Select Two Clients You Observed Or Counseled This Wee 954304 ✓ Solved
Select Two Clients You Observed Or Counseled This Week During A Family
Select two clients you observed or counseled this week during a family therapy session. Note: The two clients you select must have attended the same family session. Do not select the same family you selected for Week 2. Then, address in your Practicum Journal the following: Using the Group Therapy Progress Note in this week’s Learning Resources, document the family session. 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.
Sample Paper For Above instruction
Introduction
In this practicum journal, I will document a recent family therapy session involving two clients. I will describe each client, provide their relevant history and medical background, and justify their diagnoses based on DSM-5 criteria. Additionally, I will analyze the suitability of solution-focused therapy versus cognitive-behavioral therapy (CBT) for this family, predict therapeutic outcomes, and discuss pertinent legal and ethical considerations supported by current literature.
Family Session Overview
The family session was held at a community mental health facility, attended by two clients – a mother and her adolescent daughter. The session focused on managing familial conflicts, communication issues, and emotional regulation stemming from recent life stressors.
Client Descriptions and Medical Histories
Client 1: Mother, age 42
The mother reported experiencing significant anxiety and depression over her recent separation from her spouse, which has impacted her ability to manage daily responsibilities effectively. She has a history of generalized anxiety disorder (GAD), diagnosed five years ago, for which she has been prescribed sertraline (50mg daily). Her medical history includes hypertension, controlled with lifestyle modifications. She is currently taking medication and consulting a primary care provider regularly.
Client 2: Daughter, age 16
The adolescent daughter exhibited symptoms of disruptive mood dysregulation disorder (DMDD), including temper outbursts, irritability, and difficulty regulating emotions, particularly in academic and home settings. She has a history of ADHD diagnosed at age 10 and is prescribed methylphenidate (20mg daily). Her school reports indicate declining academic performance and frequent conflicts with peers and family members.
Diagnoses and Justification
Mother’s Diagnosis: Major Depressive Disorder, Recurrent, Moderate (DSM-5 296.32)
The mother displays persistent sadness, feelings of worthlessness, fatigue, and diminished interest in activities, aligning with DSM-5 criteria for MDD. She reports a two-month history of depressed mood, sleep disturbances, and difficulty concentrating, which is consistent with her reported symptoms during the session.
Daughter’s Diagnosis: Disruptive Mood Dysregulation Disorder (DSM-5 313.89)
Her presentation of severe irritability, frequent temper outbursts, and mood instability supports this diagnosis. The symptoms have persisted for over 12 months, with impairment across multiple settings, fitting DSM-5 criteria for DMDD.
Therapeutic Approaches: Solution-Focused vs. Cognitive Behavioral Therapy
I believe that cognitive-behavioral therapy (CBT) would be more effective for this family due to its evidence-based success in addressing mood disorders and emotional regulation issues. CBT focuses on identifying and modifying maladaptive thought patterns, developing coping skills, and improving problem-solving abilities, which aligns with the needs of both clients.
Solution-focused therapy, however, could also complement CBT strategies by emphasizing the strengths and resources within the family, fostering hope, and setting achievable goals. In practice, integrating solution-focused techniques within a CBT framework can enhance engagement and motivate clients by highlighting successful past coping experiences.
Expected Outcomes
Implementing CBT can lead to reductions in depressive and irritability symptoms, improved communication skills, and healthier emotion regulation. For the mother, this might translate into decreased anxiety levels and better stress management. For the daughter, improved mood stability and emotion regulation may lead to fewer outbursts and better classroom behavior. Evidence from studies indicates that CBT produces significant symptom reduction and improved functioning in adolescents with mood dysregulation (Santosh et al., 2017) and adults with depression (Butler et al., 2006).
Legal and Ethical Implications
Counseling minors, such as the daughter, involves adherence to legal statutes related to informed consent—parents or guardians must give consent, and assent from minors is essential. Confidentiality boundaries must be clearly established, especially concerning sensitive information, while considering the requirement to protect the child's well-being (American Counseling Association, 2014). Counselors must also be cautious in handling medication information, ensuring coordination with healthcare providers and respecting patient privacy rights.
For the mother, confidentiality remains critical; however, when parental authority and the child's safety are involved, ethical dilemmas may arise. Maintaining clear boundaries aligned with ethical standards helps foster trust and ensures compliance with legal regulations (Corey, 2017).
Conclusion
This family therapy session illustrated the complex interplay of mental health issues within a familial context. Accurate diagnosis, the choice of an appropriate therapeutic approach, and awareness of legal and ethical considerations are crucial for effective intervention. Employing evidence-based practices like CBT, integrated with solution-focused techniques, can promote meaningful change and improve family dynamics.
References
- American Counseling Association. (2014). ACA Code of Ethics. American Counseling Association.
- Butler, A. C., Chapman, J. E., Forman, E. M., & Beck, A. T. (2006). The empirical status of cognitive-behavioral therapy: A review of meta-analyses. Clinical Psychology Review, 26(1), 17–31.
- Corey, G. (2017). Theory and Practice of Counseling and Psychotherapy (10th ed.). Cengage Learning.
- Santosh, P., et al. (2017). Effectiveness of cognitive-behavioral therapy in adolescents with mood dysregulation disorder. Journal of Child Psychology, 55(4), 398–410.
- American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.).
- Young, J. E., & Klosko, J. S. (2014). Schema Therapy: A Practitioner's Guide. Guilford Press.
- Miller, W. R., & Rollnick, S. (2013). Motivational Interviewing: Helping People Change (3rd ed.). Guilford Press.
- Hofmann, S. G., et al. (2012). The efficacy of cognitive behavioral therapy: A review of meta-analyses. Cognitive Therapy and Research, 36(5), 427–440.
- Leahy, R. L. (2017). Cognitive-Behavioral Therapy Techniques. Guilford Publications.
- Shirk, S. L., & Mufson, L. (2007). Changing moods: A cognitive-behavioral approach to adolescent depression. Guilford Press.
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