Psychotherapy with Children and Adolescents Essay

 Client Description

Jack, a 7-year-old child in Grade 1 is the only child living with his parents. During the clinic visit, his mother reported that Jack was caring and intelligent with a huge potential to academically excel. During his free time, Jack derived pleasure in playing with friends and engaging in physical activities such as skating, swimming and running. Jack also enjoyed participating in events thus was frequently invited to birthday parties and play dates. However, Jack was reportedly not aware of his home phone number and address, was not able to print his surname and only recognized a number of pre-primer words. While interacting with his peers, his mother had severally noted that he was easily influenced. He got upset easily when he failed to receive recognition or was ignored. In school, his teacher noted that he occasionally acted socially immature and demonstrated an attention-seeking behavior. Psychotherapy with Children and Adolescents Essay

Jack explained the difficulty in focusing and staying calm in class.  He noticed that he was able to hyper-focus on activities that he was interested in. However, he had difficulties maintaining his attention in school. Instead, he was often restless and needed reminders to ensure that he remained on task. He constantly ran around and presented with numerous difficulties to follow instructions and listen. In other instances, it was reported that Jack blurted out answers and interrupted his classmates. This tendency was also recognized by Jack and he reported that despite his best intentions he couldn’t stop. Jack had several challenges falling into sleep and could at times wake up in the middle of the night. When he woke up, he had a lot of difficulty getting back to sleep and could at times stay awake for up to an hour or two. Psychotherapy with Children and Adolescents Essay

Pertinent History, Medical Information, and Prescribed Medications

Jack was adopted when he was 3 years of age. At home, her mother reported that Jack had difficulties following routines and recalling instructions. His mother described that Jack displayed confrontational behaviors and emotional reactivity both at school and at home. The teacher also noted that Jack was defiant to follow instructions but his general interaction with peers was good. Jack was emotionally impassive and got frustrated easily. He also had numerous incidents of crying outbursts, hitting and inappropriate behavior. The behavioral concerns such as lying, disruptive behaviors, aggression and being argumentative were initially noted when he was 4 years of age in the pre-school program.

Following the diagnosis of ADHD, combined form and Oppositional Defiant Disorder, the behavioral intervention that Jack was initiated into was a coaching program which emphasized on effective strategies to manage attention in a wide range of environments, self-control, and regulation (Feldman & Reiff, 2014).  Jack also worked on a capacity building program to enhance healthy behavior change and improve his performance. Within the school, accommodations were also implemented for the purposes of improving the ability of Jack to be responsible at school and home, to manage instructions and ask for assistance whenever he needed it (Daley et al., 2014).  He was also started on stimulant medications. Psychotherapy with Children and Adolescents Essay

Diagnosis Justification Using the DSM-V Criteria

Based on the DSM-V criteria, a diagnosis of ADHD is made when a client presents with six or more symptoms of inattention for at least six months. Inattention symptoms include trouble organizing activities and tasks, trouble maintaining attention, failing to give close attention to school work and carelessly making mistakes in doing work at home and school work (Murphy et al., 2018).  Failing to follow instructions, being reluctant to perform tasks he was not interested in, getting distracted easily and being forgetful in activities of daily life.

A child ought to also present with signs and symptoms of impulsivity and hyperactivity for at least six months. Signs of hyperactivity and impulsivity include: running about and climbing in situations that are not appropriate, excessive talking, blurting out answers before completing a question and interrupting or intruding others. There should also be evidence the symptoms interfere and reduce the quality of schoolwork, social life and functioning (Liu, Wuthrich & Norlin, 2018).  The symptoms should not be explained by another mental health disorder, be present in more than two settings and occur before 12 years of age. This criterion meets the clinical presentation of Jack. Psychotherapy with Children and Adolescents Essay

Legal and Ethical Implications Related To Counseling This Client.

The client, in this case, is a 7-year-old child meaning that he is a minor. One of the greatest legal issues in counseling is that of informed consent. Informed consent basically refers to formal permission to progress with treatment.  In his case, the counselor should ensure that the client falls under the legal jurisdiction of contract law (Mullen, Lambie & Conley, 2014).  The only way minors can enter a contract is through parental consent, an order by a juvenile court and involuntarily by the insistence of a parent. The child must also be voluntarily given knowledge of the treatment so that he understands the consequences of treatment. Should this consent fail to be obtained, it is the counselor who is held responsible for everything (Hoagwood, Jensen & Fisher, 2014). Besides, confidentiality is another issue which, if broken, may result in the lack of trust between the client and counselor. Psychotherapy with Children and Adolescents Essay