The case of Mike: A socially rejected adolescent in residential care

We present the case of Mike, a 13-year-old Caucasian male currently receiving services at a residential treatment facility. Mike has a history of significant behavior problems and a chaotic living environment, resulting in multiple out-of-home placements and eventuating in Mike becoming a ward of the state. Records indicate that various care providers have diagnosed Mike with attention-deficit/hyperactivity disorder, conduct disorder, and intermittent explosive disorder. Behavioral concerns at the time of referral for psychological services included significant social isolation from and rejection by peers, extreme social awkwardness, socially inappropriate behavior, and sexualized behavior (e.g., making lewd comments to females). Mike displays little to no insight as to either the presence or cause of his referral behaviors.