Residential Clinical Vignettes
CASE 1
Age: 16 year old Gender: Male
Status with DCF: Committed
Current placement: Inpatient Hospital
Current therapeutic treatment: Inpatient Hospital
Diagnosis: Depressive Disorder
Psychotropic Medication(s): None
This child was placed on an inpatient unit, from a Group Home, after being found at a bridge and reporting he was suicidal. He said that he was worried about the group home’s response to finding sexually graphic pictures and texts on his cell phone. He denies any issues related to sexual orientation or identity, but is often teased for wearing female clothing and for effeminate mannerisms.
At the Group Home this adolescent was struggling with the loss of his family and sexual identity issues. He often exhibits symptoms related to depression and anxiety. He has a history of outpatient therapy and in the recent past has been placed in multiple foster homes and one shelter. When he was a child he witnessed severe domestic violence, for which his father was, and continues to be incarcerated.
This adolescent male has been matched to an out of state residential facility specializing in sexual identity issues.
CASE 2
Age: 17 years old Gender: Female
Status with DCF: Committed Parole
Current placement: Residential emergency bed (short-term placement)
Current therapeutic treatment: Residential
Diagnosis: Depressive Disorder
Opioid Dependence
Cocaine Dependence
Cannabis Abuse
Psychotropic Medication(s): Zoloft (antidepressant)
This adolescent female has made impulsive decisions that put her at extremely high risk in the community. She engages in sexual activity in order to get drugs. She runs to unsafe familiar neighborhoods where drugs are easily accessible so that she can get high. When last “on the run,” she admitted to using drugs daily and spent several hundred dollars a day on heroin and crack cocaine. She was prostituting to earn money for her addiction and was associated with a human trafficking ring.
In between living with family, this adolescent has been to in-state residential treatment four times, two of the four facilities were staff secure or locked units. When home, she received in home therapeutic services. She has been to a forty-five day substance abuse program and has also been incarcerated.
This adolescent was matched to an out of state facility due to her repeated running away behavior as well as her extensive substance abuse and failure at previous attempts at treatment at CT facilities. She was matched to a facility that provides substance abuse treatment and has experience working with females who have been in similar human trafficking rings.
CASE 3
Age: 17 year old Gender: Male
Status with DCF: Dually committed
Current placement: Connecticut Junior training school
Current therapeutic treatment: Treatment provided at CJTS
Diagnosis: Conduct Disorder
Attention Deficit and Hyperactivity Disorder
Psychotropic Medication(s): Seroquel and Depakote (for mood/impulsivity), Vyvanse (for ADHD)
This adolescent male is an adjudicated delinquent as of 1/7/2009 on the charges of Criminal Mischief 3rd degree. He spent seven months prior to CJTS at Manson Youth Institute on adult charges of Sexual Assault and Unlawful restraint stemming from an incident at his previous placement (Residential Treatment Center) where he was accused of sexually assaulting a female peer. He received a four year suspended sentence and three years probation in the adult court for this incident.
This male has a criminal history dating back to 2004. He has a significant substance abuse history, although due to being in a controlled environment, this has not been an issue. He also has a fire setting history from 2004, but nothing noted since then. He has already received treatment at an in state residential facility and has also been to a forty-five day substance abuse treatment facility.
This adolescent was matched to an out of state residential treatment center that specializes in sexual offending behaviors.
CASE 4
Age: 15 year old Gender: Male
Status with DCF: Committed
Current placement: Riverview State Hospital
Current therapeutic treatment: Inpatient Services
Diagnosis: Depressive Disorder
Anxiety Disorder
Psychotropic Medication(s): Zoloft (antidepressant)
This male had been inpatient after being out of control at home, and making homicidal and suicidal threats. When inpatient, this member made several attempts to hurt himself by not following, or purposely sabotaging, medical protocol for his Type I Diabetes. He was accepted at Riverview state hospital after several failed attempts to reunify with his aunt and uncle, who at times have said that he is too much to manage at home. He has ongoing attachment issues which may be related to his biological mother voluntarily agreeing to terminate her parental rights.
He has never been placed outside of his family’s care. He has received outpatient services, such as individual counseling and partial hospitalization. Medical professionals and family have struggled to find ways to consistently manage his co-occurring medical and psychological issues.
This adolescent was matched to an out of state residential treatment center that is able to handle medically fragile children while focusing on his loss and abandonment issues.Attempts to match him to an in state facility were unsuccessful as his Diabetes represented a barrier to in state programs feeling that they could provide adequate treatment.