Psychology and Clinical Practice Portfolio, Coursework Example

Introduction

The subject is a 14-year-old, male client named, Mark, who lives with his parents and siblings in a working family home environment. Mark’s main psychological issues include suffering from episodic acute stress from ceaseless worry and low self-esteem. This is not healthy for a young teenage boy and his enrollment in our treatment center is to help him overcome these issues before they turn into major psychological or mental problems. Following is an in-depth analysis of Mark’s situation and condition, as well as a comprehensive evaluation of the same. Recommendations for further treatment is included.

Intake Assessment

1. What are your client’s presenting problems?

The client’s presenting problems are 1) anti-social behavior, 2) inattentiveness in class and at home, 3) does not ask questions when not understanding something,4) forgetting to do chores, 5) throws a tantrum when asked to do chores, 6) complaining about being tired all the time, 7) complaining about not feeling well, and 8) complaining about headaches and stomachaches.

1. What is your client’s real problem—the one that is interfering with his or her life the most?

After speaking one-on-one with the client, it seems the headaches and the stomachaches are interfering with the client’s everyday life. I must make sure this it is not a medical issue, and if it is not, then the real problem is likely due to stress, low self-esteem or minor depression. First, I need to send the client to a medical doctor to make sure the headaches and stomachaches are not a medical condition causing the problems at hand. According to the client and the client’s father, the headaches and stomachaches have been going on for a couple of years now. However, neither the client nor his father can remember if the headaches began before the behavior issues.

My first strategy is making sure the client’s headaches are not due to a medical condition. If the results come back showing the client’s pain is not because of a medical condition, then my next strategy is determining that stress and anxiety is causing the pain. Additionally, I need to find out what is causing the stress and anxiety via surveys, case studies and questionnaires.

Needs Assessment

• What are your client’s two most important needs?

My client’s two most important needs are proper knowledge about stress management and how to overcome low self-esteem. I have received the results from the client’s medical doctor, which show the headaches and stomachaches were not due to a medical condition.

• What local agencies could you contact to make referrals? (Use your research skills to find out.)

Local agencies for referrals are community-based counseling organizations and community-based psychologists in the nearby health center. Counseling would help the patient overcome problems such as low self-esteem. In this scenario, counseling would enable the client to build self-confidence and improve self-esteem. The health center psychologist would help the client solve problems such as stress (Aherne, 2009).

• What identified needs should be met later in treatment and why?

The needs categories that should be met later in the treatment are proven and inferred needs. For instance, in this case, the proven needs are those that emanate from the data collected during the assessment. From the assessment, it is evident that the client’s grandfather is suffering from cancer and this worries the two parties. The cancer problem can be solved later by arranging proper medical assistance for the grandfather. Inferred needs, in this case, are those that result from the diagnosis of the client’s medical condition. The client does not suffer from any disease attributed to the cause of the headaches and stomachaches (Gillam, 2010).

• What role do support systems play in the recovery/treatment/therapy of your client?

The role of support systems in recovery, treatment and therapy of the patient is organizing family therapy programs aimed at ensuring bonding for unity. The support systems also offer psychotherapeutic involvement aimed at bringing the client’s conditions to normalcy. The centre also provides education to family members for their problems (Gillam, 2010).

Strengths-Based Assessment Plan

The assessment plan to identify the strengths of the patient will entail a sequential description of common strengths and obstacles, as listed below.

List of Obstacles

Family (childcare, support)

Since my client is only 14-years-old, he has to rely on his father to get him to the meetings. If the father has to work 50-plus hours and take care of his sick father (client’s grandfather), it will be difficult to get my client’s father to commit to the treatment plan for his son.

Financial

The client’s father has to work 50-plus hours to make ends meet. Any lost time would put him behind on the bills and cause more stress on the family. The family’s financial situation relates to: 1) the inability to pay for the son’s treatment plan, 2) meeting the families basic needs (housing, food, clothes), and 3) the father’s pride getting in the way of accepting help.

Using the Headaches and Stomachaches as Excuses for Not Completing Certain Tasks

This is a common a problem affecting the son and, therefore, should be solved. The headaches and stomachaches in this scenario are not associated with any diseases or illnesses; therefore, they can be eliminated by assisting the client with managing the problem of stress. It is important to share information on various issues with the client, particularly information on the importance of completing tasks such as home chores and school assignments.

Father Rejecting the Treatment Plan

The father’s decision to reject the treatment plan will be overcome by working closely with him and sharing information on the importance of the treatment plan. This is, therefore, important to solving his son’s condition and eliminating any ethical issues that may taint my profession as a caregiver.

List of Strengths

Support System (AA, NA, family, friends)

In the client’s family, there is only an aunt on his father’s side; however, she lives on the other side of the country. She does, however, stay in contact by phone, mail and e-mail. There are also some friends in the area that can help if my client’s father will be to humble to receive help. It is my understanding he refuses help most of the time, due to his pride. He wants to try to do everything himself.

• Past Success in Treatment (all past experiences)
• My client has no past treatments
• Skills (time management, finding resources)
• My client has great reading and writing skills.

Financial/Basic Needs

The client is a hard worker who manages to provide basic needs for his family and pay his bills. He attains this by working more than 50 hours a week.

Other

The client is very determined to provide his family and solve his problems, despite his health condition and his family problems.

Analysis of Obstacles

1. Transportation – Since my client’s father works 50-plus hours per week to provide the basic needs for the family, he will not be able to provide the needed transportation for his son (my client) 90 percent of the time. There are several possible solutions to this problem as follows:

• Arrange for a cheap mode of transport
• Advise on further expenditure reductions for basic requirements
• Arrange transportation with the school transport system
• Ask for community support on the issue

1. Stomachache and Headache

• This obstacle will be solved by
• Providing proper medical assessment to the clien
• Giving the patient painkillers to reduce the problem
• Encourage the client to develop a positive attitude towards the problem

1. Client’s Lack of Cooperation

• To overcome the challenge, the following measures will be undertaken
• Entice the client to participate and cooperate
• Sharing information with the client about his problems

1. Lack of Adequate Support from the Father

• Encourage the father to spare some time for the son
• As the caregiver, provide enough support for the client

Action Plan

The obstacles my client might face include his age. Since he is only 14-years-old, my client has to rely on his father to get him to all of the treatment sessions. If my client’s father cannot bring him, because of work and or because he must take care of his own father (my client’s grandfather), my client’s situation will not change. Since the client is so young, the obstacles can be overcome through closer support from the caregiver and the teacher at his school.

Protected Health Information

It is very important that the rights and privacy of clients are protected regarding any type of health-related (mental or physical) information. This is information is protected by federal law and is enforced by the Health Insurance Portability and Accountability Act of 1996 (HIPAA). This act is in place to ensure that no privacy or security is breached to protect identifiable health information (HPI) or patients and clients of various entities, including health plan companies, health care providers, health care clearinghouses, etc. The clinical practice in which our patient is seen is an entity governed by HIPAA rules. Therefore, we must make diligent efforts to protect the privacy of the patient’s health information (HHS).

We aim to do this by first giving mandatory training to all practice employees on HIPAA, and how to remain compliant with its rules. We will then put HIPAA-based procedures in place to safeguard the client’s information. Additionally, we will inform the client and his family members about HIPAA and make sure they receive HIPAA literature and answer any questions they may have in this regard. It is important that all concerned (doctors, nurses, nurse’s aides, medical record keepers, laboratory technicians, etc.) are made aware of and understand the importance and penalties for violating HIPAA laws. Additionally, according to HIPAA rules, we will keep disclosure of the client’s PHI to a minimum, according to a need-to-know basis. It is also necessary to ensure any PHI is kept secure at all times. This includes PHI that may be exposed via computer screens, files, conversations, emails, snail mail, etc.

Treatment Plan Outline

Part 1: Target Behavior Summary

In this case, the patient is a 14-year-old boy who has problems when it comes to committing to completing his tasks. His attitude towards life, responsibilities and relationships causes particular problems, not only for him, but for his family as well. Such conditions of alternative response to particular problems and challenges in life could be attributed to the natural effects of puberty. Nevertheless, having an overtly defined attitude because of these matters, specifically affecting the physical, emotional and the mental state of the individual, should not be set aside.

While the patient have a desire to change and be supported by his father along the way, his family situation and his father’s work schedule makes it difficult for such treatment to go smoothly. The inability to pay for the therapy itself and to bring the child back and forth to the treatment may not be suitable for the current situation of the family, particularly the father. In relation to this, this treatment does not simply aim to fix the patient’s problem, but to give the parent (the father) a chance to rethink the situation and make some necessary adjustments to reduce further problems in the future.

Part 2: Treatment Goals

1. Improve the patient’s outlook about life through creating a better and less stressed environment for him.
2. Help the patient see his role as a person and as a son to his father in a clearer understanding.
3. Provide the father with the necessary tips and tools to make sure he is able to provide for the family, while also giving attention to the growth and development of his son.
4. Help the father see and realize the importance of being a father and not just a provider to the family.

Part 3: Proposed Course of Treatment

To be able to respond to the current issues noted in the case, it is first important to see the client (including the father) for the first two meetings (each requiring 30 minutes each: 10 minutes answering survey questions and 20 minutes interviewing with the therapist). This part will help the therapist understand what needs to be addressed in the situation with a more personal approach. The second step is having the child attend the therapy sessions alone for 30 minutes three times a week. This way, the regularity of the process, under a limited time span, will allow the patient to grasp more than when being pressured to let out so much during the sessions, when trying to finish the therapy all at once. Helping the father to cope with the challenge, on the other hand, could involve educating him about government grants he could use to support his family. This will likely lessen the time he spends at work, thus giving him more time for his family and especially his son. The patient should be guided well, taught about the stages of puberty and early adolescence. It is assumed that, with such education, the patient would understand why he experiences attitude changes thus equipping him to face such situations in a more positive and progressive manner. Through this, not only will he be able to cope with his current situation, he will also learn to build a better behavioral outlook for himself, which he could use in the future as he matures.

Progress Notes

Client Name: Mark Date/Time: 10/3/2013/

Start Time: 9:00 AM EST

End Time: 10:00 AM EST

Summary of Session: Mark showed up 5 min early for his session with his father. Mark came very well groomed and conversational telling about his grandfather that just passed away this week and that he and his father feel very depressed. That he was very close to his grandfather.

Change in Needs: Mark will need grief counseling to help with the death of his grandfather.

Progress Toward Tx. Goals: Mark has progressed with handling stress and commutation skills.

Homework: Write in a journal about anything. Write about how he feels that day. Write about the stressors he had that day and about his grandfather.
Client Name: Mark Session Date/Time: 10/30/13

Start Time: 2:00 PM EST

End Time: 3:00 PM EST

Summary of Session: Mark came right on time all dressed up says that he has a girlfriend now. Mark was very talkative today telling me about everything that has happen last couple of weeks. Tell s me that he and his dad have spending a lot time doing things together and talking about things. Mark says that he is interested in going to college and becoming a lawyer.

Change in Needs: There is no change in needs Mark is doing great at this time.

Progress Toward Tx. Goals: Mark has shown up at all the meetings and meeting all his goals.

Homework: There is no new homework just keep writing in journal.

Evaluation of Client Progress

• The client currently shows enthusiasm especially when it comes to talking about matters that interest him.
• His transition point from high school to college could be handled accordingly through giving him some assistance especially relating to surviving freshman years in college.
• Constant understanding of the client’s situation is necessary.
• Grief and other emotional elements need to be evaluated accordingly as they are being shown by the
• Client is gradually showing progress; his process response of treatment and therapy is positive.
• The need to encourage him to write more on his journal is expected to provide him with better options of managing his stress and all other emotional elements he must deal with.

Professional Development Plan

It is important to have a plan for professional development to ensure success in my career goals. Therefore, I have outlined a plan for my future in psychology. The first thing to understand is the role of a psychologist, which is studying human behavior and processes of how the mind works. In addition, a psychologist is responsible for interpreting and recording how these processes worth in relation to the environment of the subjects being evaluated (OOH).

Becoming a psychologist requires extensive academic study and a higher-level degree such as a master’s, specialist, or doctoral degree in psychology. To practice, a psychologist is required to have a license or certification. The highest level academic credential is a PhD or a PsyD in psychology. The latter is a more of a research psychologist that requires passing a comprehensive exam. The former is a clinical degreed psychologist authorized to work in clinical, counseling, school, or health service settings, and this requires a 1-year internship. This is focused on practical work and exams (OOH).

Licensing for psychologists is governed by individual state laws, which usually requires internship, 1-2 years of on-the-job experience and passing an exam. Certifications are awarded by the Nationally Certified School Psychologist (NCSP) program or the American Board of Professional Psychology (OOH).

My plan includes completing my undergraduate degree within the next 2 to 3 years and enrolling in a psychology master’s program. I plan to complete the master’s program within 2 years, and enroll in a psychology doctoral program immediately after completing the master’s. I also plan to secure an internship while in the master’s program.

References

Aherne, M. (2009). Continuing medical education, needs assessment, and program development: theoretical constructs. JCEHP, 21:6-14.

Gillam, S. (2010). Needs assessment in general practice. London: Royal College of General Practitioners. (Occasional Paper 73).

HHS. Health Information Privacy. 2013. <http://www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html>.

OOH. Psychologists. 2013. <http://www.bls.gov/ooh/Life-Physical-and-Social-Science/Psychologists.htm>.

Parker, H. (2007). Stress management. Chandni Chowk: Global Media.