Disruptive, impulse-control, and conduct disorders include conditions involving problems in the self-control of emotions and behaviors. Unlike other cases in this book, the two cases highlighted in this chapter are unique in that these problems are manifested in behaviors that violate the rights of others such as aggression, and/or that bring the client into significant conflict with societal norms or law enforcement. Questions for consideration follow each case.

Gender dysphoria is the feeling of discomfort or distress that might occur in people whose gender identity differs from their sex assigned at birth or sex-related physical characteristics. The cases in this chapter include two cases of adolescent gender dysphoria. In the first case, the adolescent is considering future transition against the backdrop of family acceptance and cultural issues while the other adolescent highlighted in this chapter has transitioned and manages depression and a history of child abuse. Questions for consideration follow each case.

Race, ethnicity, and culture influence client identity and life circumstances. Other factors, such as gender and gender identity, sexual orientation, age, socioeconomic status, religion, and ability may also play into the context of a client’s mental health or personal issues. The four cases in this chapter feature cultural aspects that have a significant role in the treatment and conceptualization by their clinicians. Culturally competent clinicians practice cultural humility and understand that clients’ backgrounds influence the ways in which they view the world and that the clinician’s role must change to accommodate these perspectives.