Case Study on Depression

Conceptualizing a Case

Academic Background -Hillary is in the 10th grade and has always struggled in school receiving low grades. Hillary doesn't have school behavioural issues; it is her academics that are poor. Hillary is currently failing in all of her classes and is going to fail the 10th grade. Hillary will turn 18 on 12.27.18

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Family and Cultural Background - Hillary was placed into DCS custody due to her parents abandoning her at the hospital, refusing to bring her home. Halle was brought to the hospital after she threatened to kill her family and or herself if she remained in the home. Hillary has a history of verbal aggression towards authority figures; yelling, slamming doors and being incredibly disrespectful. Hillary has a history/present history of self-harming (cutting). Hillary is diagnosed with Disruptive Mood Disorder and Depression; she takes prescription (Celexia and Depakote).

Physical Health - Hillary is in good physical health. She has no physical problems or disabilities.

Social Adjustment -It appears that Hillary has reached and surpassed normal social milestones although Hillary tends to act as if she has the mindset of an 8-year-old at times. Hillary befriends peers that are too young to once get along with others and had a friendly personality. Now Mena is moody around others and hostile. She does not spend as much time with her 2 close friends. She does not get along with others outside of the family as well as within the family.

Developmental Analysis

The theories of development can explain Hillary's case. The Piaget's Theory offers the affirmation that Children go through given stages regarding their intellect and ability with the aim of perceiving mature relationships. These stages occur in the same order in all children irrespective of the cultures and background. However, the age at which the stages comes may slightly vary from one individual to the other. Notably, the Piaget's assimilation and accommodation concepts substantially help to explain the developmental characteristics as observed in Hillary. Regarding the idea of accommodation, Hillary takes new information in his environment, which alters the pre-existing information with the aim of fitting the new information. This process is fundamental because it helps to establish the manner in which Hillary is going to take other new concepts, schemas and knowledge among other things. A closer look at this indicates that Hillary's social aspect of life has been tremendously affected and this is the reason why she befriends an individual younger than her age. On the other hand, the concept of Assimilation explains the manner in which Hillary perceive information and adapt to the new information. Notably, she is faced with further details, but she looks at the old information she has previously stored with the aim of interpreting the new one.

Hillary's case can further be explained from the Erikson's Theory perspective. Erikson primarily focused on the development of the brain about the personality and social development. In his view, children must undergo certain stages of development in their life. The three steps, in this case, include the trust and mistrust stage, the desire of a child to be autonomous, and the third stage which involves the beginning of the child to be assertive in the world. In general, these three stages enabled Hillary to develop a real sense of self-seeking praise and acceptance among her peers and teachers. The steps further led her to social identity, which seems to lead her into the adulthood.

Cultural Analysis

The culture significantly influences the development of an individual. Notably, the emotional and social development are primarily affected by the culture and the related factors. The emotional development refers to the manner in which a person process their feelings. For instance, children who have strong religious convictions may have strong emotional and spiritual support networks can develop emotionally. On the other hand, the social development refers to the process of getting along with other people. Undeniably, children can benefit tremendously from diverse and social experiences, thereby fostering a culture of inclusion and acceptance. In particular occasion, cultural identity helps with social development through a provision of shared interests as well as the activities to enjoy. A closer look at Hillary's case would reveal that the culture around her has greatly influenced his development. Her parent's belief in her violence prompted them to leave her in the hospital instead of taking her home. Due to the lack of the parental guidance and direction, Hillary has grown and developed to become an extremely disrespectful individual, who is even able to yell at the people who are older than her. The situation in his case has further affected his social adjustment abilities based on her inabilities to adapt to different social settings and creating productive relationships with her peers. It is through this reason that Hillary is unable to befriend children of his age, but instead those that are younger than her.

Legal and Ethical Issue

There are numerous unique legal and ethical concerns that clinicians must take into consideration when counselling the adolescents. These legal issues include informed consent, types of confidentiality, exceptions and reporting problems, the sharing of the information revealed to the practitioner to the client's parents and subpoenas. To establish an ethical counselling relationship with Hillary, I would broadly grapple with the following two considerations or questions. Firstly, can the counsellor (I) be able to admit Hillary into a treatment program without the needed to obtain the consent of her parents or any other legally responsible person? Secondly, how can the depression and the aggressive behaviour treatment programs communicate with others concerned about Hillary's welfare without violating the stringent Federal regulations regarding the protection and confidentiality of the information regarding Hillary? Generally, Hillary, as an adolescent, has the rights to consent to treatment or to refuse the procedure.

Whether the depression may admit Hillary without the parental consent will significantly depend on the statutes of the states that govern the permission as well as the parental notification within the contexts of Disruptive Mood Disorder and Depression treatment and the number of fact-based variables. These variables may include the age of the adolescent, the stages of cognitive, emotional and social development. The counselling process will involve a clinical sense to obtain consent for a treatment plan from Hillary because he is an underage adolescent. It will become relevant to take into consideration a wide range of factors that will foster a program's decision to admit Hillary for treatment without the knowledge of her parents. As a professional who will be treating Hillary who suffers from Disruptive Mood Disorder and Depression, I will be naturally concerned about her privacy and confidentiality. For people like her, the disclosure of her Disruptive Mood Disorder and Depression problem may subject her to a severe situation of stigma. Besides, such exposure may further impact the manner in which the client interacts or relates with her peers who may at time develop discomfort around her or subject her to constant ridicule. Hillary has numerous things to overcome because she is in recovery and therefore does not necessarily mean that she has to face peers before they are ready. Given the vitality associated with respecting Hillary's privacy, I will ensure that her thoughts, opinions, and the suggestions regarding her conditions are prioritised before any treatment plan is commenced.

Treatment Plan Components

Problem Identification: Depression as manifested by aggressive behaviour, irritability, poor self-esteem, low energy, excessive and suicidal ideation.

Goal Development: The symptoms of the depression will significantly be lowered and will no longer interfere with Hillary's normal functioning.

Measurable Outcomes: This will be measured by at a score of 60 or below on the YSR Withdrawn/Depressed scale at the time of discharge. Anticipated completion of this treatment plan is 30.08.2018

Creating Interventions: The Family Therapy will be used to develop a safety plan/no self-harm contract and further provide psycho-education regarding a Disruptive Mood Disorder and Depression to increase parents' insight into Hillary and to increase their ability to support and encourage Hill to embrace new coping skills.

References

Thompson, C. L., Rudolph, L. B., & Henderson, D. A. (2000). Counseling children. Pacific Grove, CA: Brooks/Cole.