A speech/theater teacher at a large urban high school refers Andrew (pseudonym for a composite profile), 16, to the school counselor because “he’s out of control and living dangerously.” The counselor, who routinely examines the student’s school file before such a meeting, finds standardized test percentiles in the high 90s, a good attendance record, and regular participation in the arts, but also a high incidence of lateness to class and an academic record that has deteriorated in high school. Family information shows an older brother attending a distant university, parental divorce when Andrew was 5, and, at age 12, Andrew relocating with his brother and mother when she remarried.
Andrew presents as personable, verbal, socially smooth—and somewhat arrogant. He claims he can raise his current low grades before the semester ends. Missed assignments are the key. He says he adds provocative comments to class discussion, and teachers like him.
His best friend lives 2000 miles away, where Andrew lived prior to his move at age 12. Andrew has gravitated toward dramatic females locally, and his current girlfriend is in high conflict at home. His grades deteriorated after becoming involved with her. He has run away several times and now has thoughts of running away with her. He mentions a special relationship with a male friend. When he drinks, he drinks too much, and his friends worry about him.
Andrew believes the psychologists he saw in the past did not understand him. He was diagnosed with attention deficit hyperactivity disorder (ADHD) and depression, but was noncompliant with medication. He recognizes that he makes poor choices. He claims not to be suicidal currently, but has been in the past. He has self-harmed. He says his father has almost no contact with him, but his father does have a close relationship with his brother. Andrew says his own problems resemble his highly intelligent father’s. Andrew has been exploring anarchic and white supremacist groups online.
The counselor plans to meet with him in a week, but will informally check on him daily and then meet with him and his mother together, a meeting Andrew quickly agrees to. Regardless of whether a referral will be made eventually, the counselor hopes to build a therapeutic relationship with Andrew to be able to provide ongoing support at school as needed.
A few days after the school counselor’s meeting with Andrew, his mother contacts the counselor because of the girlfriend. She says Andrew struggles with impulse control, is easily distracted and affected emotionally, has difficulty managing emotions, and escalates conflict quickly when sad or angry. He resists authority at home, and his arguments with her leave her worn out and sad. She says her husband, Andrew’s stepfather, ignores Andrew and does not understand giftedness.