The most likely diagnosis of the patient is major depressive disorder and it is considered as a serious mood disorder.

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.

NOTE: (positive Comment)

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The  most likely diagnosis of the patient is major depressive disorder and  it is considered as a serious mood disorder. According to the DSM-5  criteria for the diagnosis of depression, there is markedly diminished  interest or pleasure in all or almost activities most of the day; weight  reduction due to the loss of appetite; the reduction in the thoughts  and physical activities; feeling of worthlessness; reduced ability to  concentrate; and the recurrent thoughts of deaths of suicidal. Based on  the case study, it is evident that the patient has stopped attending  rehearsals for the bands two months ago since she is no longer  interested; low self-esteem; low energy; and two previous suicidal  attempts. Therefore, the patients use self-injury as a way of coping  with his depression, a means of relief, to regulate his feelings,  self-punishment, and to seek attention (McGillivray & Evert, 2014).  The patient is a 15-year-old who reports a self-harming behavior. The  patient also feels that the family is not supportive making develop  suicidal thoughts. The patient has attempted committing suicide  severally, most recently two months ago. The patient is adequately  progressing since he does not show any agitation of motor health.  The  patient is also alert of the surrounding and promptly identifies the  root of the problem. The concentration and attention of the patient are  also alert (American Psychiatric Association, 2013). Besides, the  patient shows no history of drug abuse of psychiatric medication.

The most important group therapy that can help the patient is  Cognitive-Behavioral Therapy. This therapy is important in ensuring that  unhealthy, adverse beliefs, and behaviors are replaced with healthy and  adaptive ones. This therapy helps in improving the individual thought  of the patient so that the negative and the inaccurate thoughts are  reshaped appropriately.The therapeutic approach that I will use in the  case is cognitive behavior therapy (CBT). The approach primarily focuses  on altering the behavior of the patient by avoiding destructive  behaviors and self-injury. The model is implemented through regular  meetings with the patient (American Psychiatric Association, 2013)  (Restek-Petrović et al., 2014). We will agree with the patients on the  most appropriate time for the meetings.  The model helps the patient to  identify any destructive behaviors and negative influences of the  behavior.CBT will be effective since it focuses on the negative  thoughts, challenges them, and replace them with positive opinions.  The  underlying principle of CBT is that thoughts play a vital role in the  behaviors of the patient; hence manipulation of the thoughts plays a  vital role in the changing behavior of the patient. The approach will  help the patient realize his self-worth and the impact of emotional  stress on the patient (McGillivray & Evert, 2014). CBT will enable  the patient to focus on a positive activity for his to avoid destructive  behavior and self-injury. The activities include engaging in another  game or another healthy activity.

The  patient’s parents got divorced five years ago and he lives with the  mother. The patient has minimal contact with the father. The information  could impact the therapy since the patient could be dealing with  identity issues (McGillivray & Evert, 2014).  The patientl is 15  years that lies in Erikson’s stage of psychological development that  lies between 5 and 18 years. During the stage, people must form good  social and family relations with themselves (Wheeler, 2014). If people  have poor relations in their environment, they exhibit confusion and  emotional stress. The patient in the case could be having emotional  stress that could alter the results of the therapy. The patient to  develop healthy problem-solving skills that are important in the  identification and management of the triggers of the suicidal attempts  and self-injury. The patient is expected to improve emotionally and to  manage the distress. His performance in school is expected to improve  and have a good relationship with his family. He is also expected to  report a reduction in the suicidal thoughts (McGillivray & Evert,  2014). There  are legal and ethical issues that are faced by the licensed counselor  and they must be put into considerations. The process of breaching  confidentiality is against the ethical and legal expectations and this  ruins the trust between the patient and the counselor. Psychiatrists  have a responsibility of protecting the information of the patients and  his family. The breaching of confidentiality leads to legal consequences  because of malpractice. Another ethical and legal concern is related to  autonomy whereby the patient, in this case, has the right to be  informed about the type of medication and treatment being provided to  them. However, there are situations where these might not understand the  treatment approaches and medication or diagnosis.


McGillivray,  J. A., & Evert, H. T. (2014). Group cognitive behavioural therapy  program shows potential in reducing symptoms of depression and stress  among young people with ASD. Journal of Autism and Developmental Disorders, 44(8), 2041-2051.

Restek-Petrovic,  B., Bogovic, A., Mihanovic, M., Grah, M., Mayer, N., & Ivezic, E.  (2914). Changes in aspects of cognitive functioning in young patients  with schizophrenia during group psychodynamic psychotherapy: A  preliminary study. Nordic Journal of Psychiatry, 68(5), 333-340.

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice. New York, NY: Springer.

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