Describe each client (without violating HIPAA regulations) and identify any pertinent history or medical information, including prescribed medications.
The first client is a 48-year-old female suffering from a major depressive disorder and is having suicidal thoughts after been chased out of her home by her physically and verbally abusive husband. The woman is depressed since she grew up as an adopted child, and the family does not love her. The verbal and physical abuse from the husband and hatred from her family has made her anxious and depressive. The patient is prescribed with floutexin and citalopram, which are selective serotonin reuptake inhibitors (SSRIs).
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The second client is his husband, who has a generalized anxiety disorder and anger management, which makes him upset, speak loud, and physically abusive. The husband has been isolated by most of his friends, and the wife keeps on complaining. The husband lives with self-hatred and negative self-impression. The client is prescribed with Lexapro and Celexa medications.
Using the DSM-5, explain and justify your diagnosis for each client.
Based on DSM-5, diagnosis criteria for major depressive disorder are shown when the client reveals at least five symptoms during the same 2-week period, and one symptom must be diminished pleasure or depressive mood (American Psychiatric Association, 2013). The female client revealed six symptoms of depressive mood, feeling of worthiness, indecisiveness, fatigue, significant loss weight for the last eight months, and recurrent suicidal thoughts.
Under DSM-V, generalized anxiety disorder diagnostic criteria, the client must be diagnosed with at least three symptoms, with one symptom been present or at least six months (American Psychiatric Association, 2013). In this case, the client revealed symptoms of restlessness, challenge to control the worry, sleep disturbance, poor concentration for the past one year, and irritability.
Explain whether solution-focused or cognitive behavioral therapy would be more effective with this family. Include expected outcomes based on these therapeutic approaches.
In this case, solution-focused therapy will be the most effective therapy for the family. Solution-focused therapy focuses more on discussing the most effective solutions as contrasting to concentrating on the problem ( Nichols & Davis, 2020 ). Solution-focused is the most effective family therapy since it focuses on establishing immediate possible solutions to the issue at hand (de Castro & Guterman, 2008). The therapist will help the two clients to formulate a solution based on the scenario, set realistic goals, and implement the solution. Thus, the client and therapist work together to improve the quality of life.
Solution-focused therapy is expected to produce positive and life-changing results. It is expected that after the therapy, the couple will change their view of each other and get back together. After the therapy, the wife will learn to appreciate who she is, see her worth, and stop suicidal thoughts. On the other hand, the husband will learn to control his aggressive behavior and begin optimistically viewing himself.
Explain any legal and ethical implications related to counseling each client.
The therapist has to follow the ethical principle of informed consent when providing counseling to the first client (Patterson, 2014). The therapist should allow the woman to make an informed decision on whether to continue to wither marriage or get a divorce. In the second client, the therapist should ensure confidentiality by not disclosing the husband’s problem to the wife or third party.
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
De Castro, S., & Guterman, J. (2008). Solution-focused therapy for families coping with suicide. Journal of Marital & Family Therapy, 34 (1), 93–106. doi:10.111/j.1752-0606.2008.00055.x
Nichols, M., & Davis, S. D. (2020). The essentials of family therapy (7th ed.). Boston, MA: Pearson.
Patterson, T. (2014). A cognitive behavioral systems approach to family therapy. Journal of Family Psychotherapy, 25 (2), 132–144. doi:10.1080/08975353.2014.910023
