help with treatment plan due in 48 hours

CREATING YOUR CLIENT CASE

UNIT 9 ASSIGNMENT

Name

COUN 5254 Child and Adolescent Counseling

Instructor

INSTRUCTOR

June 9, 2024

BIOPSYCHOSOCIAL ASSESSMENT FORM

- Client Demographic Data

Name: Jared

Age: 5 years

Gender: male

Race: African American

Ethnicity: Diaspora African

Religion: Pentecostal

Other Relevant Information:

Jared comes from a middle-class family. Both parents have college education.

Social-Cultural Information:

Jared’s parents live in an urban community predominantly occupied by African Americans. Jared’s father works as an IT manager while his mother works as a high school principal. Jared’s family recognizes the crucial value of education. All children are required to attend school. Jared’s family often organizes family gatherings. The family is spiritual as everyone has to attend the Catholic Church service on Sundays.

-Presenting Problem

The client is seeking counseling because he has a 5-year-old son who hits and curses at his teachers and classmates. The 5-year-old has been experiencing behavioral issues. He has portrayed physical and verbal aggression. The behavior of the 5-year-old has raised concerns among the teachers. Jared parents discussed to event where he has thrown a chair and broke into tears. Situational factors such as family difficulties and transitions might have caused behavioral issues. Other situational factors include trigger events in the classroom and activities such as competitive games. Environmental factors such as peer interactions, the home environment, parental style, and teacher interactions might also have contributed to the behavioral issues. Behavioral factors include the child’s emotional regulation and aggression. Other behavioral factors that might have led to the behavioral issues include the client’s anger, coping mechanism and behavioral patterns.

-Current Stressors

The known stressors are frustrations that Jared has displayed and family conflict. Jared’s father and mother differ in their parenting styles. While Jared’s father is restrictive, his mother is permissive.

-Current Symptoms

The client exhibits various symptoms such as physical aggressions and verbal aggressions. The client curses both staff members and fellow students. He also throws objects and hits others. The client has displayed physical aggression twice. He has thrown a chair in the classroom on two occasions. The emotional symptoms of the client include anger, frustration, and impulsivity while physical symptoms include tension and headaches. The physical and emotional symptoms occur daily and are severe.

-Family History

Top of Form

Family members' names and ages to include parents, grandparents, and siblings:

Jared has two siblings: Felix age 12 years and Brian age 15 years. Jared’s father is James aged 44 years while his mother is Caroline aged 38. Both paternal grandfather and grandmother died a while ago. Jared’s maternal grandfather also died after a short illness. Jared’s maternal grandmother is still alive. She is 80 years-old. Jared has an 18-year-old cousin named Sarah who is currently pregnant. The cousin often stays with Jared’s family after his parents disowned her.

Bottom of Form

Provide a detailed narrative of the genogram you created: 

The genogram shows that Jared is a 5-year-old male who has two siblings. Felix is aged 12 while Brian is aged 15 years. Jared enjoys a good relationship with his mother, but a negative relationship with his father. Jared’s sibling, Brian enjoys a good relationship with his aunt, Teresia. Jared’s paternal grandfather died aged 80 years due to diabetes. Jared’s paternal grandmother also died at age 80 after suffering from diabetes from a long period. Jared’s maternal grandfather also died at age 79 after a short illness. Jared has never met his paternal grandfather and grandmother. He also never met his maternal grandfather. Jared’s maternal grandmother is; however, alive and very healthy. She spends her time with Jared’s parents. Jane and Ian have an estranged relationship. They became estranged when Ian suffered from alcohol use disorder for a long period.

Special family circumstances or events:

Jared’s family members have strong relationships. Even though Jared’s aunt and uncle have a strained relationship, they interact with Jared’s family positively. Jared’s mother agreed to take in Sarah when she got pregnant. Sarah’s parents do not talk to her even when they attend family gatherings. However, they have a good relationship with all other family members. Jared’s parents have a strong relationship, but they differ in their parenting styles. Jared’s father believed that more rules and restrictions should be imposed on Jared to control his behavior. On the other hand. Jared’s mother believes that he needs tender love and care to tame his aggressive behaviors. Jared has a good relationship with his pregnant cousin Sarah who stays at their home.

-Current Living Situation and Environment

Housing (apartment, single-family home, etc.): single-family home with seven bedrooms.

Who is living in current household? (Parents, grandparents, siblings, etc.): Both parents, James and Caroline, Jared’s maternal grandmother, Kate, Jared’s two siblings, Brian and Felix, and Jared’s cousin, Sarah.

Household Stressors impacting client (financial, space issues, safety concerns): Jared has been impacted by parental disagreement. Jared’s parents have often argued about the best approach to deal with his behavioral issues.

-Family History of Mental/Psychological Issues

Jared’s paternal grandmother was diagnosed with bipolar disorder. She experienced unusual shifts in her concentration, energy, and mood. Jared’s paternal grandmother had to undergo treatment for her bipolar disorder. She often experienced mood swings that made it difficult for her to interact with other family members. Jared’s father was depressed after he lost his parents. Jared’s mother Caroline also faced anxiety.

- Client Personal History

Major Life Events: first day of school

History of Trauma and/or abuse:

No known abuse or trauma

-Physical/Medical Information

Developmental history (birth issues, developmental milestones, etc.): Jared has achieved his developmental milestones. He has not experienced developmental issues.

Physical/medical history: Jared has a good physical health and has not been diagnosed with health issues

Current physical/medical state: Jared’s parents explained that he had bruises after falling several times. However, these have been treated. Jared also had a cold and had been coughing. Currently, Jared is in good physical state.

Current Medications (prescribed or OTC): cold medicine

Other medical issues (allergies, etc.): No known allergies or other medical issues

-Previous Mental Health History/Treatment:

Jared does not have a history of mental health issues.

-Substance Abuse/Addiction History and Current Situation:

There is no addiction history among Jared’s family members.

-Ecomap Analysis

Jared has a poor relationship with other students and teachers due to his behavioral issues. However, he relates well with his siblings and mother. Jared has a strenuous relationship with his father and neighbors. Jared rarely interacts with members of the community. The existing stressors include negative peer relationships, family conflict, parental expectations, and academic pressure. Parental conflict has a negative impact on children’s wellbeing. According to Lax (Lax, 2020), “Families are systems of interconnected individuals, none of whom can be understood in isolation from the system” (p. 55). The family system could support the client through treatment and counseling. The negative peer relationships adversely affect the self-esteem of children.

-Legal and Ethical Considerations

Explore the general legal and ethical considerations you have as a counselor: The general legal and ethical considerations include respect for confidentiality, avoiding harm, obtaining informed consent and following the existing laws when treating a client. While dealing with clients, one should respect their privacy (ACA 2014). One should ensure they do not share client’s information with other people. Before initiating treatment, it is important to ask for consent from the clients. Treatment plans should adhere to existing laws.

-Legal, Ethical, and Other Considerations (including diversity)

The legal issues affecting this case include student records, safety, and the rights of the client. Federal law protects the personal information of students. Details about the client’s case should not be exposed (Goldman et al. 2020). Another legal issue is safety for other students and teachers. Schools are obliged to keep their employees and students safe. While handling cases, school members should consider the legal rights of the offenders. In this case, the right to fair hearing can impact the client.

Other legal issues affecting this case include appropriate treatment and parental rights. Instructors should provide the same opportunities and standards to students. They should respect diversity. Teachers should ensure that they do not treat minority groups in the classroom unfairly since this could raise legal issues. They should ensure that interactions with students are professional. Jared’s parents might raise legal issues regarding their involvement in the case. They might sue the school if certain decisions are made without their knowledge.

Ethical issues include informed consent, confidentiality, and harm. Counselors are required to respect client privacy. They should only obtain information that is useful in treating clients (ACA 2014). After obtaining information, counselors should avoid sharing it with third parties. Counselors should obtain informed consent. In this case, the ethical issue is obtaining informed consent from a 5-year-old who might not be able to give consent. The counselor might involve parents to ask them for permission before treating the 5-year-old.

Counselors should avoid harming the client. While prescribing treatment, they should ensure that such treatments may not harm the client. Counselors should ensure they provide a safe environment (Goldman et al. 2020). If a safe environment is created, Jared can easily share information. Counselors should ensure that Jared does not physically harm other people. Since Jared is facing behavioral issues, he might harm himself. Counselors face the ethical issue of ensuring that there is no harm while handling the client.

Counselors should take into consideration families’ cultural diversity. They should be culturally sensitive while dealing with individuals from minority groups. The person who handles Jared’s case needs to be sensitive of his cultural background (McCabe et al. 2020). An equitable environment should be created. The counselor should ensure that regardless of Jared’s cultural background, he feels respected and valued.

Treatment Plan

Appropriate DSM-5 diagnoses

ICD-10-CM

313.81 191.3 Oppositional Defiant Behavior (Moderate)

Deferential Diagnosis: (conduct disorder)

V61.8 Z62.891 Sibling Relational Problems

V62.3 Z55.9 Academic or Educational Problems

Oppositional Defiant Disorder

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 disorder is characterized by persistent and frequent patterns of irritable or angry mood. Children suffering from oppositional defiant disorder have defiance and aggression characteristics. They are often resentful, easily annoyed, often angry, touchy, defiant, annoys others, blame their mistakes on others, and argumentative. They also argue with other children and authoritative figures (American Psychiatric Association, 2013). Oppositional Defiant Behavior is often associated with learning disorders and attention deficit disorders. The frequency and persistence of behaviors is used to differentiate normal behaviors from abnormal behaviors. Younger children should display behaviors for six months and include frequent reoccurrences. Jared’s symptoms that matched the criteria include being verbally and physically aggressive and cursing both staff members and fellow students.

Differential diagnosis: conduct disorder

Children suffering from conduct disorder display aggressive behaviors. They often violate rules and engage in actions such as theft and demolition of property (Hawes et al., 2023). One should display at least three symptoms for a period of 12 months.

Theoretical Foundation

Cognitive behavioral therapy can be applied to Jared’s treatment. It changes the way people behave and think. Cognitive behavioral therapy is often used for the treatment of depression and anxiety; however, it can be used to treat other mental health issues (Nakao et al., 2021). Cognitive behavioral therapy can be used to help Jared change his negative behaviors and patterns. Jared can replace his negative thoughts with positive ones. Cognitive behavioral therapy can also be used to teach Jared how to deal with frustrations and conflicts.

Family therapy is effective for the treatment of oppositional defiant disorder. Family interactions shape the inappropriate and noncompliant behaviors of children (Schaefer & Cangelosi, 2016). Use of family therapy can help counselors to understand the rules and patterns of a family. Family therapy can be used to address Jared’s issues. It can help identify aspects of Jared’s family relations and life that cause behavioral issues.

Family therapy focuses on the entire family while cognitive behavioral therapy focuses on an individual. Family therapy links the behavioral issues of a person to his family. It changes family interaction patterns (Lax, 2020). Cognitive behavioral therapy focuses on the behaviors and feelings of an individual. It helps modify one’s behaviors and thoughts.

Long-term goals

· Jared will decrease disruptive, defiant and negative attention seeking behaviors in the classroom to increase academic performance.

· Jared will use assertive communication to respectfully communicate his feeling to authoritative figures in order to reduce his negative interactions with those in authority

· Jared will learn triggers to his anger and coping skills to express anger in a healthy manner.

Short-term goals

Decrease disruptive behaviors

· Jared will follow the teacher directions in the classroom without throwing a tantrum 3x out of the week in order to increase academic performance.

· Jared will participate in-group time with peers without having an outburst 2x out of the week in order to promote positive peer interaction.

Reduction of negative interactions

· Jared will comply with classroom rules 3x out of the week.

· Jared will use I messages to positively communicate his needs and feelings to authoritative figures 3x a week to decrease his defiant behavior.

Improvement in ability to express anger

· Jared will verbally express to his teacher when he needs to take a time out to reduce his anger and frequency of outburst in the classroom 2x out of the week.

· Jared will remain aware of warning signs to his anger, and immediately use 1 of the 5 coping skills learned to reduce his anger 3 x out of the week.

Interventions

Individual counseling interventions

Journalling is an individual counseling intervention that can help address Jared’s issues such as aggressive behaviors. One can ask Jared to explain his negative feelings and thoughts. Another intervention would be storytelling. The counselor could create a story about the relationship between negative thoughts and certain behaviors (Schaefer & Cangelosi, 2016). He/she could make Jared understand that certain behaviors are caused by negative thoughts.

Family sculpting is an intervention that can be used to address Jared’s problems. Family sculpting sessions allow family members to express their perceptions and feelings. They enable family members to improve communication and resolve misunderstandings. Family sculpting is grounded in play therapy (Lin et al., 2022). The counselor could ask Jared to sculpt his family members and arrange them based on their relationships.

Family counseling interventions

Role-playing is a family counseling intervention that can be applied in this case. The counselor could request Jared and his family members to role-play different scenarios. Role-play masks can be used to show reactions to various situations. Role-playing could help the counselor understand how the client reacts to various situations (Schaefer & Cangelosi, 2016). It could be used by the client to improve and practice his social techniques. Role-playing could help Jared learn how to manage aggression.

Laughter play could help the client with emotional regulation. It could reduce frustration and anger. The counselor could request all family members to take turns in making everyone laugh. Laughter play could help build strong relationships among the family members (Schaefer & Cangelosi, 2016). It could also help eliminate aggressive behaviors portrayed by the client.

Group counseling interventions

One of the group counseling interventions that can be used in this case is puppet play. This enables clients to express their troublesome experiences, thoughts, and emotions (Hamidifard et al., 2023). The counselor can collect puppets and introduce children to the puppets. He/she can require all children to tell stories about the puppets.

Group play therapy can also be used in this case. This intervention is used to help clients facing behavioral issues (Reshadi et al., 2020). To apply group-play therapy, Jared can be asked to engage with other students or group members. He can acquire social skills by interacting with other students. Jared can stop being aggressive if he acquires social skills.

Community Resources and Social Support

(Identify and evaluate the community resources and social supports in your home community that are available for this client. Also, identify the strengths and limitations of the supports and resources.)

Choices Coordinated Care Solutions

Services Provided: The organization is a wraparound program that collaborates with the client family, school, providers, government agencies, and managed care organization to provide the client and their family with support and referrals to meet their needs such as health care, education, housing, etc…

Ginger Bread House

Services Provided: The Gingerbread House is a Child Advocacy Program that assist children in many aspects such as reducing stress levels and anxiety that can be caused by traumatic events.

Behavioral Health Crisis Line

Services Provided: This is a crisis prevention hotline that is used to prevent a crisis from occurring or a suicide attempt.

YMCA of Northwest Louisiana

Services Provided: This is a recreation center. Where individuals can learn social skills and form healthy bonds.

David Raines Community Center

Services Provided: This is a Community Center that offer support services such as behavioral health service, dental and family medicine.

Brentwood Hospital

Services Provided: This is a behavioral hospital that provides the client with psychiatric evaluations, medication management,

educational support, and etc…

Treatment Plan Academic Resources

Case Conceptualization

REFERENCES

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi org.library.capella.edu/10.1176/appi.books.9780890425596

Hamidifard, S., DashtBozorgi, Z., & Hafezi, F. (2023). The Effectiveness of Play Therapy based on Cognitive Behavioral Approach on Social Anxiety and Self-Harm Behaviors in Children with Autism Disorder.  Iranian Journal of Psychiatric Nursing,  11(3), 70-80.

Hawes, D. J., Gardner, F., Dadds, M. R., Frick, P. J., Kimonis, E. R., Burke, J. D., & Fairchild, G. (2023). Oppositional defiant disorder.  Nature Reviews Disease Primers,  9(1), 31.

Lax, W. D. (2020). Systemic family therapy with young children and their families: Use of the reflecting team. In  Children in family therapy (pp. 55-74). Routledge.

Lin, X., He, T., Heath, M., Chi, P., & Hinshaw, S. (2022). A systematic review of multiple family factors associated with oppositional defiant disorder.  International journal of environmental research and public health,  19(17), 10866.

Nakao, M., Shirotsuki, K., & Sugaya, N. (2021). Cognitive–behavioral therapy for management of mental health and stress-related disorders: Recent advances in techniques and technologies.  BioPsychoSocial medicine,  15(1), 16.

Reshadi, H., Golpayegani, F., Bayat, B., & Majdian, V. (2020). Effectiveness of group play therapy on resilience and self-control strategies in children of divorced parents.  Quarterly Journal of Child Mental Health,  6(4), 63-73.

Schaefer, C. E., & Cangelosi, D. (2016).  Essential play therapy techniques: Time-tested approaches. Guilford Publications.

Shreveport- Bossier Department of Community Development Community Resource Assistance  https://www.shreveportla.gov/DocumentCenter/View/14051/Community-Assistance-Resource-Guide-2018Links to an external site.

 U.S. Census Bureau QuickFacts: Shreveport city, Louisiana. (n.d.). Www.census.gov.  https://www.census.gov/quickfacts/fact/table/shreveportcitylouisianaLinks to an external site.

 SERVICES. (n.d.). David Raines CHC. Retrieved May 31, 2024, from  https://www.davidraineschc.org/copy-of-servicesLinks to an external site.

 UHS-NVT. (n.d.). Programs & Services. Brentwood Hospital. Retrieved May 31, 2024, from  https://brentwoodbehavioral.com/programs-and-services/Links to an external site. 

-  Annotated Bibliography

ACA (2014). 2014 ACA Code of Ethics. Retrieved from https://www.counseling.org/docs/default-source/default-document-library/ethics/2014-aca-code-of-ethics.pdf?sfvrsn=55ab73d0_1#:~:text=The%20ACA%20Code%20of%20Ethics,and%20counselors%2Din%2Dtraining.

The code of ethics guides professional counselors on ethical practice. It explains that counselors should create and safeguard documentation for providing professional services. Counselors should obtain consent and avoid harm. They should respect the privacy of their clients. Counselors should ensure that the private information of clients is safeguarded.

Goldman, J., Stein, C. L. E., & Guerry, S. (2020). Principles of Child Assessment. In  Psychological Methods of Child Assessment (pp. 3-13). Routledge.

This article explains the ethical guidelines for psychologists. The authors explain that parents have the right to access information about their children. psychologists should consider ethical issues while handling child cases. They should take into account student’s needs. Psychologists should obtain informed consent and respect the privacy of their clients.

Lax, W. D. (2020). Systemic family therapy with young children and their families: Use of the reflecting team. In  Children in family therapy (pp. 55-74). Routledge.

The author explains that family therapy can be used to address behavioral issues among children. While conducting family therapy, it is important to allow children to participate in the clinical interviews. Children can be asked to provide their perceptions regarding family therapy. Existing conflicts can be resolved if all family members are involved.

McCabe, K. M., Yeh, M., & Zerr, A. A. (2020). Personalizing behavioral parent training interventions to improve treatment engagement and outcomes for culturally diverse families.  Psychology Research and Behavior Management, 41-53.

The authors explain that cultural assessments can be used to tailor interventions to individual families. They explain that cultural sensitivity should be maximized while dealing with minority groups. The existing behavioral interventions have not been efficient due to their lack of cultural sensitivity. Therefore, it is important to incorporate cultural sensitivity to ensure that minority groups can benefit.

Thongseiratch, T., Leijten, P., & Melendez-Torres, G. J. (2020). Online parent programs for children’s behavioral problems: a meta-analytic review.  European child & adolescent psychiatry,  29(11), 1555-1568.

The authors explain that online parent programs are effective in handling children’s behavioral issues. Parents can learn strategies of dealing with their children’s behavioral issues during the online training programs. online programs improve the mental health of parents and address the existing emotional and behavioral problems among children.

Genogram

Erick Owens, 1930-2010

Chris, 1901-1980

Grandmother

James, Dad, depressed

Caroline, mum, anxiety

Jane

Ian

Brian

Felix

Jared

Peter

Teresia

Sarah

Catherine, 1935-2015, bipolar disorder

Ecomap

Jared

Grandmother

mother

brother

brother

father

students

teacher

neighbor

paental conflict

Peer relationships

academic pressure

parental expectations