Discussion ch | NURS 6660 – Psychiatric Mental Health Nurse Practitioner Role I: Child and Adolescent | Walden University

 I NEED A RESPONSE TO THIS ASSIGNMENT

2 REFERENCES

What the practitioner did well

In this week’s media, the therapist interviewed an adolescent male referred for a mental health evaluation due to anger management issues. The therapist discussed the client’s rights and limitations in privacy and confidentiality at the beginning of the session. As part of the informed consent process, the therapist was correct to clarify confidentiality and the roles, responsibilities, and expectations at the outset of treatment (American Psychological Association [APA], 2010). Transparency in treatment helps build the foundation for a strong therapeutic alliance. The therapist briefly inquired about the reason for the visit but shifted his attention to discussing the client’s school and leisure activities. He also asked about the client’s established support system. This informs the therapist that the client has other people that he can confide in and seek support. By delaying conversations about the problem, the adolescent client and therapist can get better acquainted, which reduces the development of resistance and reluctance in the client. The “warm-up” questioning allows the young male client to become acclimated to the back-and-forth verbal exchanges of therapy before discussing deeply personal or potentially threatening topics (Barrett & Rappaport, 2011). The therapist successfully paraphrased and reflected to understand the client’s experience of and feelings towards his mother. 

Areas the practitioner could improve

The therapist had missed opportunities to gather essential details from the adolescent client. The client expressed disdain for school. Key areas that the therapist missed with that revelation are how long the client had negative feelings towards school, what led to this feeling, how his grades, and his disciplinary actions at school. The therapist was correct to inquire about the client’s understanding of the reason for his visit, but he asked in a manner that caused the client to react defensively. The statement “she must have a reason” should be omitted. After that statement, the client looked away, crossed his arms, shrugged his shoulders, and told him to “ask her.” If the adolescent client feels judged and misunderstood, he will be reluctant to engage in treatment. The therapist’s mission is to help the teen divulge as much helpful information as possible to assess, diagnose, and treat properly. This mission is most effectively accomplished when therapists build a strong therapeutic relationship that represents respect and empathy for their clients’ problems (Ucar, 2017). 

Compelling concerns 

The client began to discuss the cause of his frustration with his mother. He expressed feeling “annoyed” because she persistently “nags” to share his feelings, making him hostile and resistant. Dysfunction within the family structure creates and maintains emotional and psychological issues in individuals. Unhealthy family dynamics negatively influence the way adolescents view themselves, others, and the environment, leading to poor interpersonal interactions (Al Ubaidi, 2017). Understanding and altering the household dynamic is critical to the success of the adolescent client’s treatment. 

Next question to ask and why

The next question to ask the client would be about his major stressors and how he tries to cope. Adolescents have varying life experiences and challenges. Assessing the client’s stressors gives me insight into his cognitive, physical, and social functioning. Significant life events and stressors have been linked to mental health and behavioral problems in adolescents. How the client copes or adapts determines his experience of distress and the ability to function. Revealing the client’s previous coping skills allows me to identify emotional issues and maladaptive patterns that perpetuate his problems.

References

Al Ubaidi, B. A. (2017). Cost if growing up in dysfunctional family. Journal of Family 

     Medicine and Disease Prevention, 3(3), 1-6.

American Psychological Association. (2010). Ethical principles of psychologists and code 

     of conduct. Retrieved on 11-30-20, from http://www.apa.org/ethics

Barrett, J., & Rappaport, N. (2011). Keeping it real: Overcoming resistance in adolescent 

     males mandated into treatment. Adolescent Psychiatry, 1, 28-34.

Ucar, S. (2017). Reluctance and resistance: Challenges to change in psychotherapy. Journal 

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