Patient 1
Description of the Patient, Pertinent History, and Medical Information
The patient is a student aged 16 years. He lives with his parents, who provide for all his basic needs. Academically, the patient performs poorly despite being in year six. When compared to his classmates, he is huge. The patient has a primary target of being an engineer. From birth to one year, he did not show any response whenever his name was called. This prompted his parents to doubt his ability to hear. Inability to respond typically depicts that one is unable to interact (Phipps & Vorster, 2011). In addition to this, he had reduced eye contact with anyone close to him. Typically, nurses can use eye contact to assess interpersonal sensitivity. At the age of three, he was critically examined whether he had any psychological disorder.
At the age of four, his parents were advised to use the picture exchange communication system. This was meant to enable him to know how to communicate with distinctive signs and symbols. It is a visual-based treatment procedure aimed at addressing the issue he was facing. Then also, they were advised to talk to him often. They were to try and ask him questions, even using signs to understand him better. This would then enhance the communication between a patient other people.
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Diagnosis
According to my analysis, the patient has Autism Spectrum Disorder (ASD). The inability to maintain eye contact and respond accordingly signified an issue associated with the development of his brain. This also hinders his socialization and communication with other people around him. What his parents thought was a hearing impairment when he was young turned out to be autism. It can hinder the ability to maintain ideal communication with other people (Wheeler, 2014). Secondly, his age and inability to perform well despite being in a lower class depict that he is not normal. His failure to communicate well and socialize with other people and the environment hinders his ability to acquire ideal knowledge and skills through learning. Family therapy is effective in determining the ASD condition (Saltzman et al., 2013). Owing to this and the symptoms exhibited in the past, the patient has ASD.
Legal Implications
Given his way of thinking and communication, deciding to enact psychotherapy on him would be a direct breach his right to consent.
Patient 2
Description of the Patient, Pertinent History, and Medical Information
The patient is a girl aged 12 years. Her performance in school has been low since she joined school. She lives with her parent, who has provided all that she needs in school and at home. She is very active; thus, she likes engaging herself in many activities. She says that she wants to be a doctor when she finishes school. When she was young, she experienced several accidents. At one moment, she got burned while playing near a fire in the kitchen. Despite being warned by her mother, she never listened. Then also, she forgot doing her homework often. Besides, she has never settled down in class like other learners, but she is always moving up and downplaying instead of reading.
When she was seven, her parents took her to a psychiatrist to ascertain her sanity. Narrative therapy was used to examine him. It is an ideal method of identifying the main issue affecting a patient (Freedman, 2014). She was found to be healthy but hyperactive. In this case, the doctor prescribed Dextroamphetamine Sulfate to work on her brains and enhance her attention span. Nonetheless, through this therapy, her family believes that her situation would significantly improve. Family therapies are considered to have a profound impact on handling psychological disorders (Nichols, 2014). However, the case persisted.
Diagnosis
According to my assessment, the girl has attention deficit hyperactivity disorder. Her inability to concentrate and settle down while in school and at home shows that she is indeed suffering from this condition. Besides, she gets involved in accidents such as burns as a result of being too active and unsettled. Then also, she tends to forget instructions and punishments easily. She always failed to do assignments despite the sanctions she was often subjected to. All in all, she performed poorly since she never concentrated on learning any concept in class. All these shows that she has ADHD.
Legal Issue with Counseling this Patient
She may not adhere to treatment procedures due to her inability to concentrate and forgetfulness. However, enforcing treatment procedures on her without her consent may be a breach of her rights.
References
Freedman, J. (2014). Witnessing and positioning: Structuring narrative therapy with families and couples. Australian & New Zealand Journal of Family Therapy, 35(1), p20–30. Retrieved from https://www.questia.com/read/1P3-3462467741/witnessing-and-positioning-structuring-narrative
Nichols, M. (2014). The essentials of family therapy (6th ed.). Boston, MA: Pearson. Chapter 8, "Experiential Family Therapy" (pp. 129–147). Chapter 13, "Narrative Therapy" (pp. 243–258)- http://download.library1.org/main/2275000/0a39ea5f4ebc842f8e5337d13bfe3040/Michael%20P.%20Nichols%20-%20The%20Essentials%20of%20Family%20Therapy-Pearson%20%282013%29.pdf
Phipps, W. D., & Vorster, C. (2011). Narrative therapy: A return to the intrapsychic perspective. Journal of Family Psychotherapy, 22(2), p128–147. Retrieved from https://sci-hub.tw/10.1080/08975353.2011.578036
Saltzman, W. R., Pynoos, R. S., Lester, P., Layne, C. M., & Beardslee, W. R. (2013). Enhancing family resilience through family narrative co-construction. Clinical Child and Family Psychology Review, 16(3), p294–310. Retrieved from http://transition.cstsonline.org/assets/media/documents/Panelists_Papers/Readings_Saltzman_Enhancing%20Family%20Resilience.pdf
Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice. New York, NY: Springer.- Retrieved from http://media.springerpub.com/media/samplechapters/9780826110008/9780826110008_chapter.pdf
