Practicum-Week 3 Journal Entry and Submission

Select a client that you observed or counseled this week. Then, address the following in your Practicum Journal:
• Describe the client (without violating HIPAA regulations) and identify any pertinent history or medical information, including prescribed medications Assignment 3: Practicum-Week 3 Journal Entry and Submission.
• Using the DSM-5, explain and justify your diagnosis for this client.
• Explain whether cognitive behavioral therapy would be effective with this client. Include expected outcomes based on this therapeutic approach. Support your approach with evidence-based literature.
• Explain any legal and/or ethical implications related to counseling this client.
Note: Be sure to use the Practicum Journal Template, located in the Learning Resources.
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Client Description

A, R 16 y/o female who was on1013hold presented at the emergency department accompanied with her mother with complaints of aggressive behavior and agitation. The patient had also reportedly threatened suicide 2 weeks ago in case she was not let go to live with her grandmother. The mother also reported an increased risk of the patient harming herself, some episodes of hallucination and delusion. All the patient’s vital signs were within the normal range. Currently, the medications she is on include: celexa 10mg. Prozac 20mg po daily for mood and Ativan 0.5mg po daily for anxiety.

Diagnosis Using the DSM-5 model

For this week’s journal, the client presented with the symptoms of hallucinations, delusions, disorganized speech and suicide idealization. All these are classical symptoms of schizophrenia according to the DSM-model (American Psychiatric Association, 2013). According to the DSM-5 model, the diagnosis of schizophrenia is made from multiple etiologies. However, the major symptoms for diagnosis are two or more symptoms of auditory and verbal hallucinations, delusions and disorganized speech (American Psychiatric Association, 2013). The mother also reported that the patient had aggressive behavior, agitation, and was at high risk for harming herself. Basing on the mother’s report, these symptoms had persistent for close to two weeks. To add on, basing on the fact that the patient was on 1013 hold, it is automatic that these symptoms had impaired the patient’s life to an extent that she could no longer practice self-care actively participate in school and was unable to form positive relations and this warrants the diagnosis of schizophrenia.

Efficiency of Cognitive Behavioral Therapy For This Client and Expected Outcomes

Cognitive behavioral therapy is the first line of treatment for patients diagnosed with schizophrenia as it is for this patient (Morrison, 2013). With the use of CBT, the 13 y/o patient as diagnosed with schizophrenia will be able to reduce the depressive and negative symptoms that she has by connecting her behavior, feelings and thoughts to establish areas of weakness. Besides, CBT would contribute to her ability to: remain compliant to treatment, set goals, develop positive actions and to eliminate the roadblocks to the recovery process. According to Addington & Lecomte (2014), the expected outcome is that: the patient will be able to relate individual thoughts, feelings and behavior and take more control in daily life for a return to normal functioning Assignment 3: Practicum-Week 3 Journal Entry and Submission.

Legal/ Ethical Implications Related to Counseling of This Client.

When establishing a therapeutic relationship with this patient, basing on the fact that she is 13 years old, it is necessary to observe the ethical principle of confidentiality (Kurpad, 2018). Confidentiality of clients is a mandatory requirement which a psychiatrist/therapist should possess for the purposes of protecting the therapy given to the client and not revealing the details of the cognitive behavioral therapy (Kurpad, 2018). As an ethical concern, confidentiality in this case is a right of the client to privacy and it enhances communication. Irrespective of age, every information that is shared by the client should not be disclosed to either of her parents unless with the consent of the 13 y/o patient. Doing otherwise may result to mistrust and would destroy the therapeutic relation between the client and the healthcare provider (Kurpad, 2018). As a result, therapeutic goals will be less likely to be achieved.

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders

(5th ed.). Washington, DC.

Addington, J., & Lecomte, T. (2014). Cognitive behaviour therapy for schizophrenia. F1000

Medicine Reports, 4, 6.

Benfield, J. (2018). Professional Practice In Counseling And Psychotherapy: Ethics And The Law. Healthcare Counseling & Psychotherapy Journal, 18(1), 30.

Kurpad, S. S. (2018). Ethics in psychosocial interventions. Indian Journal Of Psychiatry, 60S571-S574.

Morrison, A. K. (2013). Cognitive Behavior Therapy for People with Schizophrenia. Psychiatry (Edgmont), 6(12), 32–39.

Petiprin, A. (2016). Psychiatric and mental health nursing. Nursing Theory Assignment 3: Practicum-Week 3 Journal Entry and Submission .

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