Behavioral Disorders

Behavioral Disorders

Behavioral disorders are a group of mental health illnesses that cause disruptive behaviors and limit social and cognitive functionalities. These disorders are common in children and adolescents. Anxiety disorders are an umbrella behavioral disorders that encompass panic disorders, general anxiety disorders, and phobias. The case presented details of panic disorder as a behavioral and social disorder.

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Case Study

The case presented is of a 13-year-old Latino boy living with his grandmother. On multiple occasions, the client was brought to the clinic with complaints of shortness of breath, chest pain, and palpitations. These symptoms began eight months ago but have since increased in intensity prompting hospital visitation. The grandmother also reports that the symptoms are often accompanied by profuse sweating, tremors, and sometimes nausea. The symptoms have no established pattern or attributing factors and often come abruptly. The past two months have seen the patient have more episodes of these attacks. The client has no history of drug or substance abuse. He has never experienced any significant illnesses in the past. His mother is currently incarcerated in a nursing home with multiple illnesses. She was diagnosed with panic disorder and was thought to have been having this disorder during her pregnancy for the client. The whereabouts of his father are not known.

Assessment Procedures in the Intake/ Initial Sessions

The assessment process for this client is targeted at obtaining further information on the client’s presenting complaint that will help in the diagnosis. Personal information and the biodata of the patient form the preliminary step in the assessment process. Obtaining information on the clinical manifestations of the client is another important step during the assessment as it gives insight into the condition the client may be experiencing. The subjective assessment process gives information on symptoms’ onset, severity, and causal factors. Subjective findings help in ruling out the presence of comorbidity and the somatic involvements of the disease. Physical examination of clients is another step in the assessment that can help determine their health status and inform them of the interventions to apply.

Diagnosis

The client had a positive diagnosis of panic disorder. This disorder is characterized by occasional episodes of intense fear or discomfort that are often abrupt and have no attributing etiology. Palpitations, tremors, sweating, tachycardia, and dyspnea accompany these attacks. The DSM-5 states that a positive diagnosis of a panic disorder is made in the presence of recurrent abrupt attacks followed by one month or more of persistent attacks (Kim, 2019). During diagnosis, it is important to rule out other causal factors for panic attacks. The client’s case presented showed shortness of breath, palpitations, tremors, sweating, and chest pain. These symptoms are presented occasionally during schooling and at home and are consistent with a panic disorder as described in DSM-5. The client was also at an increased risk for panic disorders since his mother also had panic disorders. According to Kim & Kim (2018), there is close to a 40% chance that first-degree relatives of persons with panic disorders will develop the disease.

Treatment Goals

The overall goal of treating panic disorders is to lower the frequency of symptoms and manifestations to enable the individual to lead a normal life. To attain this, the client will be expected to track their symptoms, follow up on their illness with their healthcare providers, and adhere to their medication whenever necessary. Another treatment goal is to equip individuals with this disorder with appropriate coping skills to help them manage their symptoms.

Description of Interventions that will be Utilized Throughout the Treatment

A combination of pharmacologic and pharmacologic interventions is warranted to achieve the treatment goals. Antidepressant and benzodiazepine medications are the mainstay pharmacological interventions that are effective in the symptomatic relief of panic disorders. Selective serotonin reuptake inhibitors are used as first-line agents. Psychotherapy with cognitive behavioral therapy (CBT) is a nonpharmacologic intervention effective in managing panic disorders and attacks. CBT will equip the client with appropriate coping skills necessary for symptom management of the disorder (Baker & Waite, 2020). The treatment plan for this client will employ CBT and pharmacotherapy with SSRIs.

The treatment plan for this client will employ CBT. In a mock CBT session, the first step is laddering. This practice technique helps individuals identify and organize their negative thought processes and establish the root causes of negative and fearful thinking. This step is followed by narrowing down the client’s thought process to their core beliefs. Core beliefs detail the individual’s biggest fears, perspectives, or thinking of how the world works and what happens if a contravention of how they think the world works occurs. Behavioral therapy is then designed for the client who challenges his perspective on life and assumptions about his core beliefs (Ellis, 2022). For example, if his core belief is feeling worthless and always believing that if he does not achieve whatever he wants, he experiences an attack, the therapy is designed to expose him to not getting what he wants. With repetition, the client may learn how to confront his fears.

Ethical and Cultural Considerations

The client is a 13-year-old Latino living with his grandmother. Cultural considerations that should be made when treating this client include unfamiliarity with the treatment approach, language barriers, the impact of religion on the client’s health, belief in alternative medicines, distrust of caregivers or the healthcare system, and personal experiences (Acle et al., 2021). The caregivers, in this regard, should be culturally competent and maintain sensitivity towards these considerations. Ethical considerations that may be apparent when treating this client are integrity, respectfulness, and benevolence (Marks et al., 2021). Benevolence defines the virtue of doing good to the patients. Integrity entails upholding the client’s beliefs when treating them, while respectfulness entails respecting their values and beliefs.

Consistently, behavioral disorders such as panic disorders are serious illnesses that cause a functional deficit in individuals. If left untreated, these disorders may cause other serious illnesses. DSM assists caregivers in diagnosing behavioral disorders. Prompt treatment with pharmacotherapy or psychotherapy is often warranted after a positive diagnosis has been made. The goal is often to lower the frequency of symptoms to allow the individual to lead a normal life.

References

Acle, A., Cook, B., Siegfried, N., & Beasley, T. (2021). Cultural Considerations in the Treatment of Eating Disorders among Racial/Ethnic Minorities: A Systematic Review. Journal Of Cross-Cultural Psychology, 52(5), 468-488. https://doi.org/10.1177/00220221211017664

Baker, H., & Waite, P. (2020). The identification and psychological treatment of panic disorder in adolescents: a survey of CAMHS clinicians. Child And Adolescent Mental Health, 25(3), 135-142. https://doi.org/10.1111/camh.12372

Ellis, P. (2022). Here’s Exactly What a Cognitive Behavioral Therapy Session Looks Like. Men’s Health. Retrieved 18 September 2022, from https://www.menshealth.com/health/a33697198/cbt-therapy-session-what-its-like-video/.

Kim, E., & Kim, Y. (2018). Panic disorders: The role of genetics and epigenetics. AIMS Genetics, 05(03), 177-190. https://doi.org/10.3934/genet.2018.3.177

Kim, Y. (2019). Panic Disorder: Current Research and Management Approaches. Psychiatry Investigation, 16(1), 1-3. https://doi.org/10.30773/pi.2019.01.08

Marks, J., Rosenblatt, S., & Knoll, J. (2021). Ethical Challenges in the Treatment of Anxiety. FOCUS, 19(2), 212-216. https://doi.org/10.1176/appi.focus.20210001

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Create a case study of a child or an adolescent and their family presenting for therapy, as well as an overview of treatment. Be sure to include a description of the case study and presenting issue, a description of assessment procedures, your diagnosis, treatment goals, interventions, ethical considerations, and cultural considerations. a thorough outline. Your outline should be structured as indicated below. Be sure to show how your assessment and treatment are rooted in both developmental and family systems frameworks.

1. Presentation of the case study including family demographics, dynamics, and a description of the presenting issue (include an ecomap and/or genogram if needed)

2. Assessment procedures in the intake/ initial sessions

3. Diagnosis (including a description of the diagnosis and supporting information)

4. Treatment goals

5. Description of interventions that will be utilized throughout treatment, with one detailed description of a mock session

6. Ethical and cultural considerations

Use at least three scholarly sources (journal articles or book chapters)