Psychotherapy with Children and Adolescents
Name
University Affiliation
Psychotherapy with Children and Adolescents
Client Description
The client is a 17-year-old female who has previously been diagnosed with depression and anxiety. She has been put under medication, psychotherapy, and lifestyle adjustment. The psychotherapist has put the patient under both antidepressants and antianxiety medication. It was never considered necessary to prescribe antipsychotic medicine since the client has been relatively stable and has no signs of schizophrenia or bipolar disorder.
However, the client has been subjected to psychotherapy, which involves speaking to a therapist as part of her maintenance schedule. The therapy aims to ensure that she does not relapse into the depressive state. Some of the uncontrollable factors seemed causative to the client’s depression. For instance, the client has strong relationships with people in her life, which means she is over empathetic. While this is usually a virtue in friendships, it can be detrimental to a post-depressive patient.
The interactions the therapist has had with the client during the maintenance stage reveal this fact. She seems highly emotional and vulnerable following one of her friends’ death, who was also a client at the office. She is currently reporting problems sleeping and the inability to focus on various activities. Despite these challenges, the patient has recorded some positive outcomes since the last session. She notes that she enjoys a better relationship with her brother and the nightmares seem to have stopped.
DSM-5 and Diagnosis
The client should be diagnosed with one of three mental disorders: Attention Deficit Hyperactivity Disorder (ADHD), clinical depression, and panic disorders. The symptoms that she is currently experiencing suggest that she may be dealing with one of these health issues. Additionally, her past diagnoses and treatment establish a premise on which treatment should be recommended. Classified as a neurodevelopment disorder, ADHD is symbolized by A06 in the DSM-V chart.
ADHD is characterized by difficulties focusing on a single task and a tendency toward impulsive behaviors and hyperactivity. The client has reported problems focusing on her daily chores, which could be associated with the ailment. Groves et al. (2020) investigate the link between emotive wellbeing and the symptoms of ADHD. If it is established that she is dealing with ADHD, Ritalin may be administered alongside maintenance therapy to offset the symptoms. Raposo (2019) examines some studies conducted on the impact of Ritalin on the brain. The psychotherapist needs to conduct further tests before recommending any medication.
The client has previously been diagnosed with clinical depression. The present symptoms associated with loss of interest in otherwise enjoyable activities could hint that she is relapsing to her earlier state. Under DSM-V, clinical depressions is a mood disorder symbolized as D02. However, psychotherapy should be careful not to dismiss the symptoms as something that the patient can overcome using will-power or motivation. If they determine that the patient has clinical depression, reintroducing selective Serotonin Reuptake Inhibitor may be necessary.
Finally, the specialist needs to investigate whether the client could be dealing with panic disorder. The American Psychiatric Association (2013) presents a detailed analysis of the modern DSM-V chart. The ailment is classified under anxiety in the DSM-V chart and symbolized by E01. Panic disorder is usually associated with an intense fear that lasts several minutes and leads to problems focusing. While it is unlikely that the client is dealing with panic attacks, the therapist needs to further investigate the matter. A suitable approach involves checking whether the client has any pathological symptoms linked to the lack of focus.
Legal and Ethical Implications
Mental health professionals need to address the various legal issues involving how they handle clients and their data. As a mental health professional handling the client, it is vital to determine the line that separates crossing a boundary and violating professional ethics. Similarly, one needs to study and practice the moral ethics which govern bartering, touching, ang giving gifts to the clients. Another critical concern for professionals is understanding the specific conditions under which confidentiality may be breached. The professional has a duty to warn, protect, and report a client under conditions. They also need to adhere to the laws governing elder and child abuse when dealing with their clients.
While professionals may cross the line when diagnosing their clients for mental disorders, they must remain judicious to ensure that they do not violate their patients’ rights. American Nurses Association (2014) reviews the professional standards healthcare providers need to follow. Some of the rights that mental health patients need to enjoy in every psychotherapy office include open and honest communication, informed consent, confidentiality, and access to healthcare. The professional is required to avoid crossing the boundary when attending a client. However, he or she is legally prohibited from violating their patients’ rights. In the case study, sharing the patient’s name, address, location, and diagnosis with insurance companies would be a violation of confidentiality and may lead to a suit. If the psychotherapist engaged in such acts, he can easily lose his right to practice and risk deregistration by the APA.
Bartering, touching, and offering gifts to clients is strictly prohibited in the line of duty. Touching and bestowing gifts to clients can only be done in accordance with standard treatment procedures. Such interventions would also be recorded in the client’s file as part of the diagnosis or treatment. Wheeler (2013) examines the best practices that psychiatric nurses need to follow. For instance, a psychotherapist may decide to test a client’s cognitive power and emotional response by giving them an item they love wrapped as a gift. They may also extend their hand to determine whether they are suffering from haphephobia, which is a fear of being touched.
Resources
American Nurses Association. (2014). Psychiatric-Mental Health Nursing 2nd Edition. Nursing Standards.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Am Psychiatric Assoc. Washington, DC.
Groves, N. B., Kofler, M. J., Wells, E. L., Day, T. N., & Chan, E. S. (2020). An Examination of Relations Among Working Memory, ADHD Symptoms, and Emotion Regulation. Journal of Abnormal Child Psychology, 1-13.
Raposo, C. (2019). Researchers analyze the effects of Ritalin on the developing brain. [UFRGS News and Information]. Porto Alegre, RS.
Wheeler, K. (2013). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice. Springer Publishing Company.