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 Respond  by providing one alternative therapeutic approach. Explain  why you suggest this alternative and support your suggestion with  evidence-based literature and/or your own experiences with clients. 

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   In this discussion, the case that shall be considered is that of the  withdrawn child. This is a young white boy that seems to keep everything  to himself and he also acts like he has no problem. This is a possible  case of mood disorder. The child is likely to be suffering from  depression. It should be noted that the video about the withdrawn child  provided very limited information about the boy. As such, the diagnosis  is one that can only be speculated. This child seems to be in a sad or  depressed mood and he also seems to have lost interest in activities  that would otherwise bring pleasure or joy to him. He could be coping  with a situation at home that causes his withdrawal or h could also be  anxious about something. However, for the sake of this discussion, the  focus shall be on depressed mood. Dealing with this client needs  patience. A withdrawn child like this might be feeling guilty or ashamed  of opening. As a therapist, there is need to let the child known that  he is in safe hands and that he can trust the process. Through effective  communication and active listening, it is possible to ensure that the  child starts to open up and accept that he is bothered by something.  This way, the health practitioner can understand the behavior and  reaction of the client (Sibiya, 2018).

   In the Diagnostic and Statistical Manual, depression can be diagnosed  if at least 5 of the provided symptoms are present. Also, one of the  symptoms that is present should be depressed mood or lack of interest or  pleasure especially in activities that an individual was used to. This  child indeed seems to be in a depressed mood. He also seems to lack  interest, and this is why he is withdrawn. The other symptoms that can  be speculated from the video include loss of energy, excessive and  inappropriate guilt, lack of concentration and restlessness especially  when questioned. According to the manual, thee symptoms should not be  attributed to a psychological or other medical issue and they should  lead to significant distress in the life of the client (APA, 2013). This  is a child that needs help in order to live a normal life like his  peers. His mood needs to be regulated in a manner that is normal  especially for his age. He needs to come out of the dark place where he  is withdrawn and become a happy boy. 

   This calls for both pharmacological and non-pharmacological  interventions. The non-pharmacological intervention shall be cognitive  behavioral therapy. This shall be a group-based therapy. In a cluster  randomized control trial, it was concluded that individual -based  cognitive behavioral therapy is an effective intervention in the  treatment of depression in adolescents. This therapy was said to be  effective in managing the symptoms associated with depression in  adolescents (Idsoe, Keles, Olseth & Ogden, 2019). As such, this  should be prioritized and optimized in this withdrawn adolescent.  Secondly, the child can also be started on antidepressants, but this is a  decision that should not be made fast. It is of great importance to  first evaluate the client after sessions of individual-based cognitive  behavioral therapy. It is actually expected that after the appropriate  number of sessions, the boy will have a better mood. He will stop being  withdrawn and his self-esteem shall increase. The therapy should also  help to being active in different activities like his peers. 

   Antidepressants are supposed to be avoided in this case because they  increase the risk of suicide in adolescents. In a black box warning by  the FDA, antidepressants should be considered as drugs that increase the  risk of suicide in both children and adolescents, especially at the  beginning of therapy or when there is need to change the drugs  (Moreland, Bonin, Brent & Solomon, 2014). Therefore, it is important  to avoid antidepressants now. The non-pharmacological intervention is  expected to have better outcomes.



Idsoe,  T., Keles, S., Olseth, A. R., & Ogden, T. (2019). Cognitive  behavioral treatment for depressed adolescents: results from a cluster  randomized controlled trial of a group course. BMC psychiatry, 19(1),  155

Moreland,  C. S., Bonin, L., Brent, D., & Solomon, D. (2014). Effect of  antidepressants on suicide risk in children and adolescents. Up To Date  [on-line database]

Sibiya,  M. N. (2018). Effective Communication in Nursing. Nursing, 19.  Retrieved from