Clinical and Psychological Practice - Case Study Example

Psychological Therapy Name Institution Psychological Therapy Counselling as a vital part of clinical and psychological practice is supposed to proceed based upon the demands of the circumstances of a particular patient. This means that the right process of acquiring information is necessary and the most vital questions that prompt responses that are useful to therapy a key. In a scenario where a child undergoes depression due to issues of marriage by her parents, expert counselling skills are necessary. When a counsellor does not come down to internalize the situation of the patient who in this case is a teen of sixteen, the sessions run into futility when the interest of the patient is lost (Cone & Hawkins, 2007). The case of Lisa exposes various aspects of psychotherapy and counselling that clinical experts need to be breast with in their professional practice. Lisa is depressed after her parent’s separated and attempts to commit suicide. She then conducts a counsellor but is not able to proceed with sessions claiming she disliked the counsellor. This involves conceptualizing the whole therapeutic process from the investigation of the problem of the patient, consideration of the interventions and the possible alternatives and the eventual implementation. However, the case study affirm the fact that the successful use of this is dependent on the competence of the counselling expert in terms of the information they can collect from the patient or her relatives. To this end, the essay will explore the various counselling and clinical practices that are vital in ensuring patient-centered intervention to their problems. This will involve the consideration of various ethical underpinnings to clinical therapy and integrate the PICO questioning criteria that guides clinical decision-making procedures for identification of appropriate counselling. One of the vital aspects of clinical practice is the ability to combine knowledge gained from professional training, expertise and experience to provide the most productive patient experience in a therapeutic intervention (Lilienfeld, 1994). These clinical attributes are supposed to form the basis for the formulation of a selection criteria that defines what is to be included and excluded in the therapeutic process and counselling sessions (Ingram et al, 2008). In this case, the circumstances of the sixteen year-old teen dictate that the manner in which resources and information will be sought for the purpose of intervention be wide and comparative. Interventions that re ideal in this scenario will be effective if they target to review family attachment. The inclusion criteria for search should target to establish relevance to the present case study. This is because clinical resources and information are vast and derived from across the various branches in clinical practice. This means that reference to case studies should be open enough to ensure that all possible information as long as it can be relevant can be tapped as basis for therapeutic judgment and for the eventual decision making as to what clinical interventions will be appropriate for the case study (Barlow, 1981). Searching EBP papers should therefore follow the relevance inclusion criteria such as to have a wider possibility of accessing resources while restricting them on the stated lines. The 16 year old is experiencing suicide ideation and this means that depression oriented interventions will be of central significance too. They are effective since they integrate aspects of psychotherapy, value testing and rehabilitation of thoughts patterns (Salkovskis, 2011). In correspondence with this, an inclusion criteria can also be the basis upon which the exclusion criteria is determined. EBP papers that are to be considered for use in this case study only have to be relevant to the case study scenario similar to one in which an adolescent seem to be driven towards suicide. The therapies that have to be found in these papers include acceptance and commitment therapy, attachment-based family therapy and the family intervention for suicide Prevention. The relevance criteria therefore formed a basis for both the inclusion and in effect the exclusion criterion. The case study of Lisa raises various clinical issues that have to be considered in the formulation of an intervention counselling therapy. First of all, the case requires serious background analysis of the causation of suicide attempts (McFall, 200). This calls for further analysis of Lisa’s history and her behaviors. It is only safer that a clinical intervention focusing on dressing the cause exhaustively as this is the only guarantee of eliminating chances of the recurrence of similar suicide tendencies. As such, it becomes the foremost preoccupation of the clinical officer to isolate the cause from the effects (McFall, 200). This will ensure that targeted focus is assigned to each case without blanketing the problems to only lead to a partial redress. Besides this, problems in Lisa’s history emanate from the fact that when she had attempted to take her life through swallowing an entire bottle of aspirin, clinical care did not address the cause of this but only the effects. When a counselling therapy has to be undertaken, it is a key to see the bigger picture. Another vital clinical aspect involves the keeping of records. This is important in case a referral becomes necessary. To ensure there can be smooth transitional care, the diagnostic, treatment as well as prognostic events have to be well documented. In the scenario, the current clinician has to solely rely on the information supplied by Lisa’s mother which may be inaccurate and inconsistent (Yates, 2013). There is no accurate clinical account of her earlier problems and this may obscure proper recollection of her patient history in terms of the medication, timing and dosage that would have become a resourceful part of the current therapeutic experience. One of the vital factors that will determine the success of the procedure is the prior conceptualization of its steps through proper research on the necessary equipment and resources. The events that will be carried out in the process of therapy have to be timely considered for early preparedness. The proper understanding of the scenario will guide the PICO questions that the clinician formulates (Yates, 2013). They are the key that help in the conceptualization of the advancement of therapy from diagnosis of symptoms, consideration of therapy alternatives administration of therapy as well as review of therapy outcomes. The case study nevertheless present various ethical concerns emanating from the fact that the patient in question is a minor yet to acquire decision-making rights. It is imperative that the mother of patient, Lisa, is kept informed on what diagnostic as well as intervention procedures her daughter will undergo (Achenbach et al, 1987). This is a right since the patient on her own cannot make decisions on what is best for her. The mother can therefore be of vital assistance in helping determine what intervention best suits her daughter. Informed consent helps harness the support of the family in continuing to implement the intervention away from the counselling therapist. Besides this, all clinical procedures have to be undertaken with respect to the will of the parents and expert knowledge of the clinician should not prejudiced this fact (Salkovskis, 2011). As such the intervention should be modelled to align with the interest of the patients as willed by the mother. It also goes without saying that due discretion should be exercised in the handling of information between the mother and the daughter. Information given by the daughter about the mother should be disclosed to her carefully and vice versa in order to avoid causing friction between them leading to a self-defeating clinical endeavor (Ho, 2008). Respect for family values should superintend other issues in order to main the filial relationship between mother and daughter intact at the end of the intervention. This mean that the confidentiality rule remains in play here and information used responsibly. It is of importance in addressing a suicide related subject that evidence that is causative be a primary desire of the clinical psychologist. In accordance to the experience in cases related to the one under study handled by Sturmey (2006), acceptance based behavior therapy is one of the proposed interventions that can help Lisa in her individual therapy. Using this therapy will boost the acceptance by the adolescent of the latest state of her family (Lilienfeld, 1994). The clinician should focus on helping the teenager appreciate the realities of life that seem to be frustrating her ideals. The therapy will encourage the flexibility of her thinking through mindfulness and activate a value-based response to difficult situations (Horowitz et al, 2008). Alternatively, attachment-based family therapy will be used in which Lisa will be made to accept the reality of the fact that marriages are bound to get to levels of divorce. This is through challenging her fixation with an ideal parental state of living with both of her parents (Rave, 2006). The therapy has been used in cases where an adolescent is frustrated by family situations and focus to modify the cognitive and emotional experiences of an individual member for the good of the entire family. Concurrent with this, is another family therapy called the family intervention for suicide Prevention. It was applied in a case where a teen tried to take her life when she was taken to a boarding school and due to the separation, a boy of 13 started manifesting self-harming behaviors to which he blamed on the separation from parents. The therapy involves counseling sessions that are integrated with a simulation of the ideal as desired by the adolescent. However, it tilts towards delivering to the adolescent the needs and comforts whose absence account for the causation of suicide ideation. In Lisa’s case, it may be difficult to bring back the separated parents together. A way should be found to compensate for that need to be with a farther and mother even if it has to mean introducing a father-figure. To implement an intervention, it will be guided by the question, for an adolescent experiencing suicide ideation, does the use of family- based therapies that are cognitive do better in eliminating the suicide thoughts than the use of counselling sessions? As such, attachment-based family therapy will be the preferred family based intervention for the case of Lisa. The teen seems to be perceiving the divorce to mean that the parents have separated from her. The teen should be encouraged to embrace her mother’s concern and support and to accept her closeness rather than withdrawing. Lisa will need to be made to understand her mother’s role in her new divorced state to instill consistent discipline with which she has to understand (Ho, 2008). According to Hollon et al (2003) psychotherapy is supposed to involve spells of environment change where Lisa can express all her frustrations. Sessions in the gym, shopping sprees and hours of gaming can be effective to simulate if not create a contextual shift where Lisa can appreciate that life can still be lived and laughing and enjoyment are still possible (Riva & Molinari, 1998). When her emotions and temperament has been brought to balance, sessions of joint talk integrating the mother will also suit the case. The two will be involved in the therapy to offer chance for the two to bond and manifest the outcomes of the intervention. During this sessions, the mother needs to show acceptance to Lisa for what she is and what she thinks of what is left of their marriage. However, this should be done with care not to turn the mother into a friend rather than a parent (Gibbs & Huang, 1989). The mother has to also beware not to burden her child with her marriage and focusing on allowing the girl to remain a teenager anyway. The therapy will also involve creating a typical household scenario to observe the organization and practicing of daily routines and how this has Lisa and her mother interacting. Focus will be on ensuring the mother remains a decision-maker and gives directions in consideration of the child’s interests and thoughts. On the whole, the scenario presents a case where various ethical and clinical issues play out to determine the nature of intervention that the patient needs. The case requires that all diagnostic procedures are undertaken with a view to establish the symptomatic development of the patient’s suicide attempts. The issues of causation is the central focus of the development of the intervention therapy. The inclusion and exclusion criteria for resources have to be on line of relevance. This means that various cases that are related to the one for Lisa are studied for a comparative consideration of the solution. The PICO questioning format that is a vital clinical aspect in defining the problem formed the basis for modelling the intervention to be centered on the interests and premises of the case. However, the process of formulating and implementing the intervention has to be conscious to abide by the basic ethical considerations of confidentiality. It will also have to place the interests of the patient as willed by her mother central. This will mean that the right to informed consent will be of the essence. The intervention will involve psychological rehabilitation to make the patient adjust to the new family state after divorce. As such, focus will be on breaking Lisa’s fixation with an ideal family state to accept separation and deal with it. The therapy will also aim at an environmental shift to offer hope of life to the patient even without her parents being in a typical marital state. Sessions to invoke perceptive shift and spell responsibility for the mother and daughter will help ensure continued realization of the intervention’s outcomes. Reference Yates, C. (2013). Evidence-Based Practice The Components, History, and Process. Counseling Outcome Research and Evaluation, 4(1), 41-54. Rave, D. T. (2006). Questioning the Efficiency of Summary Judgment. New York University Law Review, 81, 875-910. Gibbs, J. T., & Huang, L. N. (1989). Children of color: Psychological interventions with minority youth. Jossey-Bass. Achenbach, T. M., McConaughy, S. H., & Howell, C. T. (1987). Child/adolescent behavioral and emotional problems: implications of cross-informant correlations for situational specificity. Psychological bulletin, 101(2), 213. Sturmey, P. (2006). Functional analysis in clinical psychology. John Wiley & Sons. Ho, D. Y. (2008). Cultural values and professional issues in clinical psychology: Implications from the Hong Kong experience. American Psychologist, 40(11), 1212. Salkovskis, P. M. (2011). Cognitive-behavioural factors and the persistence of intrusive thoughts in obsessional problems. Behaviour research and therapy, 27(6), 677-682. Horowitz, L. M., Rosenberg, S. E., Baer, B. A., Ureño, G., & Villaseñor, V. S. (2008). Inventory of interpersonal problems: psychometric properties and clinical applications. Journal of consulting and clinical psychology, 56(6), 885. Hollon, S. D., Shelton, R. C., & Davis, D. D. (2003). Cognitive therapy for depression: conceptual issues and clinical efficacy. Journal of Consulting and Clinical Psychology, 61(2), 270. Ingram, R. E., Miranda, J., & Segal, Z. V. (2008). Cognitive vulnerability to depression. Guilford Press. Cone, J. D., & Hawkins, R. P. (Eds.). (2007). Behavioral assessment: New directions in clinical psychology. Brunner/Mazel. McFall, R. M. (2001). Manifesto for a science of clinical psychology. The clinical psychologist, 44(6), 75-88. Barlow, D. H. (1981). On the relation of clinical research to clinical practice: Current issues, new directions. Journal of Consulting and Clinical Psychology, 49(2), 147. Lilienfeld, S. O. (1994). Conceptual problems in the assessment of psychopathy. Clinical Psychology Review, 14(1), 17-38. Riva, G., & Molinari, E. (1998). Virtual environments in clinical psychology and neuroscience: Methods and techniques in advanced patient-therapist interaction (Vol. 58). IOS press. Read More

The therapies that have to be found in these papers include acceptance and commitment therapy, attachment-based family therapy, and the family intervention for suicide Prevention. The relevance criteria, therefore, formed a basis for both the inclusion and in effect the exclusion criterion.

The case study of Lisa raises various clinical issues that have to be considered in the formulation of an intervention counselling therapy. First of all, the case requires serious background analysis of the causation of suicide attempts (McFall, 200). This calls for further analysis of Lisa’s history and her behaviors. It is only safer than a clinical intervention focusing on dressing the cause exhaustively as this is the only guarantee of eliminating chances of the recurrence of similar suicide tendencies. As such, it becomes the foremost preoccupation of the clinical officer to isolate the cause from the effects (McFall, 200). This will ensure that targeted focus is assigned to each case without blanketing the problems to only lead to a partial redress. Besides this, problems in Lisa’s history emanate from the fact that when she had attempted to take her life by swallowing an entire bottle of aspirin, clinical care did not address the cause of this but only the effects. When counseling therapy has to be undertaken, it is key to see the bigger picture. Another vital clinical aspect involves the keeping of records. This is important in case a referral becomes necessary. To ensure there can be smooth transitional care, the diagnostic, treatment, as well as prognostic events, have to be well documented. In the scenario, the current clinician has to solely rely on the information supplied by Lisa’s mother which may be inaccurate and inconsistent (Yates, 2013). There is no accurate clinical account of her earlier problems and this may obscure proper recollection of her patient history in terms of the medication, timing, and dosage that would have become a resourceful part of the current therapeutic experience. One of the vital factors that will determine the success of the procedure is the prior conceptualization of its steps through proper research on the necessary equipment and resources. The events that will be carried out in the process of therapy have to be timely considered for early preparedness. The proper understanding of the scenario will guide the PICO questions that the clinician formulates (Yates, 2013). They are the key that helps in the conceptualization of the advancement of therapy from diagnosis of symptoms, consideration of therapy alternatives administration of therapy as well as a review of therapy outcomes.

The case study nevertheless presents various ethical concerns emanating from the fact that the patient in question is a minor yet to acquire decision-making rights. It is imperative that the mother of the patient, Lisa, is kept informed on what diagnostic as well as intervention procedures her daughter will undergo (Achenbach et al, 1987). This is a right since the patient on her own cannot make decisions on what is best for her. The mother can therefore be of vital assistance in helping determine what intervention best suits her daughter. Informed consent helps harness the support of the family in continuing to implement the intervention away from the counselling therapist. Besides this, all clinical procedures have to be undertaken with respect to the will of the parents and expert knowledge of the clinician should not prejudice this fact (Salkovskis, 2011). As such the intervention should be modeled to align with the interest of the patients as willed by the mother. It also goes without saying that due discretion should be exercised in the handling of information between the mother and the daughter. Information given by the daughter about the mother should be disclosed to her carefully and vice versa in order to avoid causing friction between them leading to a self-defeating clinical endeavor (Ho, 2008). 

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