Week 7 Discussion Response to Classmates

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Please no plagiarism and make sure you are able to access all resource on your own before you bid. One of the references must come from Flamez, B. & Sheperis, C. J. (2015) and/or Sommers-Flanagan, J., & Sommers-Flanagan, R. (2007). I have also attached my discussion rubric so you can see how to make full points. Please respond to all 3 of my classmates separately with separate references for each response. You need to have scholarly support for any claim of fact or recommendation regarding treatment. I need this completed by 01/12/19 at 6pm.

Read a selection of your colleagues' postings. Respond to your colleagues' postings.

Respond in one or more of the following ways:

· Ask a probing question.

· Share an insight gained from having read your colleague's posting.

· Offer and support an opinion.

· Validate an idea with your own experience.

· Make a suggestion.

· Expand on your colleague's posting.

1. Classmate (A. Mor)

Selena’s Case 

I would like to discuss the case of Selena. Selena is a 16-year-old Native American sophomore girl in High School. She has been brought into counseling because her mother is worried about her change in behavior. Selena’s mother thinks that her behavior change is due to the recent move from the Indian Reservation to a more urban area. The case also states that they moved because of her Selena’s new romantic relationship. Since the move, Selena has been very irritable, lost 14 pounds, and quit her part-time job. Her mother states that she thinks Selena has a hard time adjusting to school and it is showing because her grades have gone from low A’s to low Bs and high C’s. She is also not attending school as much as she should. In her defense, Selena states that school is boring and stupid. Along with stating how she feels about school, she mentions very subliminal messages of death. She mentions death as a good thing to get out of school activities. For example, Selena’s mom stated that the other day Selena stated, “Maybe if I get hit by a truck I won’t have to take that algebra test.” While Selena’s mother takes this comment very seriously, Selena states that she is just expressing her feelings about algebra. 

Reasoning

I believe that Selena’s problem exists because of the new environment. High school can be a tough time for an adolescent. This is sometimes during the time that the child is kind of finding their flow of things and being their own person (Sommers-Flanagan & Sommers-Flanagan, 2007). The case doesn’t speak much about the discussion of the move so I am wondering if Selena had a say so in this move. Selena most likely had to make new friends, get used to a new neighborhood that does not have much of her cultural values, and she has to learn a new school system. All of these factors can be frustrating because these are all factors that she has to deal with on a daily. The part that can be hard is that she no longer has a comforting place to go to. Her home is now filled with a new person, her neighborhood is unfamiliar, along with her school. All of this at once, I can imagine it can take a toll on someone especially if you have no one to vent to about it. 

Cognitive Intervention 

Treatment interventions in children and adolescents are still in the development stage due to most of the interventions being for adults (Flamez & Sheperis, 2015). Most of the therapeutic interventions do not address the development needs of children and prepubescent. In order to find the best intervention, I would want to first conduct an assessment to analyze depressive symptoms and suicide. To make an educated guess, I would use cognitive therapy to try to help Selena to change her thoughts and magnify her emotional state. I would hope to of course gain trust with her so that we could get to the root of the problem. In helping her with changing her mindset, we would practice scenarios and focus on a negative way to look at the scenario and also the positive way. 

References

· Flamez, B. & Sheperis, C. J. (2015). Diagnosing and treating children and adolescents: A guide for clinical and school settings. Hoboken, NJ: John Wiley & Sons, Inc.

§ Chapter 9 “Depressive Disorders”

· Sommers-Flanagan, J., & Sommers-Flanagan, R. (2007). Tough kids, cool counseling: User-friendly approaches with challenging youth(2nd ed.). Alexandria, VA: American Counseling Association.

§ Chapter 4, "Rapid Emotional Change Techniques: Teaching Young Clients Mood Management Skills"

§ Chapter 8, "Assessment and Management of Young Clients Who Are Suicidal"

2. Classmate (K.Rog)

Assessing Mood Disorders

Main Discussion Post

Irritable children and adolescents often feel miserable which can cause others around them to be miserable as well (Sommers-Flanagan & Sommers-Flanagan, 2007). Children may sulk, get into trouble at school, be negative, and feel misunderstood (Flamez & Sheperis, 2016). With this in mind working with children and adolescents can be more challenging than working with adults. They are quicker to shut down as well as push back against counseling. Differentiation between normal childhood moods and depressed moods is based on the symptoms that exist, the stress level, and dysfunction (Flamez & Sheperis, 2016).

Presenting Symptoms

Monte is a 9 year old white male who has been referred to counseling by his school (Child and Adolescent Counseling Cases, n.d.). Monte is verbally aggressive and insults others (Child and Adolescent Counseling Cases, n.d.). Monte has a very chaotic family as his parents are rarely present and he is being cared for by his sisters (Child and Adolescent Counseling Cases, n.d.). There is no sign of abuse but Monte appears to have low self-esteem as he can be clingy when left alone with teachers and wants their approval (Child and Adolescent Counseling Cases, n.d.). Monte’s behavior has gotten worse in the last 2 years as he has trouble concentrating and is overeating (Child and Adolescent Counseling Cases, n.d.). He has frequent headaches and has poor school attendance (Child and Adolescent Counseling Cases, n.d.).

Reasoning

One reason that Monte’s problems may exists could be due to the lack of parental attention and affection he is getting at home. The fact that he is so attached to his teachers and seeks their approval are signs that he wants and needs more attention. Children with disruptive behavior disorders have difficulties such as problems at school, learning difficulties, and social problems (Ramires, Godinho, & Goodman, 2017). Monte is showing all of the symptoms which correlate to a disruptive mood dysregulation disorder. Also to be diagnosed with disruptive mood dysregulation disorder children must show signs before age 10 and have disruptive outbursts three or more times a week (Flamez & Sheperis, 2016). Monte meets these criteria since he is 9 years old and he consistently acts up in school. He is already blaming everyone else for his shortcomings and behavior as he stated that school is stupid, he gets bad teachers, and things will not improve for him (Child and Adolescent Counseling Cases, n.d.).  

Intervention

One intervention that I think would be helpful is to get the parents more involved with Monte’s therapeutic process. Therefore taking the time to educate the parents on his behavior and how they contribute to his moods is essential. In an effort to help improve Monte’s social and emotional development, working simultaneously with the parents while working with Monte can be helpful (Ramires, et al., 2017). The initial stages of treatment interventions can be mainly supportive which includes educating and encouraging the client (Ramires, et al., 2017).  Educating the parents about Monte’s behavior and the reasons for his behavior will help them realize the importance and severity of the role that they play in his behavior.

Conclusion

Most children often experience episodes of appetite changes, reduced concentration, low self-worth, and behavioral problems (Flamez & Sheperis, 2016). Understanding the reasoning behind these episodes can be challenging. Including the parents in the counseling process can help educate and motivate them to take what is learned in counseling into the home.

References

Document: Child and Adolescent Counseling Cases: Mood Disorders and Self-Harm

Flamez, B., & Sheperis, C. J. (2016). Diagnosing and treating children and adolescents: A guide for clinical and school settings. Hoboken, NJ: John Wiley & Sons, Inc.

Ramires, V. R., Godinho, L. R., & Goodman, G. (2017). The Therapeutic Process of a Child Diagnosed With Disruptive Mood Dysregulation Disorder. Psychoanalytic Psychology,34(4), 488-498. http://dx.doi.org/10.1037/pap0000134

Sommers-Flanagan, J., & Sommers-Flanagan, R. (2007). Tough kids, cool counseling: User-friendly approaches with challenging youth (2nd ed.). Alexandria, VA: American Counseling Association.

3. Classmate (A.Mai)

Adolescence is a life stage of great complexity and turmoil during which several risk activities may emerge. From all maladaptive behaviors in coping with life, suicidal tendencies, suicidal ideations, and self-harming actions are the most troublesome mental health displays, that get the most attention from the communities and professionals (Ferrer & Kirchner, 2015).

Case conceptualization

Salena, a 16-year-old Native American who is referred in counseling by her mother. Lately, she displays increased aggression and irritability, while some statements she made worried her mother. Recently both moved from an Indian reservation to a more urban area. Salena’s mother has a new boyfriend, and the relationship prompted the life change. Salena had difficulties adjusting to the new school and new community. In the last three months since they moved, her irritability increased, she lost a lot of weight without trying to, and her grades dropped significantly while having difficulties concentrating. Salena stopped enjoying any recreational activities, quit her part-time job and made troublesome comments about death. When confronted, she minimized the statements, avoiding a straight answer. She does not have a history of mental illness, and there is no evidence she is abusing any substance Laureate Education, 2019).  

One reason

The DSM-5 defines adjustment disorder as “the presence of emotional or behavioral symptoms in response to an identifiable stressor(s) occurring within three months of the onset of the stressor(s)” (American Psychiatric Association, 2013).

The literature shows that living stressful events is linked to increased suicidal behavior and thoughts. Family, personal and relational losses, and problems may be precipitants of suicidal behavior in children and adolescents. Many studies have linked impulsivity to suicidal tendencies (Ferrer & Kirchner, 2015). Salena is coping with stress and change in general by displaying withdraw, lack of interest and start thinking about more radical alternatives for escape, such as death. Experiencing these thoughts is a long process, and fortunately, Salena is at the beginning. She seems to have a good relationship with her mother, and this is a strong protective factor. Her mother saw the first signee of depression and referred her to a professional.

While eliminating other causes such as mental health history, problems at home, substance abuse, serious traumatic events, it is safe to assume that the main reason why Salena is decompensating is a failure to adjust the new environment. The fact she is coming from an Indian reservation is a valid argument for this theory. Besides the fact she is at a critical stage in life when changes are sudden, unpredictable and tumultuous, she is coming from a cultural minority who experienced oppression for centuries. The shift from a reservation specific rules and morals, with a certain persisting stigma, may have been against Salena’s dreams. The move might have been a traumatic event for an adolescent who begins to make sense of the world.

One intervention

While the study of depression treatment for children and adolescents is still in the incipient stage, evidence-based therapies for suicidal ideations, gestures and self-harming behaviors that have been found to be the most effective, are Cognitive Behavioral Therapy (CBT) and Interpersonal Therapy (IPT) (Flamez & Sheperis, 2015). 

As a counselor, I will first develop a therapeutic relationship with Salena. Being aware that adjustment to the new environment might be the main trigger for her mood, I will imply a culturally sensitive approach. Through both methods, tailored to Salena’s personality and special circumstances, I will approach therapy from the strengths angle instead of discussion mostly risk factors. We might start a conversation about her life in the reservation, and what she enjoys. Later we will explore what can she, as a person who witnessed first-hand life on a reservation, bring as a strength in her new environment. I will take in consideration that she did not have any active suicidal ideation, plans or ruminating ideas of taking her own life and that her risks are in a developing phase. Together we will attempt to divert her current trend of thoughts from a pessimistic, angry one to an optimistic life approach with healthy dreams about her future.

 Conclusion:

The U.S. Surgeon General’s 2012 National Strategy for Suicide Prevention called for “effective programs and practices that increase protection from suicide risk.” American Indian/Alaska Natives adolescents compared with other adolescents, showed more than double incidents in suicidal ideations, attempts or completed suicide actions. Death by suicide rates, despite interventions and treatment, remain the same for three decades (Zamora-Kapoor, Nelson, Barbosa-Leiker, Comtois, Walker & Buchwald, 2016).

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders, Fifth edition (DSM-5). Washington, D.C: American Psychiatric Publishing.

Ferrer, L., & Kirchner, T. (2015). Suicidal tendency among adolescents with adjustment disorder: Risk and protective personality factors. Crisis: The Journal of Crisis Intervention and Suicide Prevention, 36(3), 202–210. https://doi-org.ezp.waldenulibrary.org/10.1027/0227-5910/a000309

Flamez, B. & Sheperis, C. J. (2015). Diagnosing and treating children and adolescents: A guide for clinical and school settings. Hoboken, NJ: John Wiley & Sons, Inc.

Laureate Education (2019).  Child and adolescent counseling cases: Mood disorders and self-harm (Week 7, Case 2). Retrieved fromhttps://class.waldenu.edu/webapps/blackboard/content/listContentEditable.jsp?content_id=_49482902_1&course_id=_16485089_1

Zamora-Kapoor, A., Nelson, L. A., Barbosa-Leiker, C., Comtois, K. A., Walker, L. R., & Buchwald, D., (2016). Suicidal ideation in American Indian/Alaska Native and White adolescents: The role of social isolation, exposure to suicide, and overweight. American Indian & Alaska Native Mental Health Research: The Journal of the National Center, 23(5), 86–100. https://doi-org.ezp.waldenulibrary.org/10.5820/aian.2304.2016.86


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Learning Resources

Please read and view (where applicable) the following Learning Resources before you complete this week's assignments.

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Readings

· Flamez, B. & Sheperis, C. J. (2015). Diagnosing and treating children and adolescents: A guide for clinical and school settings. Hoboken, NJ: John Wiley & Sons, Inc.

  • Chapter 9 “Depressive        Disorders”

· Sommers-Flanagan, J., & Sommers-Flanagan, R. (2007). Tough kids, cool counseling: User-friendly approaches with challenging youth(2nd ed.). Alexandria, VA: American Counseling Association.

  • Chapter 4, "Rapid        Emotional Change Techniques: Teaching Young Clients Mood Management        Skills"
  • Chapter 8, "Assessment        and Management of Young Clients Who Are Suicidal"

· Gutierrez, P. M. (2006). Integratively assessing risk and protective factors for adolescent suicide Click for more options . Suicide and Life-Threatening Behavior, 36(2), 129–135.
© 2006 by BLACKWELL PUBLISHING. Reprinted by permission of BLACKWELL PUBLISHING via the Copyright Clearance Center.

· Pirruccello, L. M. (2010). Preventing adolescent suicide: A community takes action Click for more options . Journal of Psychosocial Nursing and Mental Health Services, 48(5), 34–41.
© 2010 by SLACK INCORPORATED. Reprinted by permission of SLACK INCORPORATED via the Copyright Clearance Center.

· Document:Child and Adolescent Counseling Cases: Mood Disorders and Self-Harm Click for more options

· Document:Child and Adolescent Suicide Risk Factors and Warning Signs Click for more options

· Document:Suicide Assessment Procedures, Documentation, and Risk Factors Click for more options

· DSM-5 Bridge Document:Mood Disorders and Self-Harm Click for more options

Media

  • Laureate Education (Producer).      (2011). Child and adolescent counseling [Video      file].
         Retrieved from https://class.waldenu.edu
  • "Mood Disorders and        Self-Harm" (approximately 20 minutes)

Optional Resources

  • Everall, R. D., Altrows, K. J.,      & Paulson, B. L. (2006). Creating a future: A study of resilience in      suicidal female adolescents. Journal of Counseling &      Development, 84(4), 461–471.
         Retrieved from the Walden Library databases.
  • Maples, M. F., Packman, J.,      Abney, P., Daugherty, R. F., Casey, J. A., & Pirtle, L. (2005).      Suicide by teenagers in middle school: A postvention team approach. Journal      of Counseling & Development, 83(4), 397–405.
         Retrieved from the Walden Library databases.
  • Hallab, L., Covic, T. (2010).      Deliberate self-harm: The interplay between attachment and stress. Behaviour Change, 27(2), 93–103.
         Retrieved from the Walden Library databases.
  • Nock, M. K. (2009). Why do      people hurt themselves? New insights into the nature and functions of      self-injury. Current Directions in Psychological      Science, 18(2), 78–83.
         Retrieved from the Walden Library databases.
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  • Please no plagiarism and make sure you are able to access all resource on your own before you bid. One of the references come from Flamez, B. & Sheperis, C. J. (2015) and/or Sommers-Flanagan, …