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cf_week_5_assignment_.docx
Week 5 Assignment
NAME
Week 5 Assignment
Diagnosis and Goal Setting
Case study information:
Edward is a 12-year old Korean boy in the 6th grade. He is shy and often keeps to himself. Teachers expressed concerned to his parents because Edward chose to read during PE rather than engage with his classmates in games and activities. Since winter break, however Edward is like a different adolescent. He disrupts class by making noises, dancing in the halls, and mocking the teacher.
Edward’s parents report that he mocks his sister when she cries and then laughs at her when she cries harder. The shift in personality happened quickly according to the parents. As far as discipline, the parents report, “nothing helps.” The school recommended an alternative learning center for the remainder of the term.
Although they are supportive of the school, they are concerned about Edward losing Robotics Club, as it is the one place where he has friends. When the parents explain to Edward what it means to be sent to an alternative learning center, he becomes very upset and promises to do better the next day. Unfortunately, he does not. When asked about his behaviors at school, he refuses to talk about it.
Client Name: Edward
Client Age: 12-years-old
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Description |
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Determine an appropriate DSM-5 diagnoses. |
ICD-9-CM ICD-10-CM 313.81 191.3 Oppositional Defiant Behavior (Moderate) Deferential Diagnosis: (Separation Anxiety Disorder) V61.8 Z62.891 Sibling Relational Problems V62.3 Z55.9 Academic or Educational Problems
Oppositional Defiant Behavior is defined as a behavior disorder, which typically begins during childhood, and causes an individual to show frequent patterns of defiant/hostile behavior and disobedience towards authority figures. This behavior must be evident for at least six months and include frequent reoccurrences that consist of at least four of the following behaviors: loss of temper, often angry, easily annoyed, disobedient and argumentative towards authority figures, purposely annoys others, spiteful/vindictive, and blames others for their mistakes, and inappropriate behavior. Oppositional Defiant Behavior is often associated with learning disorders and attention deficit disorders.
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Develop a minimum of two appropriate long-term goals. |
Edward will eliminate his disruptive, defiant, and negative attention seeking behavior to increase academic performance. Edward will develop essential social skills that will allow him to form meaningful friendships with his peers and increase his social interaction. Edward will use assertive communication to respectfully discuss his feelings with authoritative figures. Edward will resolve family conflict between him and his sister and form a meaningful bond.
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Develop a minimum of two short-term goals for each identified long-term goal. |
Edward will decrease the frequency of his defiant and disruptive behavior to at 2x a week in order to increase academic performance. Edward will participate in activities in PE at 3x a week to increase social interaction amongst his peers. Edward will use I messages to positively communicate his needs to those in authority at least 3x a week to decrease defiant behavior. Edward will spend at least 20 minutes daily engaging in a bonding activity to increase the positive interaction between himself and his sister. |
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Identify a minimum of three current or potential legal issues that may impact the client’s treatment in counseling. |
Potential Legal Issues 1.School counselors have an obligation to protect minors’ confidentiality to the extent possible, while also being aware of parental rights to information Kres et. Al (2018) Informed consent cannot always be obtain so the counselor can make a decision on the client’s behalf that promotes the students welfare (ASCA, 2010). All US states have deemed Counselors as mandated reporters, which holds them to certain legal obligation. As a mandated reporter, counselors are to report any suspicion of child maltreatment, including physical, mental, or sexual abuse and neglect, to the proper authorities Kres et. Al (2018). When working with children and adolescents it is important for counselors to be mindful of their guardian’s legal rights as well as their ethical responsibility to the client. For example, if Edward disclose thoughts of harming himself or others that counselor is legally obligated to report this information.
2.The Health Insurance Portability and Accountability Act of 1996 known as HIPPA is a federal law that protects the patients’ health information from being shard without the persons consent or knowledge. The state of Louisiana allows the electronic transmission of patient’s health records. Before sharing any information, the counselor must obtain written consent from the parents of Edward. Since Edward is not yet of legal age to consent, his parents have full access to his medical records. His parents can obtain records of all third parties who Edwards’s information has been shared with. The Legislative law Louisiana’s §1165.1. Healthcare information; records stated that All health providers must provide patients (upon request) with a copy of all information that has been transmitted to an outside company, public, or private agencies. If the counselors breaks HIPPA laws Edwards parents may choose to terminate services.
3.Edward and his family are Korean and comes from a more culturally diverse background than his counselor comes. His parents views on counseling, parenting techniques, and family values are differ from the counselor. When working with a client who is from a diverse cultural background the counselor needs to remain culturally competent. If the counselor is not culturally competent, legal issues may arise regarding, parental involvement, disclosure issues, as well as issues with therapeutic approaches based on cultural norms of the client and there family. The state of Louisiana “§7.1.6 states “the managed care organization (MCO) shall require that providers deliver services in a culturally competent manner to all members, including those with limited English proficiency and diverse cultural and ethnic backgrounds (Cultural Competency Louisiana Provider Guide, 2018).” The state of Louisiana also requires providers to attend trainings on cultural competency. If the counselor is not culturally, sensitive Edwards parents may choose to terminate services do to feeling disrespected.
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Identify a minimum of three current or potential ethical issues that may impact the client’s treatment in counseling.
When counseling youth, conflicts between ethical and legal issues sometimes arise Kres et. al (2018). Ethical codes may also conflict with counslelors personal values. However, the client needs are priority and counselors should refrain from imposing their values and beliefs onto the client. |
Potential Ethical Issues
1.The ACA Code of ethics B.1.c respect for confidentiality states that counselors must protect the confidential information of prospective and current clients. Counselors disclose information only with appropriate consent or with sound legal or ethical justification (ACA, 2014). Although the counselor has a legal obligation to confidentiality with Edward, there are limitations to confidentiality due to him being a minor. The counselor must disclose certain confidential information with parents such as informed consent related to confidentiality and consent to enter counseling.
2.Although the counselor will need to disclose some confidential information with Edward's parents throughout the counseling process, it is important to discuss responsibility of the parents before counseling begins. The ACA code B.5.b. Responsibility to Parents and Legal Guardians states that Counselors must inform parents and legal guardians about the role of counselors and the confidential nature of the counseling relationship, consistent with current legal and custodial arrangements (ACA, 2014). The counselor should build a collaborative relationship with Edwards’s parents that will be beneficial to him thought the counseling process.
3.It may be beneficial to Edward if the counselor collaborates with his teachers and school counselors to discuss his disruptive and defiant behavior. Collaboratively the parties can work together to develop a plan that can be enforced at school to decrease and eliminate Edwards undesirable behavior. Before disclosing information to a third party the counselor must obtain consent from Edwards’s parents. The counselor should also discuss the benefits of involving third parties in the counseling process. The ACA code B.5.c states When counseling minor clients or adult clients who lack the capacity to give voluntary consent to release confidential information, counselors seek permission from an appropriate third party to disclose information (ACA, 2014).
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Support your work with a minimum of four recent (5 years or newer) peer-reviewed journal articles in addition to other academic resources ( DSM-5, APA code of ethics, et cetera). |
American Counseling Association. (2014). 2014 ACA code of ethics. https://www.counseling.org/docs/default-source/default- document-library/2014- code-of-ethis-finaladdress.pdf Jongsma, A. E., Jr., Peterson, L. M., McInnis, W. P., & Bruce, T. J. (2014). The adolescent psychotherapy treatment planner (5th ed.). John Wiley & Sons. ProQuest Ebook Central-Detail page (capella.edu) American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi org.library.capella.edu/10.1176/appi.books.9780890425596 First, M. B. (2014). DSM-5 handbook of differential diagnosis. American Psychiatric Association Publishing. https://doi-org.library.capella.edu/10.1176/appi.books. 9781585629992 Kress, V. E., Paylo, M. J., & Stargell, N. (2018). Counseling Children and Adolescents. Pearson Education (US). https://capella.vitalsource.com/books/9780134745244 Asca Ethical Standards for School Counselors, www.schoolcounselor.org/getmedia/44f30280-ffe8-4b41-9ad8-f15909c3d164/EthicalStandards.pdf. Accessed 14 May 2024. Louisiana Laws - Louisiana State Legislature, legis.la.gov/Legis/law.aspx?d=964709. Accessed 13 May 2024. Cultural Competency - Louisiana Provider Guide, www.amerihealthcaritasla.com/pdf/provider/resources/acla-cultural-competency-provider-guide.pdf. Accessed 14 May 2024. Ledyard, P. (1998). Counseling minors: Ethical and legal issues. Counseling and Values, 42(3), 171. https://library.capella.edu/login?url=https://www.proquest.com/scholarly-journals/counseling-minors-ethical-legal-issues/docview/207573742/se-2
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Diagnosis and Goal Setting
Case study information:
Sarah is a five-year-old Hispanic female in kindergarten. She has a twin sister Esther, and they are very close in their sibling relationship. They still sleep in the same bed together even though they each have their own bedroom. Until recently, they did not have friends, choosing to play only with each other. When Sarah and Esther entered Kindergarten, the school placed them in separate classes. Although Esther transitioned without issue and quickly made friends, Sarah has not. She has not spoken since the first week of school. Her relationship with her sister has deteriorated. Sarah spends her free time hiding under her bed, drawing or holding her dolls.
Sarah’s parents thought it was a phase and she would adjust, but when Esther had a sleep over with her new friends, Sarah ran away. Her parents searched the neighborhood and could not find her. After an hour, they called the police. The police searched the neighborhood and they finally found her in the park.
Client Name: Sarah
Client Age: 5-years-old
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Item |
Description |
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Determine an appropriate DSM-5 diagnoses. |
ICD-9-CM I CD-10-CM 300.23 F40.10 Social Anxiety Disorder (Social Phobia) Deferential Diagnosis (Separation Anxiety Disorder) V61.8 Z62.891 Sibling Relational Problems V62.9 Z60.9 Unspecified Problem Related to Social Environment V71.02 Z72.810 Child Adolescent Antisocial Behavior
Separation Anxiety Disorder is an anxiety disorder that causes excessive fear related to the separation from those the individual is attached to. Social Phobia is also associated with the disorder. Separation anxiety disorder is evident when 3 or more of the following occur: recurring distress when anticipating or experiencing separation from home or objects, persistent or excessive worry about losing attachment figures, excessive worry about and untoward event, persistent refusal to go outside the home, persistent refusal to sleep away from home, repeated nightmares involving separation, and repeated compilation of physical symptoms when separated (First,2014). The anxiety or persistent avoidance must be evident for at least 4 weeks in children/ adolescents. Separation Anxiety Disorder can affect an individual in socially, academically, as well as their occupation.
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Develop a minimum of two appropriate long-term goals. |
Sarah will eliminate her anxiety associated with her feeling sad and lonely when separated from her sister. Sarah will rebuild her bond with her sister. Sarah will develop essential social skills that will allow her to form meaningful friendships with her peers and increase his social interaction. Sarah will use assertive communication to express her feelings to her family, peers and teachers.
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Develop a minimum of two short-term goals for each identified long-term goal. |
Sarah apply healthy coping skills 4x a week in order to decrease feelings of anxiety. Sarah will spend at least 20 minutes a day engaging in a bonding activity to increase the positive interaction between herself and her sister. Sarah will participate in playtime with her peers at 3x a week to increase social interaction amongst her peers. Sarah will use I messages to positively communicate his needs to those in authority at least 3x a week to effectively communicate her feeling
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Identify a minimum of three current or potential legal issues that may impact the client’s treatment in counseling. |
Potential Legal Issues 1. When counseling a minor, we obtain informed consent throughout the counseling process. Sarah’s counselor may feel that it will be beneficial to record sessions to assure that the client is showing process throughout the counseling process. The parent or legal guardian must give informed consent if the counselor determines that recording a session is necessary. Louisiana La. Admin. Code tit. 46 § LX-2105 states that licensees must obtain permission prior to recording sessions. Licensees can obtain informed consent electronically or through other means (Louisiana Counseling License for LPC, LPC - S Certification in LA, 2024). Counselors often review sessions as a form of training. However, without consent, Sarah's counselor cannot share recorded sessions with his or her supervisor and colleagues. The Louisiana La. Admin. Code tit. 46 § LX-2105 law also stated that the counselor must obtain permission to observe from the client's parent or guardian before observing counseling sessions, reviewing session transcripts, or viewing recordings of sessions with supervisors, faculty, peers, or others within the training environment. (Louisiana Counseling License for LPC, LPC - S Certification in LA, 2024) If the counselor does not obtain consent in these matters than legal, actions may be taken against the counselor. 2.The state of Louisiana allows the electronic transmission of patient’s health records. Records can be transmitted via computer, electronic mail, facsimile machine, phones, voicemail, and other technology. LA Admin Code LX-2105 stated that counselors must take precaution to ensure the confidential of information transmitted electronically. Sarah’s counselor may have questions about her diagnosis, age-appropriate interventions, etc. If Sarah's counselor consults with a supervisor or colleague, she may need to send her medical records electronically. If the wrong person receives Sarah's health information, her parents may pursue legal action against the counselor.
3.Sarah and her family are Hispanic and come from a more culturally diverse background than her counselor. Her parents views on counseling, parenting techniques, and family values may be different from the counselor as well. When working with a client who is from a diverse cultural background the counselor needs to remain culturally competent. Remaining culturally competent allows the counselor to avoid causing harm and imposing values on the client. Louisiana Admin Code LX-2103 states the counselor should remain aware of their personal values, beliefs, and behaviors to avoid imposing values that are not consistent with counseling goals (Louisiana Counseling License for LPC, LPC - S Certification in LA, 2024). If the counselor is not culturally competent, legal issues may arise regarding, parental involvement, disclosure issues, as well as issues with therapeutic approaches based on cultural norms of the client and there family. |
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Identify a minimum of three current or potential ethical issues that may impact the client’s treatment in counseling. |
Potential Ethical Issues
1.Sarah is a minor and has separation and social anxiety. Sarah may be reluctant to talk if she attends session alone. The counselor may encourage Sarah’s parents to join sessions. The ACA Code of ethics B.4.b Couples and Family states that during group and family counseling the counselor is to clearly define who the client is along with expectations and limitations of confidentially (ACA, 2014). Both the counselor and family need to understand that Sarah is the focus of the session.
2.The counselor cannot provide Sarah’s parent with detailed documentation of the session however they are required to educate parents on the counseling process. It is important to discuss the responsibility of the parents before counseling begins. The ACA code B.5.b. Responsibility to Parents and Legal Guardians states that Counselors must inform parents and legal guardians about the role of counselors and the confidential nature of the counseling relationship, consistent with current legal and custodial arrangements (ACA, 2014).
3.Sarah can benefit from her counselor collaborating with her teachers to discuss promoting social interaction between Sarah and her peers. Collaboratively the parties can work together to develop a plan that can be enforced at school to decrease and eliminate Sarah’s social anxiety. Before disclosing information to a third party the counselor must obtain consent from Sarah’s parents. The counselor should also discuss the benefits of involving third parties in the counseling process. The ACA code B.5.c states When counseling minor clients or adult clients who lack the capacity to give voluntary consent to release confidential information, counselors seek permission from an appropriate third party to disclose information (ACA, 2014).
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Support your work with a minimum of four recent (5 years or newer) peer-reviewed journal articles in addition to other academic resources ( DSM-5, APA code of ethics, et cetera). |
American Counseling Association. (2014). 2014 ACA code of ethics. https://www.counseling.org/docs/default-source/default- document-library/2014- code-of-ethis-finaladdress.pdf Nongoma, A. E., Jr., Peterson, L. M., McInnis, W. P., & Bruce, T. J. (2014). The adolescent psychotherapy treatment planner (5th ed.). John Wiley & Sons. ProQuest Ebook Central-Detail page (capella.edu) American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi org.library.capella.edu/10.1176/appi.books.9780890425596 First, M. B. (2014). DSM-5 handbook of differential diagnosis. American Psychiatric Association Publishing. https://doi-org.library.capella.edu/10.1176/appi.books. 9781585629992 Kress, V. E., Paylo, M. J., & Stargell, N. (2018). Counseling Children and Adolescents. Pearson Education (US). https://capella.vitalsource.com/books/9780134745244 Asca Ethical Standards for School Counselors, www.schoolcounselor.org/getmedia/44f30280-ffe8-4b41-9ad8-f15909c3d164/EthicalStandards.pdf. Accessed 14 May 2024. Ledyard, P. (1998). Counseling minors: Ethical and legal issues. Counseling and Values, 42(3), 171. https://library.capella.edu/login?url=https://www.proquest.com/scholarly-journals/counseling-minors-ethical-legal-issues/docview/207573742/se-2 Louisiana Administrative Code, Chapter 21, Section LX-2105 - Confidentiality, Privileged Communication, and Privacy | Louisiana Administrative Code | Justia. (2024, March 20). Justia Law. https://regulations.justia.com/states/louisiana/title-46/part-lx/subpart-1/chapter-21/section-lx-2105/ Louisiana Administrative Code, Chapter 21, Section LX-2103 - Counseling Relationship | Louisiana Administrative Code | Justia. (n.d.). Justia Law. Retrieved May 17, 2024, from https://regulations.justia.com/states/louisiana/title-46/part-lx/subpart-1/chapter-21/section-lx-2103/
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