PRAC 6650: Psychotherapy with Groups and Families
Assignment 1: Practicum – Week 8 Journal Entry (Due in Week 10)
Students will:
- Develop effective documentation skills for group therapy sessions *
- Develop diagnoses for clients receiving group psychotherapy *
- Evaluate the efficacy of cognitive behavioral therapy for groups *
- Analyze legal and ethical implications of counseling clients with psychiatric disorders *
Select two clients you observed or counseled this week during a group therapy session. Note: The two clients you select must have attended the same group session.
Then, in your Practicum Journal, address the following:
- Using the Group Therapy Progress Note in this week’s Learning Resources, document the group session.
- Describe each client (without violating HIPAA regulations), and identify any pertinent history or medical information, including prescribed medications.
- Using the DSM-5, explain and justify your diagnosis for each client.
- Explain whether cognitive behavioral therapy would be effective with this group. Include expected outcomes based on this therapeutic approach.
- Explain any legal and/or ethical implications related to counseling each client.
- Support your approach with evidence-based literature.
PRAC 6650: Psychotherapy with Groups and Families: Sample Essay
Describe each client (without violating HIPAA regulations), and identify any pertinent history or medical information, including prescribed medications.
The group therapy session was for adult clients. The first client is Amy, a 28-year-old woman who presents as anxious. She works in a secretarial position and has been working since she finished high school. She is anxious and nervous most of the time. She rarely dates, but desperately wants to get married and start a family. However, she has few friends and is afraid of socializing. She spends most of her evenings at home watching a show on television or reading a book. By the time she presented for the group therapy, Amy had begun having panic attacks and she sometimes thinks that she might die. The group therapy began exploring why Amy is not dating, and it was discovered that she had been sexually abused as a child. She never informed anyone about the abuse. She developed strong feelings of anger towards men, but understands that she will eventually develop a relationship with a man as she gets married. She has feelings of ambivalence that have developed into anxiety while lead her to avoid and isolate men. She has difficulty sleeping, is irritable, easily fatigued, and restless.
The second client is Diana, a 35-year-old woman who is married with three children. She is active in the community. She was first diagnosed with depression at the birth of her first child and antidepressants were prescribed to manage the condition. Her family has a decent income and her husband is supportive, and yet they appear to struggle with their financial responsibilities. It has been a challenge taking each of the three children to school, football practice, dance, music lessons and the like, not to mention the many social activities that she attends. She feels that she does not have any time for herself, and feels guilty whenever she takes time to do something she enjoys. She tried talking to some of her friends about these issues but that did not seem to help. She is aware that depression is a common problem that is typically managed through medication, but still feels that no one understands what she is going through. She feels fatigued, hopeless and wants to change her life.
Using the DSM-5, explain and justify your diagnosis for each client.
Amy has been diagnosed with generalized anxiety disorder. She has excessive worry and anxiety (apprehensive expectations) that occur frequently about social activities and events. In addition, she finds it difficult to control the worry. Besides that, the worry and anxiety is associated with difficulty sleeping, irritability, easily fatigued, and restlessness. Also, the worry and anxiety has caused clinically significant distress in social and other functioning areas. Additionally, the worry and anxiety is not attributable to physiological effects of a substance or another medical condition. Furthermore, the anxiety and worry is not better explained by another mental disorder. As such, she is diagnosed with generalized anxiety disorder (Locke, Kirst & Shultz, 2015).
Diana has been diagnosed with depression. She is a depressed mood nearly every day. She has markedly diminished pleasure and interest in her daily activities. She feels worthless and inappropriate guilt. She is indecisive nearly every day. She feels fatigued nearly every day. These symptoms are not attributable to physiological effects of a substance or another medical condition, and have caused her significant distress in important areas of functioning. As such, she is diagnosed with depression (American Psychiatric Association, 2015).
Explain whether cognitive behavioral therapy would be effective with this group. Include expected outcomes based on this therapeutic approach.
Cognitive behavioral therapy (CBT) would be effective with this group as it would seek to change how the group members think. To be more precise, it would help them tune into their internal dialogue in order to change the maladaptive thinking patterns. It challenges their beliefs and assumptions while helping them to change their thinking while being more realistic so as to feel better. Besides that, they learn about problem solving even as they are encouraged to take an active role in the group activities. CBT would work for the group by educating the clients to learn about becoming their own therapists while focusing on the present and problem solving (Green, 2019).
Explain any legal and/or ethical implications related to counseling each client.
Amy and Diana are adults, and counseling them presents some legal and ethical concerns. The first concern is to maintain professional boundaries without developing a personal relationship. It is outside the ethical boundaries to counsel a person with a personal relationship as each client deserves an objective and unbiased therapist who would offer the expected confidentiality (Wheeler, 2014). The second concern is professional ability. The therapist must be trained and skilled to offer the counseling services. It is important that a therapist to only offer the services for which he/she is trained. The third concern is maintaining confidentiality with regards to keeping all personal information confidential to include contact information, patient notes and intake forms. The information must be stored securely and only accessible to authorized persons. The fourth concern is respect for patient differences that include different cultures, walks for life and backgrounds (Remley Jr. & Herlihy, 2016).
References
American Psychiatric Association (2015). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Author.
Green, S. (2019). Cognitive Behavioral Therapy for Anxiety and Depression During Pregnancy and Beyond: How to Manage Symptoms and Maximize Well-Being. Routledge.
Locke, A., Kirst, N., & Shultz, C. (2015). Diagnosis and Management of Generalized Anxiety Disorder and Panic Disorder in Adults. American Family Physician, 91(9), 617-624.
Remley Jr., T., & Herlihy, B. (2016). Ethical, Legal, and Professional Issues in Counseling (5th ed.). Pearson.
Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice. Springer.