Practicum – Week 8 Journal Entry Essay Assignment
Practicum – Week 8 Journal Entry
This week, you complete a two-part journal entry.
Learning Objectives
Students will:
• Develop diagnoses for clients receiving psychotherapy*
• Evaluate efficacy of existential-humanistic therapy for clients*
• Analyze legal and ethical implications of counseling clients with psychiatric disorders*
• Analyze clinical supervision experiences*
* The Assignment related to this Learning Objective is introduced this week and submitted in Week 10.
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For Part 1, select a client whom you observed or counseled this week (other than the client used for this week’s Discussion). Then, address the following in your Practicum Journal:
• Describe the client and identify any pertinent history or medical information, including prescribed medications Practicum – Week 8 Journal Entry Essay Assignment.
• Using the DSM-5, explain and justify your diagnosis for this client.
• Explain whether existential-humanistic therapy would be beneficial with this client. Include expected outcomes based on this therapeutic approach.
• Explain any legal and/or ethical implications related to counseling this client.
• Support your approach with evidence-based literature.
For Part 2, reflect on your clinical supervision experiences. Then, address the following in your Practicum Journal:
• How often are you receiving clinical supervision from your preceptor?
• What are the sessions like?
• What is the preceptor bringing to your attention?
• How are you translating these sessions to your clinical practice? Practicum – Week 8 Journal Entry Essay Assignment.
Journal entry
Part 1
- Describe the client.
James is a 62-year-old Caucasian male. He has been admitted into the emergency room unconscious having been brought in by the personnel at the elderly home facility where he stays. He gained consciousness 30 minutes after admission. An interview with medical personnel reveals that he uses un-prescribed heroin as a pain reliever to address chronic back pain that he has experienced over the last five years. The back pain began after a bad fall while at home. He reports that he has been using heroin for the last two years but is very careful on how much he uses since he occasionally supplements the heroin with ice packs as a pain reliever. He further adds that he purchases the heroin from local dealers and has been careful not to expose his stash of drugs to the personnel at the elderly home facility. In addition, he has been careful to prevent his children from knowing that he uses heroin. In fact, he puts on a strong public face to show that everything is ok and he is not in pain. Practicum – Week 8 Journal Entry Essay Assignment. He admits that there are times when the back pain is unbearable and he ends up writhing in pain without the ability to engage in any other activity.
- Identify any pertinent history or medical information, including prescribed medications.
James had an accident five years ago at home. He fell and hurt his back. Since then he has occasionally experienced chronic back pain that sometimes becomes debilitating. His initial case worker determined that he was at risk of developing an addiction and dependence on opioid pain medication. That was because he was demanding increasingly larger quantities of the medication at a faster rate Practicum – Week 8 Journal Entry Essay Assignment. The case worker recommended that he use alternative pain management therapies. Rather than explore alternative pain management therapies, James decided to look for other opioid sources since prescription opioid was closed to him. This led him to acquire heroin from dealers in his locality. Currently, he barely function without the heroin to manage his pain. He does not use any other prescription medication.
- Using the DSM-5, explain and justify your diagnosis for this client.
Using DSM-5, James would be diagnosed with opioid use disorder. He initially used prescription opioids to manage his back pain and has since turned to using heroin to manage the pain since the prescriptions stopped. He has been acquiring the heroin from local dealers. He knows that purchasing and using heroin is a criminal activity since heroin is a controlled medication. He is aware that he will definitely be arrested by the police if found purchasing or using heroine. Besides that, he is aware that using heroin [resents a danger to his life owing to its addictive and dependence properties. Also, the drug has interfered with his personal responsibilities and safety. Overall, James exhibits excessive and compulsive heroin use, thus meeting the conditions for opioid use disorder based on DSM-5 criteria (Levounis, Zerbo & Aggarwal, 2016). Practicum – Week 8 Journal Entry Essay Assignment.
- Explain whether existential-humanistic therapy would be effective with this client. Include expected outcomes based on this therapeutic approach.
Existential-humanistic therapy would be effective for this client. That is because the approach considers opioid use disorder is resultant from existential struggles, a true statement for the present client who developed the disorder from a need to address his chronic back pain. Using this approach would allow the client to focus on human potential, life meaning and objective reality, allowing him to create a life that does not revolve around managing his back pain. In addition, it would allow him to accept that pain is an inevitable part of life and that he is yet to reach his full potential, something that would only occur if he can live with the pain (Brooks, 2015). Although he is free to freely make the decisions that shape his life, he should make a decision that has meaning to his life since using heroin is a way of escaping his pain since it only removes him from his physical reality of the pain. Also, taking heroin is only temporarily pleasurable in eliminating the pain by introduces unfavorable negative consequences (Wheeler, 2014).
- Explain any legal and/or ethical implications related to counseling this client.
Counseling James has an ethical implication. There is a confidentiality concern when it is considered that heroin is an illegal substance and the therapist could identify information about the dealers. How to handle such information is a challenge since reporting it to law enforcement officers violates confidentiality expectations while protecting other heroin users through blocking their supply. Practicum – Week 8 Journal Entry Essay Assignment. On the other hand, failing to report the information implies that other heroin users would still have their supply, turning them into addicts (Gunn & Taylor, 2014).
Part 2
- How often are you receiving clinical supervision from your preceptor?
I receive clinical supervision from my preceptor once weekly.
- What are the sessions like?
The sessions are typically tense but informative. The sessions are tense because I am supposed to ignore the presence of the preceptor and yet I can see him observing me and making notes. I typically feel that I am making mistakes when he takes notes. Also, the sessions are informative since the preceptor objectively evaluates my approach to care, guiding me on how to improve care delivery. Besides that, the presence of the preceptor makes it difficult to communicate with the client, especially with regards to disclosing confidential or embarrassing information since there is a third party (preceptor) that the client feels would disclose the information outside the session.
- What is the preceptor bringing to your attention?
The preceptor brings to my attention the things issues that I should change or improve in my practice, as well as commending me on the things that I did well. The clinical supervision is objective with a view to improving my practice.
- How are you translating these sessions to your clinical practice?
I am translating the supervised clinical session to clinical practice through incorporating the comments from the preceptor. Supervision is intended to improve my practice while confirming that I apply correct conventional approaches. Practicum – Week 8 Journal Entry Essay Assignment.
References
Brooks, T. (2015). Alcohol and public health. New York, NY: Routledge.
Gunn, J. & Taylor, P. (2014). Forensic psychiatry: clinical, legal and ethical issues (2nd ed.). Boca Raton, FL: CRC Press.
Levounis, P., Zerbo, E. & Aggarwal, R. (2016). Pocket guide to addiction assessment and treatment. Arlington, VA: American Psychiatry Association Publishing.
Wheeler, K. (Eds.) (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (2nd ed.). New York, NY: Springer Publishing Company. Practicum – Week 8 Journal Entry Essay Assignment.