Please pay attention to the information belowZero plagiarismfive references not less than 5years89 year old African American female living in the long term facility. He was diagnosed with Anxiety disorder. Patient on Xanax 30mg twice a day. Patient was seen by psych MD and no medication was recommended. Stable at this timeSelect a client that 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 whether cognitive behavioral therapy would be effective with this client. Include expected outcomes based on this therapeutic approach. Support your approach with evidence-based literature. Explain any legal and/or ethical implications related to counseling this client.
Introduction: In this Practicum Journal entry, I will be discussing a client that I observed this week. I will be describing the client’s background and medical information, including prescribed medications. Using the DSM-5, I will then explain and justify the diagnosis given to this client. Furthermore, I will discuss the possible effectiveness of cognitive behavioral therapy with this client, including expected outcomes based on this approach. Finally, I will explore any legal and ethical implications that may be associated with counseling this client.
Client Description: The client I observed this week was an 89-year-old African American female residing in a long-term care facility. The client was diagnosed with an anxiety disorder and was prescribed Xanax, 30mg twice a day. During her evaluation, the client reports feeling anxious most of the time, especially when she is alone. She also mentions that she has trouble sleeping at night and that she has experienced some memory loss. The client has no significant medical history.
DSM-5 Diagnosis: Based on the client’s presenting symptoms, she met the criteria for Generalized Anxiety Disorder (GAD). The DSM-5 defines GAD as excessive anxiety and worry about multiple events or activities, occurring more days than not for at least six months. The client’s anxiety is causing distress and interferes with her daily life activities. There are no physiological causes that explain her symptoms besides the presence of an anxiety disorder.
Cognitive Behavioral Therapy: Cognitive Behavioral Therapy (CBT) can be an effective approach when treating GAD. This technique involves modifying negative thoughts and behaviors that may be contributing to the anxiety. For example, the client may have a fear of being alone, leading to negative thoughts, anxious feelings, and difficulty sleeping. CBT would focus on identifying negative thoughts and replacing them with a more realistic view of the situation. Expected outcomes for this approach include an improvement in the client’s anxiety symptoms, improved sleeping patterns, and enhanced overall quality of life.
Legal and Ethical Implications: When counseling this client, there are several legal and ethical implications to consider. Confidentiality is paramount when working with clients, especially within a long-term care facility. The clients’ medical records must be kept confidential, and no information may be released without explicit written consent from the client or her designated representative. Additionally, cultural sensitivity and awareness should be considered when working with an African American client. Ensuring her cultural beliefs and values are respected will lead to better therapeutic outcomes. Finally, it is essential to ensure that the client understands the risks and benefits of treatment, including the potential for adverse side effects from medication. The client’s autonomy and right to informed consent must be respected throughout the counseling process.
1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Pub.
2. Butler, A. C., Chapman, J. E., Forman, E. M., & Beck, A. T. (2006). The empirical status of cognitive-behavioral therapy: A review of meta-analyses. Clinical psychology review, 26(1), 17-31.
3. National Institute on Aging. (2021). Anxiety disorders in older adults. Retrieved from https://www.nia.nih.gov/health/anxiety-disorders-older-adults
4. U.S. Department of Health and Human Services. (2013). HIPAA Privacy Rule and Sharing Information Related to Mental Health. Retrieved from https://www.hhs.gov/hipaa/for-professionals/special-topics/mental-health/index.html
5. Welfel, E. R. (2016). Ethics in counseling and psychotherapy: Standards, research, and emerging issues. Cengage Learning.
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