Assignment 2: Practicum – Week 2 Journal Entry: Two Clients in Family Therapy
Group Therapy Progress Note
American Psychological Association | Division 12 http://www.div12.org/ 1
Client: __________________________________________________ Date: ___________
Group name:________________________________________________ Minutes:________
Group session # ______ Meeting attended is #:______ for this client.
Number present in group _____ of _____ scheduled Start time:________ End time: ________
Assessment of client
1. Participation level: ❑ Active/eager ❑ Variable ❑ Only responsive ❑ Minimal ❑ Withdrawn
2. Participation quality: ❑ Expected ❑ Supportive ❑ Sharing ❑ Attentive ❑ Intrusive
❑ Monopolizing ❑ Resistant ❑ Other: _____________________________________
3. Mood: ❑ Normal ❑ Anxious ❑ Depressed ❑ Angry ❑ Euphoric ❑ Other: _______________
4. Affect: ❑ Normal ❑ Intense ❑ Blunted ❑ Inappropriate ❑ Labile ❑ Other:_______________
5. Mental status: ❑ Normal ❑ Lack awareness ❑ Memory problems ❑ Disoriented ❑ Confused
❑ Disorganized ❑ Vigilant ❑ Delusions ❑ Hallucinations ❑ Other:__________________
6. Suicide/violence risk: ❑ Almost none ❑ Ideation ❑ Threat ❑ Rehearsal ❑ Gesture ❑ Attempt
7. Change in stressors: ❑ Less severe/fewer ❑ Different stressors ❑ More/more severe ❑ Chronic
8. Change in coping ability/skills: ❑ No change ❑ Improved ❑ Less able ❑ Much less able
9. Change in symptoms: ❑ Same ❑ Less severe ❑ Resolved ❑ More severe ❑ Much worse
10. Other observations/evaluations:________________________________________________________
In-session procedures:
_______________________________________________________________________________
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Homework: Assignment 2: Practicum – Week 2 Journal Entry: Two Clients in Family Therapy
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Other Comments:
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Signatures Date
Week 2 Journal Entry: Two Clients in Family Therapy
The family therapy involved two clients namely, Miss. A, a 17-year-old girl and the mother. This was the first time Miss. A was attending a counseling session. Miss. A has revealed to the parent that she was feeling suicidal and did not want to live anymore. The mother reported that for the last three months the daughter has become undisciplined and would argue with everyone in the house. The mother was very angry and had decided to throw her out. Assignment 2: Practicum – Week 2 Journal Entry: Two Clients in Family Therapy.
Miss. A Description
Miss. A is a 17-year-old girl who attended family therapy with the mother. According to A, she has been feeling sad and hopeless for the last two months ever since her baby sister passed away. The mother adds that her classwork was exemplary before, but lately she is a poor performer in class. Miss. A reported that she is no longer interested in classwork or other activities she formerly enjoyed Assignment 2: Practicum – Week 2 Journal Entry: Two Clients in Family Therapy. The mother added that the daughter rarely sleeps and always seems distracted. The client further reported that she feels suicidal, worthless, has lost weight because she has been having poor appetite, and she no longer has energy to do anything. The is also easily irritable, the reason she has been fighting with her mother.
Mother’s Description
The mother reported that she is unable to handle her daughter because she is also dealing with her issues. She reported that she was diagnosed with posttraumatic stress disorder (PTSD) when she was 21-years after she was sexually abused. She was brought up in a dysfunctional family and she was involved in substance abuse since her teenage years. She does not want her daughter to go through the mental torture she went through and thus she is overly strict with her daughter. She further reported that she also feels overwhelmed due to the loss of her last-born daughter and is unable to handle A’s tantrums. The mother underwent cognitive behavioral therapy after sexual abuse and has not received any other treatment since then.
Miss A’s Diagnosis
According to DSM-5, A manifests symptoms of major depressive disorder. The symptoms of major depressive disorder encompass appetite changes, sleep problems, irritability, fatigue, poor concentration, poor functioning while at work and academically, hopelessness, worthlessness, suicidal thoughts, etc. (Wang et al, 2017). Miss. A is manifesting majority of these symptoms and thus fits the diagnosis of major depressive disorder (Tendon, 2015).
Mother’s Diagnosis
The diagnosis of the mother is PTSD. Symptoms of PTSD include having had traumatic events such as sexual abuse, near-death events, etc (Lancaster et al, 2016). The mother went through a traumatic experience (sexual abuse) when she was young. The traumatic event has significantly distressed the mother and as a result she is having problems with her parenting.
Legal & Ethical Implications Allied to Counseling Clients
Legal and ethical issues associated with counseling of both clients consist of; informed consent, decision-making and maintaining confidentiality. The therapist is supposed to get informed consent from A and her mother before any treatment to ensure that they make informed treatment decisions. According to Bellesheim (2016) maintaining confidentiality during family therapy is important because there are numerous parties involved. Therefore, the therapist should thus ensure the two parties sign confidentiality forms and inform them that they should not disclose the information revealed during therapy to third parties.
References
Bellesheim K. (2016). Ethical Challenges and Legal Issues for Mental Health Professionals Working With Family Caregivers of Individuals with Serious Mental Illness. Ethics & Behavior. 26(7), 607-620.
Lancaster C, Teeters J, Gros D & Back S. (2016). Posttraumatic Stress Disorder: Overview of Evidence-Based Assessment and Treatment. J Clin Med. 5(11), 105. Assignment 2: Practicum – Week 2 Journal Entry: Two Clients in Family Therapy
Tendon R. (2015). Bipolar and Depressive Disorders in Diagnostic and Statistical Manual of Mental Disorders-5: Clinical Implications of Revisions from Diagnostic and Statistical Manual of Mental Disorders-IV. Indian J Psychol Med. 37(1): 1–4.
Wang J, Wu X, Lai W, et al. (2017). Prevalence of depression and depressive symptoms among outpatients: a systematic review and meta-analysis. BMJ Open. 1(7).
Students will:
Apply documentation skills to examine family therapy sessions *
Develop diagnoses for clients receiving family psychotherapy *
Analyze legal and ethical implications of counseling clients with psychiatric disorders *
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.
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 (without violating HIPAA regulations) each client, and identify any pertinent history or medical information, including prescribed medications.
Using the Diagnostic and Statistical Manual of Mental Health Disorders, Fifth Edition (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. Assignment 2: Practicum – Week 2 Journal Entry: Two Clients in Family Therapy
References
Required Readings
Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice. New York, NY: Springer.
Chapter 12, “Family Therapy” (pp. 429–468)
Nichols, M. (2014). The essentials of family therapy (6th ed.). Boston, MA: Pearson.
Chapter 3, “Basic Techniques of Family Therapy” (pp. 29–48)
Chapter 4, “The Fundamental Concepts of Family Therapy” (pp. 49–68)
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
Note: It is highly recommended that you use this resource as a reference guide throughout the course. Retrieved from Walden Library databases.
L’Abate, L. (2015). Highlights from 60 years of practice, research, and teaching in family therapy. American Journal of Family Therapy, 43(2), 180–196. doi:10.1080/01926187.2014.1002367
Note: Retrieved from Walden Library databases.
Mojta, C., Falconier, M. K., & Huebner, A. J. (2014). Fostering self-awareness in novice therapists using internal family systems therapy. American Journal of Family Therapy, 42(1), 67–78. doi:10.1080/01926187.2013.772870
Note: Retrieved from Walden Library databases.
Nichols, M., & Tafuri, S. (2013). Techniques of structural family assessment: A qualitative analysis of how experts promote a systemic perspective. Family Process, 52(2), 207–215. doi:10.1111/famp.12025
Note: Retrieved from Walden Library databases.
Papero, D. V. (2014). Assisting the two-person system: An approach based on the Bowen theory. Australian & New Zealand Journal of Family Therapy, 35(4), 386–397. doi:10.1002/anzf.1079
Note: Retrieved from Walden Library databases. Assignment 2: Practicum – Week 2 Journal Entry: Two Clients in Family Therapy