{"id":1070,"date":"2020-04-12T07:27:06","date_gmt":"2020-04-12T07:27:06","guid":{"rendered":"https:\/\/papersspot.com\/blog\/?p=1070"},"modified":"2020-04-12T07:27:11","modified_gmt":"2020-04-12T07:27:11","slug":"journal-entry-2","status":"publish","type":"post","link":"https:\/\/papersspot.com\/blog\/2020\/04\/12\/journal-entry-2\/","title":{"rendered":"Journal Entry"},"content":{"rendered":"\n

Introduction<\/strong><\/p>\n\n\n\n

The journal entry for this week will address effective\ndocumentation skills for group therapy sessions; I will develop diagnoses for 2\nclients receiving group psychotherapy and evaluate the efficacy of cognitive\nbehavioral therapy for groups using this group as a reference. Finally, I will\nanalyze legal and ethical implications of counseling clients with psychiatric\ndisorders.<\/p>\n\n\n\n

Client #1<\/strong><\/p>\n\n\n\n

            MK is a 31-year-old\nCaucasian single mother, who is currently employed full time with USPS. She was\nraised with her siblings by their parents, her father is still living, but her mother is dead, cause of death is\nsuicide following struggles with depression and anxiety.  <\/p>\n\n\n\n

Presenting Problems<\/strong><\/p>\n\n\n\n

            Depression and\nMood Disorders. <\/p>\n\n\n\n

            MK is alert and oriented to person, place, time, and\nsituation. Her clothing and hair are clean. She reported around four\nhours of sleep daily. She denies suicidal and homicidal ideation and denies any\nsuicide attempts but admits struggling at work due to lack of concentration.<\/p>\n\n\n\n

Medical History <\/strong><\/p>\n\n\n\n

            MK has struggled\nwith depression for over 10 years; she sometimes isolates herself from family\nmembers and friends for days.  She does\nnot report any incidence of abuse. She was first diagnosed with depression at\nthe age of 19 and was placed on Fluoxetine 10mg once daily in the morning. She\nis currently on Zoloft 100mg daily.               <\/p>\n\n\n\n

Diagnosis<\/strong><\/p>\n\n\n\n

Depressed mood and\/or loss of\ninterest or pleasure in life activities for at least 2 weeks and at least five\nof the following symptoms that cause clinically significant impairment in\nsocial, work, or other important areas of functioning almost every day<\/p>\n\n\n\n

1. Depressed mood most of the day.<\/p>\n\n\n\n

2. Diminished interest or pleasure\nin all or most activities.<\/p>\n\n\n\n

3. Significant unintentional weight\nloss or gain.<\/p>\n\n\n\n

4. Insomnia or sleeping too much.<\/p>\n\n\n\n

5. Agitation or psychomotor\nretardation noticed by others.<\/p>\n\n\n\n

6. Fatigue or loss of energy.<\/p>\n\n\n\n

7. Feelings of worthlessness or\nexcessive guilt.<\/p>\n\n\n\n

8. Diminished ability to think or\nconcentrate, or indecisiveness.<\/p>\n\n\n\n

9. Recurrent thoughts of death\n(APA, 2000, p. 356). (American Psychiatric Association, 2013).
<\/p>\n\n\n\n

Group Therapy\nProgress Note<\/strong><\/p>\n\n\n\n

 Client:  Maria King                                          \n               Date: 6-17-2018<\/strong><\/p>\n\n\n\n

Group\nname:________________________________________________ Minutes: 45  <\/strong><\/p>\n\n\n\n

Group session # 4               Meeting attended is #:<\/strong> 2 for this client. <\/strong><\/p>\n\n\n\n

Number present in group 2 of\n2 scheduled Start time:  11 AM              End time: 11:50 AM <\/strong><\/p>\n\n\n\n

Assessment of client <\/strong><\/p>\n\n\n\n

1. Participation level: \u2751 Active\/eager<\/strong> \u2751 Variable \u2751 Only responsive \u2751 Minimal \u2751 Withdrawn <\/p>\n\n\n\n

2.\nParticipation quality: \u2751 Expected \u2751 Supportive \u2751 Sharing \u2751 <\/strong>Attentive<\/strong> \u2751 Intrusive <\/p>\n\n\n\n

\u2751 Monopolizing \u2751 Resistant \u2751 Other:\n_____________________________________ <\/p>\n\n\n\n

3.\nMood: \u2751 Normal \u2751 Anxious<\/strong> \u2751 Depressed<\/strong> \u2751 Angry \u2751 Euphoric \u2751 Other:\n_______________ <\/p>\n\n\n\n

4.\nAffect: \u2751 Normal \u2751 Intense \u2751 Blunted \u2751 Inappropriate \u2751 Labile \u2751 Other:_______________ <\/p>\n\n\n\n

5.\nMental status: \u2751 Normal \u2751 Lack awareness \u2751 Memory problems \u2751 Disoriented\n<\/strong>\u2751 Confused <\/p>\n\n\n\n

\u2751 Disorganized \u2751 Vigilant \u2751 Delusions \u2751 Hallucinations \u2751 Other:__________________ <\/p>\n\n\n\n

6.\nSuicide\/violence risk: \u2751 Almost none \u2751 Ideation<\/strong> \u2751 Threat \u2751 Rehearsal \u2751 Gesture \u2751 Attempt <\/p>\n\n\n\n

7.\nChange in stressors: \u2751 Less severe\/fewer \u2751 Different\nstressors<\/strong>\n\u2751 More\/more severe \u2751 Chronic <\/p>\n\n\n\n

8.\nChange in coping ability\/skills: \u2751 No change \u2751 Improved \u2751 Less\nable<\/strong>\n\u2751 Much less able <\/p>\n\n\n\n

9.\nChange in symptoms: \u2751 Same \u2751 Less severe \u2751 Resolved \u2751 More\nsevere<\/strong>\n\u2751 Much worse <\/p>\n\n\n\n

10.\nOther observations\/evaluations:________________________________________________________\n<\/p>\n\n\n\n

\n In-session procedures: <\/strong>\n Self introduction\n Expression of feelings and issues experienced\n Discussion on coping skills\n <\/td><\/tr>
\n  \n <\/td><\/tr>
\n  \n <\/td><\/tr>
\n  \n <\/td><\/tr>
\n  \n  \n <\/td><\/tr>
\n Home Work: <\/strong>\n  \n  \n  \n  \n Other Comments: <\/strong>\n  \n  \n  \n  \n  \n  \n <\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n

Client #2<\/strong><\/p>\n\n\n\n

            CP is a\n33-year-old married, Hispanic female who is employed as a nurse in a local\nlevel one trauma center. She lives with her\nhusband and three children aged 10, 11 and 17 in a gated low crime\ncommunity. She was previously married, but\nher husband who was a truck driver was killed in a road rage incident barely 3\nmonths after their wedding. She immigrated to\nthe United States with her parents at the age of 2; her father is a\nconstruction worker while her mother trained to become a certified nursing\nassistant.<\/p>\n\n\n\n

The Presenting Problem<\/strong><\/p>\n\n\n\n

            PTSD, Anxiety, and Depression<\/p>\n\n\n\n

The client is alert and oriented to\nperson, place, time, and situation. Her clothing and hair are clean. She\nreported to around four hours of sleep daily. She denies suicidal and homicidal\nideation and denies any suicide attempts but admits struggling at work due to\nlack of concentration.           <\/p>\n\n\n\n

Medical History<\/strong><\/p>\n\n\n\n

            CP has never seen\na therapist or seek psychological help as\na child or adult. There is no relevant past psychological history until she\nlost her first husband and she slipped into depression. Her 17-year-old daughter is from her first\nmarriage. She is currently on a combination of Paxil 40mg once daily and Xanax\n1 mg twice daily as needed. She reports severe anxiety whenever her husband is\nlate and has some phobia for driving. Recently her 15-year-old has requested to learn how to drive, and she opposed it but was convinced by her\nhusband that road rage is not an everyday event.            <\/p>\n\n\n\n

Diagnosis<\/strong><\/p>\n\n\n\n

Posttraumatic Stress Disorder\n(PTSD) is a form of anxiety disorder that is caused by an event that creates\npsychological trauma; to make a definitive diagnosis, clinical symptoms must be\npresent for at least one month (American Psychiatric Association, 2013).\nThe criteria for PTSD include specifying qualifying experiences of traumatic\nevents, four sets of symptom clusters, and two subtypes. There are also\nrequirements around duration of symptoms, how it impacts one\u2019s functioning and ruling out substance use and\nmedical illnesses.<\/p>\n\n\n\n

\n Criterion<\/strong>*<\/a><\/sup><\/strong><\/strong>\n <\/td>\n Description<\/strong>\n <\/td>\n Specific\n examples<\/strong>\n <\/td><\/tr><\/thead>
\n Criterion A\n <\/td>\n Exposure to stressor\n <\/td>\n \u2022 Direct exposure
\n \u2022 Witnessing trauma
\n \u2022 Learning of a trauma
\n \u2022 Repeat or extreme indirect exposure to aversive details\n <\/td><\/tr>
\n Criterion B\n <\/td>\n Intrusion symptoms\n <\/td>\n \u2022 Recurrent memories
\n \u2022 Traumatic nightmares
\n \u2022 Dissociative reactions (flashbacks)
\n \u2022 Psychological distress at traumatic reminders
\n \u2022 Marked physiological reactivity to reminders\n <\/td><\/tr>
\n Criterion C\n <\/td>\n Persistent avoidance\n <\/td>\n \u2022 Trauma-related\n thoughts or feelings
\n \u2022 Trauma-related external reminders such as people, places or activities\n <\/td><\/tr>
\n Criterion D\n <\/td>\n Negative alterations in\n cognitions and mood\n <\/td>\n \u2022 Dissociative amnesia
\n \u2022 Persistent negative beliefs and expectations
\n \u2022 Persistent distorted blame of self or others for causing trauma
\n \u2022 Negative trauma-related emotions: fear, horror, guilt, shame and anger
\n \u2022 Diminished interest in activities
\n \u2022 Detachment or estrangement from others
\n \u2022 Inability to experience positive emotions\n <\/td><\/tr>
\n  \n <\/td>\n  \n <\/td>\n  \n <\/td><\/tr>
\n  \n <\/td>\n  \n <\/td>\n  \n <\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n

Group Therapy\nProgress Note<\/strong><\/p>\n\n\n\n

 Client:  Clarisse Pearce                                                                  Date: 6-17-2018<\/strong><\/p>\n\n\n\n

Group\nname:________________________________________________ Minutes: 45  <\/strong><\/p>\n\n\n\n

Group session # 2               Meeting attended is #:<\/strong> 2 for this client. <\/strong><\/p>\n\n\n\n

Number present in group 2 of\n2 scheduled Start time:  11 AM              End time: 11:50 AM <\/strong><\/p>\n\n\n\n

Assessment of client <\/strong><\/p>\n\n\n\n

1. Participation level: \u2751 Active\/eager<\/strong> \u2751 Variable \u2751 Only responsive \u2751 Minimal \u2751 Withdrawn <\/p>\n\n\n\n

2.\nParticipation quality: \u2751 Expected \u2751 Supportive \u2751 Sharing \u2751 <\/strong>Attentive<\/strong> \u2751 Intrusive <\/p>\n\n\n\n

\u2751 Monopolizing \u2751 Resistant \u2751 Other:\n_____________________________________ <\/p>\n\n\n\n

3.\nMood: \u2751 Normal \u2751 Anxious<\/strong> \u2751 Depressed<\/strong> \u2751 Angry \u2751 Euphoric \u2751 Other:\n_______________ <\/p>\n\n\n\n

4.\nAffect: \u2751 Normal \u2751 Intense \u2751 Blunted \u2751 Inappropriate \u2751 Labile \u2751 Other:_______________ <\/p>\n\n\n\n

5.\nMental status: \u2751 Normal \u2751 Lack awareness \u2751 Memory problems \u2751 Disoriented\n<\/strong>\u2751 Confused <\/p>\n\n\n\n

\u2751 Disorganized \u2751 Vigilant \u2751 Delusions \u2751 Hallucinations \u2751 Other:__________________ <\/p>\n\n\n\n

6.\nSuicide\/violence risk: \u2751 Almost none \u2751 Ideation<\/strong> \u2751 Threat \u2751 Rehearsal \u2751 Gesture \u2751 Attempt <\/p>\n\n\n\n

7.\nChange in stressors: \u2751 Less severe\/fewer \u2751 Different\nstressors<\/strong>\n\u2751 More\/more severe \u2751 Chronic <\/p>\n\n\n\n

8.\nChange in coping ability\/skills: \u2751 No change \u2751 Improved \u2751 Less\nable<\/strong>\n\u2751 Much less able <\/p>\n\n\n\n

9.\nChange in symptoms: \u2751 Same \u2751 Less severe \u2751 Resolved \u2751 More\nsevere<\/strong>\n\u2751 Much worse <\/p>\n\n\n\n

10.\nOther observations\/evaluations:________________________________________________________\n<\/p>\n\n\n\n

\n In-session procedures: <\/strong>\n Self introduction\n Expression of feelings and issues experienced\n Discussion on coping skills\n <\/td><\/tr>
\n  \n <\/td><\/tr>
\n  \n <\/td><\/tr>
\n  \n <\/td><\/tr>
\n  \n  \n <\/td><\/tr>
\n Home Work: <\/strong>\n  \n  \n  \n  \n Other Comments: <\/strong>\n  \n  \n  \n  \n  \n  \n <\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n

Legal and Ethical\nImplications of Counseling<\/strong><\/p>\n\n\n\n

            The Health Insurance Portability and Accountability\nAct (HIPAA), ensures that individuals\u2019\nhealth information is properly protected while allowing the flow of health\ninformation needed to provide and promote high-quality health care and\nto protect the public’s health and well-being. Maintaining confidentiality in\ngroup therapy can be challenging, the\npsychologist\/psychiatrists does not have absolute control on the\nconfidentiality of information provided and therefore cannot assure group\nmember that information provided during the session would be kept private. The\nprovider should, however, make it clear that there is a risk of information\nshared in the group may not be secure. Every effort must be made to provide\nparticipants with education on the need to maintain confidentiality. Trust will\nensure the flow of information and optimize therapy. The legal obligation to\nprovide information to protect the patient and the community overrides\nconfidentiality either in the individual therapy or group therapy.<\/p>\n\n\n\n

Appropriateness of Cognitive\nBehavioral Therapy for this Group<\/strong><\/p>\n\n\n\n

            The cognitive-behavioral model of therapy proposes\nthat clients with substance abuse problems lack the effective coping skills to\ndeal with situations and give in to temptation (Marlatt & Donovan, 2008).\nCognitive behavioral therapy (CBT) is based on three levels of cognition which\nincludes dysfunctional assumptions, core beliefs, and negative automatic\nthoughts. CBT is that it emphasizes self-discovery in the client (McLeod, 2015)\nand would be beneficial for clients in this group because it will help\nthem to conceptualize the reasons behind their thoughts and empower them to\nmake positive changes. CBT would be appropriate for this patient, but a\ncomprehensive approach to treatment to increase the client\u2019s chance for success\n(Keane, 2018).
<\/p>\n\n\n\n

Reference<\/strong><\/p>\n\n\n\n

American Psychiatric Association.\n(2013). Diagnostic and statistical manual of mental disorders. Washington, DC:\nAuthor. <\/p>\n\n\n\n

Fenn, K., & Byrne, M. (2013).\nThe key principles of cognitive behavioral therapy. Education and inspiration\nfor general practice, 6(9), 579-585. doi:10.1177\/1755738012471029<\/p>\n\n\n\n

Keane, H. (2018). Facing addiction\nin America: The Surgeon General’s Report on Alcohol,           Drugs, and Health U.S. DEPARTMENT OF HEALTH AND HUMAN\nSERVICES, OFFICE OF THE SURGEON GENERAL\nWashington, DC, USA: U.S. Department of     Health\nand Human Services, 2016 382 pp. online (gre. Drug and Alcohol Review, 37(2),      282-283. doi:10.1111\/dar.12578<\/p>\n\n\n\n

Marlatt, G. A., & Donovan, D.\nM. (2008). Relapse prevention: Maintenance strategies in the treatment of\naddictive behaviors. <\/p>\n\n\n\n

McLeod, S. A. (2015). Cognitive\nbehavioral therapy. Retrieved from  www.simplypsychology.org\/cognitive-therapy.html<\/p>\n","protected":false},"excerpt":{"rendered":"

Introduction The journal entry for this week will address effective documentation skills for group therapy sessions; I will develop diagnoses for 2 clients receiving group psychotherapy and evaluate the efficacy of cognitive behavioral therapy for groups using this group as a reference. Finally, I will analyze legal and ethical implications of counseling clients with psychiatric […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-1070","post","type-post","status-publish","format-standard","hentry","category-research-paper-writing"],"_links":{"self":[{"href":"https:\/\/papersspot.com\/blog\/wp-json\/wp\/v2\/posts\/1070","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/papersspot.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/papersspot.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/papersspot.com\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/papersspot.com\/blog\/wp-json\/wp\/v2\/comments?post=1070"}],"version-history":[{"count":1,"href":"https:\/\/papersspot.com\/blog\/wp-json\/wp\/v2\/posts\/1070\/revisions"}],"predecessor-version":[{"id":1071,"href":"https:\/\/papersspot.com\/blog\/wp-json\/wp\/v2\/posts\/1070\/revisions\/1071"}],"wp:attachment":[{"href":"https:\/\/papersspot.com\/blog\/wp-json\/wp\/v2\/media?parent=1070"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/papersspot.com\/blog\/wp-json\/wp\/v2\/categories?post=1070"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/papersspot.com\/blog\/wp-json\/wp\/v2\/tags?post=1070"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}