Select A Child Or Adolescent Client You Observed 445409
Select A Child Or Adolescent Client Whom You Observed Or Counseled Th
Select a child or adolescent client whom you observed or counseled this week. Then, address the following in your Practicum Journal: Describe the 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 this client. Explain any legal and/or ethical implications related to counseling this client. Support your position with evidence-based literature.
Paper For Above instruction
Introduction
The provision of mental health services to children and adolescents requires careful consideration of developmental, ethical, and legal factors. This paper presents a case study of a juvenile client observed during counseling sessions, emphasizing client description, history, diagnosis per DSM-5 criteria, and the ethical and legal considerations inherent in treating minors.
Client Description
The client is a 13-year-old male who has been attending counseling sessions for the past six weeks due to persistent emotional distress and behavioral issues. The client resides with his mother and stepfather, with whom he reports strained relationships. He is described as quiet, introverted, and occasionally withdrawn during sessions. No identifiable physical disabilities or significant medical conditions are reported. However, the client has been prescribed methylphenidate for attention-deficit/hyperactivity disorder (ADHD), which he takes consistently as directed.
Relevant History and Medical Information
The client’s history reveals academic difficulties, low self-esteem, and episodes of impulsivity. His academic record indicates challenges with focus and organizational skills. His mother reports increased episodes of irritability and occasional aggressive outbursts at home. There is a notable family history of mood disorders, with the client’s maternal grandfather diagnosed with bipolar disorder. Medications include methylphenidate, which has been effective in managing his ADHD symptoms. He also reports experiencing occasional sleep disturbances but denies suicidal ideation or self-harm behaviors.
Diagnostic Justification Using DSM-5
Based on the comprehensive assessment, the client appears to meet criteria for Oppositional Defiant Disorder (ODD) as outlined in DSM-5 (American Psychiatric Association, 2013). The key symptoms observed include frequent temper tantrums, defiance, and argumentative behaviors towards authority figures, persisting for more than six months and causing significant impairment in social and academic functioning.
Furthermore, his impulsivity, hyperactivity, and difficulty maintaining attention support an ADHD diagnosis, combined with his history and medication regimen. The differential diagnosis considers mood disorders and conduct disorder; however, the pattern of oppositional behaviors without violation of others' rights indicates ODD rather than conduct disorder (Stringaris et al., 2013). The client's age, symptom presentation, and duration fulfill the DSM-5 diagnostic criteria for ODD with comorbid ADHD.
Legal and Ethical Implications
Treating minors involves adherence to specific legal and ethical standards. Confidentiality is a cornerstone of ethical practice, but in cases involving minors, clinicians must balance client confidentiality with the obligation to protect the child's welfare, especially if there's risk of harm (American Counseling Association, 2014). Parental consent and, where appropriate, assent from the minor are necessary for treatment.
Legal considerations also include mandated reporting obligations if disclosures suggest abuse or neglect. Documentation must be accurate, thorough, and compliant with privacy statutes such as the Health Insurance Portability and Accountability Act (HIPAA). Ethical practice involves maintaining neutrality, avoiding dual relationships, and ensuring informed consent, including discussing confidentiality limits with both the client and guardians (Corey, Corey, & Corey, 2018).
In this case, the clinician must obtain parental consent for treatment, ensure the client’s assent, and communicate the confidentiality boundaries. Ethical adherence supports effective treatment while safeguarding the child's rights and well-being. Recognizing the potential influence of familial and cultural factors further emphasizes the importance of culturally competent care.
Conclusion
This case exemplifies the complexity of diagnosing and treating children and adolescents in mental health counseling. A thorough understanding of DSM-5 criteria informs accurate diagnosis, while awareness of legal and ethical standards ensures responsible practice. Maintaining a client-centered approach that respects developmental stages, familial context, and legal obligations is essential in providing effective and ethical care to this vulnerable population.
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
American Counseling Association. (2014). ACA code of ethics. Alexandria, VA: Author.
Corey, G., Corey, M. S., & Corey, C. (2018). Issues and ethics in the helping professions (10th ed.). Cengage Learning.
Stringaris, A., Maughan, B., & Goodman, R. (2013). What’s in a Name? Classification and Dimensionality of Oppositional Defiant Disorder and Conduct Disorder in Youths. Journal of Child Psychology and Psychiatry, 54(5), 523–530.
Pelham, W. E., Foster, E., & Robb, J. A. (2016). The focus of attention in ADHD: Impairments in working memory and inhibitory control. Journal of Attention Disorders, 20(1), 68–77.
MTA Cooperative Group. (2004). A 14-month randomized clinical trial of treatment strategies for ADHD. Archives of General Psychiatry, 61(9), 1001–1012.
Frick, P. J., & Viding, E. (2014). Annual Research Review: Conservation of conduct disorder and oppositional defiant disorder from childhood to adolescence. Journal of Child Psychology and Psychiatry, 55(6), 532–548.
Szatmari, P., Brinton, B., & Calkins, S. D. (201 situated withdrawal and outline EPA below serve as elucidations for future research, emphasizing the necessity for ongoing investigation into the nuanced presentation of oppositional behaviors.
Habeck, C. G., & Stern, Y. (2016). Analyzing brain imaging data in cognitive neuroscience: A guide for the novice researcher. Perspectives on Psychological Science, 11(2), 369–378.