Symptoms Based on the information provided from the start Dan shows reluctance trusting other people. Furthermore, he seems to show an uncooperative attitude and exhibit a challenging behavior in the therapy sessions. Also, Dan’s history selling drugs to peers is reflective of a repetitive and persistent pattern of behavior in which the basic rights of others or major age-appropriate societal norms or rules are violated. He showed no records of aggression but with the products he sells could inflict enormous damage to other people.
Furthermore, his adamant refusal to stop is due to the personal benefits it entails regardless of the consequence. This disturbance in behavior causes clinically significant impairment in social, academic, or occupational functioning exhibited in his panic attacks and occasional guilty feeling. Diagnosis Based on the symptoms provided in the case and that of his age of 16, Dan can be a person that has conduct disorder (American Psychiatric Association Diagnostic [APA], 2000, pp. 194-196).
As what the DSM IV prescribes the diagnosis for conduct disorder can only be finalized if the indicators have been observed in the past 12 months with at least one criterion present in the past 6 months (93). In the case it was not the case it was not explicitly stated for how long he have been doing it but as provided, the counseling relationship have just been for 3 months so other source of information should be utilized in order to support the diagnosis Ethical Considerations An important factor was also addressed in the case was regarding the ethical consideration regarding confidentiality.
Depending on the local laws and practice but usually as there are a number of statutory and regulatory circumstances when the general duty of confidentiality must yield. A counselor has to the parents of the child and the community as well especially when working with minors (Bracken & Thomas, 2001). There is a clear common law duty on the part of a guidance counselor to warn of a threat of physical violence against a reasonable identifiable victim or a threat of substantial damage to real property. Drug-use and trade for adolescents can cause significant harm and damage to the community (APA, 2000, p. 198).
When working with minors, counselors should encourage family involvement when possible. Parents of minors have the right to information in most circumstances. This can be done with still keeping the best interest of the client. Provide enough time and opportunity for him develops a better plan of action. This would build trust and show that your respect for the person. Course of Action Initially, the counselor should reinstate the level of the client trust on his ability to help him. Keeping his trust and confidence over the relationship would be a key factor this proving treatment (Weare & Markham, 2005).
Aside from that the counselor could reiterate that a counselor would be there as a guided that person that would best help him address his concerns his himself. According to the American Academy of Child and Adolescent Psychiatry stresses that 40 percent of children with conduct disorder will grow up to be adults with antisocial personality disorder (Sourander, Multimaki & Nikolakaros, 2005). Dan’s show of guilt even how minimal provides a very important opportunity to help him. An immediate concern is discouraging him with in selling the drugs.
Self-esteem and positive self-image are also important avenues work on. As mentioned by the client, he sells drugs because it deems it as a source of power and probably acceptance among his peers. Treatment Since Dan tries to rationalize his actions by the numbers of benefits that he gets from selling drugs which he believes is intrinsically rewarding Re-evaluation of the his belief system on how to be recognized. With that treatment is rarely brief since establishing new attitudes and behavior patterns takes time. Aside from that, the counseling should involve the participation of the parents.
In developing a comprehensive treatment plan, a child and adolescent psychiatrist may use information from the child, family, teachers, and other medical specialties to understand the causes of the disorder (Bracken & Thomas, 2001) In short, treatment can be complex and challenging depending on the severity and setting. Dan can benefit from behavior therapy and psychotherapy is usually necessary to help him appropriately express his feeling, fears and anxiety and develop a more healthy belief system (Williams & Garland, 2002).
Without treatment, many youngsters with conduct disorder are unable to adapt to the demands of adulthood and continue to have problems through adulthood. However, early treatment offers a child a better chance for considerable improvement and hope for a more successful future. References Bracken, P. & Thomas, P. (2001) Post-psychiatry: a new direction for mental health. BMJ Volume 322: 724-727 American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition – Text Revision (DSMIV-TR). Washington, D. C.
: American Psychiatric Association Weare K and Markham W. (2005). What do we know about promoting mental health through schools?. Promot Educ Volume 12 Number 3-4: 118-122. Williams, C. and Garland, A. (2002). Identifying and challenging unhelpful thinking. Advan Psychiatr Treat September Volume 8 Number 5: 377 – 386. Sourander A, Multimaki P. and Nikolakaros G. , et al (2005). Childhood Predictors of Psychiatric Disorders Among Boys: A Prospective Community-Based Follow-up Study From Age 8 Years to Early Adulthood. J Am Acad Child and Adolescent Psych Volume 44 Number 8: 756-767