Assignment 5: Practicum – Week 10 Journal Entry Assignment 5: Practicum – Week 10 Journal Entry Select a child or adolescent client whom you observed or counsel

Assignment 5: Practicum – Week 10 Journal Entry

Assignment 5: Practicum – Week 10 Journal Entry

Select a child or adolescent client whom you observed or counseled this week. Then, address the following in your Practicum Journal.


: Describe the 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 this client.


: Explain any legal and/or ethical implications related to counseling this client.


: Support your position with evidence-based literature.




Learning Resources

Required Readings


Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (2nd ed.). New York, NY: Springer Publishing Company.

Chapter 17, “Psychotherapy With Children” (pp. 597–624)
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.


Bass, C., van Nevel, J., & Swart, J. (2014). A comparison between dialectical behavior therapy, mode deactivation therapy, cognitive behavioral therapy, and acceptance and commitment therapy in the treatment of adolescents. International Journal of Behavioral Consultation and Therapy, 9(2), 4–8. doi:10.1037/h0100991


Koocher, G. P. (2003). Ethical issues in psychotherapy with adolescents. Journal of Clinical Psychology, 59(11), 1247–1256. PMID:14566959

McLeod, B. D., Jensen-Doss, A., Tully, C. B., Southam-Gerow, M. A., Weisz, J. R., & Kendall, P. C. (2016). The role of setting versus treatment type in alliance within youth therapy. Journal of Consulting and Clinical Psychology, 84(5), 453–464. doi:10.1037/ccp0000081


Zilberstein, K. (2014). The use and limitations of attachment theory in child psychotherapy. Psychotherapy, 51(1), 93–103. doi:10.1037/a0030930

The client in this practicum was a 23-year-old male who was in his sophomore year in University. The patient presented himself for a checkup due to persistent headaches, insomnia and hallucinations. He had lately experienced difficulties understanding class concepts and it was getting harder for him to concentrate. The patient had lost his only sibling in a tragic road accident a few months back. The patient has a history of mental illness that led him to try and commit suicide two years back. During this time, the patient had broken up with his girlfriend for 6 years and he felt that he could not cope with the loneliness. The patient had tried to commit suicide by slitting his wrists but his sister found him just in time before he bled out to death. The patient denies anyone in his immediate family suffering from any psychiatric conditions. He however feels that he was brought up on a shaky family unit foundation as his mother separated from his father soon after he was born. The patient occasionally uses cocaine and marijuana when he needs to “relax” after a stressful day.


The patient presents symptoms of a post-traumatic stress disorder based on the classifications of the Diagnostic and Statistical Manual of Mental Heal Disorders 5th Ed. (DSM-5) The patient presents self-destructive behavior angry outbursts, sleep disturbance and problems with his concentration. (American Psychiatric Association, 2013). The patient has lately kept to himself in school and he has not been in a relationship since breaking up with his former girlfriend. He results to using illicit drugs in order to handle the pressures of life. The patient also has a substance abuse disorder. The trauma of losing his girlfriend was seemingly re-created in the loss of his sister who had been his strength during his tough time. He is still dealing with the bereavement and the wounds of loss have been re-opened. The patient is afraid of getting close to people emotionally for the fear of losing them. He keeps to himself as a way to ensure he does not suffer the pain of loss.Assignment 5: Practicum – Week 10 Journal Entry

Legal and Ethical Implications

Given the patient’s history of inflicting self-harm it was in his best interest that the hospital admitted him for observation. The client however felt that they only needed medication for the headaches which would in turn help him to get enough sleep. The patient was attaching all the symptoms to the insufficient sleep and the headache. However, the problem was much deeper and it was ethically right for the hospital to safeguard the patient’s wellbeing. The patients was admitted for four days and he was later discharged under the condition that he would go and live in with a friend or a member of his family while attending counseling sessions from a certified therapist of his choice. Special concerns with this patient were voiced as he was keeping to himself and he had a history of inflicting harm upon himself when faced by stressful situations. The patient had not gotten over the loss of his girlfriend and the death of his sister. He was still in a denial or bereavement state that worsened his social skills and tenacity to handle issues of life (Tramontin, 2010). The patient was likely to snap and do something drastic at the slightest disappointment or provocation.


Wheeler, K. (Eds.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (2nd ed.). New York, NY: Springer Publishing Company.

Hume, M. (2014). Venous Thrombosis and Pulmonary Embolism. Cambridge: Harvard University Press. p. 14

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