Select two clients you observed or counseled this week during a group therapy session for children and adolescents. Note: The two clients you select must have attended the same group session
Then, address in your Practicum Journal: Child and Adolescents Attending Group Therapy Essay
• Describe each client and identify any pertinent history or medical information, including prescribed medications.
• Using the DSM-5, explain and justify your diagnosis for each client.
• Explain any legal and/or ethical implications related to counseling each client.
• Support your approach with evidence-based literature.
Child and Adolescents Attending Group Therapy
The clients A and B were attending a CBT group therapy. There were 12 therapy sessions. During the therapy, the clients were educated on how to identify the negative thought patterns and replace these thoughts with more healthy/positive ones (Knutsson et al., 2017). The clients were also trained about various coping skills so that they can positively cope with challenging and stressful situations in their lives (Spirito et al., 2011). This journal entry describes two adolescent clients who attended a CBT group therapy, make diagnoses, and conclude by discussing the ethical and legal issues present in counseling of the pediatric population with mental disorders.
Description of Client A
Client A, a 16-year-old boy presented for therapy with the mother. The client had been undergoing emotional challenges that had negatively affected his academic performance. According to the mother, the client would have episodes of extreme happiness and at times periods of extreme sadness. The client was socially withdrawn and never maintained friendships with friends. Sometimes, the client would engage in risky behaviors like taking his dad’s car and driving recklessly. He would also be restless, overly active, and rarely slept at night. During some episodes, he would not attend his classes. However, after a few weeks, his mood would significantly change. During such periods, he would withdrawal from everyone, become sad, have crying spells, lost appetite, and reported insomnia. He would constantly argue with his sibling because he was very irritable. One year ago, he was prescribed valproic acid and aripiprazole but there was no full symptom remission.
Description of Client B
Client B, a 15-year-old girl presented for therapy with the mother after suicide attempt through paracetamol overdose. The client began exhibiting depressive symptoms two years ago. The mother reported that she was overeating and had gained so much weight. She stopped socializing with her friends and relatives and rarely attended family or any social events. The client reported sleeping difficulties, concentration problems, feeling hopeless and worthless, and irritability. Further examination revealed that her affect was apathetic and flat and made poor eye contact. She had never attended any therapy or received any form of treatment for her depressive symptoms.
Diagnosis for Client A
Client A manifests symptoms of bipolar 1 disorder as exhibited by the depressive and manic episodes for this client (American Psychiatric Association, 2013). The manic episodes for this client are characterized by the client being overly active, restlessness, rarely sleeping, and engaging in risky behaviors during such episodes. The depressive episodes are characterized by insomnia, social withdrawal and reduced interactions, sadness, and loss of appetite. According to McCormick et al (2015), bipolar 1 disorder is typified by depressive or manic symptoms. The manic episodes are characterized by lack of sleep, engaging in risky behaviors, concentration problems, restlessness, having excessive energy, and being euphoric. The manic symptoms are very severe and cause social impairment during bipolar 1 disorder. The depressive episodes are less severe and are typified by lack of energy, sleep disturbances, sadness, etc. (McCormick et al., 2015). During manic periods, the client would not attend school and this indicates the severity of manic episodes, supporting the diagnosis of bipolar 1 disorder for this client. Child and Adolescents Attending Group Therapy Essay
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Diagnosis for Client B
The diagnosis for client B is major depressive disorder. Major depressive disorder is characterized by symptoms such as sadness, appetite changes, concertation difficulties, lack of energy, anhedonia, weight changes, and suicidal thoughts ((Khodayarifard et al., 2016). The majority of the symptoms are consistent the whole day and significantly impairs social life and causes significant distress. Client B manifests majority of these symptoms and she has experienced the symptoms for over two years, and thus the symptoms are consistent with the diagnostics criteria for major depressive disorder.
Legal and Ethical Implications
There are various legal and ethical issues involved in the counselling of the pediatric population. First, the pediatric population in many states are not allowed to consent to their treatment, but their parents give consent. However, children and adolescents are allowed to assent to their treatment. Therefore, when counseling the two clients, the therapist should seek assent from them and ensure they are actively involved in the treatment decisions. Additionally, parents have the right to protect the minors and make treatment decisions on their behalf (Darby & Weinstock, 2018). The confidentiality of children should be protected and thus the information disclosed during therapy should not be revealed, unless the information indicates a probability of danger to self or others (Darby & Weinstock, 2018).
The diagnosis for client A is bipolar 1 disorder while client B is major depressive disorder as pet the DSM-5 criteria. Both clients underwent CBT group therapy where they were educated on how to replace their maladaptive thoughts, with more positive thoughts. The legal and ethical considerations during the treatment of the two clients include informed consent and confidentiality issues.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: American Psychiatric Association.
Darby, W. C., & Weinstock, R. (2018). The Limits of Confidentiality: Informed Consent and Psychotherapy. Focus (American Psychiatric Publishing), 16(4), 395–401. https://doi.org/10.1176/appi.focus.20180020.
Khodayarifard M, Pritz A & Goodarzi A. (2016). Cognitive-behavioral Family Therapy of the Adolescent Depression (A Case Study). International Journal of Psychotherapy, 20(1). 66-79:
Knutsson J, Bäckström B, Daukantaitė D & Lecerof F. (2017). Adolescent and Family-focused Cognitive-behavioural Therapy for Paediatric Bipolar Disorders. A Case Series, 24(3):589-617.
McCormick U, Murray B & McNew B. (2015). Diagnosis and treatment of patients with bipolar disorder: A review for advanced practice nurses. J Am Assoc Nurse Pract, 27(9): 530–542.
Spirito, A., Esposito-Smythers, C., Wolff, J., & Uhl, K. (2011). Cognitive-behavioral therapy for adolescent depression and suicidality. Child and Adolescent Psychiatric Clinics, 20(2), 191-204.
Assignment 2: Practicum – Week 10 Journal Entry
- Develop effective documentation skills to examine group therapy sessions with children and adolescents *
- Develop diagnoses for child and adolescent clients receiving group psychotherapy *
- Analyze legal and ethical implications of counseling child and adolescent clients with psychiatric disorders *
Select two clients you observed or counseled this week during a group therapy session for children and adolescents. Note: The two clients you select must have attended the same group session. If you select the same group you selected for the Week 8 or Week 9 Journal Entries, you must select different clients.
Then, address in your Practicum Journal the following:
- Using the Group Therapy Progress Note in this week’s Learning Resources, document the group 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 any legal and/or ethical implications related to counseling each client.
- Support your approach with evidence-based literature.
By Day 7
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Child and Adolescents Attending Group Therapy Essay