Practicum Journal: Psychotherapeutic Approaches to Group Therapy Paper

Practicum Journal: Psychotherapeutic Approaches to Group Therapy Paper

2-3 page Practicum Journal Week 8

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)Practicum Journal: Psychotherapeutic Approaches to Group Therapy Paper, and identify any pertinent history or medical information, including prescribed medications.

Using the DSM-5, explain and justify your diagnosis for each client.

Reference Link
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

ORDER A PLAGIARISM-FREE PAPER NOW

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.

Include Reference Page
Support your approach with evidence-based literature.

Below is the template of the last journal I completed and includes the group therapy progress note and format this paper can be in. No cover page needed. Practicum Journal: Psychotherapeutic Approaches to Group Therapy Paper.

Assignment: Practicum – Week 2 Journal Entry

Group Therapy Progress Note

Client: Ms. Shoemaker

Date: 6/4/2018
Group name: Family Therapy
Minutes: 60 Group session # 1 Meeting attended is #: 4 for this client.
Number present in group 2 of 2 scheduled Start time: 9 am End time: 10 am
Assessment of client 1. Participation level: ❑ Active/eager ❑ Variable ❑ Only responsive ❑ Minimal ❑ Withdrawn 2. Participation quality: ❑ Expected ❑ Supportive ❑ Sharing ❑ Attentive ❑ Intrusive ❑ Monopolizing ❑ Resistant ❑ Other: _____3. Mood: ❑ Normal ❑ Anxious ❑ Depressed ❑ Angry ❑ Euphoric ❑ Other: _______________ 4. Affect: ❑ Normal ❑ Intense ❑ Blunted ❑ Inappropriate ❑ Labile ❑ Other: _______________ 5. Mental status: ❑ Normal ❑ Lack awareness ❑ Memory problems ❑ Disoriented ❑ Confused ❑ Disorganized ❑ Vigilant ❑ Delusions ❑ Hallucinations ❑ Other: __ 6. Suicide/violence risk:Practicum Journal: Psychotherapeutic Approaches to Group Therapy Paper ❑ Almost none ❑ Ideation ❑ Threat ❑ Rehearsal ❑ Gesture ❑ Attempt 7. Change in stressors: ❑ Less severe/fewer ❑ Different stressors ❑ More/more severe ❑ Chronic 8. Change in coping ability/skills: ❑ No change ❑ Improved ❑ Less able ❑ Much less able 9. Change in symptoms: ❑ Same ❑ Less severe ❑ Resolved ❑ More severe ❑ Much worse 10.

Other observations/evaluations: Patient expresses resentment towards her mother who allowed her to endure abuse as a child and has never really overcome this. Also claims her mother was absent a lot of her childhood. Patient has complaints of flashbacks, nightmares and parts of her childhood she does not remember. She has 5 other siblings alive who she had poor relationships with as the patient reports issues with trust and confidence.Practicum Journal: Psychotherapeutic Approaches to Group Therapy Paper. Her brother who was her only support, died 2 months prior from a heart attack at the age of 40 who also endured the same treatment as a child. Patient claims that her other sisters were not abused.

Pertinent history or medical information: Patient is a 37 y/o African American female with a history of depression, anxiety, physical and mental abuse. Patient and her deceased brother were abused by her father and her mother’s boyfriend from the age of 5 to 11 years old when she was finally taken out of the home and placed with social services. Patient states she was in a traumatic car accident a few years ago that messed up her back, leaving her with chronic pain and fibromyalgia. She also has an associate degree in social work and was working in a group home but lost her job after the car accident.Practicum Journal: Psychotherapeutic Approaches to Group Therapy Paper.

Prescribed medications: Lexapro 20mg once daily for depression and Xanax 5mg as needed for anxiety.

Post- Traumatic Stress Disorder 309.81
According to Diagnostic and Statistical Manual (DSM) criteria for PTSD includes recurrent, involuntary and intrusive distressing memories, flashbacks, vivid nightmares, and negative alterations in cognitions such as estrangement from her mother and sisters (2013). Patient also
has marked alterations in emotion when referring to the abuse she endured as a child. Lastly, the patient has had significant distress in her social and occupational life all of which have lasted over the past few years.

Client: Mother Mrs. Shoemaker

Date: 6/4/2018

Group name: Family Therapy
Minutes: 60 Group session # 1 Meeting attended is #: 1 for this client.
Number present in group 2 of 2 scheduled Start time: 9 am End time: 10 am
Assessment of client 1. Participation level: ❑ Active/eager ❑ Variable ❑ Only responsive ❑ Minimal ❑ Withdrawn 2. Participation quality: ❑ Expected ❑ Supportive ❑ Sharing ❑ Attentive ❑ Intrusive ❑ Monopolizing ❑ Resistant ❑ Other: _____3. Mood: ❑ Normal ❑ Anxious ❑ Depressed ❑ Angry ❑ Euphoric ❑ Other: _______________ 4. Affect: ❑ Normal ❑ Intense ❑ Blunted ❑ Inappropriate ❑ Labile ❑ Other: _______________ 5. Mental status: ❑ Normal ❑ Lack awareness ❑ Memory problems ❑ Disoriented ❑ Confused ❑ Disorganized ❑ Vigilant ❑ Delusions ❑ Hallucinations ❑ Other: __Practicum Journal: Psychotherapeutic Approaches to Group Therapy Paper 6. Suicide/violence risk: ❑ Almost none ❑ Ideation ❑ Threat ❑ Rehearsal ❑ Gesture ❑ Attempt 7. Change in stressors: ❑ Less severe/fewer ❑ Different stressors ❑ More/more severe ❑ Chronic 8. Change in coping ability/skills: ❑ No change ❑ Improved ❑ Less able ❑ Much less able 9. Change in symptoms: ❑ Same ❑ Less severe ❑ Resolved ❑ More severe ❑ Much worse 10.

Other observations/evaluations: Mother claims to not have any issues with mental health nor have any history of abuse noted with her children. She is in denial throughout the session and has an excuse for every accusation. She denies treating her daughters any differently and doesn’t interact much during the session.

Pertinent history or medical information: Patient denies any history at this time but was reported by daughter that she had sustained multiple abusive relationships throughout her life.

Prescribed medications: Patient refuses to disclose medication list.

In-session procedures: Focused on supportive therapy for group members to build trust and confidence (Wheeler, 2014). Intake assessment completed. Led an open discussion to stimulate members of the family to speak freely and express their concerns (Nichols, 2014)Practicum Journal: Psychotherapeutic Approaches to Group Therapy Paper. Systemic Family Therapy is chosen to guide therapy as it focuses on emotional turmoil between patients, while assessing the multi-generational framework of the family, according to Wheeler, (2014). An environment that was calm, with decreased anxiety and interrupt conflict was aimed for. Lastly, members were encouraged to speak to one another rather in third person to neutralize triangles. Later in sessions, repaired relationships with other sisters will be recommended.

Legal and/or Ethical Implications

​Confidentiality in a group setting adds more dynamics then in an individual setting as promises set forth between the therapist and the patient should be upheld in the group sessions. This can become difficult as some information is necessary to heal relationships within the family therapy session and withholding certain information may not benefit anyone. Another major aspect to cover with these patients is when confidentiality must be broken, and this is when abuse, neglect or self-harm is suspected.

References

American Psychiatric Association. (2013)Practicum Journal: Psychotherapeutic Approaches to Group Therapy Paper. Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

Nichols, M. (2014). The essentials of family therapy (6th ed.). Boston, MA: Pearson.

Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to
guide for evidence-based practice. New York, NY: Springer.

 

Student Name: xxx

E-mail Address: xxx@waldenu.edu

Practicum Placement Agency's Name: xxx

 

Preceptor’s Name: xxxx

 

Preceptor’s Telephone: 81xx

Preceptor’s E-mail Address: xxx

 

 

Week Dates Times Total Hours for This Time Frame Activities/Comments Learning Objective(s) Addressed
2 6/4 9am-5pm 8 Hours 37-year-old female seen for depression. Has 8 children, single mother. Molested by her brother and father.Practicum Journal: Psychotherapeutic Approaches to Group Therapy Paper. Co-dependent/attachment issues with her children, doesn’t like them to snuggle or touch her much. Low self-esteem, obese. No medications. Very open and honest, transparent. 8-year-old boy diagnosed with oppositional defiant disorder, referred by mom. Issues started in kindergarten, issues with authority. Escalates when mom is not around. Positive reinforcement does not work. First time in counseling- second session.Practicum Journal: Psychotherapeutic Approaches to Group Therapy Paper. Very social but mood varies, impulsive, strong willed. Dishonest, manipulates situations. Christian family. Youngest of two children. Lives with mom and mom’s boyfriend. Father not involved much. Dec 2016, Dad's girlfriend who patient was very close with died 3 weeks after having his half sibling. Child protective services issue but resolved as patient took bite out of a marijuana edible.Practicum Journal: Psychotherapeutic Approaches to Group Therapy Paper. Conducted play therapy and met with mother and son for family therapy after an individual session completed. 12-year-old male intake assessment and family counseling session with mother for behavioral issues. The patient has recently experienced a loss of his father to incarceration for 5-year minimum stay. He spent 50% custody with his father and since has been very emotional at school and hard on himself. 12-year-old girl diagnosed with ODD and mother is very overbearing. Pt has problems with authority.Practicum Journal: Psychotherapeutic Approaches to Group Therapy Paper. Coping mechanisms to express herself better as she believes she is not heard. Supportive therapy to patient suffering from loss of his baby sister. Child broke down and cried when touching on subject so further progression into this event will happen next session. According to Wheeler, supportive therapy can be performed to help patient's gain self-esteem and coping mechanisms to certain stressors in life (2014). Structural family planning conducted with the patient suffering from depression and anxiety was performed to relook at the family structure, rules and expectations (Nichols, 2014)Practicum Journal: Psychotherapeutic Approaches to Group Therapy Paper. Also, CBT was utilized to assist the patient in figuring out her positive aspects and was sent home with homework for next week (Wheeler, 2014). APA cross cutting measures- helps diagnose and understand the severity of challenges the patient is exhibiting. Every patient is given a level one assessment and will receive a level two based on results. Vanderbilt scales given to patients being ruled out for ADHD and ODD. Wheeler, K. (Ed.). (2014)Practicum Journal: Psychotherapeutic Approaches to Group Therapy Paper. Psychotherapy for the advanced practice psychiatric nurse: A how-to
guide for evidence-based practice (2nd ed.). New York, NY: Springer Publishing
Company.Practicum Journal: Psychotherapeutic Approaches to Group Therapy Paper
2 6/6 8:00-16:00 8 Hours 8:00- 9:00 Meeting with preceptor and other clinical interns to review goals for the day. Went over theories that will be incorporated into the group therapy sessions. Reviewed history on patients that will be seen in the office.Practicum Journal: Psychotherapeutic Approaches to Group Therapy Paper 10:00-12:00 Visited a school in low socioeconomic area to check on students admitted into the services. Conducted follow-up play therapy with 7-year-old child suffering from Oppositional Defiant Disorder. Pt had some struggles listening to authority this week and we went over scenarios of alternative decisions the pt could have made. 8-year-old child suffering from ODD, ADHD, and anxiety and depression follow up session from last week.Practicum Journal: Psychotherapeutic Approaches to Group Therapy Paper. Teacher reported that pt is doing very well this week. Provided supportive therapy to reintegrate encouragement and self-esteem. Follow up with 13-year-old suffering from depression, anxiety, ADHD, and PTSD. Play therapy conducted. Pt says that bullying is continued but he stays away from those children. brought in healthy snacks to reintegrate healthy eating and give the boy some insight on choices he can make that are safe. Supportive therapy provided. Lunch Break 12-1pm. 1:15-2:15pm Intake assessment with a 45 y/o mother and her daughter who has issues following rules and being disobedient regularly. She has no appreciation for authority and does not respect boundaries in the home. Reviewed goals of therapy and gained history. 2:15-3:15 Debrief with preceptor regarding options to use with this family. Went over Structural Family Therapy to begin therapy. 3:15-4pm Structural family therapy follow up parents of adolescent daughters ages 13 and 16 acting out and not following rules. Indication for lack of boundaries and communication dysfunction.Practicum Journal: Psychotherapeutic Approaches to Group Therapy Paper Structural family therapy was used this week throughout many family sessions as it is a good choice in families that need assistance with power struggle, specific boundaries being made and followed, and accommodating all members of the family’s interaction styles, according to Nichols, (2014). Another type of therapy that was used this week was play therapy for children suffering from ADHD, ODD, and PTSD.Practicum Journal: Psychotherapeutic Approaches to Group Therapy Paper Play therapy has been proven to be a very successful intervention including role play and reenacting scenarios for children suffering from ODD, according to Theodore (2017). Nichols, M. (2014). The essentials of family therapy (6th ed.). Boston, MA: Pearson. Theodore, L. (2017)Practicum Journal: Psychotherapeutic Approaches to Group Therapy Paper Handbook of evidence-based interventions for children and adolescents.

BUY A PLAGIARISM-FREE PAPER HERE

Assignment: Practicum – Week 2 Journal Entry

 

Group Therapy Progress Note

 

Client: Ms. Shoemaker

 

Date: 6/4/2018

Group name: Family Therapy

Minutes: 60 Group session # 1 Meeting attended is #: 4 for this client.

Number present in group 2 of 2 scheduled Start time: 9 am End time: 10 am

Assessment of client 1. Participation level: ❑ Active/eager ❑ Variable ❑ Only responsive ❑ Minimal ❑ Withdrawn 2. Participation quality: ❑ Expected ❑ Supportive ❑ Sharing ❑ Attentive ❑ Intrusive ❑ Monopolizing ❑ Resistant ❑ Other: _____3. Mood: ❑ Normal ❑ Anxious ❑ Depressed ❑ Angry ❑ Euphoric ❑ Other: _______________ 4. Affect: ❑ Normal ❑ Intense ❑ Blunted ❑ Inappropriate ❑ Labile ❑ Other: _______________ 5. Mental status: ❑ Normal ❑ Lack awareness ❑ Memory problems ❑ Disoriented ❑ Confused ❑ Disorganized ❑ Vigilant ❑ Delusions ❑ Hallucinations ❑ Other: __ Practicum Journal: Psychotherapeutic Approaches to Group Therapy Paper6. Suicide/violence risk: ❑ Almost none ❑ Ideation ❑ Threat ❑ Rehearsal ❑ Gesture ❑ Attempt 7. Change in stressors: ❑ Less severe/fewer ❑ Different stressors ❑ More/more severe ❑ Chronic 8. Change in coping ability/skills: ❑ No change ❑ Improved ❑ Less able ❑ Much less able 9. Change in symptoms: ❑ Same ❑ Less severe ❑ Resolved ❑ More severe ❑ Much worse 10.Practicum Journal: Psychotherapeutic Approaches to Group Therapy Paper

 

Other observations/evaluations: Patient expresses resentment towards her mother who allowed her to endure abuse as a child and has never really overcome this. Also claims her mother was absent a lot of her childhood. Patient has complaints of flashbacks, nightmares and parts of her childhood she does not remember. She has 5 other siblings alive who she had poor relationships with as the patient reports issues with trust and confidence.Practicum Journal: Psychotherapeutic Approaches to Group Therapy Paper Her brother who was her only support, died 2 months prior from a heart attack at the age of 40 who also endured the same treatment as a child. Patient claims that her other sisters were not abused.

 

Pertinent history or medical information: Patient is a 37 y/o African American female with a history of depression, anxiety, physical and mental abuse. Patient and her deceased brother were abused by her father and her mother’s boyfriend from the age of 5 to 11 years old when she was finally taken out of the home and placed with social services. Patient states she was in a traumatic car accident a few years ago that messed up her back, leaving her with chronic pain and fibromyalgia. She also has an associate degree in social work and was working in a group home but lost her job after the car accident.

 

Prescribed medications: Lexapro 20mg once daily for depression and Xanax 5mg as needed for anxiety.

 

Post- Traumatic Stress Disorder 309.81Practicum Journal: Psychotherapeutic Approaches to Group Therapy Paper

According to Diagnostic and Statistical Manual (DSM) criteria for PTSD includes recurrent, involuntary and intrusive distressing memories, flashbacks, vivid nightmares, and negative alterations in cognitions such as estrangement from her mother and sisters (2013). Patient also

has marked alterations in emotion when referring to the abuse she endured as a child. Lastly, the patient has had significant distress in her social and occupational life all of which have lasted over the past few years.

 

 

Client: Mother Mrs. Shoemaker

 

Date: 6/4/2018

 

Group name: Family Therapy

Minutes: 60 Group session # 1 Meeting attended is #: 1 for this client.

Number present in group 2 of 2 scheduled Start time: 9 am End time: 10 am

Assessment of client 1. Participation level: ❑ Active/eager ❑ Variable ❑ Only responsive ❑ Minimal ❑ Withdrawn 2. Participation quality: ❑ Expected ❑ Supportive ❑ Sharing ❑ Attentive ❑ Intrusive ❑ Monopolizing ❑ Resistant ❑ Other: _____3. Mood: ❑ Normal ❑ Anxious ❑ Depressed ❑ Angry ❑ Euphoric ❑ Other: _______________ 4. Affect: ❑ Normal ❑ Intense ❑ Blunted ❑ Inappropriate ❑ Labile ❑ Other: _______________ 5. Mental status: ❑ Normal ❑ Lack awareness ❑ Memory problems ❑ Disoriented ❑ Confused ❑ Disorganized ❑ Vigilant ❑ Delusions ❑ Hallucinations ❑ Other: __ Practicum Journal: Psychotherapeutic Approaches to Group Therapy Paper6. Suicide/violence risk: ❑ Almost none ❑ Ideation ❑ Threat ❑ Rehearsal ❑ Gesture ❑ Attempt 7. Change in stressors: ❑ Less severe/fewer ❑ Different stressors ❑ More/more severe ❑ Chronic 8. Change in coping ability/skills: ❑ No change ❑ Improved ❑ Less able ❑ Much less able 9. Change in symptoms: ❑ Same ❑ Less severe ❑ Resolved ❑ More severe ❑ Much worse 10.Practicum Journal: Psychotherapeutic Approaches to Group Therapy Paper

 

Other observations/evaluations: Mother claims to not have any issues with mental health nor have any history of abuse noted with her children. She is in denial throughout the session and has an excuse for every accusation. She denies treating her daughters any differently and doesn’t interact much during the session.

 

Pertinent history or medical information: Patient denies any history at this time but was reported by daughter that she had sustained multiple abusive relationships throughout her life.

 

Prescribed medications: Patient refuses to disclose medication list currently.

 

More info needed to diagnose patient based on the DSM-5 criteria.

 

 

In-session procedures: Focused on supportive therapy for group members to build trust and confidence (Wheeler, 2014). Intake assessment completed. Led an open discussion to stimulate members of the family to speak freely and express their concerns (Nichols, 2014). Systemic Family Therapy is chosen to guide therapy as it focuses on emotional turmoil between patients, while assessing the multi-generational framework of the family, according to Wheeler, (2014). An environment that was calm, with decreased anxiety and interrupt conflict was aimed for. Lastly, members were encouraged to speak to one another rather in third person to neutralize triangles. Later in sessions, repaired relationships with other sisters will be recommended.Practicum Journal: Psychotherapeutic Approaches to Group Therapy Paper

 

Homework:

  1. Each member to come up with stressors and unresolved issues within the family.
  2. Each to create a three generational genogram
  3. Other Comments: After the genome is reviewed and each member is differentiated, a plan can be created to decrease negative feelings.

 

 

Legal and/or Ethical Implications

 

Confidentiality in a group setting adds more dynamics then in an individual setting as promises set forth between the therapist and the patient should be upheld in the group sessions. This can become difficult as some information is necessary to heal relationships within the family therapy session and withholding certain information may not benefit anyone. Another major aspect to cover with these patients is when confidentiality must be broken, and this is when abuse, neglect or self-harm is suspected.Practicum Journal: Psychotherapeutic Approaches to Group Therapy Paper

 

 

 

References

 

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders

 

(5th ed.). Washington, DC: Author.

 

Nichols, M. (2014). The essentials of family therapy (6th ed.). Boston, MA: Pearson.

 

Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to

 

guide for evidence-based practice. New York, NY: Springer.Practicum Journal: Psychotherapeutic Approaches to Group Therapy Paper