Pelton_Holly_u03a1_Creating_Your_Client_Case

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Feb 20, 2024

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CREATING A CLIENT CASE: HALLIE 1 Client Case: Hallie Holly Pelton COUN5254: Child & Adolescent Counseling Dr. Jonathan Gray Capella University January, 2024

CLIENT CASE: HALLIE 2 Introduction Hallie is overwhelmed, emotionally hurt, and scared about her future and where she stands in her family. She feels like everyone around her has a good life except for her. Her mother, Abigail, stays out late at nightclubs and comes home drunk in the middle of the night. She only sees her father, Noah, every other weekend. The last couple of times she went to her father, her soon-to-be stepmother, Sarah, and her dad could only talk about their new baby and their wedding coming up. School is overwhelming now that she knows she doesn’t make a difference by getting good grades. When she plays outside with her friends, she watches how close their parents are to them. She doesn’t know how to deal with her emotions healthily at this time in her life. Biopsychosocial Information Hallie is an 11-year-old who is going through a personal and familial dilemma. She identifies herself as a female. She is Caucasian, and her religion is Christian. Hallie’s social- cultural views and aspects reveal that she liked school and social life before her situational and environmental factors began. Contributing factors The client's stress sometimes causes her to feel weighed down, drained, and dizzy. The inability to overcome her anxiety and depression is a result of the client’s need to seek mental health counseling services. For example, the client doesn’t want to maintain personal hygiene, such as taking showers or wearing clean clothes, due to the effort she must put forth to complete these small daily tasks. Minor tasks such as these are causing the client to feel lightheaded or dizzy as well. For example, the client mentioned a time when she was trying to brush her teeth, but her head felt as though it was spinning. It worsened while she was bent down over the sink;

CLIENT CASE: HALLIE 3 the client ended up lying down instead. The client's nutrition has been a negative individual factor as well. Since she has a lack of energy and depression, she doesn’t feel hungry anymore. Hunger feels like another daily task that she doesn’t have the capacity for anymore. She likes to draw and write in her spare time, but since her vision and energy levels have been affected, she hasn’t had the ability to turn toward those outlets yet. The client’s familial stressors are overwhelming for her to adjust to. Her father, Noah, and his fiancé Sarah, are happy and in love with each other. The client states that visiting her dad twice a month is not enough for her to feel a bond, especially now that they are going to have a baby together. She feels like the third wheel at her dad's house. Her mother, Abigail, doesn’t usually come home after her workday lately. She usually stays out until late. The only time the client gets to talk with her mom is in the morning when they are both getting ready for the day. The client says her mother, Abigail, doesn’t like her father, Noah, and how he deserted their relationship. Her mother always downs everything her father does and says. Abigail’s parents have passed on. The only grandparent the client can talk with is Adam, Noah’s father. Grandfather Adam talks with her on the phone on her birthdays and Christmas. He sends cards in the mail for those occasions as well. Adam is in an assisted living home and has been there since the client can remember. They are not very close. The client's community and cultural relationships are strained due to her overwhelming feelings about her familial life at home. Her mom’s friend Natalie comes over to check on her occasionally after school to make sure she’s eating, but the client hasn’t felt like interacting with her like she used to. They would play the Connect Four game sometimes while the food was cooking, which was a good memory the client had of her. Since the client's mom stopped returning home after work every day, Natalie made a comment about how hard it is to be a single

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CLIENT CASE: HALLIE 4 mom and that it could be the client's attitude as to why Abigail doesn’t want to come home. That made the client stop talking to Natalie altogether. The client goes to church on Sunday with her friends Brooke and Cole. She has difficulty concentrating and following what her friends and the pastor say. The same occurrences happen at school. She has difficulty focusing on the teacher in class and cannot wrap her head around the concepts being taught. Certain societal factors in the client's life affect her life drastically. Since her mother makes a good amount of money at the office, the client can go horseback riding twice weekly. The client wants a horse of her own, but she cannot because she lives in New York City. She is trying to keep up with her horseback riding because it is the only thing that gives her feelings of freedom from her familial burdens. The client plays soccer in the spring and can walk from her house to the park to practice. Her neighborhood is busy, so she must be on high alert and keep her friends around whenever she goes out for her safety. Since she has not felt good mentally, she has not been able to meet up with her friends the way she wants to.

CLIENT CASE: HALLIE 5 Ecomap Genogram

CLIENT CASE: HALLIE 6 Relationships Relationships in the community can significantly help the client through peer support groups. Peer support groups for children with blended families can help the client understand that she is not alone with her feelings about her new stepparent and stepsibling. For example, the Blended Family Support group for kids and teens would be a sound support system for the client. According to Gath (2022), children who have step-parents undergo more psychological stress than children who do not. Those with peer support groups are better aware of the severity of depression (Stuckey et al., 2021). School-based programs that are provided during or after school may help the client considerably. An afterschool academic program called Kids Strive may help her gain her footing back in school and catch up on her academics. Kids Strive is a program that gets children together to study and cooperate on academic tasks. School programs showed a significant increase in test scores and an increase in mental health productivity in students with mental health issues (Shahraki-Sanavi et al., 2020). The library may be a good resource for the client through treatment and throughout their lifetime. The client can browse through books, videos, and articles about remarriage and blended family systems in the adolescent and teen section. This could also help the client answer her own questions anytime she chooses without counsel. Emotional regulation and maturity are shown to be deficient due to emotional isolation and lack of strong emotional support (Fatima et al., 2021). For example, if the client is willing to read various books and watch videos about her dilemma in her own time, she can share it during our session, which can only help her grow her mentality about her situation.

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CLIENT CASE: HALLIE 7 Ethics The potential ethical issues in this case include the client's developmental sensitivity. According to the ethics code A.2.c., Counselors are required to safeguard the comprehension levels of the client. If the counselor has developmental milestones that have not been met, counselors can adjust their practices accordingly. This encourages the client to be empowered and affirmed with their identity and gain trust in the client. Developmentally appropriate materials for minors will promote growth and increase the effectiveness of counseling techniques. If the child is too young to understand certain aspects of a treatment plan, adjustments or reevaluation of possible intervention can be based on the case. This may impact the client's mental health by helping them properly understand and use the techniques learned in counseling (American Counseling Association [ACA], 2014). For example, if Hallie does not understand that maintaining positive coping mechanisms in stressful times is helpful, the counselor can assist her by supplying her with materials to carry out the positive coping mechanisms rather than talking about them, such as providing her paint supplies for home use whenever she feels overwhelmed, she can start to paint to relieve stress. Another ethical issue that can be present in this case is the inability to give consent. Since the client is a minor, the parental rights and responsibilities of the client are under the care of the parent or guardian in charge of the minor. According to the ethics code A.2.d., the inability to give consent is there to ensure that the client is given appropriate decisions about whether they can make their own decisions. If the client, in this case, does not want counseling, yet the client's parents do, the counselor must try to incorporate the client in decision-making, services, and techniques to strive for the approval of the client and gain trust (ACA, 2014). This may impact the client's mental health due to the inability to have a choice in the matter of counseling. For

CLIENT CASE: HALLIE 8 example, if the minor does not want counsel, the counselor can include play therapy or positive techniques to make the experience overall something the client enjoys. This can help create and maintain a positive client-counselor relationship. An ethical issue that may be present in this case is the release of confidential information. Since the client is a minor, the counselor can seek third-party permission to disclose case information. According to B.5.c., code counselors would inform the client of the release of confidential information and help them understand the way the counselor would safeguard their information accordingly (ACA, 2014). This may impact the client's mental health by disclosing that the counselor and client's private conversations can also be shared, causing fear for the client. Most of the time, the client does not want information to be disclosed from the session; however, if done so carefully, the client can be safeguarded from the counselor in a meticulous way, thus creating counsel for the counselor and further assistance for the client. Legality A potential legal issue with this client is neglect. This could be an issue in this case due to the amount of time the client is home alone after school. In New York City, there is no set age for a child to stay home alone, but neglect might be prominent in this case. The counselor could talk with the parent about the long hours alone after school, or if the counselor feels that sharing this with the parent might cause the client to be in danger, the counselor has the right to call Child Protection Services to conduct a thorough investigation if they feel that its necessary (Fatima et al., 2021). This may impact the client's mental health due to the changes in lifestyle that may take place if neglect allegations come back in favor of Child Protective Services. However, if the mother, Abigail, understands that her being out too much is causing adverse

CLIENT CASE: HALLIE 9 effects on her child and solves that dilemma, the client's life and mental health may look brighter due to having her mother present at home. Confidentiality is maintained at the utmost importance in counseling. New York state law protects minors' ability to stay confidential and cannot be discharged to parents or law enforcement without proper consent. The counselor can only break confidentiality if the client is in danger to themselves or others. For example, if the counselor decides to talk to the parent about things the child did not want disclosed, a breach of trust can happen thus halting the cooperation in sessions. A confidentiality breach impacts the client's trust and mental health due to the bond that the client and counselor need to have while in treatment. If confidentiality is maintained, the client will feel confident talking with the counselor about sensitive topics (ACA, 2014). The counselor is expected to have consent forms authorized by the parent or caretaker of the adolescent client. Both parents may need to sign the consent forms depending on the custody agreement. The consent forms would clearly state that the mental care services are to remain confidential unless there is suspected child abuse, if the client is in danger of any kind, or if the client reports any abuse of any kind. For example, if the counselor does not have consent forms, the parent may feel uneasy about moving forward with mental health treatment due to not understanding what is to be expected out of the sessions. This may impact the client's mental health in the situation by disclosing certain rights the parent may have regarding the client's services. (ACA, 2014). Evaluative Annotated Bibliography Fatima, S., Bashir, M., Khan, K., Farooq, S., Shoaib, S., & Farhan, S. (2021). Effect of presence and absence of parents on the emotional maturity and perceived loneliness in

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CLIENT CASE: HALLIE 10 adolescents. Journal of Mind and Medical Sciences, 8(2), COV11- 266. https://doi.org/10.22543/7674.82.P259266 This study was conducted about emotional maturity in minors absent from their parents. When conducted, they realized that the study showed a significant negative relationship between emotional maturity and loneliness. They also found that parental presence supported emotional regulation in minors. The absence of parents creates greater feelings of emotional isolation and a lack of strong emotional support. Gath, M. E. (2022). Parents and Adolescents in Stepfamilies: Longitudinal Links to Physical Health, Psychological Distress, and Stress. Journal of Child and Family Studies, 31(1), 17–28. https://doi.org/10.1007/s10826-021-02078-z This study looked at the family structure over an eight-year period. The report is about a minor living with stepfamilies and one-parent families. The study concluded that mental health distress from step-parent families is present and experienced the most stress psychologically and socially. This demonstrates critical differences between parents and minors living with this family type. Pilato, J., Dorard, G., Chevrier, B., Leu, A., & Untas, A. (2022). Quality of Life of Adolescents Facing a Parental Illness: A Person-Oriented Approach. International journal of environmental research and public health, 19(13), 7892. https://doi.org/10.3390/ijerph19137892

CLIENT CASE: HALLIE 11 In this study, the subjects were evaluated with the person-centered approach and how the quality of life is for adolescents who have parental illness, including mental illness. The adolescents studied show that they are a high-risk group who showed low social acceptance, lower academic performance, and low moods and emotions. The study concluded that adolescents had scored high on empathy and caring, thus determining that they are more likely to favor a helpful role in their future. Shahraki-Sanavi, F., Ansari-Moghaddam, A., Mohammadi, M., Bakhshani, N. M., & Salehiniya, H. (2020). Effectiveness of school-based mental health programs on mental health among adolescents. Journal of education and health promotion, 9, 142. https://doi.org/10.4103/jehp.jehp_421_19 This study was conducted on 420 adolescents and investigated the effectiveness of school programs on adolescents. The results were congruent with a hypothesis that stated that there was a difference between the adolescent mental health productivity of those who went to a mental health program and those who did not. They found that mental health improved, and parent- teacher cooperation and test scores increased with those who chose a school program. Stuckey, H., Hivner, E. A., Kraschnewski, J. L., Molinari, A. M., Costigan, H. J., & Sekhar, D. L. (2021). “I wouldn't even know what to do,” Adolescent and Parent Perspectives on Identifying, Understanding, and Seeking Help for Adolescent Depression. Psychiatric Quarterly, 92(4), 1459-1472. https://doi.org/10.1007/s11126-021-09918-7

CLIENT CASE: HALLIE 12 This study focused on depressive themes that presented themselves in adolescent-parent focus groups. The themes for this study included that the group recognized that depression is a serious concern, both parent and child would actively seek help with depression, and neither parent or child could understand how to address someone who was depressed. The study concluded that the randomized clinical trial needed to address the serious issue of depression in schools and how to produce helpful awareness on the topic. Conclusion Hallie is overwhelmed, emotionally hurt, and scared about her future and where she stands in her family. Her presenting problems, current stressors, and familial dilemmas are causing her mental anguish, which she cannot heal herself. Relationships such as her relationship with herself, family, and community are all aspects that affect her mental health. She does not know how to deal with her emotions independently at this time; thus, a counseling professional can help with her overall quality of life by providing quality care through ethical and legal practices so that she is insured to have quality mental health care.

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CLIENT CASE: HALLIE 13 References American Counseling Association. (2014). ACA code of ethics . https://www.counseling.org/resources/aca-code-of-ethics.pdf Fatima, S., Bashir, M., Khan, K., Farooq, S., Shoaib, S., & Farhan, S. (2021). Effect of presence and absence of parents on the emotional maturity and perceived loneliness in adolescents. Journal of Mind and Medical Sciences, 8(2), COV11- 266. https://doi.org/10.22543/7674.82.P259266 Gath, M. E. (2022). Parents and Adolescents in Stepfamilies: Longitudinal Links to Physical Health, Psychological Distress, and Stress. Journal of Child and Family Studies, 31(1), 17-28. https://doi.org/10.1007/s10826-021-02078-z Pilato, J., Dorard, G., Chevrier, B., Leu, A., & Untas, A. (2022). Quality of Life of Adolescents Facing a Parental Illness: A Person-Oriented Approach. International journal of environmental research and public health, 19(13), 7892. https://doi.org/10.3390/ijerph19137892 Shahraki-Sanavi, F., Ansari-Moghaddam, A., Mohammadi, M., Bakhshani, N. M., & Salehiniya, H. (2020). Effectiveness of school-based mental health programs on mental health among adolescents. Journal of education and health promotion, 9, 142. https://doi.org/10.4103/jehp.jehp_421_19 Stuckey, H., Hivner, E. A., Kraschnewski, J. L., Molinari, A. M., Costigan, H. J., & Sekhar, D. L. (2021). “I wouldn't even know what to do,” Adolescent and Parent Perspectives on Identifying, Understanding, and Seeking Help for Adolescent Depression. Psychiatric Quarterly, 92(4), 1459-1472. https://doi.org/10.1007/s11126-021-09918-7

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