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Respond by providing one alternative therapeutic approach. Explain why you suggest this alternative and support your suggestion with evidence-based literature and/or your own experiences with clients.
NOTE: (positive Comment)
The patient in this story is a 15year-old male Native American. The patient is from a divorced family with no known psychiatric history. The patient appears to be losing interest in activities recently with self-harm thoughts and attempts. He also reported a recent history of attempted suicide by overdosing on acetaminophen. There is reported insomnia, low self-esteem, and low energy level. It is now difficult for his mother to please him. He is withdrawn from friends and endorses depression.
DSM5: The suggestive diagnosis for this youngster is Major Depressive disorder. A major depressive disorder is a severe mood disorder. People suffering from significant depressive disorder experience persistent feelings of sadness and hopelessness and lose interest in activities they once enjoyed. The individual having depression must experience five or more symptoms in two weeks, and these symptoms must consist of depressed mood or loss of interest or pleasure. (Truschel, 2020). This diagnosis is consistent with the reported patient’s low energy, low self-esteem, suicidal thoughts and attempts, and loss of interest in activities like stopping to attend school band rehearsal. The patient reported a loss of close friends due to interpersonal conflict, with his school grades declining. They feel negative and worthless, anger, poor performance, poor attendance at school, misunderstood, extremely sensitive, and avoidance of social interaction. (Mayo Clinic, 2018). The patient reportedly denied auditory or visual hallucinations; no abnormality was observed in his concentration or attention level. Memory was observed to be intact, and no new substance use was reported.
The group therapy approach that may be beneficial for this patient is Interpersonal Psychotherapy for Adolescents (IPT-A). This psychotherapeutic approach aims to make improvements in problematic relationships and circumstances connected to the child’s current behavior. This therapy evaluates an adolescent’s social, emotional, and academic functioning and establishes a therapeutic relationship that will enable a closer look at and identify the factor that is causing the current mood change or behavior. (APA, 2019)
The expected outcome of this therapy is the improvement of communication between the patient and relations- Patient learns how to effectively communicate his emotions and strategic means of solving problems in a relationship. Also, social confidence is built in a patient with interpersonal psychotherapy by teaching problem-solving strategies. The patient learns how to deal with future depressive episodes and improve his relationship with others. With Interpersonal Psychotherapy approach, social isolation is reduced, and the interpersonal relationship becomes better resulting in improvement in depression
LEGAL AND ETHICAL IMPLICATIONS
The issue of confidentiality must be assured. Therapists must obtain the child’s consent and that of the parents or guardian by writing before psychotherapy or psychiatric treatment is considered. The issue of autonomy is respected as the patient has every right to accept or refuse the treatment. Establishment of a therapeutic relationship is vital in adolescents as they have a problem with trust. The therapist must ensure that whatever therapeutic approach is for the patient’s benefit and not for experimentation of knowledge. Finally, the therapist must ensure that his or her actions are justified during the therapeutic section. The therapist must respect the professionalism, boundaries, and respect. (Drake, 2020)
American Psychology Association- APA (2019) Depression Treatments for Children and Adolescents. Retrieved from; https://www.apa.org/depression-guideline/children-and-adolescents/
Drake, W (2020) Ethical Issues in Counseling with Children and Adults. Retrieved from https://www.betterhelp.com/advice/counseling/ethical-issues-in-counseling-with-children-and-adults/
Mayo Clinic (2018) Depression (major depressive disorder). Retrieved from https://www.mayoclinic.org/diseases-conditions/depression/symptoms-causes/syc-20356007
Truschel, J (2020) Depression Definition and DSM-5 Diagnostic Criteria. Retrieved from https://www.psycom.net/depression-definition-dsm-5-diagnostic-criteria/#:~:text=Depression%20DSM-5%20Diagnostic%20Criteria%201%20Depressed%
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