Psychotherapeutic Approach To Group Therapy With Children
Psychotherapeutic Approaches to Group Therapy with Children and Adolescents
Group therapy may be beneficial for children and adolescents, because it often provides an environment that normalizes clients’ thoughts, feelings, and behaviors. However, as with any therapeutic approach, group therapy might not be appropriate for every client, every setting, or even every therapist. When selecting therapies, you must always consider the psychodynamics of the client and your own skill set.
This week, as you assess and develop diagnoses for clients presenting for child and adolescent group psychotherapy, you examine the effectiveness of this therapeutic approach. You also consider legal and ethical implications of counseling children and adolescent clients with psychiatric disorders.
Learning Objectives
Students will:
· Assess clients presenting with disruptive behavior
· Analyze group therapeutic approaches for treating clients presenting with disruptive behavior
· Evaluate outcomes for clients presenting with disruptive behavior
To prepare:
· Review this week’s Learning Resources and reflect on the insights they provide.
· Read the case study I am Feeling Like I’m Going Crazy below
· For guidance on assessing the client, refer to pages 137-142 of the Wheeler text in this week’s Learning Resources.
Post an explanation of the most likely DSM-5 diagnosis for the client in the case study. Be sure to link those behaviors to the criteria in the DSM-5. Then, explain group therapeutic approaches you might use with this client. Explain expected outcomes for the client based on these therapeutic approaches. Finally consider legal and ethical implications of counseling children and adolescent clients with psychiatric disorders. Support your approach with evidence-based literature.
Required Readings( Need 3 references)
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
McGillivray, J. A., & Evert, H. T. (2014). Group cognitive behavioural therapy program shows potential in reducing symptoms of depression and stress among young people with ASD. Journal of Autism and Developmental Disorders, 44 (8), 2041-2051. doi:10.1007/s10803-014-2087-9
Restek-Petrović, B., Bogović, A., Mihanović, M., Grah, M., Mayer, N., & Ivezić, E. (2014). Changes in aspects of cognitive functioning in young patients with schizophrenia during group psychodynamic psychotherapy: A preliminary study. Nordic Journal of Psychiatry, 68 (5), 333-340. doi:10.3109/08039488.2013.839738
Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice. New York, NY: Springer.
Chapter 17, “Psychotherapy with Children” (pp. 597–624)
Chapter 20, “Termination and Outcome Evaluation” (pp. 693–712)
Document: I am Feeling Like I’m Going Crazy
Required Media
Microtraining Associates (Producer). (2009). Leading groups with adolescents [Video file]. Alexandria, VA: Author.
Psychotherapy.net (Producer). (2002). Adlerian parent consultation [Video file]. Mill Valley, CA: Author.
The approximate length of this media pice is 117 minutes.
Optional Resources
Psychotherapy.net (Producer). (2012). Group counseling with adolescents: A multicultural approach [Video file]. Mill Valley, CA: Author.
© 2020, Walden University
NRNP 6650: Psychiatric Mental Health Nurse Practitioner Role I: Child and Adolescent
Case Study: I am Feeling Like I’m Going Crazy
IDENTIFICATION: The patient is a 15-year-old male of Native American descent who resides at home
with his mother and 6-year-old brother.
He is seen for the psychiatric evaluation on an inpatient crisis unit. Collateral information was obtained
from the patient’s mother.
CHIEF COMPLAINT: “I am feeling like I’m going crazy”
HISTORY OF CHIEF COMPLAINT: Patient reports that he intentionally cut his leg at school yesterday
before gym class. He realized that he would not be able to participate in class because he could not
control the bleeding of the cuts. He went to the nurse and she referred him to the ER for admission. The
ER provider admitted him to the acute psychiatric unit as he was at risk of harming himself due to
suicidal ideation. He reports that he harmed himself by cutting as he was feeling abandoned by his
boyfriend. He states that he is not emotionally supportive. He reports that self-injurious behavior began
10 months ago, and he uses a disposable razor to cut his upper arm or forearm. He reports problems
with sleep onset. He reports low self-esteem and low energy level. He endorsed a history of two prior
suicide attempts by taking a palm-full of acetaminophen; the most recent attempt was 2 months ago.
He did not report his attempt denies serious adverse effects. His last suicidal ideation due to pressure of
getting good grades and low self-esteem. He used to participate in the school band but stopped
attending rehearsals about 2 months ago because he was no longer interested.
Patient’s mother expressed frustration and difficulty understanding why the patient treats her
disrespectfully when she gives the patient everything the patient wants, such as clothing and money to
go out with friends. The patient’s mother acknowledged that she works a lot and is infrequently at
home, but stated that when she tries to spend time with the patient and express interest in his life, the
patient shuts her out or states that he does not have time to spend with her because she needs to finish
his homework. Patient’s mother additionally expresses confusion about why the patient behaves so
differently than she did at that age, reporting that he was expected to be respectful and comply with her
mother’s requests.
PAST PSYCHIATRIC HISTORY: No prior psychotherapy or trials of psychiatric medication.
MEDICAL HISTORY: Multiple wounds noted on patient’s right upper arm, which appear to be healing. No
known allergies. No acute or chronic medication conditions. Review of systems is negative. Patient
appears to be average height and weight. He denies any recent changes in weight.
HISTORY OF DRUG OR ALCOHOL ABUSE: No alcohol use. States that he tried marijuana once 3 months
ago. Denies use of any other illicit substances.
© 2020, Walden University
FAMILY HISTORY: Patient’s parents were both born in the US. The patient was born in the United States.
Patient reports that her parents got divorced when she was 5 years old. His father currently lives in Los
Angeles and he has minimal contact with him. Family history of mental illness denied.
Personal History
Perinatal: No known perinatal complications.
Childhood/Adolescence: The patient attends the local private high school where he used to get good
grades in her classes, mostly As and Bs; however, he states her grades have declined recently and she is
in danger of failing several classes. He reports recent loss of close friends due to interpersonal conflict.
He identifies as pansexual and is currently dating a male peer. They have been dating for the past 2
months. He states that she would like to have sex with him, but he is not ready yet.
TRAUMA/ABUSE HISTORY: Patient denies trauma or abuse history.
Mental Status Examination
Appearance: Good grooming and hygiene. Cooperative.
Behavior and psychomotor activity: no increased or decreased psychomotor agitation. Sits quietly in
chair.
Consciousness: Alert.
Orientation: To person, place, time.
Memory: Not formally assessed but appears to be intact based on patient’s ability to relate details from
the past.
Concentration and attention: Not formally assessed, but no indication of abnormalities.
Visuospatial ability: Not formally assessed.
Abstract thought: Intact.
Intellectual functioning: Appears to be above average.
Speech and language: Quiet volume, regular rate and rhythm.
Perceptions: No evidence of perceptual disturbance. Patient denies auditory and visual hallucinations.
Thought processes: Coherent and goal directed.
Thought content: Distressed about peer relationships.
Suicidality or homicidality:
Denies current suicidal or homicidal ideation; however, reports suicidal thoughts yesterday on the way
to the hospital.
Mood: “Depressed”
Affect: Constricted.
© 2020, Walden University
Impulse control: Limited as evidenced by impulsive self-injurious behavior.
Judgment/Insight/Reliability: Poor/Poor/Fair
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, please fill out our Order Form. Filling the order form correctly will assist our team in referencing, specifications, and future communication.
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Discussion Questions (DQ)
Initial responses to the DQ should address all components of the questions asked, including a minimum of one scholarly source, and be at least 250 words. Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source. One or two-sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words. I encourage you to incorporate the readings from the week (as applicable) into your responses.
Your initial responses to the mandatory DQ do not count toward participation and are graded separately. In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies. Participation posts do not require a scholarly source/citation (unless you cite someone else’s work). Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.
APA Format and Writing Quality
Familiarize yourself with the APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in Loud-cloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required). Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation. I highly recommend using the APA Publication Manual, 6th edition.
I discourage over-utilization of direct quotes in DQs and assignments at the Master’s level and deduct points accordingly. As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content. It is best to paraphrase content and cite your source.
For assignments that need to be submitted to Lopes Write, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me. Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes. Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own? Visit the Writing Center in the Student Success Center, under the Resources tab in Loud-cloud for tips on improving your paper and SI score.
The university’s policy on late assignments is a 10% penalty PER DAY LATE. This also applies to late DQ replies. Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances. If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect. I do not accept assignments that are two or more weeks late unless we have worked out an extension. As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.
Communication is so very important. There are multiple ways to communicate with me: Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class. Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.
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