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Assignment 1: Practicum – Week 8 Journal Entry

Learning Objectives

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 (see attachment).

· 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. (very important to use 

· 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.

Assignment 1: Practicum – Week 8 Journal Entry

Learning Objectives

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 (see attachment).

· 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. (very important to use

· 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.

,

Group Therapy Progress Note

American Psychological Association | Division 12 http://www.div12.org/ 1

Client: __________________________________________________ Date: ___________ Group name:________________________________________________ Minutes:________ Group session # ______ Meeting attended is #:______ for this client. Number present in group _____ of _____ scheduled Start time:________ End time: ________

Assessment of client

1. Participation level: ❑ Active/eager ❑ Variable ❑ Only responsive ❑ Minimal ❑ Withdrawn

2. Participation quality: ❑ Expected ❑ Supportive ❑ Sharing ❑ Attentive ❑ Intrusive

❑ Monopolizing ❑ Resistant ❑ Other: _____________________________________

3. Mood: ❑ Normal ❑ Anxious ❑ Depressed ❑ Angry ❑ Euphoric ❑ Other: _______________

4. Affect: ❑ Normal ❑ Intense ❑ Blunted ❑ Inappropriate ❑ Labile ❑ Other:_______________

5. Mental status: ❑ Normal ❑ Lack awareness ❑ Memory problems ❑ Disoriented ❑ Confused

❑ Disorganized ❑ Vigilant ❑ Delusions ❑ Hallucinations ❑ Other:__________________

6. Suicide/violence risk: ❑ Almost none ❑ Ideation ❑ Threat ❑ Rehearsal ❑ Gesture ❑ Attempt

7. Change in stressors: ❑ Less severe/fewer ❑ Different stressors ❑ More/more severe ❑ Chronic

8. Change in coping ability/skills: ❑ No change ❑ Improved ❑ Less able ❑ Much less able

9. Change in symptoms: ❑ Same ❑ Less severe ❑ Resolved ❑ More severe ❑ Much worse

10. Other observations/evaluations:________________________________________________________

In-session procedures:  _______________________________________________________________________________

 _______________________________________________________________________________

 _______________________________________________________________________________

 _______________________________________________________________________________

 __________ _____________________________________________________________________

Homework: 1.

2.

3.

Other Comments: _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ Signatures Date

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Week 8 Journal Entry The first client is a 25-year-old female who presented to the facility one year after the death of the mother. She reported having feelings of sadness and hopelessness which have affected her social interactions. At the time she presented, she reported difficulty in sleeping, and recurrent thoughts of suicide. The patient had also lost interest in activities which she previously found to be interesting. The patient was diagnosed with major depressive disorder. The diagnosis is supported by the DSM-5 criteria which state that for this diagnosis a patient should present with five or more symptoms of depression in the same two-week period (American Psychiatric Association, 2015). 2 Of the presenting symptoms, one of them should either be a loss of interest or a depressed mood.  The patient is under citalopram for the management of symptoms.

The second client is a 28-year old male who presented to the facility and was diagnosed with a generalized anxiety disorder. The patient started developing excessive worry that he would fail in his Post-graduate examinations. The worry has lasted for seven months, and it has affected his ability to read and understand school content. The patient found it difficult to control the symptoms. He also explained that he was easily fatigued, was highly irritable and was facing sleep disturbances. 3 The symptoms are in line with the DSM-5 diagnostic criteria for generalized anxiety disorder.  For a positive diagnosis, the patient must present with excessive worry or anxiety for a period exceeding six months and also three of the six cardinal symptoms of anxiety (Er, 2015). The symptoms include irritability, sleep disturbances, easy fatiguability, concentration difficulties, restlessness, and muscle tension (Er, 2015). Furthermore, the disturbances should cause clinical distress and should not be attributable to the psychological effects of a substance. The patient is administered with alprazolam.

Cognitive-behavioral therapy would be effective for the group of patients. 4 It has been shown to be effective in the management of both generalized depressive disorder and generalized anxiety disorder (Powers, de Kleine & Smits, 2017).  The expected outcomes would be an improvement of the symptoms of the patients and improved ability of the patients to engage in social interactions. There are several ethical considerations related to the counseling of each of the patients. It is important to protect the patient information which may have severe consequences on their social and personal lives if it is made public. It is also necessary to promote the confidentiality of the patient concerning the information they share. Finally, any health care provider is obligated to provide treatment with a favorable risk to benefit ratio.