Psychotherapeutic Approaches To Group Therapy With Children And ✓ Solved

Identify the most likely DSM-5 diagnosis for the client in the case study and link behaviors to the criteria in the DSM-5. Explain group therapeutic approaches you might use with this client. Explain expected outcomes for the client based on these therapeutic approaches. Consider legal and ethical implications of counseling children and adolescent clients with psychiatric disorders. Support your approach with evidence-based literature.

In a 2 page summary: Describe a child and adolescent group you are counseling. Describe a client from the group who you do not think is adequately progressing according to expected clinical outcomes. Explain your therapeutic approach with the group, including your perceived effectiveness of your approach with the client you identified.

Paper For Above Instructions

Group therapy has emerged as a versatile intervention for addressing the complex mental health needs of children and adolescents. This paper examines a clinical case of a 15-year-old male patient of Native American descent, who is struggling with self-injurious behavior, suicidal ideation, and emotional difficulties linked to interpersonal relationships. Through an analysis of the patient's symptoms, potential diagnoses, and therapeutic strategies, this paper aims to underscore the multifaceted nature of group therapy and its applicability in pediatric mental health treatment.

Potential DSM-5 Diagnosis

The primary diagnosis that aligns with the symptoms exhibited by the patient is Major Depressive Disorder (MDD). According to the DSM-5 criteria, an individual must experience at least five of the following symptoms consistently over a two-week period, one of which must be a depressed mood or loss of interest/pleasure: depressed mood, diminished interest or pleasure in most activities, significant weight loss or weight gain, insomnia or hypersomnia, psychomotor agitation or retardation, fatigue or loss of energy, feelings of worthlessness, diminished ability to think or concentrate, and recurrent thoughts of death.

In this case, the patient displays a depressed mood, low self-esteem, fatigue, and diminished interest in activities such as band participation. He demonstrates the behavior of self-harm as a maladaptive coping mechanism and possesses thoughts of suicidal ideation, linking the severity of his depression to his interpersonal relationships. Therefore, a full clinical assessment would likely yield a nuanced understanding of his mental health and possible co-occurring disorders, such as anxiety or a specific mood disorder.

Group Therapeutic Approaches

In utilizing group therapy with this client, several evidence-based therapeutic approaches may be effective:

  1. Cognitive-Behavioral Therapy (CBT): This approach can help adolescents identify and alter negative thought patterns contributing to their feelings of depression and worthlessness. Group settings allow for social learning and validation from peers.

  2. Dialectical Behavior Therapy (DBT): Designed for high-risk individuals, DBT focuses on emotional regulation, distress tolerance, and interpersonal effectiveness, which is crucial for this client given his reported issues with self-harm and peer relationships.

  3. Supportive Group Therapy: Engaging in a supportive group can provide a safe space for adolescents to express their emotions, foster connections, and help combat feelings of isolation, particularly valuable for someone struggling with loneliness and rejection.

  4. Interpersonal Therapy (IPT): Since the client's distress is tied to his relationships, IPT can help him navigate these dynamics, understand relational patterns, and cultivate healthy interaction skills.

Expected Outcomes

The anticipated outcomes from employing these approaches include:

  • Increased emotional regulation and reduced frequency of self-harming behaviors.

  • Improved self-esteem and confidence in social situations.

  • Enhanced coping skills for managing interpersonal challenges.

  • A decrease in depressive symptoms as indicated by standardized assessments and self-reports.

  • A greater sense of belonging and support from peers in the group setting.

Legal and Ethical Considerations

When counseling children and adolescents, mental health practitioners must adhere to stringent legal and ethical guidelines. Confidentiality, consent, and the minor's rights are paramount, requiring parental involvement while also respecting the adolescent’s autonomy. Counselors must navigate issues of mandated reporting, especially regarding self-injurious behavior or suicidal ideation.

Another significant legal consideration is providing informed consent, ensuring that the adolescent understands the therapeutic process, including the goals, potential risks, and the role of group dynamics. Providers must also consider cultural competence and the unique needs of diverse populations, discriminating how their backgrounds might influence treatment and engagement.

Case Summary

In a hypothetical child and adolescent counseling group, one client named Jake has displayed inadequate progress. He often resists participation, manifests non-compliance with group norms, and continues to exhibit high levels of distress, which may relate to his prior trauma experiences and current family dynamics.

For Jake, the therapeutic approach encompasses a combination of motivational interviewing and CBT tailored to foster engagement in group activities and improve his perception of group dynamics. The effectiveness of this approach is measured through Jake’s increasing willingness to share and the gradual acceptance of social support as a valuable resource.

Group therapy can be a transformative tool in ameliorating mental health issues among children and adolescents. By tailoring interventions to fit individual needs and considering their cultural context, practitioners can facilitate healing and foster resilience in young clients.

References

  • Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice. New York, NY: Springer.

  • American Nurses Association. (2014). Psychiatric-mental health nursing: Scope and standards of practice (2nd ed.). Washington, DC: Author.

  • Microtraining Associates (producer) (2009). Leading groups with adolescents. Alexandria, VA.

  • Beardslee, W. R., & Gladstone, T. R. (2001). Stress and coping in childhood: The role of family and culture. Pediatric Clinics of North America, 48(2), 487-507.

  • Brent, D. A., & Maalouf, F. T. (2010). Suicidal behavior in adolescents: A clinical update. Adolescent Medicine: State of the Art Reviews, 21(2), 215-229.

  • Furnham, A., & Cheng, H. (2000). The impact of psychological well-being on vulnerable groups. Journal of Adolescence, 23(2), 189-201.

  • Hawton, K., & van Heeringen, K. (2009). Establishing the effectiveness of interventions for self-harm: A meta-analysis. Archives of General Psychiatry, 66(6), 637-646.

  • Payne, J. (2017). Children and adolescents in group therapy: A review of current literature. Australian & New Zealand Journal of Psychiatry, 51(12), 1239-1250.

  • Rosenberg, M. (2010). The role of self-esteem in the formation of depression among adolescents. Journal of Child Psychology and Psychiatry, 51(1), 37-46.

  • Steinberg, L. (2005). Cognitive and affective development in adolescence. In D. O. W. Silver (Ed.), Handbook of Adolescent Development (pp. 24-47). New York, NY: Academic Press.