ADHD Stimulant Addiction Case Study: JuniorJunior is a 14-year-old Hispanic boy of Mexican-American heritage. He lives with his parents in San Bernadino, CA. Junior’s parents (Diego and Francisca) both have successful careers and are very concerned that he should succeed in his studies and with his friends. While Junior has always had difficulty staying focused on any one thing for longer than just a few minutes, it became worse as he entered middle school. At one point, a school counselor contacted Junior’s parents to tell them that they might want to consider having Junior tested for attention-deficit/hyperactivity disorder, or ADHD.After a brief exam and consultation, a doctor prescribed a moderate dosage of dextroamphetamine to help Junior focus. The effects were dramatic and instantaneous. He was pleasantly dedicated to the tasks before him, and his grades improved over the next 6-week period. After a while, the dose was increased because the medication was not working as well. Junior’s doctor was a little hesitant but figured that Junior’s physical build and activity level might have something to do with the change, so he increased the dose to the highest of all of his young patients.Lately, though, Junior’s mother has noticed that his medication seems to be running out before it should. At first she thought little of it because he had lost some pills down the drain before, and it was nothing. A few months ago, however, the pharmacist told her that their insurance would not fill the prescription for at least well over a week. This has now happened three times. Once, she was sure he had been out, and suddenly there were 4 pills in the bottle that looked different than the first set. Junior denied that he switched the pills. She had him take the pills while she was watching, and the effects were perfectly normal. As Junior suggested, she believed she must have dreamt up the difference in the pills. Things have changed very recently. Junior has lost weight, and he looks “wired” but simultaneously “exhausted.” Francisca thinks Junior has been taking his medication incorrectly, maybe even obtaining more somehow. For the last 2 days, he has had nose bleeds and has not been sleeping at night. Francisca decided to act quickly when Junior “broke down” and told her that he had been having “weird things” in his vision. He whispered to her that he did not want to hurt her, though he had a “bad thought” about hitting her when she questioned him. He went to their church on his own after school yesterday to pray about his thoughts of harming his mother and the frightening things he had been seeing. Francisca hopes these things are hallucinations and wants to figure out how to help her son before something bad happens
Generally, mental health professionals attempt to empower clients to care for their own problems by supporting client agency. However, in some cases clients may be stifled in their efforts to self-advocate. In other instances, clients may make dangerous, potentially lethal decisions out of misinformation or attempts to get high. Mental health professionals should be prepared to identify warning signs that might indicate a need to protect a client beyond asking that she or he take the necessary steps.
For this Assignment, review the ADHD case study of “Junior” in the Learning Resources. Consider the ethical implications of the client’s presentation as well as the role of the mental health professional in treating this client. Plan steps to begin treatment of this client’s condition.
By Day 7
In a 2- to 3-page, APA-formatted paper, include the following:
- An explanation of what may be occurring in this case.
- An explanation of the psychopharmacological interventions a mental health professional might recommend to treat this client and why these interventions might be necessary.
- Address ethical implications that may be present in the client’s presentation
- Address larger ethical implications of medical treatment of ADHD by the mental health professional
Support your explanations with scholarly evidence and information from the DSM-5.
Lichtblau, L. (2011). Psychopharmacology demystified. Clifton Park, NY: Delmar, Cengage Learning.
Chapter 5, “Cognitive Enhancers” (pp. 65–74)
Preston, J. D., O’Neal, J. H., & Talaga, M. C. (2017). Handbook of clinical psychopharmacology for therapists (8th ed.). Oakland, CA: New Harbinger.
Chapter 23, “Child and Adolescent Psychopharmacology” (pp. 255-276)
Coker, T. R., Elliott, M. N., Toomey, S. L., Schwebel, D.C., Cuccaro, P., Emery, S. T., & … Schuster, M. A. (2016). Racial and ethnic disparities in ADHD diagnosis and treatment. Pediatrics, 138(3), e20160407.
Quinn, M., & Lynch, A. (2016). Is ADHD a “Real” Disorder?. Support For Learning, 31(1), 59-70.
Document: ADHD Stimulant Addiction Case Study: Junior (PDF)
Use this document to guide you as you complete this week‘s Assignment.
American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Arlington, VA, American Psychiatric Association, 2013.