Clinical Supervision 19899659

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case study presents an adolescent client with a likely diagnosis of Major Depressive Disorder (MDD).   The comprehensive assessment provided by the case study thoroughly addresses all aspects of the client’s life that indicate abnormal symptoms that require treatment (Wheeler, 2014).  The client’s suicidal ideation, depressed mood, decline in focus with school, lack of self-worth, and sleep problems are symptoms consistent with MDD (American Psychiatric Association, 2013).  This client expresses fatigue and troubles with interpersonal conflict as well as uncontrollable feelings and actions of self-harm.  His depressed mood and constricted affect are evident, as well as the collateral information offered by the mother illustrates symptoms of depression (American Psychiatric Association, 2013).  His perceived lack of social support would make him a good candidate for group therapy to treat his depression.    

            An effective group therapeutic intervention for depressed adolescents is group cognitive behavioral therapy (CBT) (Keles & Idsoe, 2018).  CBT works by identifying and changing some of the automatic thoughts that are leading to maladaptive behaviors and coping.  Considering the prevalence of depression across all ages, particularly adolescents, group CBT is an appropriate and effective treatment (Keles & Idsoe, 2018).  One of the other factors that makes group CBT effective is the social support that is offered in the group setting (Nardi, et al., 2017).  This client has verbalized a lack of emotional support and understanding among peers, so the social support offered in the group would be appropriate and effective for this client.  Group CBT shows effect for adolescents with depression and anxiety that persists beyond the treatment duration (Rith-Najarian, et al., 2019).  The projected outcomes for this client are positive related to the effectiveness of group CBT.   

Counseling a group of adolescents has ethical and legal implications related to consent and adherence to treatment programs, as the adolescents are often forced into treatment by parents.  This can make it challenging for providers when the adolescent clients are not interested or invested in treatment.  However, this case study presents a client who appears interested in seeking help and treatment related to his symptoms.  It is important to consider the client’s consent ethically even when the legal consent is obtained by the parent or guardian. 

References

American Psychiatric Association.  (2013).  Diagnostic and statistical manual of mental

disorders (5th ed.).  Retrieved from https://dsm-psychiatryonline-

org.ezp.waldenulibrary.org/doi/book/10.1176/appi.books.9780890425596

Keles, S., & Idsoe, T.  (2018).  A meta-analysis of group Cognitive Behavioral Therapy

(CBT) interventions for adolescents with depression.  Journal of Adolescence, 67,

129-139.  doi:10.1016/j.adolescence.2018.05.011.

Nardi, B., Massei, M., Arimatea, E., & Moltedo-Perfetti, A.  (2017).  Effectiveness of

group CBT in treating adolescents with depression symptoms: A critical review. 

International Journal of Adolescent Medicine and Health, 29(3), 854-860. 

doi:10.1515/ijamh-2015-0080.

Rith-Najarian, L.R., Mesri, B., Park, A.L., Sun, M., Chavira, D.A., & Chorpita, B.F.

(2019).  Durability of cognitive behavioral therapy effects for youth and

adolescents with anxiety, depression, or traumatic stress: A meta-analysis on

long-term follow-ups.  Behavior Therapy, 50(1), 225-240. 

doi:10.1016/j.beth.2018.05.006.

Wheeler, K.  (Ed.).  (2014).  Psychotherapy for the advanced practice psychiatric nurse:

A how-to guide for evidence-based practice.  New York, NY: Springer.