Describe each client (without violating HIPAA regulations)
Students will:
Develop effective documentation skills for group therapy sessions *
Develop diagnoses for clients receiving group psychotherapy *
Evaluate the efficacy of cognitive behavioral therapy for groups *
Analyze legal and ethical implications of counseling clients with psychiatric disorders *
* The Assignment related to this Learning Objective is introduced this week and submitted in Week 10.
Select two clients you observed or counseled this week during a group therapy session. Note: The two clients you select must have attended the same group session.
Then, in your Practicum Journal, address 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 whether cognitive behavioral therapy would be effective with this group. Include expected outcomes based on this therapeutic approach.
Explain any legal and/or ethical implications related to counseling each client.
Support your approach with evidence-based literature Describe each client (without violating HIPAA regulations)
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Psychotherapy with groups and families
Part 1.
The case involved a family that sought psychotherapy for spousal and domestic abuse. The family seeking therapy is comprised of two members. The first member is the mother, Maria, a 24 year old women of Latino descent. She is a housewife with no marketable skills and moved into the country seven years ago upon getting married to her husband. She reports that her husband has been physically and emotionally abusive towards her. He does not allow her to have friends of contact with her family. She further adds that the abuse has escalated to an extent that she feared for her life. Although she is currently separated from her husband after the police intervened after the neighbors made repeated reports to them. She is fearful that she does not have any marketable skills or a social support system in place thus making her vulnerable to manipulation from her husband. She is not on any prescription medication Describe each client (without violating HIPAA regulations).
The second member is the daughter, Angela, a 7 year old child. She is non-communicative and appears fearful in the presence of adult males. She has scars from beatings by her father. She is not on any prescription medication.
Part 2.
Using DSM-5, Maria has been diagnosed as suffering from intimate partner violence. The diagnosis is based on the set criteria that includes being subjected to violence and aggression from an intimate partner who was her husband in this case. She has experienced severe and chronic episodes of spousal violence over the course of her marriage. To be more precise, she meets two out of four conditions for this diagnosis. Besides that, she has been repeatedly subjected to emotional abuse (psychological aggression). These aspects of her relationship support the diagnosis (Sperry, 2016).
Using DSM-5, Angela has been diagnosed as suffering from child physical and psychological abuse. This diagnosis is based on the scars on her body that act as evidence of physical abuse. In addition, her fear of male adults and non-communicative nature are evidence that she has been psychologically abused by her father (Sperry, 2016). Describe each client (without violating HIPAA regulations).
Part 3.
The family therapy should apply cognitive behavioral therapy (CBT) as an appropriate approach. The family are victims of physical and psychological abuse that was targeted at controlling them. This had a negative effect on their behaviors, emotions and thoughts. CBT addresses the negative effects of the abuse through applying a stepwise methodology that identifies the problem, reflects on past abuse, evaluates how the abuse was justified, reflecting on how emotions affected thoughts that ultimately affected behavior, and developing self-talk that changes and challenges the negative emotions to protect the clients (Wheeler, 2014).
Part 4.
Counseling Maria has legal implications over confidentiality and disclosures. The abuse has legal implications and there could be sensational details that the counselor is obligated to report to law enforcement officers. This is particularly the case if the abuse is still ongoing and the police are not aware. This could be challenging since Maria has been assured of confidentiality and that none of the information she discloses will be shared with a third party without her prior informed permission (Cautlin & Lilienfeld, 2015). Describe each client (without violating HIPAA regulations).
Counseling Angela has ethical implications. She is a child and issues of informed consent come into play since she is not consulted on whether or not she wants to attend therapy. In addition, there is an issue of confidentiality since the mother expects to be informed about the case details even if Angela expresses a desire to have all the case details kept confidential and not disclosed to other parties (Cautlin & Lilienfeld, 2015).
References
Cautin, R. & Lilienfeld, S. (2015). The encyclopedia of clinical psychology, volume II Cli-E. Hoboken, NJ: John Wiley & Sons.
Sperry, L. (2016). Handbook of diagnosis and treatment of DSM-5 personality disorders: assessment, case conceptualization, and treatment (3rd ed.). New York, NY: Routledge.
Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: a how-to-guide for evidence-based practice (2nd ed.). New York, NY: Springer Publishing Company, LLC. Describe each client (without violating HIPAA regulations).
Students will:
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 Describe each client (without violating HIPAA regulations).
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
Describe each client (without violating HIPAA regulations)
Group Therapy Sessions with Children and Adolescents
Description of clients, identifying any pertinent history or medical information
Client A, a seven-year-old girl presented to the hospital psychiatric department with a history of feeling anxious when not together with her mother and sleeping away from home. This happened when the girl slept at a friend’s or relative’s home or while in a school camp. She expressed her nervousness as a worry that something bad would happen to her mother. Whether the detachment had was anticipated or had occurred, the client and her mother stated that she would experience worry, fear, stomach churning, crying, trembling and sweating. At the period of consultation, the client was not under any medication and medical history revealed that the client did not have any other clinically significant feature.
Client B, a twelve- year old boy was brought to the pediatrician by his mother who was concerned that the boy is no longer rides bikes or play with toys with other children in the neighborhood. Over the last one month, the boy has been isolating himself and has become more irritable with no recognized trigger, has complained of frequent stomachaches and headaches over the last numerous weeks, and worries that all people in the family will die. Teachers have reported inattentiveness and impulsive behaviors in the class. The boy has also been having random durations of uncontrollable screaming and crying with no trigger Describe each client (without violating HIPAA regulations). There doesn’t exist a history of trauma, psychotic medication, changes in everyday life or recent losses.
An explanation and justification diagnosis for each client using the DSM-5
Client A is suffering from separation anxiety disorder (SAD). The DMS-5 defines SAD as a developmentally unsuitable and excessive nervousness about separation from home or from those to whom the patient is attached. According to Cooper-Vince et al (2014), diagnostic criteria describe excessive anxiety associated with separation as demonstrated by the existence of at least three of the specified SAD symptoms. These symptoms include recurrent extreme distress when separation from key attachment figures or home is anticipated or occurs, excessive and persistent worry anxiousness about losing or on probable harm happening to a key attachment figure, excessive and persistent nervousness that an untoward incident will result in separation from the key attachment figure and persistent refusal or reluctance to go elsewhere for fear of being separated. Other symptoms include excessively and persistently reluctant or fearful of not being with key attachment figures or at home and frequent reports of physical symptoms like vomiting, nausea, stomachaches, and headaches when a detachment from key attachment figures is anticipated or occurs. Describe each client (without violating HIPAA regulations).
Client B is suffering from major depressive disorder (MDD). As Fatemi and Clayton (2016) indicate, according to the DSM-5 diagnostic criteria for MDD include the presence of at least five depressive symptoms for two or more weeks. These symptoms include the existence of irritable/depressed mood or anhedonia, reduced along with other depressive symptoms like reduced capability to have fun, sleep disturbance, impaired social relationships or social withdrawal suicidal ideation or thoughts of death, lack of energy, poor concentration. These symptoms should not be as a result of the effects of medication, drug or alcohol use, or a universal medical illness.
Ethical and legal implications related to counseling clients
A key ethical implication related to counselling both clients is competency. According to Ziomek-Daigle (2017), it is the ethical responsibility of children and adolescent psychotherapist to ensure that they have the proper treating and competency in child and adolescent psychotherapy. There exist diverse systems, such as school, peers, community and family interacting with the child. Successful and adolescent psychotherapy needs specialized skills and knowledge in counselling these populating along with a thorough knowledge of the bigger systemic context affect the adolescent’s life and behavior Describe each client (without violating HIPAA regulations).
Confidentiality and informed consent are other major ethical issues when counselling children and adolescents. it is a legal and ethical responsibility for a counselor to get informed consent from clients utilizing a language they are able to understand. As Sori and Hecker (2015) allege, children and adolescents who have not reached the legal age of giving consent, the counselor is required to obtain consent from the parent, but the child must agree to take part in counselling. Sori and Hecker (2015) claim that confidentiality issues are intricate in treating children and adolescents because their legal guardians or parents are usually involved in the counselling process and can access their medical records. Therefore, the counselor must maintain a balance amid the ethical responsibility of informing the parents on any treatment performed and the progress of the treatment, and the clients’ right to autonomy and privacy. Describe each client (without violating HIPAA regulations).
References
Cooper-Vince, C., Emmert-Arponson, B., Pincus, D., & Comer, J. (2014). The diagnostic utility of separation anxiety disorder symptoms: An item response theory analysis. Journal of Abnormal Child Psychology, 42(3): 417-248
Fatemi, S., & Clayton, P. (2016). The Medical Basis of Psychiatry. New York: Springer.
Sori, C., & Hecker, L. (2015). Ethical and Legal Considerations When Counselling Children and Families. Australian and New Zealand Journal of Family Therapy, 36(4): 450-464.
Ziomek-Daigle, J. (2017). Counselling Children and Adolescents: Working in School and Clinical Mental Health Settings. Boca Raton, FL: Taylor & Francis. Describe each client (without violating HIPAA regulations).