NURS 6640 Discussion: Counseling Adolescents
NURS 6640 Discussion: Counseling Adolescents
Discussion: Counseling Adolescents
The adolescent population is often referred to as “young adults,” but in some ways, this is a misrepresentation. Adolescents are not children, but they are not yet adults either. This transition from childhood to adulthood often poses many unique challenges to working with adolescent clients, particularly in terms of disruptive behavior. In your role, you must overcome these behaviors to effectively counsel clients. For this Discussion, as you examine the Disruptive Behaviors media in this week’s Learning Resources, consider how you might assess and treat adolescent clients presenting with disruptive behavior.
LEARNING OBJECTIVES
Students will:
- Assess clients presenting with disruptive behavior
- Analyze 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.
- View the media, Disruptive Behaviors. Select one of the four case studies and assess the client.
- For guidance on assessing the client, refer to pages 137-142 of the Wheeler text in this week’s Learning Resources.
Note: To complete this Discussion, you must assess the client, but you are not required to submit a formal Comprehensive Client Assessment.
Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click Submit, you cannot delete or edit your own posts, and cannot post anonymously. Please check your post carefully before clicking Submit!
BY DAY 3
Post an explanation of your observations of the client in the case study you selected, including behaviors that align to the criteria in DSM-5. Then, explain therapeutic approaches you might use with this client, including psychotropic medications if appropriate. Finally, explain expected outcomes for the client based on these therapeutic approaches. Support your approach with evidence-based literature.
NURS 6640 Week 9 Counseling Adolescents
NURS 6640, Week 9 Main Discussion Post
Counseling Adolescents
The case study I selected to discuss involved the blaming adolescent. The client presented appears as a middle adolescent male. In the scenario, the adolescent has stolen a car that does not belong. To justify why he has taken the car, he placed the blame on the owner of the car because he left the keys in it. He also mentions that his parents need counseling, not him. Unfortunately, he does not take full responsibility for his poor actions. He appears to believe he is innocent, and others are to blame for his actions.
Diagnosis
His behavioral actions may be a result of uncontrolled emotions such as anger. Disruptive, impulse-control and conduct disorders are a group of psychiatric conditions that affect the self-regulation of emotions and behaviors and begin in childhood or adolescence (Amboss, 2018). A differential diagnosis for the presented client would be oppositional defiant disorder. According to the Substance Abuse and Mental Health Services Administration (2016), the oppositional defiant disorder is classified as a pattern of angry/irritable mood, argumentative/defiant behavior, or vindictiveness lasting at least six months. It is essential to investigate the possible causes of ODD. Defiant behavior in children can be triggered by family abuse, unstable home environment, or sudden change in family structure.
Therapeutic Approaches
A recommended therapeutic approach would be cognitive behavioral therapy (CBT), which involves the psychotherapist collaborating with the client. Cognitive behavior therapy helps the patient understand that they are not bad, but the behavior may be (Wheeler, 2014). With CBT, clients learn to cope effectively with negative emotions by developing new cognitive and behavioral skills. To change an emotion, one must change how they behave or act.
An additional therapeutic approach I would use would be dialectical behavior therapy, which is a research-based therapy. The client presents with impulse control, poor insight, and defiance. Dialectical behavior therapy focuses on the client’s overall behavior. Clients with difficulty managing the emotional challenges of their lives because they lack the needed behavioral coping skills. With the use of this therapy, the client would openly discuss their feelings, display insight into their decision process while judgment is not portrayed. A strong commitment to change must be displayed. According to Mindfulness Therapy Associates (2019), Research has shown that DBT treatment is most effective when it includes individual therapy, a weekly skills training group, and assistance with skills application by phone with the own therapist between sessions.
Psychotropic Medications
Research shows psychotropic medications are not recommended to treat ODD in children and that no drugs have been specifically approved. ODD should be treated as an emotional and behavior challenge that requires therapy, changes in a person’s environment and support to develop better social skills (Good Therapy, 2019). Since children diagnosed with ODD are often diagnosed with ADHD, stimulant medications can be used as a source of treatment.
Expected Outcomes
With the implementation of therapeutic approaches such as cognitive-behavioral therapy and dialectical behavior therapy, clients will be empowered to make their own decisions. Hopefully, they will have a greater understanding that there are consequences to all chosen choices, and they are held accountable for their actions. Additional mental health conditions, such as ADHD or conduct disorder, need to be examined to determine if associated with ODD. With an understanding and managing feelings of defeasance and opposition, clients maintain happy relationships and tend to excel at work and school.
References
Amboss. (2019). Disruptive, impulse-control, and conduct disorders. Retrieved from
https://www.amboss.com/us/knowledge/Disruptive%2C_impulse-
control%2C_and_conduct_disorders
Good Therapy. (2019). Oppositional Defiant Disorder Treatment. Retrieved from
https://www.goodtherapy.org/learn-about-therapy/issues/oppositional-and-defiant-
disorder/treatment
Mindfulness Therapy Associates. (2019). Dialectical Behavior Therapy (DBT). Retrieved from
Contact
Substance Abuse and Mental Health Services Administration. (2016). DSM-5 Changes:
Implications for Child Serious Emotional Disturbance [Internet]. Rockville (MD):
Substance Abuse and
Mental Health Services Administration (US); Table 18, DSM-IV to DSM-5
Oppositional Defiant Disorder Comparison. Retrieved from:
https://www.ncbi.nlm.nih.gov/books/NBK519712/table/ch3.t14/
Substance Abuse and Mental Health Services Administration. DSM-5 Changes: Implications for Child Serious Emotional Disturbance [Internet]. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2016 Jun. Table 18, DSM-IV to DSM-5 Oppositional Defiant Disorder Comparison. Available from: https://www.ncbi.nlm.nih.gov/books/NBK519712/table/ch3.t14/
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).
Substance Abuse and Mental Health Services Administration. DSM-5 Changes: Implications for Child Serious Emotional Disturbance [Internet]. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2016 Jun. Table 18, DSM-IV to DSM-5 Oppositional Defiant Disorder Comparison. Available from: https://www.ncbi.nlm.nih.gov/books/NBK519712/table/ch3.t14/
Discussion: Counseling Adolescents
To prepare:
Review this week’s Learning Resources and reflect on the insights they provide.
View the media, Disruptive Behaviors. Select one of the four case studies and assess the client.
For guidance on assessing the client, refer to pages 137-142 of the Wheeler text in this week’s Learning Resources.
Case study on blaming adolescent :
Write an explanation of your observations of the client in the case study you selected, including behaviors that align to the criteria in DSM-5. Then, explain therapeutic approaches you might use with this client, including psychotropic medications if appropriate. Finally, explain expected outcomes for the client based on these therapeutic approaches. Support your approach with evidence-based literature.
| Excellent
90–100 |
Good
80–89 |
Fair
70–79 |
Poor
0–69 |
|||
| Main Posting:
Response to the Discussion question is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources. |
40 (40%) – 44 (44%)
Thoroughly responds to the Discussion question(s). Is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources. No less than 75% of post has exceptional depth and breadth. Supported by at least three current credible sources. |
35 (35%) – 39 (39%)
Responds to most of the Discussion question(s). Is somewhat reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module. 50% of the post has exceptional depth and breadth. Supported by at least three credible references. |
31 (31%) – 34 (34%)
Responds to some of the Discussion question(s). One to two criteria are not addressed or are superficially addressed. Is somewhat lacking reflection and critical analysis and synthesis. Somewhat represents knowledge gained from the course readings for the module. Cited with fewer than two credible references. |
0 (0%) – 30 (30%)
Does not respond to the Discussion question(s). Lacks depth or superficially addresses criteria. Lacks reflection and critical analysis and synthesis. Does not represent knowledge gained from the course readings for the module. Contains only one or no credible references. |
||
| Main Posting:
Writing |
6 (6%) – 6 (6%)
Written clearly and concisely. Contains no grammatical or spelling errors. Adheres to current APA manual writing rules and style. |
5 (5%) – 5 (5%)
Written concisely. May contain one to two grammatical or spelling errors. Adheres to current APA manual writing rules and style. |
4 (4%) – 4 (4%)
Written somewhat concisely. May contain more than two spelling or grammatical errors. Contains some APA formatting errors. |
0 (0%) – 3 (3%)
Not written clearly or concisely. Contains more than two spelling or grammatical errors. Does not adhere to current APA manual writing rules and style. |
||
| Main Posting:
Timely and full participation |
9 (9%) – 10 (10%)
Meets requirements for timely, full, and active participation. Posts main Discussion by due date. |
8 (8%) – 8 (8%)
Meets requirements for full participation. Posts main Discussion by due date. |
7 (7%) – 7 (7%)
Posts main Discussion by due date. |
0 (0%) – 6 (6%)
Does not meet requirements for full participation. Does not post main Discussion by due date. |
||
| First Response:
Post to colleague’s main post that is reflective and justified with credible sources. |
9 (9%) – 9 (9%)
Response exhibits critical thinking and application to practice settings. Responds to questions posed by faculty. The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives. |
8 (8%) – 8 (8%)
Response has some depth and may exhibit critical thinking or application to practice setting. |
7 (7%) – 7 (7%)
Response is on topic and may have some depth. |
0 (0%) – 6 (6%)
Response may not be on topic and lacks depth. |
||
| First Response:
Writing |
6 (6%) – 6 (6%)
Communication is professional and respectful to colleagues. Response to faculty questions are fully answered, if posed. Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in standard, edited English. |
5 (5%) – 5 (5%)
Communication is mostly professional and respectful to colleagues. Response to faculty questions are mostly answered, if posed. Provides opinions and ideas that are supported by few credible sources. Response is written in standard, edited English. |
4 (4%) – 4 (4%)
Response posed in the Discussion may lack effective professional communication. Response to faculty questions are somewhat answered, if posed. Few or no credible sources are cited. |
0 (0%) – 3 (3%)
Responses posted in the Discussion lack effective communication. Response to faculty questions are missing. No credible sources are cited. |
||
| First Response:
Timely and full participation |
5 (5%) – 5 (5%)
Meets requirements for timely, full, and active participation. Posts by due date. |
4 (4%) – 4 (4%)
Meets requirements for full participation. Posts by due date. |
3 (3%) – 3 (3%)
Posts by due date. |
0 (0%) – 2 (2%)
Does not meet requirements for full participation. Does not post by due date. |
||
| Second Response: Post to colleague’s main post that is reflective and justified with credible sources. |
9 (9%) – 9 (9%)
Response exhibits critical thinking and application to practice settings. Responds to questions posed by faculty. The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives. |
8 (8%) – 8 (8%)
Response has some depth and may exhibit critical thinking or application to practice setting. |
7 (7%) – 7 (7%)
Response is on topic and may have some depth. |
0 (0%) – 6 (6%)
Response may not be on topic and lacks depth. |
||
| Second Response: Writing |
6 (6%) – 6 (6%)
Communication is professional and respectful to colleagues. Response to faculty questions are fully answered, if posed. Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in standard, edited English. |
5 (5%) – 5 (5%)
Communication is mostly professional and respectful to colleagues. Response to faculty questions are mostly answered, if posed. Provides opinions and ideas that are supported by few credible sources. Response is written in standard, edited English. |
4 (4%) – 4 (4%)
Response posed in the Discussion may lack effective professional communication. Response to faculty questions are somewhat answered, if posed. Few or no credible sources are cited. |
0 (0%) – 3 (3%)
Responses posted in the Discussion lack effective communication. Response to faculty questions are missing. No credible sources are cited. |
||
| Second Response: Timely and full participation |
5 (5%) – 5 (5%)
Meets requirements for timely, full, and active participation. Posts by due date. |
4 (4%) – 4 (4%)
Meets requirements for full participation. Posts by due date. |
3 (3%) – 3 (3%)
Posts by due date. |
0 (0%) – 2 (2%)
Does not meet requirements for full participation. Does not post by due date. |
||
| Total Points: 100 | ||||||
Name: Discussion Rubric
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