I work in residential treatment. We have kids like your son there. Some of them are able to really change their lives when they are placed in a structured environment where they have to learn to manage those impulses and emotions, and are taught the appropriate skills. Whether he goes to residential treatment or an intensive outpatient program or whatever treatment is chosen, it will have to come down to his choice to look around and see what he is doing to his life and the people around him and decide to make different choices.