Running head: ERIC THEODORE CARTMAN

Eric Theodore Cartman Tammy Daniel Coles Walden University

ERIC THEODORE CARTMAN Eric Theodore Cartman Eric Theodore Cartman is a 10-year-old, white Caucasian male child from a lower middle class single parent household. He lives in a small, close-knit town in Colorado and has 3 close friends who dont treat him well. He does not fit in well with his peers and is often at odds with adults. His physical health is generally good. He is an obese child with poor eyesight who has

previously been diagnosed with HIV but has miraculously recovered from the disease through the use of a highly experimental treatment (Eric Cartman, 2012). He is a natural leader and often uses cohersion, humiliation and blackmail to convince his peers to act in negative and illegal ways. He prefers to allow others to do his biding as opposed to doing it himself. He has worked with several counselors previously and been through multiple treatment programs without sustained success. Specific Background and Presenting Information Eric Cartman has been arrested 6 times but has been actively involved in many illegal activities. Some of Erics confirmed crimes include Murder, Prostitution, Vandalism, Manslaughter, Murder-by-proxy, Enforced Suicide, Attempted Murder, Attempted Genocide, Cannibalism/Enforce Cannibalism, Assault, Smuggling, Drug Possession, Theft, Obstruction a Criminal Investigation/Obstruction of Justice, Armed Robbery, Kidnapping/ False Imprisonment, Arson, Grave robbing, Unlicensed Surgery, Terrorism, War Crimes, Medical Terrorism/Assault, Piracy, Breaking an Entering, Credit Fraud, Identity Theft, Child Abuse, Embezzlement, Underage Driving/Hit and Run, Resisting Arrest, Shoplifting, Blackmailing, Framing, Planting Evidence, Torture, Fraud, Plagiarism, Rape, Contempt of Court, Vigilantism, and Slander (Eric Cartman, 2012). He has a long history of horrible and illegal acts against others. Many of these

ERIC THEODORE CARTMAN acts were onset by Erics short fuse and his quest for revenge when he believes he has been wronged (Eric Cartman, 2012).

Eric has been actively involved in prostitution and hate crimes. He is well known for being racist, sexist, xenophobic and biased against many other groups including those of different religions. He is known for being impatient, temperamental, and an instigator of negative behaviors amongst his friends. He demonstrates an inflated sense of self-worth and seems to consider all other people to be beneath him. He is a controlling child with an astonishing ability to get others to submit to his will regardless of how heinous the actions are that he wants them to commit. His behavioral patterns demonstrate a significant danger to society. He has a history of presenting as a calm and well-behaved child in previous counseling sessions but has caused serious harm to those who are counseling him. His affect is often deceptive of his actual intentions and feelings. Data Collection Methods In Erics case, a safety and risk assessment would be vital. There are many presenting issues including but not limited to violent tendencies, narcissism, psychopathology, unpredictability and anti-social behavior that a battery of assessments would need to be as allinclusive as possible. Evaluating how much of a danger Eric poses to society would be the first issue that would require assessment. Some specific assessments that would be recommended for in this case include the Wechsler Intelligence Scale for Children-Fourth Edition (WISC-IV), the Beck Youth Inventories- 2nd edition (BYI-2) or the Minnesota Multiphasic Personality InventoryAdolescent (MMPI-A) (depending on Erics abilities, the MMPI-A is more comprehensive but intended to be used with children between 14-17), the Wide Range Achievement Test (WRAT), the Devereux Scales of Mental Disorders (DSMD), and likely a Thematic Apperception Test (TAT). Hare PCL: Youth Version (PCL:YV) and Millon Pre-Adolescent Clinical Inventory (M-

ERIC THEODORE CARTMAN 4 PACI) are alternate assessments that could be also considered to get a clear diagnostic picture in Erics case (Gregory, 1996). The child tends to behave and act in deceptive manners, so it would be important to make sure that any test administered to him is closely monitored and independent. It would be important to collect health information and to conduct an examination to establish if there is any brain abnormality, evidence of an injury, or any other specific medical condition that could account for Erics extreme and dangerous behaviors. Ruling out a medical cause would be important and assessing the childs health could help establish the childs ability to take psychiatric medication if deemed a viable treatment option. A homestudy should be conducted as well to assess whether Erics home environment is conducive to successful treatment. Given his current behavior, assessing his mothers fitness to parent would be important to establish if the child should ever be allowed to return to his mothers care. Acquiring information from previous counselor and professionals that have worked with Eric in combination with medical reports and a battery of clinical behavioral assessments would be recommended in the case. Five Axis Diagnosis per; DSM-IV-TR (American Psychological Association, 2005) Erics case is extremely complex with his behaviors somewhat fitting multiple diagnostic codes. The following five-axis diagnosis is conditional upon a thorough assessment. Axis I312.81 Conduct Disorder, Childhood-Onset Type-Severe (Eric has shown a pattern of being of considerable danger to others, but is too young for Anti-social Personality Diagnosis) 297.1 Delusional Disorder-Mixed Type (Grandiose, Persecutory, and Jealous types are equally present), provisional

ERIC THEODORE CARTMAN 300.9 Unspecified Mental Disorder (There is evidence to suggest that Eric may have a mental disorder that is not included in the DSM-IV-TR classifications, but his behavior does not match the criteria for an unspecified psychotic disorder) Axis IIV61.20 Parent-Child Relational Problem V71.02 Child or Adolescent Antisocial Behavior Axis III278.0 Obesity, morbid 795.71 Nonspecific Serologic Evidence of Human Immunodeficiency Virus

Axis IVProblems with Primary Support Group: Mother provides inadequate discipline, may be neglectful and permissive. Possible drug use and prostitution in the home as well. Problems with Social Environment: Child is discriminated against by peers due to his weight. Educational Problems: Discord with teachers and classmates Economic Problems: Mother has inadequate finances. Problems Related to Interaction with the Legal System/Crime: There are multiple arrests, child has committed several crimes. Child has been incarcerated short term due to his offenses. Other psychosocial and Environmental Problems: Discord with non-famlly caregivers including teachers, principles, counselors, social workers, and other mental health professionals and previous evidence of non-compliance to therapeutic attempts.

ERIC THEODORE CARTMAN Axis VGAF: 10 Persistent danger of severely hurting others, child has a history of recurrent violent and homicidal behavior. Child poses a significant threat to society. Related Psychosocial or Family Issues Some specific family issues in Erics case include a permissive parent who does not provide a structured environment for him to thrive in. His mother has been accused of being a drug user, a prostitute, and commonly bringing strange men home for sexual relations while Eric

is in the residence. His mother is known to indulge Erics whims and not discipline him. Her poor parenting skills pose a major issue in Erics ability to remain in his mothers home. Shumaker and Prinz (2000) found that high percentage of preteens (children under the age of 13) that murder come from homes that have has been domestic violence, physical abuse, or poor/absent parenting. We do not have any specific evidence of domestic or physical abuse in Erics home, but there is significant evidence to suggest poor or absent parenting. Erics father was never actively involved in his life and after being lied to by many people about whom his father was, Eric finally discovered that his father was a man that he arranged to have killed but had never directly met. Eric had been involved in a dispute with the mans son and arranged to have both his father and the boys mother killed. (Shumaker & Prinz, 2000). His family is on the low end of the economic scale and Eric is very sensitive about being the 2nd poorest child in school. His social environment is not supportive and his close friends rarely treat him in a friendly manner. His peers and friends ostracize him for his weight and often tell him that they hate him. Erics closest friend and confidant is a stuffed frog he calls Clyde Frog. He has been removed from his mothers care twice by social services. Once for an accusation of sexual molestation by his mother that was later proven untrue and once for his mother having a

ERIC THEODORE CARTMAN meth lab, that later turned out to be Erics doing as well. There is no evidence of Eric being disciplined by his mother in either case. Erics home environment does not provide any level of structure that he needs for success. Related Career or Vocational Issues Given Erics age, there are no current career or vocational issues to be specifically addressed. Proposed Treatment or Intervention Initial admission to a psychiatric facility where Eric can be observed closely would be

highly recommended. He would need to be evaluated medically to ensure that there is no medical condition or injury that is responsible for Erics extreme behavior. He would need to be evaluated for possible pharmacological intervention, especially if there is the possibility that it may assist in Erics compliance with treatment. Prior to full committal in a psychological institution, the child should be evaluated as a possible candidate for a therapeutic foster home while his mothers home is being evaluated for its suitability. There is limited data on how effective hospitalization or institutionalization is for treating children who commit multiple murders, but Pfeffer (1980) suggests that hospitalization is often the best first phase of intervention, but not the best situation for long-term treatment. Initial removal from society would likely be deemed necessary in Erics case based on his criminal history and the danger he poses to others. The prognosis in Erics case is dim and long-term hospitalization does not improve the potential outcome of treatment. According to Myers (2004), children who commit serial murders do so predatorily as opposed to affectively. He suggests that there is significant evidence that children who kill in a serial manner, do so to satisfy their own sadistic needs. He suggests that children like Eric who get pleasure out of killing will continue to

ERIC THEODORE CARTMAN do so (Myers, 2004). Eric would require supervision regardless of the long-term treatment method selected. Eric would likely respond best initially to a white male counselor due to his biases and prejudges at this point. A systematic use of reinforcement could be tested as a possible behavior management option for Eric. Rational Emotive Behavior Therapy would be the recommended approach going into treatment (Butcher, Mineka & Hooley, 2012). Family therapy could be

considered if the child may return to his mothers home. The ultimate goal of treatment should be to ensure that Eric is no longer a threat to himself or others. Continuing Assessment and Proposed Follow Up Eric is going to need to continue in intensive psychotherapy for the long-term, possible throughout his entire life. Eric would need to be closely monitored based on his pattern of dangerous and erratic behavior. If pharmacological intervention was utilized, compliance with taking the recommended drugs in the prescribed amounts would have to be closely monitored as well. In the foreseeable future, there is no evidence that Eric can thrive and be a productive member of society until he no longer poses a danger. Periodic Personality and Behavior inventories along with clinical observations would be the best tools to monitor progress during treatment. Potential Legal and Ethical Issues There are many major issues when working with Eric. Shumaker and Prinz point out that a child under the age of 13 presents a unique set of challenges for both the legal system and the counselor treating them. Most legal and ethical codes are developed for adolescents and adults (Shumaker & Prinz, 2000). With Erics extreme case, his age would pose a major challenge because disclosure and mandatory reporting laws are fuzzy for a child his age. The A.P.A Code of

ERIC THEODORE CARTMAN 9 Ethics requires counselors to report any instance of crime that involves harm to a child (A.P.A, 2009). Given Erics age and interactions, many of his unprosecuted offenses would likely be committed against children. In Erics case, this would present a major ethical challenge. Reporting issues not only pose ethical conflicts, but also negatively affect the therapeutic relationship that a counselor could establish with Eric. Building Erics trust would be extremely difficult with disclosure requirements. The therapeutic relationship could be permanently damaged by mandatory reporting of every incident, but according to the ethics code, it would be required. The A.P.A Code of Ethics also mandates that a counselor works in the best interest of an individual and with Eric, this could be extremely difficult as he may be thrust into the legal system and detained away from therapy to face charges for his crimes (A.P.A, 2009). Erics risk of incarceration for his crimes poses a significant threat to therapy.

ERIC THEODORE CARTMAN References American Psychological Association (2005). Diagnostic and statistical manual of mental disorders fourth edition text revision. (IV ed., Vol. TR). Daryaganj, New Delhi: Jaypee Brothers Medical Publishers (P) LTD. American Psychological Association. (2002). American Psychological Association ethical principles of psychologists and code of conduct. Retrieved February 9, 2009, from http://www.apa.org/ethics/code2002.html Butcher, J. N., Mineka, S., & Hooley, J. M. (2012). Abnormal psychology. (14 ed. custom). Boston: Pearson Education, Inc. Eric cartman. (2012). C. By-SA (Ed.), South Park Archives. Retrieved from http://southpark.wikia.com/wiki/Eric_Cartman

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Gregory, R. J. (1996). Psychological testing: history, principles, and applications-. (2nd ed., pp. 151-386). Needham Heights, MA: Simon & Shuster Company. Myers, W. (2004). Serial murder by children and adolescents. Behavioral Sciences & The Law, 22(3), 357-374. Pfeffer, C. R. (1980). Psychiatric hospital treatment of assaultive homicidal children. American Journal of Psychotherapy, 34(2), 197-207. Retrieved from http://psycnet.apa.org/psycinfo/1980-23924-001 Shumaker, D., & Prinz, R. (2000). Children who murder: a review. Clinical Child And Family Psychology Review, 3(2), 97-115.