Select Two Clients In A Family Therapy Session Note

Select Two Clients In A Family Therapy Session Note The Two Clients

Select two clients in a family therapy session. Note: The two clients must have attended the same family session. Then, address the following: 2-3 pages 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 whether solution-focused or cognitive behavioral therapy would be more effective with this family. Include expected outcomes based on these therapeutic approaches. Explain any legal and/or ethical implications related to counseling each client. Support your approach with evidence-based literature.

Paper For Above instruction

Selection and Diagnostic Analysis of Clients in Family Therapy

Family therapy offers a unique platform to address the complex interplay of interpersonal dynamics, mental health concerns, and systemic factors influencing clients' wellbeing. In this context, selecting two clients from a shared therapy session requires careful consideration of their individual histories, diagnoses, and the therapeutic approaches that best suit their needs. This paper provides a comprehensive description of two hypothetical clients who attended a family therapy session, analyzes their diagnostic profiles using the DSM-5, discusses the potential effectiveness of solution-focused versus cognitive-behavioral therapy, and considers the ethical and legal implications associated with their treatment.

Client Profiles and Clinical Backgrounds

Client A: Sarah, a 16-year-old adolescent girl

Sarah is a 16-year-old adolescent presenting with symptoms of irritability, mood swings, and difficulty concentrating, consistent with her recent academic struggles and social withdrawal. She reports a history of anxiety and occasional panic attacks, for which she has been prescribed a selective serotonin reuptake inhibitor (SSRI). Her medical history reveals no chronic illnesses beyond adolescence-related asthma, managed with inhalers. Family history indicates that her mother experienced depression during her teenage years, which occasionally affected family interactions. Sarah's recent behavioral changes have been a concern for her parents, particularly her withdrawal from extracurricular activities and deterioration in peer relationships.

Client B: Mr. Johnson, a 45-year-old father

Mr. Johnson is a 45-year-old male employed as a construction project manager. He reports experiencing persistent irritability, difficulty sleeping, and increased feelings of guilt following recent conflicts with his teenage daughter, Sarah. He seeks therapy for managing stress and improving family communication. His medical history includes hypertension, managed with antihypertensive medication, and a recent episode of depressive symptoms following a breakup 12 months prior. His reports indicate occasional alcohol use as a coping mechanism. Mr. Johnson's family history includes a paternal grandfather diagnosed with bipolar disorder and a maternal aunt with depression, raising considerations for mood disorder diagnosis.

DSM-5 Diagnoses and Justifications

Sarah's Diagnosis

Based on her presentation—irritability, mood swings, withdrawal, academic decline, and history of anxiety—Sarah’s symptoms align with Disruptive Mood Dysregulation Disorder (DMDD) or, alternatively, Major Depressive Disorder (MDD) with atypical features, depending on the persistence and severity of her mood disturbances. Given the age and symptomatology, a diagnosis of Mood Disorder, NOS, might be considered if symptoms don’t fully meet criteria for MDD. Her anxiety symptoms suggest comorbid Generalized Anxiety Disorder (GAD). After thorough assessment, a diagnosis of unspecified depressive disorder with comorbid anxiety is justified, considering her age and symptom pattern (American Psychiatric Association, 2013).

Mr. Johnson's Diagnosis

Mr. Johnson exhibits symptoms indicative of Major Depressive Disorder (MDD), characterized by persistent irritability, sleep disturbances, guilt, and prior depressive episodes. The family history of bipolar disorder necessitates careful assessment to rule out bipolar spectrum disorders; however, current presentation lacks manic or hypomanic episodes, supporting MDD diagnosis. His stress related to family conflicts and recent life events worsen his mood symptoms. The comorbid hypertension and alcohol use highlight the importance of integrated treatment approaches (Fava & Davidson, 2014).

Therapeutic Approaches: Solution-Focused vs. Cognitive Behavioral Therapy

Considering the systemic issues in the family context and the individual presenting symptoms, Cognitive Behavioral Therapy (CBT) is likely more effective for Sarah and Mr. Johnson individually and in conjunction with family therapy. CBT's evidence-based effectiveness in treating adolescent mood disorders and adult depression, especially when addressing cognitive distortions, behavioral activation, and emotional regulation, makes it a suitable choice (Hofmann, Asnaani, Vonk, Sawyer, & Fang, 2012). The focus on restructuring maladaptive thought patterns and enhancing coping skills can significantly improve outcomes for both clients.

Solution-focused brief therapy (SFBT) emphasizes building on existing strengths and setting achievable goals within a brief timeframe. While SFBT is effective in improving family communication and resolving specific issues, its limitations in addressing underlying mood pathology suggest it may be less comprehensive than CBT for these clients’ diagnoses (Kim, 2008). However, combining SFBT techniques for family dynamics with CBT for individual psychopathology could optimize benefits.

Expected Outcomes

For Sarah, CBT can facilitate mood stabilization, reduction in anxiety symptoms, and improved social and academic functioning. The therapy may also address familial communication patterns impacting her mood. For Mr. Johnson, CBT aims to reduce depressive symptoms, improve stress management, and develop healthier communication with his family. Both clients could experience enhanced emotional regulation, decreased symptom severity, and improved family functioning. Family sessions integrating these approaches may further strengthen relational bonds and promote ongoing support (Henggeler & Sheidow, 2016).

Legal and Ethical Considerations

Legal and ethical implications include maintaining confidentiality, especially considering the minor status of Sarah and the adult status of Mr. Johnson. Informed consent must be obtained from both clients or their guardians, with clear disclosures about the limits of confidentiality, particularly if safety concerns arise (American Counseling Association, 2014). Ethical considerations involve cultural competence, respecting client autonomy, and avoiding dual relationships. Additionally, therapists must be vigilant about potential harm, including warning signs of suicidality or self-harm, which are ethically mandated to address promptly (Reamer, 2018). Documentation and adherence to state licensing laws ensure legal compliance throughout treatment.

Conclusion

In summary, selecting Sarah and Mr. Johnson for family therapy involves understanding their individual histories, diagnoses, and the systemic factors influencing their mental health. Applying DSM-5 criteria justifies their diagnoses—Mood Disorder NOS with anxiety for Sarah and MDD for Mr. Johnson. CBT emerges as the preferred therapeutic modality, given its robust evidence base for mood and anxiety disorders, with integration of solution-focused techniques to enhance family communication. Ethical and legal considerations, including confidentiality and informed consent, underpin effective and responsible clinical practice. Ultimately, combining individual and family-centered evidence-based interventions can promote resilience, emotional health, and relational harmony within this family unit.

References

• American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.).
• American Counseling Association. (2014). ACA Code of Ethics.
• Fava, G. A., & Davidson, K. G. (2014). Cognitive behavioral therapy. In M. J. Hubble, B. L. Duncan, & S. D. Miller (Eds.), The Heart and Soul of Change (pp. 274–292). American Psychological Association.
• Henggeler, S. W., & Sheidow, A. J. (2016). Casebook for Parent–Child Interaction Therapy. Guilford Publications.
• Hofmann, S. G., Asnaani, A., Vonk, I. J., Sawyer, A. T., & Fang, A. (2012). The efficacy of cognitive behavioral therapy: A review of meta-analyses. Cognitive Therapy and Research, 36(5), 427–440.
• Kim, J. S. (2008). Examining the effectiveness of solution-focused brief therapy: A meta-analysis. Research on Social Work Practice, 18(2), 107–116.
• Reamer, F. G. (2018). Ethical standards in social work: A review of the NASW code of ethics. Social Work, 63(1), 12–20.