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Respond to your colleagues by suggesting an alternate therapeutic approach. Support your feedback with evidence-based literature and/or your own experiences with clients.
The client is a 17-year-old white girl that was accompanied by her mother to the clinic. She has two older brothers in the university and they are all studying to be doctors. Her father is a doctor and her mother is a nurse in the community hospital. She self-reported that she has been feeling very anxious of late. For a duration of about 8 months, she has been very worried about school especially now that she is almost done with her high school. Her grades don’t look so good and she is worried that she might not be able to follow the family tradition of working as a doctor, something that her father wants for her. She also dreams about the same but it is the fact there is too much that is expected from her that worries her.
The client has been finding it hard to cope with the worrying and this has further affected her performance which makes the situation worse. Her father has been putting so much pressure on her and this is not helping. She has been restless and is always on edge. She is always irritable and this affects how she relates with her parents and colleagues at school. She has challenges when it comes to concentrating at school and at the end of the day, she feels more fatigued than ever. Her sleep has not been normal. She finds it hard to fall asleep and staying asleep about 2-3 nights in a week. These disturbances cannot be attributed to any other mental or psychiatric illnesses. According to the interview and the comprehensive assessment, it was concluded that this was a case of generalized anxiety disorder due to pressure from school and her performance (APA, 2013).
The approach that was selected for this client was cognitive behavioral therapy. This is one of the most effective empirical treatment for generalized anxiety disorder and it is also a proper alternative to pharmacological interventions. The mother to the client and the client agreed that it would be better to avoid drugs after they were educated about potential side effects. Cognitive behavioral therapy is also considered as a first-line intervention to generalized anxiety disorder (Hirsch et al., 2019). The other reason for using cognitive behavioral therapy with this client is because she was entertaining negative thoughts that led to uncontrolled worrying. Using CBT allows the client to be able to change how she deals with the reason for her excessive anxiety. After a few weeks of therapy and after involving her father in a few sessions, it became clear that she could start controlling her anxiety and she found the will to cope with pressure from school. She even reported that the sleep disturbance reduced significantly.
The role of her father in her education and performance may have serious impact on the expected outcomes. This is why her father was included in a few sessions. It was very clear from the initial meeting that she was not only worried about her performance but also about not being able to meet the expectations that her father has for her and her future career. Allowing them to discuss about the issue as a family encouraged the parents to also appreciate their contribution to her anxiety. They therefore agreed to give her more support instead of pressure. Generalized anxiety disorder is one of the most common mental disorders in children and adolescents. Detecting it early is important in order to ensure that the quality of life of the affected person is not significantly affected (Bhatia & Goyal, 2018). The role of parents in exacerbating the problem should also be considered, especially when it comes to school performance.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Pub.
Bhatia, M. S., & Goyal, A. (2018). Anxiety disorders in children and adolescents: Need for early detection. Journal of postgraduate medicine, 64(2), 75
Hirsch, C. R., Beale, S., Grey, N., & Liness, S. (2019). Approaching Cognitive Behavior Therapy For Generalized Anxiety Disorder From A Cognitive Process Perspective. Frontiers in psychiatry, 10, 796