14
Signature Assignment
Shaphan A. Green
APSY 440
Los Angeles Pacific University
Child and game plan
The child that I will be using in my signature assignment will be an eight year old girl who is diagnosed with a depression. In making sure the assignment is completed on time management will play a huge role. Staying organized and continuing to stay on top of due dates will be what assists me in the completion of my signature assignment. Each week there is something due for the assignment, I will continue to build the assignment in pieces to complete the full assignment. Research will be done throughout the weeks to help me be successful with the assignment.
Questions for professor
1. Will the psychological disorder depression work for this assignment?
2. Are you looking for us to get our professional references only from scholarly Journals?
3. Are there any sites you recommend when looking for good resourceful references?
Part 1: Information on child client
Name: Rose Jones
Age: 8 years old
DOB: 11/04/2010
Gender: Female
Ethnic background: More than one race- African American/White
Education: Discovery School of Arts
Education level: 3rd grade
Family functioning: Both parents involved in child’s life. Parents have shared custody of child. Parents seem to communicate well, however, still issues between the two causing some issues to affect co-parenting relationship.
Living situation: 50/50 custody between mother and father
Family history: Mother diagnosed with bipolar disorder and father diagnosed with anxiety. Youngest out of all siblings and only one out of siblings to be referred to therapy. Mother and father no longer together. Rose and siblings go back and forth between mother and father weekly.
Siblings: one brother and two sisters
Medical issues: No diagnosed medical issues, assessment in progress.
Current medication: No current medications administered to client.
Part 2: Description
Rose Jones (child client) parents were referred to myself to be seen by primary health care provider. Rose has been seen a number of times by primary health care provider due to concern of Roses behavior, appetite, mood swings, and a consistent emotion of being sad. Rose has had a huge loss of interest in daily activities to include school, school and homework, extracurricular activities, and involvement in family activities. Client is described to have a persistent depressed mood which has caused impairment to daily life. Primary and health care provider and parents have asked for assessment to be done and a medical diagnostic if there is one. Once assessed and diagnosed, if therapy is needed parents have given consent to therapy sessions in agreement to working towards assisting Rose. Parents have also given consent to medication usage if any needed.
Rose’s behavior in schooled has altered very much. Outbursts of different emotions frequently happening causing behavioral issues in class. Emotions range from sad, mad, confused, and unhappy. Moods often encountered are sadness, hopelessness, anxiety, and loss of interest and pleasure in activities. Excessive crying an irritability is at a high for Rose. Parents are now becoming concerned with sleep habits since Rose is not able to sleep. When client is sleep she is often moving around seeming as though she cannot become comfortable to get good rest. Client begins days very agitated as if she did not get enough rest. Appetite loss has occurred with weight loss happening. No past treatment has been given and client has not been given any medication for current symptoms.
Part 3: Research
Depression is a disorder defined as being sad, down, or blue. Depression came about as early as 1665 and has become more common and had a rapid growth in the number of people who have been diagnosed. Different qualities and factor possessed by people can help in labeling as an individual as “depressed”. Environmental factors also often play a part in one who is diagnosed with depression, this is considered to be their “environmental trigger”. A statement made in the scholarly journal “The Nature of Clinical Depression: symptoms, Syndromes, and Behavior Analysis” is “In each case the underlying physiology is presumably different, but the experienced phenomena may be sufficiently similar to prompt the tact.” (Jonathon W Kanter, 2008) This statement is allowing us to know there is no one case that is the same. Each individual who is diagnosed is thoroughly assessed by interviews, interactions, in different locations. This gives the psychologist knowledge of the client’s everyday life. The cause of depression is not exactly known and research continues. However, different factors are said to be involved such as biological differences, brain chemistry, hormones, and inherited traits.
Psychologists are careful to use the term “depression” to avoid diagnosing a client incorrectly. The accuracy when diagnosing is very important in this disorder because of how loosely the term is thrown around. Depression affects how one feels, thinks and behaves. Depression can lead to a various emotional and physical problems that impacts the daily function of an individual. Depression has many different symptoms and an individual who has this disorder encounters these symptoms daily and usually the full day. Depression is not something that you can “snap out of”. Common symptoms of clinical depression are irritability, frustration and/or angry outburst, loss of interest in normal activities, insomnia, and lack of energy, weight issues, slowed thinking, and many more. Depression is also associated with anxiety also, symptoms of each usually be triggers for the other. Symptoms in adult and children are often times similar. Depression usually begins in the early teen’s years but can happen at any time in one life. Research has shown that depression is more common in woman than in men. Different factors can trigger depression in one’s life like a traumatic event, stressful events, history of other mental illnesses, and even certain medications. Complications often are encountered by an individual who suffers with the disorder. Common complications are drug and alcohol abuse, obesity which can lead to diabetes, social isolation, family conflicts, and suicidal feelings.
Treatment goals for an individual diagnosed with depression is very important but often times are not studied. When providing treatment for a diagnosed patient it is imperative to provide “patient-center care”. This means to make sure all aspect of the patient’s life is taken in to consideration. Psychologists take the time to be responsive to a patient’s needs and values when making treatment decisions. Research evidence has shown that when this is done the patient’s treatment outcome has a positive result. Another factor that plays a part in treatment is the psychologist knowing their patients individual goals. This gives a better understanding when working to help the patient with the disorder. When one is directly involved with their patient it is likely that the patient will have a greater commitment in their treatment. A better understanding of the individual diagnosed with depression values is important because a meaningful treatment is imperative. Treatment for a diagnosed patient is typically therapy sessions. These therapy session can be cognitive behavioral therapy, behavior therapy, or psychotherapy. Different types of specialists seen are clinical psychologists, psychiatrist, and primary care doctors. Medications are prescribed to certain patients depending on the seriousness of the diagnosed individual. The medication prescribed are typically antidepressants. Ten things that a specialist might incorporate in beginning treatment with a patient diagnosed with depression are getting a routine, setting goals, exercise, eating healthy, getting sleep, taking on responsibilities, challenging negative thoughts, supplements, and incorporating new activities into your days.
Part 4: Assessment Process
Interviews
Clinical interviews have been conducted. Interviews have been done with mother, father, and Rose. First interview were conducted in office all on the same day November 28 2018. Rose’s second interview took place at her home on December 3 2018. Interview with mother went well, very open to speaking about what is going on with Rose. She described her changes in moods, eating, and sleeping habits and was able to give a lot of detail and insight to what is going on at home. Father was not as open at first but began to open up about the different changes he has noticed in Rose.
Rose’s first interview she was not open to conversation with myself. Questions were asked and short answers were given, patient being very reserved. Rose was very anxious and timid. Patient also was very volatile, however not showing any signs of anger. All moods consisted of sad and depressed. Rose at times was irritable and argumentative when a question was brought up that her parents gave an answer to. Second interview was more unstructured and a lot smoother than the first. Rose seem to be a lot more comfortable in her own home. Able to see how she interacted with parents and siblings. Rose is very guarded and prefers not to socialize with others. Rose is reticent and does not open up to anyone about her thoughts. Patient is very sensitive to change.
Past records
These records have been looked over by myself. Records are from primary health care provider. Provider has spoken to parents about different medications that are able to be given once diagnosed. Provider has stated all information provided by parents and by patient when patient was seen. Last medical exam by primary provider was October 13 2018.
Teachers input
I was able to meet Roses teacher and interview her. Mrs. Woods was able to explain the different emotion that she has experienced while having Rose in her class. Mrs. Woods explained Rose to often be reserved and a loner at school. Teacher states that Rose is often times in a sad and depressed mood not liking to engage in class activities whether the activities are in the classroom or outside on the playground. Teacher also explains Roses issue with being able to concentrate in class. Rose lacks concentration often times in class.
Testing
Labs were recently done through primary care provider.
Medications
No medications will be given at this time
Assessment instrument
The assessment instrument used for this client was The Depression Scale of Beck Youth Inventories. This instrument is used to assess depression, anxiety, disruptive behavior, and self-concept in a child. There are five inventories with twenty questions each. Each inventory taking a time of five minutes each. The five inventories include questions about thoughts, feelings, and behavior. It is scored by being compared to the table results of the examinees raw score, cumulative percentage, and severity level.
With the interviews, observations, and assessment done I will recommend that Rose does begin intervention for the mood disorder depression. Rose does meet the criteria of four symptoms listed in the DSM-V-TR. Those symptoms include significant weight loss, insomnia, inability to concentrate, and fatigue. These symptoms are also accompanied by irritability and loss of interest in day to day activities. Medications will be held off on right now as we wait to see how the therapies will begin to help. Rose will begin play therapy three times a week. I will continue to meet with Rose both structurally and unstructured to continue to find the underlying issue to the behavior observed.
Part 5: Recommendations
First recommendation is to continue with therapy sessions. These sessions are to include structural and unstructured sessions. Child will also be involved in play therapy to allow child to feel able to be comfortable and possibly open up as she plays. I believe for this to be the best treatment plan to start off with. Child will engage in these interactions for a couple months a will be reevaluated. These sessions are to also assist in helping child find interest in day to day activities once again. Second recommendation is for parents to be more involved with the child. Assist child with homework even when the help is not needed. The interaction with child could possibly show child the love that she may feel she does not get enough of. Parents should try to be more involved with school and at home. Third recommendation is school should keep a close eye on Rose when she is there and if possible maybe get a teacher to interact with her at recess and lunch. The more interaction with Rose, the higher the possibility of lifting her spirits and desires. The goal behind the therapy sessions and parents and school being more attentive is to allow Rose to feel the love and attention that all children desire. Children enjoy to feel as if they are their parent’s world. The more they receive this attention the more they want to continue to impress. Rose is having difficulty with the split of the parents. Parents should do their best in showing Rose an approach of healthy co-parenting. The less stress she feels and sees the better.
Part 6: Therapy Session plans
Rose’s therapy and behavioral plans will include both structured and unstructured sessions. Therapy will include one on one sessions with myself. We will use these sessions to talk about her days and weeks. Trying to get rose to engage in conversation and open up. These will be the structured sessions that Rose goes through. The unstructured sessions will be the play sessions that Rose gets to interact in. These sessions will be held with other children at times just to get interaction with children her age. Other sessions will be play therapy with myself. At times these play therapies will be set up to where I ask her to perform a task with me with the toys and other times they will just be us interacting and engaging together freely. In my office I have a variety of toys that Rose can play with. Toys that will allow her to set up and play out different scenarios using Barbie’s, toy animals, toy dinosaurs, toy cars, toy houses. All of these giving her the ability to play out different scenarios.
Behavioral plans are set up for Rose. Rose’s parents, teacher, and I are all aware of the plans for her behavior. These plans are just to continue to observe Rose and her different moods within these next couple weeks as she goes through therapy. The goal is to see if these therapy sessions assist in altering Roses moods and ways throughout her days. Also with her parents being more hands on and involved we are looking to see if this helps with her moods. She has no bad behavior in school just lack of interest in activities. With her play sessions of interacting with other children involved in therapy, we are looking to see if this assists her with engaging and playing with other students. Rose’s behavioral plan as of now is just to observe as we go through these first few weeks of therapy.
Part 7: Ethical and cultural issues
One ethical issue that we could come across in this case is parents possibly withholding information about different things going on with child or one parent no longer wanting to partake in the help for their children because they feel they no longer need the help. This could possibly happen because of the divorce of the parents. No parents want to look as if they are the reason behind the Childs behavior and moods. This is because if one parent is beginning to feel as though the other is not doing their due diligence as a parent they could easily take them to court to try and switch up the custody agreement in where the parent who is supposedly causing the depression will not be able to be a part of the child’s days. This scenario could happen when the parents who are divorced maybe start to become frustrated with what is going on with their child and the only way they know to take their frustration out is on each other. In this case with my client I plan to avoid this by keep everyone heavily involved and also being of help with the parents. Counseling them in ways to assist Rose and how to keep a very open line of communication with one another. A good relationship between the parents of a child whether divorced or not could only be of benefit to the child or children involved.
A second ethical problem that could potentially happen is parents not wanting to allow the help with their child to become a part of research. Divorce is common now days and the number of children being affected by the divorce is rising. So as a psychologist we want research to happen in these instances so that we assist other health professionals become knowledgeable of the situation. This research could benefit a lot of people around the world that are going through the same thing. Roses parents could possibly not want to give consent to allow my work done with Rose to turn in to research. I as a professional would respect their wishes but I would take the time to educate them on how beneficial this could be to other health care professionals allowing them to assist their child client or even giving knowledge to other parents facing this same problem.
A third scenario that could cause ethical issues in this case could be the child client not wanting information that they provided to the psychologist given to their parent. Rose is only eight years old but possibly could be a lot more mature mentally just from the environment she has been involved in. The client could want to keep privacy within the therapy sessions they partake in with their psychologist. This could cause issues between the psychologist and parents. The psychologist would have to make a professional decision on whether or not he or she would be able to respect the child client’s wishes.
The only cultural issues that I could possibly see happening in my case is the lack of knowledge the African American culture has on how beneficial therapy or seeking counseling could actually be. The culture is taught that you only see a therapist or psychologist when you are “crazy”. So at no time do you seek help from that type of professional. This is a generational/cultural curse that needs to come to an end. Knowledge on mental and mood disorders really should be taught. Diagnosing a child at a young age and getting them the intervention needed could possibly save their life. Too many times we see parents refuse to get help for their children because of the lack of knowledge and negativity that is seen on “getting help”. Next thing we know children are committing suicide. Unfortunately divorce is at an all-time high rate and we have to understand the affect it is having on children and as parents it is time to intervene and get the help that is needed.
Biblical issues are common in the sense that the African American culture is taught that God can fix it all. As long as you give it to God you will be ok. This is true, however we need to understand that God has blessed these humans who are professionals of this type of work and has made this their calling. He has made these individuals to live their life in assisting people who are going through hard times. If a faith based way is what one believes in there are so many routes that are available that are faith based now days.
References
Griffin, R. M. (2015, May 17). 10 Natural Depression Treatments. Retrieved from WebMD: https://www.webmd.com/depression/features/natural-treatments
Jonathon W Kanter, A. M. (2008). The Nature of Clinical Depression: Symptoms, Syndromes, and Behavior Analysis. Retrieved from Association for Behavior Analysis International: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC239534
Staff, M. C. (2018, Feb 03). Depression (major deprissive disorder). Retrieved from Mayo Clinic: https://www.mayoclinic.org/diseases-conditions/depression/symptoms-causes/syc-20356007
