Week 12-4 Journal Entry: Select A Client You Observed

Week 12 4 Journal Entryselect A Client That You Observed Or Couns

Choose a client you observed or counseled during your practicum. Provide a detailed yet anonymized description of the client, including relevant history and medical information such as prescribed medications. Using the DSM-5, analyze and justify a clinical diagnosis for this client. Discuss whether cognitive-behavioral therapy (CBT) would be effective for treating this client, and explain the expected outcomes based on this therapeutic approach. Support your analysis with evidence-based literature. Additionally, consider any legal or ethical considerations that may arise when counseling this client, referencing applicable ethical guidelines and legal standards.

Paper For Above instruction

In the context of practicum training, selecting and analyzing a client involves a comprehensive understanding of the client’s psychological profile, medical history, and the therapeutic potential of different intervention approaches. For this paper, I observed a client, herein referred to as John to maintain confidentiality, who presented with symptoms consistent with depression and anxiety. John was a 30-year-old male, employed full-time, with a history of episodic depressive episodes and occasional panic attacks. He was prescribed selective serotonin reuptake inhibitors (SSRIs) by his psychiatrist, and no other significant medical conditions were noted. His history included a family history of depression and personal experiences of recent job stress and relationship difficulties, which appeared to exacerbate his symptoms.

Utilizing the DSM-5 criteria, John's presentation aligns with a diagnosis of Major Depressive Disorder (MDD), moderate severity, with comorbid Generalized Anxiety Disorder (GAD). According to the DSM-5 (American Psychiatric Association, 2013), MDD is characterized by persistent depressed mood, loss of interest, changes in appetite or sleep, feelings of worthlessness, and difficulty concentrating, all of which John reported. GAD is evidenced by excessive worry occurring more days than not for at least six months, along with associated physical symptoms such as restlessness and muscle tension, which John also endorsed during sessions.

Considering the diagnostic profile and evidence from the literature, cognitive-behavioral therapy (CBT) is highly recommended for this client. CBT is an empirically supported treatment effective in managing both depression and anxiety disorders (Hofmann, Asnaani, Vonk, Sawyer, & Fang, 2012). Its structured approach aims to identify and modify maladaptive thought patterns and behaviors, which are central to John's presenting problems. The therapy would focus on cognitive restructuring to challenge negative automatic thoughts and behavioral activation to increase engagement in pleasurable and meaningful activities, thereby alleviating depressive symptoms.

Expected outcomes of CBT for John include a reduction in depressive symptoms, improvements in anxiety levels, and enhanced coping skills (Beck, 2011). Research indicates that patients undergoing CBT show significant symptom reduction and improved quality of life, with effects generally maintained during follow-up periods (Butler, Chapman, Forman, & Beck, 2006). Moreover, CBT’s active and collaborative style fosters treatment engagement and self-efficacy, essential for long-term management of depression and anxiety (Hollon, Thase, & Markowitz, 2019).

Legal and ethical considerations in counseling this client include maintaining confidentiality and obtaining informed consent, especially given the use of recorded sessions and documentation. As per the American Counseling Association’s Code of Ethics (ACA, 2014), counselors must ensure that clients understand the nature of therapy, their rights, and the limits of confidentiality, particularly when working with clients on medicated treatment plans. Additionally, therapists must recognize their scope of practice, coordinate care with other healthcare providers, and be vigilant for risk factors such as suicidal ideation, ensuring appropriate interventions. Ethical practice also includes cultural competence—being sensitive to the client’s cultural background and personal values, which influence treatment adherence and outcomes (Knapp & VandeCreek, 2012).

In conclusion, analyzing a practicum client through a diagnostic lens supports targeted and effective intervention strategies. Employing evidence-based approaches like CBT offers promising outcomes and aligns with ethical standards. Continued reflection on legal and ethical responsibilities ensures the provision of competent, respectful, and ethical care, fostering positive client outcomes in mental health practice.

References

• American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).
• Beck, J. S. (2011). Cognitive Behavior Therapy: Basics and Beyond (2nd ed.). Guilford Press.
• 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.
• Hollon, S. D., Thase, M. E., & Markowitz, J. C. (2019). Treatment and prevention of depression. Nature Reviews Neuroscience, 20(3), 159–172.
• Knapp, S., & VandeCreek, L. (2012). Practical ethics for psychologists: A positive approach. American Psychological Association.
• American Counseling Association. (2014). ACA Code of Ethics. American Counseling Association.
• Beck, A. T. (2011). Cognitive therapy of depression. Guilford Press.
• 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.