In the past I posted a couple of 'Pop Quizzes' or dilemmas that I have run across in the therapy world. Sometimes, there are no right answers. Here is the latest.... By most definitions, at age 13 'Junior' could be described as a 'pre-sociopath'. He has killed and tortured animals, has threatened to kill both his mother and sister in the past, he describes himself as a pyromaniac and states that he finds fire 'pretty'. He has been hospitalized multiple times and is on his 3rd Residential Treatment Center (RTC) placement. The mother, after exhausting all treatment options signed custody over to the state in an effort to get him the long term help he needed. After almost a year in his current placement, Junior has started to make progress - he is less violent, he is able to go on outings with mother and sister and not be threatening, he is able to address his past behaviors in therapy. Mom was becoming hopeful.... In the state of Texas there is an agency that evaluates all the kids in state care to determine if they are in the least restrictive placement possible. This agency has reviewed Juniors records and determined that despite Juniors - ongoing aggression (peers and adults), being intentionally cruel to younger peers, stealing, lying, history of sexual acting out, suicidal statements as recent as last month and tantrums that can last for an hour or more - this agency feels that he is ready for a foster home. Despite multiple appeals, a recent psychiatric evaluation that recommends continued placement in a locked environment and describes him as violent with a lack of regard for others - he has to be moved. What's a mom to do? A. Allow him to be placed in a foster home - his last foster placement lasted about two months and ended with him being hospitalized and accused of some type of sexual activity with one of the younger children in the home. Although he does not know that he is leaving, he has been adamant that he does not want to go to another foster home and is likely to be disruptive just because he does not want to be there. B. Allow him to come home - he wants to go home and may be willing to work harder to maintain at home then in a foster home - but then there's the whole past homicidal threat thing. He was very violent when he was at home - but it's been almost four years since he's lived there. Mom is a single parent who does not have a lot of family support. C. Allow the state place him in another Residential Treatment Center (RTC). There are none in the area and Texas is a big state. He could easily be placed in an area where mom could not visit him regularly. Despite past problems, he and his mother are very attached. Good Luck!