The patient is an 11-year-old Native American girl who resides with her biological father, his girlfriend, two younger sisters,

    April 23, 2024

The patient is an 11-year-old Native American girl who resides with her biological father, his girlfriend, two younger sisters, and a newborn, half-brother in a small apartment located on a reservation in Southeast South Dakota. The patient is in 5th grade and attends the public school. The patient’s presenting problem is her behavior, which is defiant, aggressive, rude to authority, and her best friends are almost all older than she is. The patient dwells on her desires to live with her alcoholic mother, who does not have custody. The patient’s mother lives in the same community, and all family members are involved with Tribal Social Services. The patient has mentioned she goes to see her mother after school sometimes (which she is prohibited from doing) and has stated she cleans house while her mother sleeps. What course of action would you take with this child and why?

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