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.
In this discussion, the case that shall be considered is that of the withdrawn child.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 It should be noted that the video about the withdrawn child provided very limited information about the boy.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 A withdrawn child like this might be feeling guilty or ashamed of opening.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 He also seems to lack interest, and this is why he is withdrawn.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 He needs to come out of the dark place where he is withdrawn and become a happy boy.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 https://www.intechopen.com/books/nursing/effective-communication-in-nursing