Practicum – Week 5 Journal Entry
Cognitive-behavioral therapy (CBT) is a psychotherapy that has been demonstrated to be effective in treating mental disorders such as major depressive disorder. This journal entry will discuss two clients (mother and the daughter) who attended group therapy. The diagnosis of both clients will be done according to DSM-5 criteria. The paper will finally discuss the legal and ethical factors allied with treating the clients.
Description of Client 1
Client 1, was a 15-year-old female who had withdrawn from friends and family for the last 4 months, easily irritable, rarely sleeps and had become extremely unkempt. She no longer eats and this has affected her weight. The mother had reported that her daughter had started skipping school and her academic performance had dropped significantly. The client reported feeling sad all the time, being hopeless and worthless and also reported she does not see any reason for living. These symptoms began after the dad died suddenly from a car crash. The client does not have any notable medical issues or any other mental health issue. Practicum – Week 5 Journal Entry
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Diagnosis of Client 1
The diagnosis of client 1 is a major depressive disorder (MDD). This is because as per the DSM-5 criteria, symptoms of major depressive disorder in the pediatric population include sadness, sleep problems, loss of appetite, irritability, weight changes, problems with concentration, declined academic performance, losing interest from activities that were pleasurable before, lack of energy, feeling worthless and hopeless, among other symptoms (American Psychiatric Association, 2016). The client manifests over four of these symptoms for more than 2 weeks and therefore fits the diagnosis of MDD.
Description of Client 2
The second client was a 44-year-old female and the mother to client 1. The client reported feeling being a poor mother because lately she lacks the energy to take care of her children, and gets easily irritable whenever her children try to be close to her. She also reported having persistent headaches, oversleeping, overeating and having added a lot of weight lately. The client further reported feeling sad, anxiety and having crying spells and also rarely concentrates while at work. There are some days she wakes up and feels she does not have the energy to go to work and hence has missed work several times.
The client does not any significant history of mental or medical illness and also denied a history of substance abuse. She is a widow and a mother of two children and is a teacher by profession. Regarding medication, the client has been taking Ibuprofen for relieving headaches.
Diagnosis of Client 2
The diagnosis of client 2 is also major depressive disorder (MDD). The DSM-5 criteria stipulate that symptoms of major depressive disorder include sadness, sleep problems, loss of appetite, irritability, weight changes, problems with concentration, declined academic performance, losing interest from activities that were pleasurable before, lack of energy, feeling worthless and hopeless, among other symptoms (American Psychiatric Association, 2016). The client manifests the majority of the aforementioned symptoms and the symptoms have lasted for more than two weeks and therefore fit the diagnosis of MDD. Practicum – Week 5 Journal Entry
Efficacy of Cognitive Behavior Therapy (CBT)
Both clients will undergo a CBT to overcome their depression. Through CBT, the clients will be educated on how to identify the maladaptive feelings, thoughts, and behaviors and substitute them with more positive thoughts (Wolgensinger, 2015). The clients will be educated on how they can identify feelings of sadness and replace them with healthy and positive feelings. As a result, the two clients will be able to organize their disrupted belief system and have the system replaced with a healthy and positive belief system and therefore CBT will be effective in treating the two clients (Linde et al, 2017).
Legal and Ethical Implications
HIPAA obligates all mental health practitioners to adhere to the required regulations. For instance, PMHNPs are expected to ensure privacy and confidentiality of the clients. Since this is group therapy, it will be critical for the PMHNP to inform all group members about the required confidentiality and privacy rules where all members will be expected to ensure privacy and confidentiality of all information shared during the therapy (Mark et al, 2017). The PMHNP is also expected to seek informed consent from the group members before they participate in the therapy. This will ensure they participate in group therapy voluntarily and make an informed choice to take part in the therapy. In addition, client 1 is a minor and thus it will be important for the PMHNP to seek assent from the client and consent from the client’s mother for the client to take part in the treatment (Hiriscau et al, 2016).
American Psychiatric Association. (2016). Supplement to Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. American Psychiatric Association.
Hiriscau E, Nicola S, Danuta W & Theil S. (2016). Identifying Ethical Issues in Mental Health Research with Minors Adolescents: Results of a Delphi Study. Int J Environ Res Public Health. 13(5): 489.
Linde K, Treml J, Steinig J, Nagl M & Kersting A. (2017). Grief interventions for people bereaved by suicide: A systematic review. PLoS ONE. 12(6).
Mark C, How C & Yin P. (2017). Depression in primary care: assessing suicide risk. Singapore Med J. 58(2): 72–77.
Wolgensinger L. (2015). Cognitive behavioral group therapy for anxiety: recent developments. Dialogues Clin Neurosci. 17(3), 347–351.
Practicum – Week 5 Journal Entry