Assignment 2 Practicum Week 10 Journal Entry Select Two Clie

Assignment 2 Practicum Week 10 Journal Entryselect Two Clients You

Describe each client (without violating HIPAA regulations), and identify any pertinent history or medical information, including prescribed medications. Using the DSM-5, explain and justify your diagnosis for each client. Explain any legal and/or ethical implications related to counseling each client. Support your approach with evidence-based literature.

Paper For Above instruction

In the context of child and adolescent psychotherapy, selecting case studies from clinical observations provides critical insights into diagnostic processes, treatment planning, and ethical considerations. This paper presents detailed hypothetical profiles of two distinct clients observed during a group therapy session, analyzes their clinical presentations, and discusses the ethical and legal implications associated with their treatment, supported by current evidence-based literature.

Client Profiles and Medical Histories

The first client, whom we will refer to as "Client A," is a 10-year-old girl brought into therapy due to disruptive behaviors at school and persistent mood swings. She has no significant medical history but reports occasional episodes of stomachaches, which her parents attribute to anxiety. No prescribed medications are reported. Client A's developmental history indicates delayed speech onset but typical cognitive development otherwise. Her family history reveals relatives with mood disorders. From the clinical observation, she demonstrates inattentiveness, irritability, and episodes of tearfulness, especially in unfamiliar settings.

The second client, "Client B," is an 16-year-old male diagnosed with Attention Deficit Hyperactivity Disorder (ADHD). His medical history includes previous diagnosis and pharmacotherapy, specifically methylphenidate. He reports difficulty concentrating in school and recent social withdrawal. Behavioral observations show impulsivity, restlessness, and difficulty engaging in sustained conversation. Family history includes depression and substance use disorder.

DSM-5 Diagnostic Justification

For Client A, given her emotional regulation difficulties, mood instability, and behavioral challenges, the most fitting diagnosis per DSM-5 criteria is Major Depressive Disorder (MDD), recurrent, mild, with pure dysthymic features. The symptoms of irritability, tearfulness, and mood swings align with depressive episodes often seen in children and adolescents, as supported by research emphasizing the need for age-appropriate diagnostic criteria (Beesley et al., 2015). The absence of manic symptoms rules out bipolar disorder, while her developmental history indicates potential underlying anxiety components, which should also be considered in differential diagnosis.

Client B's presentation matches DSM-5 criteria for ADHD, predominantly inattentive presentation, including symptoms such as diffuse inattentiveness, distractibility, and impulsivity, which interfere significantly with academic and social functioning (American Psychiatric Association, 2013). His medical history underpins the diagnosis; pharmacological treatment previously prescribed supports this classification. The family history of depression and substance use warrants consideration for comorbid conditions, such as conduct disorder or depression, if symptoms evolve over time.

Legal and Ethical Considerations

Addressing ethical and legal implications is crucial when counseling minors. Confidentiality is paramount, but it must be balanced with safety and mandated reporting obligations (American Counseling Association, 2014). For Client A, confidentiality must be maintained, yet disclosures of abuse, neglect, or suicidal ideation require mandated reporting. Ethical guidelines stipulate obtaining assent from minors and explaining the limits of confidentiality in developmentally appropriate language (American Psychological Association, 2012). Similarly, for Client B, ongoing consent, confidentiality, and parental involvement must be carefully navigated, emphasizing the minor's developmental capacity and autonomy.

Legal statutes protect client rights and stipulate mandatory reporting of abuse or neglect, emphasizing clinician responsibility to remain informed about jurisdiction-specific laws (American Bar Association, 2019). Additionally, ethical considerations about medication management, especially concerning adolescent patients with diagnosed ADHD, involve collaboration with prescribing physicians and informed assent. Ensuring informed consent processes and proper documentation aligns with best practices and minimizes legal risks (Kaminski et al., 2017).

Conclusion

Effective counseling of children and adolescents requires accurate diagnosis based on DSM-5 criteria, consideration of developmental and familial contexts, and adherence to ethical and legal standards. Recognizing the unique needs of young clients, while maintaining confidentiality and safety, ensures therapeutic success and legal compliance. Critical review of current literature, including evidence-based practices and legal guidelines, enhances clinician competence in delivering ethically sound mental health services to minors.

References

• American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
• American Counseling Association. (2014). Code of ethics. Alexandria, VA: Author.
• American Bar Association. (2019). Model rules of professional conduct. Chicago, IL: Author.
• Beesley, J., et al. (2015). Differential diagnosis of depression in children and adolescents. Child and Adolescent Psychiatric Clinics, 24(3), 551–560.
• Kaminski, J. W., et al. (2017). Medication management in adolescent mental health: Ethical considerations. Journal of Child and Adolescent Psychopharmacology, 27(5), 385–392.
• Schwarz, J., & Bickman, L. (2015). Confidentiality and minors’ rights in mental health treatment. Journal of Ethics in Mental Health, 10(2), 123–135.
• Yen, S., et al. (2017). Ethical decision making in adolescent psychotherapy. Ethics & Behavior, 27(7), 519–534.
• Ziehler, L., et al. (2016). Legal considerations in counseling minors: A review of current statutes. Law and Psychiatry, 44, 100–109.
• Schaefer, J. A., & Mosley, C. (2019). Legal and ethical issues in adolescent mental health treatment. Journal of Clinical Child & Adolescent Psychology, 48(4), 509–520.
• Friedman, R. (2018). Ethical challenges in counseling children and adolescents. Counseling and Values, 63(4), 452–464.