Client Description
Issa, a six-year-old, is an only child who is ‘difficult’, as described by his parents Fatma and Hakim. The parents report that it is nearly impossible for anyone to make Issa do anything. His teachers report Issa to be a bully and a very aggressive child, always disrupting the class with mischief. The sternness of his teachers and that of his parents only seem to aggravate his situation making him more violent. The parents report that Issa had previously used Anticonvulsant medicine (Depakote) as a mood depressant, but was later stopped when nothing changed.
Client Diagnosis
Issa can be said to be suffering from oppositional defiant disorder (ODD), which is usually characterized by disobedience, hostility, negative and defiant behavior towards anyone they regard as an authority figure ( Bass, Nevel & Swart, 2014) . The justification of diagnosing Issa with ODD is from the fact that these symptoms have persisted more than six months, tends to blame others for his mistakes, it has impaired his academic and social functioning, and this defiant behavior is always directed at authority figures ( Wheeler, 2014) .
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Legal and Ethical Implications
There are a number of ethical and legal concerns as it pertains counselling this client, which include informed consent, the sharing of information that has been revealed to the practitioner by the client with the parent, confidentiality, reporting concerns, and exceptions ( Koocher, 2003) . Notably, the counsellor is faced with the ethical and legal concern of information sharing, which is crucial in trying to tackle the issue, especially by those directly involved with the child. McLeod et al. (2016) points out the importance of ‘involvement’ when tackling psychiatric disorders in children, mainly since the psychiatrist is only a small part of the whole process. The need to have the parents, the teachers, the medical team, and the society involved supersedes the need for privacy ( Zilberstein, 2014) . Nevertheless, therein lies an ethical and legal constraint that binds the counsellor and demands of them to maintain a level of privacy, which may limit any form of intervention.
References
Bass, C., Nevel, J. V., & Swart, J. (2014). A comparison between dialectical behavior therapy, mode deactivation therapy, cognitive behavioral therapy, and acceptance and commitment therapy in the treatment of adolescents. International Journal of Behavioral Consultation and Therapy , 9 (2), 4–8. doi: 10.1037/h0100991
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th Ed) . Washington DC.
Koocher, G. P. (2003). Ethical issues in psychotherapy with adolescents. Journal of Clinical Psychology , 59 (11), 1247–1256. doi: 10.1002/jclp.10215
McLeod, B. D., Jensen-Doss, A., Tully, C. B., Southam-Gerow, M. A., Weisz, J. R., & Kendall, P. C. (2016). The role of setting versus treatment type in alliance within youth therapy. Journal of Consulting and Clinical Psychology , 84 (5), 453–464. doi: 10.1037/ccp0000081
Wheeler, K. (2014). Psychotherapy for the advanced practice psychiatric nurse a how-to guide for evidence-based practice . New York, NY: Springer Publishing Company, LLC.
Zilberstein, K. (2014). The use and limitations of attachment theory in child psychotherapy. Psychotherapy , 51 (1), 93–103. doi: 10.1037/a0030930
