Assignment 3 Practicum Week 9 Journal Entry Select A Child

Assignment 3 Practicum Week 9 Journal Entry Select A Child Or Ado

Choose a child or adolescent client whom you observed or counseled this week. In your practicum journal, describe the client without violating HIPAA regulations, including relevant history or medical information such as prescribed medications. Using the DSM-5, explain and justify your diagnosis for this client. Additionally, discuss any legal and/or ethical implications related to counseling this client. Support your discussion with evidence-based literature. Review the provided practicum journal template and sample to guide your writing. Create reasonable fictional client information consistent with mental health nursing standards, including a detailed time log and journal entries. Incorporate at least five credible references from scholarly sources to substantiate your analysis.

Paper For Above instruction

In this practicum journal, I observed and counseled a 13-year-old female client, herein referred to as "Sara," who presented with symptoms consistent with generalized anxiety disorder (GAD). Sara's background revealed a history of academic stress, familial discord, and episodes of somatic complaints such as headaches and stomachaches without identifiable medical causes. Her medical history was unremarkable, but she was prescribed a low-dose selective serotonin reuptake inhibitor (SSRI) by her pediatrician to manage anxiety symptoms. Sara's developmentally appropriate cognitive and emotional milestones were evident, although she exhibited excessive worry, restlessness, and difficulty concentrating during sessions, consistent with her reported experiences.

Using the DSM-5 criteria, Sara's symptoms align with a diagnosis of GAD. She reports pervasive and uncontrollable worry about academic performance, family relationships, and peer interactions, lasting more than six months. She demonstrates physical symptoms such as muscle tension and sleep disturbances, which support the diagnosis. The justification for this diagnosis rests on her endorsement of excessive worry occurring more days than not, the presence of physical symptoms, and significant distress impacting her daily functioning (American Psychiatric Association, 2013). Evidence indicates that early intervention and cognitive-behavioral therapy (CBT) tailored to adolescents are effective in reducing anxiety symptoms and improving functioning (Bass, van Nevel, & Swart, 2014).

Legal and ethical considerations in counseling Sara involve maintaining confidentiality while being aware of mandatory reporting requirements if there is suspicion of abuse or neglect. Informed consent protocols must be adapted for her age, involving guardians' participation while ensuring Sara's assent. Ethical practice requires establishing a trusting therapeutic alliance, respecting her developmental stage, and applying evidence-based interventions with cultural sensitivity (Koocher, 2003). As her clinician, it is essential to navigate the balance between autonomy and safeguarding her well-being while adhering to state laws and ethical standards.

This case underscores the importance of a comprehensive, evidence-based approach to treating anxiety disorders in youth. Integration of psychotherapy, specifically CBT, along with medication management when indicated, offers a biopsychosocial treatment plan that addresses both symptoms and underlying factors. Continuous assessment and culturally sensitive therapeutic practices are paramount in promoting positive outcomes for adolescent clients like Sara (Wheeler, 2014; Zilberstein, 2014).

In conclusion, this case highlights the necessity of applying DSM-5 criteria rigorously, understanding ethical implications ethically, and implementing evidence-based interventions for adolescent anxiety disorders. Close collaboration with guardians, integration of pharmacological and psychological treatments, and adherence to legal and ethical standards underpin effective mental health nursing practice with children and adolescents.

References

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
  • Bass, C., van Nevel, J., & Swart, J. (2014). A comparison between dialectical behavior therapy, mode deactivation therapy, cognitive behavioral therapy, and acceptance and commitment therapy in the treatment of adolescents. International Journal of Behavioral Consultation and Therapy, 9(2), 4–8. doi:10.1037/h0050134
  • Koocher, G. P. (2003). Ethical issues in psychotherapy with adolescents. Journal of Clinical Psychology, 59(11), 1247–1256.
  • Wheeler, K. (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (2nd ed.). Springer Publishing.
  • Zilberstein, K. (2014). The use and limitations of attachment theory in child psychotherapy. Psychotherapy, 51(1), 93–103. doi:10.1037/a0034591
  • McLeod, B. D., Jensen-Doss, A., Tully, C. B., Southam-Gerow, M. A., Weisz, J. R., & Kendall, P. C. (2016). The role of setting versus treatment type in alliance within youth therapy. Journal of Consulting and Clinical Psychology, 84(5), 453–464. doi:10.1037/ccp0000092
  • Additional references should be added to reach the total of ten credible sources following APA format.

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