a history of suspense due to his bullying and recalcitrant actions that have increased over the once six months. Incidents include physical aggression towards peers and authority, vandalization, and numerous other circumstances of rule-breaking. Billy is known to condemn those around him for his defiance and aggressive actions and becomes protective when his actions are brought to attention.

Co-Occurring Symptoms

Billy’s actions are noted to have increased roughly six months a gone, and around the same time that marijuana began being set up in his things. Their parents state that when they defy Billy of their findings, he incontinently becomes aggressive and can increase physical aggression fleetly. The schoolteacher and parents report Billy going missing for a period at the academy or late at night. At roughly the same time as changing marijuana in Billy’s things, his interest in favored rest conditioning was dissuaded, and he stopped going out with musketeers and sharing in pursuits he used to enjoy.

BHS 450 Topic 4 Billy Case Study

Co-Occurring diseases

Grounded on the actions explained by parents and preceptors, Billy is suspected of having symptoms of the disruptive complaint Oppositional recalcitrant complaint (ODD) combined with Cannabis Use Disorder. Adolescents are more likely to suffer from co-occurring substance use diseases when diagnosed with disruptive geste diseases (SAGE Publishing,n.d). Disruptive geste diseases include oppositional recalcitrant complaint, intermittent explosive complaint, conduct complaint, pyromania, and kleptomania. These diseases include the symptoms of problems in a child or adolescent’s capability to control the expression of their feelings, violating the rights of others, and being at odds with authority numbers and social morals.

Oppositional recalcitrant complaint-( F91.3)

ODD is a disruptive geste complaint that involves the display of a pattern of defiance, negativity, and opposition that creates problems with parents, preceptors, siblings, and peers. The individual criteria include six or further months of at least four of the following symptoms acted upon at least one existent that isn’t a stock pattern of wrathfulness, perversity, argumentativeness, defiance, and vindictiveness (APA, 2013). Billy’s actions meet all five of the symptoms associated with the individual criteria.

When considering if actions are normal or problematic, the continuity and frequency of the actions must be considered (APA, 2013). The schoolteacher and parents agree that Billy has displayed all the below symptoms roughly three times, but they have increased in the last six months. Billy has also entered correctional action at the academy previous to the six months, but the frequency of correctional action has increased. The characteristics that have been set up to increase the threat of a child developing a disruptive geste complaint include avoidant attachment, caregiver depression, stress, low socioeconomic status, caregiver perceptivity, and low quality of care paying( Wilmshurst, 2015).

With the current information, Billy’s parents have expressed that finances have shifted negatively and that this has impacted their family’s life. Billy’s actions are frequent and cause problems in his social, academic, and home life. The inflexibility of ODD must also be considered when considering opinions. ODD has three inflexibility situations( 1) Mild, symptoms do in one setting;( 2) moderate, some symptoms do in at least two settings; and( 3) severe, some symptoms do in three or further settings( APA, 2013). All of Billy’s symptoms have been reported to do at the academy and at home. Further information would be demanded to rule out severe ODD, but at this time, moderate is likely.

Cannabis Use Disorder-( Mild F12.10, and Moderate-Severe F12.20)

ODD has been linked to marijuana use, and exploration suggests that grown-ups suffering from severe aggression tone- rehabilitate with marijuana (Morse, Benson, & Flory, 2016). The testament behind cannabis use co-occurring with disruptive geste diseases is that it’s used to self-rehabilitate. Disruptive geste diseases are associated with depression, and depression is linked to marijuana operation (Morse, Benson, & Flory, 2016).

Cannabis use complaint includes the individual criteria of a problematic pattern of operation that leads to significant impairment or torture within a twelve-month period through at least two of eleven ways frequently taken in larger quantities and/ or over a longer period than intended a patient desire or unprofitable sweats to drop operation a great quantum of time spent trying to gain, use, or recover from cannabis jones or strong solicitations to use intermittent operation that results in failure to fulfill scores at work, academy, or home continued operation despite problems created by operation important social, occupational, or recreational conditioning are reduced or given up due to operation intermittent operation in physically dangerous situations use is continued despite the knowledge of the problems created or aggravated by cannabis a forbearance through the need of increased quantities or diminished effect; and pullout pattern for cannabis( APA, 2013).

Billy meets the individual criteria through at least three of the eleven symptoms. His operation has redounded in a failure to meet scores at the academy has continued despite his problems and actions being aggravated through operation and rest, and academy work and conditioning have been given up and reduced. Cannabis use complaint is broken into three inflexibility situations Mild, the presence of two to three symptoms, the presence of four to five symptoms; and( 3) severe, the presence of six or further symptoms. At the moment, Billy is at least passing mild inflexibility cannabis use complaint. Further information would need to be attained to further identify what symptoms and inflexibility Billy displays for cannabis use complaints.


American Psychiatric Association. ( 2013). individual and statistical primer of internal diseases 5th ed.). Arlington, VA Author Community- University Partnership(n.d) Early Nonage dimension and Evaluation Tool Review. Recaptured from

https//www.ualberta.ca/community-university partnership/media-library/community-university-partnership/resources/tools—assessment/basc-2jan-2012.pdf

Mayo Clinic( 2018). Oppositional recalcitrant complaint( ODD). Recaptured from

https//www.mayoclinic.org/diseases-conditions/oppositional-defiant-disorder/diagnosis treatment/DRC-20375837

Morse, M.C., Benson, K., & Flory, K.( 2016). Disruptive Behavior Diseases and Marijuana Use The Part of Depressive Symptoms. Substance abuse exploration and treatment,(Suppl1), 69 – 76.


SAGE Publishing(n.d)Co-occurring substance abuse and internal complaint. Recaptured from


Wilmshurst, L. (2015). Rudiments of Childhood and Adolescent Psychopathology. Recaptured from

http//www.gcumedia.com/digital-resources/wiley/2014/essentials-of-child-and adolescent-psychopathology_ebook_2e.php

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