Develop diagnoses for clients receiving group psychotherapy and consider legal and ethical implications of counseling these clients.

Develop diagnoses for clients receiving group psychotherapy and consider legal and ethical implications of counseling these clients.

Develop diagnoses for clients receiving group psychotherapy and consider legal and ethical implications of counseling these clients. 150 150 Nyagu

NURS 6650 Psychotherapy with Groups and Families Essay
NURS 6650 Psychotherapy with Groups and Families Essay

Practicum Week 8 This week, you will develop diagnoses for clients receiving group psychotherapy and consider legal and ethical implications of counseling these clients. Learning Resources Required Resources Document: Group Therapy Progress Note Optional Resources American Nurses Association. (2014). Psychiatric-mental health nursing: Scope and standards of practice (2nd ed.). Washington, DC: Author. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author. Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice. New York, NY: Springer. Assignment 1: Practicum – Week 8 Journal Entry (Due in Week 10) Learning Objectives Students will: Develop effective documentation skills for group therapy sessions * Develop diagnoses for clients receiving group psychotherapy * Evaluate the efficacy of cognitive behavioral therapy for groups * Analyze legal and ethical implications of counseling clients with psychiatric disorders * * The Assignment related to this Learning Objective is introduced this week and submitted in Week 10. Select two clients you observed or counseled this week during a group therapy session. Note: The two clients you select must have attended the same group session. Then, in your Practicum Journal, address the following: Using the Group Therapy Progress Note in this week’s Learning Resources, document the group session. Describe each client (without violating HIPAA regulations), and identify any pertinent history or medical information, including prescribed medications. Using the DSM-5, explain and justify your diagnosis for each client. Explain whether cognitive behavioral therapy would be effective with this group. Include expected outcomes based on this therapeutic approach. Explain any legal and/or ethical implications related to counseling each client. Support your approach with evidence-based literature. NURS 6650 Psychotherapy with Groups and Families Essay

Psychotherapy with Groups and Families

Group counselling is a therapy used to assist a three or four clients while group therapy sessions deals with between seven to thirteen individuals. In addition, group counselling focuses majorly on elimination and prevention of obstacles, self-consciousness, progress, development and improvement (Liu, Nie & Wang, 2017). Group therapy on the other hand gives focus to remediation, personality reconstruction and treatment issues. Group counselling is only a short term therapy compared to group therapy that focuses on deeper life issues of an individual.

Both group counselling and group therapy are beneficial to the clients since they provide supportive environment for the clients to air out their concerns and problems. In addition, group counselling provides a sounding board to the clients since a different perspective of problems approach is provided. In addition, the testimonies from other clients on how they have overcome is encouraging and also propelling to the clients (Burlingame, McClendon & Yang, 2018). The group counselling also gives the clients the courage to speak out their problems once they realize they are not alone and different. Through group counselling, social skills are promoted amongst thus making the clients to feel more comfortable and relieved during the sessions. Lastly, clients get a chance to learn more about themselves since the sessions provide the possible ways to uncover the areas that could be hindering an individual’s ability to overcome some issues. NURS 6650 Psychotherapy with Groups and Families Essay

In my practicum experience, I was engaged in a group counselling that consisted of eight members who were getting treatment that was medically assisted following their use of substance disorder that was discovered during the counselling sessions. My main goal was to ensure that all the clients in the therapy session got all-inclusive care via incorporation of behavioral and primary health care services as well as other necessary health care services. In addition, I consulted all the primary care providers involved in the therapy to vouch for best services for the clients from the medically assisted treatment. I also ensured that the treatment provided social skills to the clients to ensure that they felt more relief and comfort throughout the session. The clients were provided with a supportive environment that helped them to freely share their problems. The counselors ensured that all the clients were courageous and bold enough to share their experiences and problems at every stage of the session. During, the session, I assured the clients that they were not alone or any different from other individuals thus giving them the courage to open up about their issues. Lastly, I ensured that all the clients got a chance to realize their potentials by providing the possible ways to help uncover the obstacles that have been hindering their personal ability to overcome life issues. NURS 6650 Psychotherapy with Groups and Families Essay

Description of the Clients

The group therapy had eight members but I only chose two clients who attracted me most and also for the assignment. The first client is Mr. JN while the second client is Mr. MH. Both Mr. JN and Mr. MH have a history of substance disorders and started attending the therapy sessions at the same time. In addition, both clients were the most active members of the group who showed great interest to overcome their situations. Moreover, both clients attended all the therapy sessions and were ever punctual. They also encouraged other group members not to give up along the way making them the most interesting members of the group therapy to interact with. Lastly, both Mr. JN and Mr. MH were friendly and had close relationship with all the members of the group as well as the counsellors. NURS 6650 Psychotherapy with Groups and Families Essay

Mr. JN description:

Mr. JN is a 25 years old Caucasian male living with his parents since he lost his job due to substance abuse. According to Mr. JN his mother gives him total affection and compassionate love by always encouraging him to be a better person. However, he complains that his dad has never shown any concern about his well-being. In addition, he feels that the dad no longer loves him since he always pulls out a disappointment face when addressing him. According to Mr. JN, his father has never given him any financial support since he started the therapy sessions or any other personal need. Mr. JN has massive love for his family and is determined to win the love of his family back especially that of his father by the end of the therapy. The client adds to love his sister who lives in Chicago for the last four years and has never come visiting them since she left. He further explains that he misses his sister so much since she is the only sibling she has and would wish to have her closer to open to her about some personal issues. When Mr. JN was presented to the clinic by his mum he admitted to have been inhaling and injecting himself with cocaine for more than four years. In addition, he revealed to the clinician and the mother that he had been taking methadone 10mg for the last six months that has helped him to overcome some cravings for heroine. The client further opened about feeling sad and lacking the enthusiasm and energy to indulge in any social activity. In addition, Mr. JN said he felt sad, stressed and depressed since he felt like he has ruined all his life ambitions and dreams. However, on further consulting from the mother and the clinician Mr. JN explained that homicidal or suicidal thoughts have never crossed his mind. Further examination on the client showed that he was not suffering from any medical condition. The only medication Mr. JN was found to take is methadone 10mg to suppress his addiction to cocaine. The diagnosis for Mr. JN condition was SUD (Substance Use Disorder). NURS 6650 Psychotherapy with Groups and Families Essay

Mr. MH description:

Mr. MH is a 43 years old man and a father of two children. He is currently not living with his family since he separated with his wife three months ago. The client has been taking between 25 to 30 ounces of vodka daily for the last four years. His friends and parents have lately been persuading him to seek help from professional counsellors. Mr. MH revealed to us that he desperately wants to have his family back and also to reunite with his wife. Additionally, the client said he has been willing to get his job back since he has been straining financially and has also been idle most of the time. According to Mr. MH his addiction for vodka has landed him into trouble since he has lost a lot of his property and also lost his job. Additionally, his addiction has made him to physically abuse his wife and his children, an action he always regrets. The client is determined to stop his drinking habits, get his family as well as his job back. During assessment, the client was found to have previously suffered depression but did not undergo any therapy or medication. The client further admitted to have had suicidal and homicidal thoughts almost daily especially when he woke up in the morning. Mr. MH revealed that he felt disoriented, hopeless, depressed, anxious and sad about his situation. However, during the therapy sessions the client looked calm and was the most cooperative in all the sessions. Mr. MH to admit to have a traumatic childhood from his grandfather who was a drunkard and would always torture him. The grandfather would force him at times to taste his alcohol and that’s how he developed his love for alcohol at a tender age. The client would sneak in and sip his grandfather’s alcohol without his knowledge. Mr. MH was diagnosed to having an alcohol use disorder. NURS 6650 Psychotherapy with Groups and Families Essay


Diagnosis of each client using DSM-5

DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) is the American Psychiatric Association’s gold standard text on diagnostic features, symptoms and names of all the recognized mental illness inclusive of all addictions. DSM-5 acknowledges that the vulnerability of people to developing substance use disorders is not equal and automatic. Some people are faced with the problem of having low self-control thus predisposing them to addiction when they are exposed to drugs (Compton et al, 2019). The severity of substance use disorder is classified depending on the number of symptoms identified in a client. For, example, a client showing two or three symptoms are classified as mild substance disorder. In addition, a client showing four or five symptoms are classified as moderate substance disorder while patients showing more than six symptoms show a severe substance use disorder.

Mr. JN is having a substance use disorder because he has been addicted to heroin that he uses at least 5 times a day for the last four years. The latest DSM-5 indicates that alcohol, heroin, cannabis, caffeine, and hallucinogens are the substances associated with substance-related disorders. Substance use disorder occurs when an individual develops health issues and other issues at school, at home, at work or in social set ups as a result of drug use. Despite using Methadone for six months to contain his addiction, Mr. JN is still cannot stop thinking about heroin. Medical interventions indicated that the patient uses heroin 5 times daily. The client has put heroin before his work, his family, his life as well as his career. In addition, Mr. JN’s relationship between him and his dad has completely been lost. The client financial status has completely crippled and wholly depends on his mother for all his personal needs despite having a good career and a well-paying job. Additionally, the patient has disconnected from his friends since the addiction to heroin has made him become antisocial. NURS 6650 Psychotherapy with Groups and Families Essay

Mr. MH on the other hand is preoccupied with alcohol and does not seem to stop taking his vodka despite the several summons by the police after beating his wife when he is drunk. The client has showed great inability to control his addiction for alcohol going by the time he spends drinking, the amount of alcohol he takes per day as well as the huge urge to drink alcohol every morning. Mr. MH also presents with withdrawal symptoms including shaking, sweating as well as nausea.

Application of Cognitive Behavioral Therapy

Cognitive Behavioral Therapy for Substance Use Disorders (CBT-SUD) is therapy used for treating patients suffering from drug or alcohol abuse. CBT-SUD helps the patients to be more woke about their feelings, behaviors and thoughts. Through cognitive behavioral therapy for substance use disorders the clients are able to develop skills that help them achieve their goals. Patients who undergo cognitive behavioral therapy for substance use disorder develop more skills when solving personal problems (Jones& McCance-Katz, 2019).In addition, the patients who attend CBT-SUD easily manage their urges and cravings to substance use. Moreover, the patients who undergo the cognitive behavioral therapy are more committed to maintaining and making changes in their lives about substance abuse. Cognitive behavioral therapy also makes it easier for the clients to achieve the goals agreed upon at the beginning of the therapy session. Lastly, cognitive behavioral therapy helps the patients to provide self-help tools for their mood swings, teaches effective communication skills as well as helping them to dismiss insecurities and false beliefs that cause substance abuse. NURS 6650 Psychotherapy with Groups and Families Essay

Both Mr. JN and Mr. MH have been diagnosed with substance use disorder and alcohol use order respectively. Therefore, it will be necessary to apply cognitive behavioral therapy for both patients. The cognitive behavioral therapy for alcohol and heroin has shown efficacy for both monotherapy strategy. Additionally, the CBT for substance use disorder for both heroin and alcohol has shown a combination of treatment approach. The appropriate cognitive behavioral therapy intervention for both clients is the Relapse Prevention. Relapse prevention will help in the identification and prevention of high risk situations that could make causes aces to vodka and heroin.

The Legal and Ethical Implication to Counseling each Client

The use of heroin is illegal and could lead Mr. to imprisonment therefore leaving me with the dilemma of either reporting him to the authorities or not. However, according to the Federal regulations, I must protect my client by protecting the confidentiality of his information. Mr. MH on the other hand has an ethical concern of beating his wife and the children. We will not report him to the authorities but will warn him about the dangers associated with physical beating and ensure he undergoes through counselling. NURS 6650 Psychotherapy with Groups and Families Essay


Burlingame, G. M., McClendon, D. T., & Yang, C. (2018). Cohesion in group therapy: A meta- analysis. Psychotherapy, 55(4), 384.

Compton, W. M., Jones, C. M., Baldwin, G. T., Harding, F. M., Blanco, C., & Wargo, E. M. (2019). Targeting youth to prevent later substance use disorder: an underutilized response to the US opioid crisis. American journal of public health, 109(S3), S185-S189.

Jones, C. M., & McCance-Katz, E. F. (2019). Co-occurring substance use and mental disorders among adults with opioid use disorder. Drug and alcohol dependence, 197, 78-82.

Liu, J., Nie, J., & Wang, Y. (2017). Effects of group counseling programs, cognitive behavioral therapy, and sports intervention on internet addiction in East Asia: a systematic review and meta-analysis. International journal of environmental research and public health, 14(12), 1470.

Wakeman, S. E., Pham-Kanter, G., & Donelan, K. (2016). Attitudes, practices, and preparedness to care for patients with substance use disorder: results from a survey of general internists. Substance abuse, 37(4), 635-641. NURS 6650 Psychotherapy with Groups and Families Essay