10 Sep Respond by offering additional insights or alternative
Respond by offering additional insights or alternative perspectives on their diagnosis or provide alternate next questions and why you selected those.
NOTE: (POSITIVE COMMENT)
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In this video, the practitioner is dealing with a 16-year-old boy. This is a teenager and an underage. As such, the assessment of this client might be met with a number of complications such as failure to cooperate. Notably, counselling teenagers is known to be challenging especially when normal traditional talk is used because this may be a barrier to communication between the client and the practitioner (Bennet et al., 2017). In addition, there are always several ethical and legal issues owing to the age of a minor that must be put in mind during any interaction with them in clinical setting. However, the practitioner is very keen to make sure that he creates an environment that allows them to talk and discuss his client’s issue in an open manner. He first leads him into the assessment room and welcomes him to sit down. This is already a sign of hospitability and it may be effective in reducing any tension that may have existed on the part of the teenager before he got into the room. Building a rapport with any client and especially teenagers is very important in making sure that adolescents that are disengaged become engaged (Bennet et al., 2017). It is clear from the video that the teenager appreciated being welcomed into the office.
The right to privacy and confidentiality applies to any patient. Ideally, even though this is a teenager where consent for treatment comes from the parents, he still has the right to privacy and confidentiality. The practitioner was right to make sure that he knew that whatever shall be discussed there will not be told to anyone including his parents unless he is seen to have the potential of harming himself or another person. There are always competing interests between parents and children when working with minors and it is always important for the practitioner to understand how to balance these interests (Sori & Hecker, 2015).
Even though the practitioner started well, there are a few things that he needs to improve. For instance, he asked the client why he thinks he is there, and the client said that his mom made him. The practitioner went ahead and pointed out that the mother must have had a reason to do that. This was not a good approach because it appeared like he was already justifying or proving that the parent was right, and completely disregarding the feelings that the teenager has about being made to attend the session. In fact, one can notice how the attitude of the teenage changed thereafter. He even told the practitioner that he would have to ask his mother that particular question.
At this point of the interview, the only compelling concern is that the practitioner does not want to look at the problem from an objective perspective. He even makes comments about teenagers not wanting to talk with their parents. This actually validates his behavior as a teenager and to some extent, it beats the purpose of the session. The practitioner should use an approach that tries to build the relationship between the client and his mother. in any family, a person or a unit forms a subsystem. The behavior of the subsystem affects the family as a whole (Ahluwalia, Anand & Suman, 2018). In this case, it is clear that in the family there are two subsystems and the behavior of the teenager is affecting the family relationship.
The next question that should be asked is whether the client actually thinks he has anger management issue. In the DSM-5 there is no diagnosis for dysfunctional anger. However, anger management issues come out in criteria for different other issues and it is likely that this would be a case of intermittent explosive disorder. In this disorder, there is aggressive and impulsive reaction to people and property (Rynar & Coccaro, 2018). It could also be a case of irritability which is a manifestation of many other mental health issues. Therefore, asking him this question will be a start to understanding the many other circumstances surrounding his anger in order to make the right diagnosis.
References
Ahluwalia, H., Anand, T., & Suman, L. N. (2018). Marital and family therapy. Indian Journal of Psychiatry, 60(Suppl 4), S501.
Bennett, E. D., Le, K., Lindahl, K., Wharton, S., & Weng Mak, T. (2017). Five out of the box techniques for encouraging teenagers to engage in counseling. Retrieved from VISTAS Online American Counselling Association Knowledge Center website: https://www. counseling. org/docs/default-source/vistas/encouraging-teenagers. pdf
Rynar, L., & Coccaro, E. F. (2018). Psychosocial impairment in DSM-5 intermittent explosive disorder. Psychiatry research, 264, 91-95
Sori, C. F., & Hecker, L. L. (2015). Ethical and legal considerations when counselling children and families. Australian and New Zealand Journal of Family Therapy, 36(4), 450-464
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