I NEED A RESPONSE FOR THIS ASSIGNMENT

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case study presents an adolescent client with a likely diagnosis of Major Depressive Disorder (MDD).   The comprehensive assessment provided by the case study thoroughly addresses all aspects of the client’s life that indicate abnormal symptoms that require treatment (Wheeler, 2014).  The client’s suicidal ideation, depressed mood, decline in focus with school, lack of self-worth, and sleep problems are symptoms consistent with MDD (American Psychiatric Association, 2013).  This client expresses fatigue and troubles with interpersonal conflict as well as uncontrollable feelings and actions of self-harm.  His depressed mood and constricted affect are evident, as well as the collateral information offered by the mother illustrates symptoms of depression (American Psychiatric Association, 2013).  His perceived lack of social support would make him a good candidate for group therapy to treat his depression.    

            An effective group therapeutic intervention for depressed adolescents is group cognitive behavioral therapy (CBT) (Keles & Idsoe, 2018).  CBT works by identifying and changing some of the automatic thoughts that are leading to maladaptive behaviors and coping.  Considering the prevalence of depression across all ages, particularly adolescents, group CBT is an appropriate and effective treatment (Keles & Idsoe, 2018).  One of the other factors that makes group CBT effective is the social support that is offered in the group setting (Nardi, et al., 2017).  This client has verbalized a lack of emotional support and understanding among peers, so the social support offered in the group would be appropriate and effective for this client.  Group CBT shows effect for adolescents with depression and anxiety that persists beyond the treatment duration (Rith-Najarian, et al., 2019).  The projected outcomes for this client are positive related to the effectiveness of group CBT.   

Counseling a group of adolescents has ethical and legal implications related to consent and adherence to treatment programs, as the adolescents are often forced into treatment by parents.  This can make it challenging for providers when the adolescent clients are not interested or invested in treatment.  However, this case study presents a client who appears interested in seeking help and treatment related to his symptoms.  It is important to consider the client’s consent ethically even when the legal consent is obtained by the parent or guardian. 

References

American Psychiatric Association.  (2013).  Diagnostic and statistical manual of mental

disorders (5th ed.).  Retrieved from https://dsm-psychiatryonline-

org.ezp.waldenulibrary.org/doi/book/10.1176/appi.books.9780890425596

Keles, S., & Idsoe, T.  (2018).  A meta-analysis of group Cognitive Behavioral Therapy

(CBT) interventions for adolescents with depression.  Journal of Adolescence, 67,

129-139.  doi:10.1016/j.adolescence.2018.05.011.

Nardi, B., Massei, M., Arimatea, E., & Moltedo-Perfetti, A.  (2017).  Effectiveness of

group CBT in treating adolescents with depression symptoms: A critical review. 

International Journal of Adolescent Medicine and Health, 29(3), 854-860. 

doi:10.1515/ijamh-2015-0080.

Rith-Najarian, L.R., Mesri, B., Park, A.L., Sun, M., Chavira, D.A., & Chorpita, B.F.

(2019).  Durability of cognitive behavioral therapy effects for youth and

adolescents with anxiety, depression, or traumatic stress: A meta-analysis on

long-term follow-ups.  Behavior Therapy, 50(1), 225-240. 

doi:10.1016/j.beth.2018.05.006.

Wheeler, K.  (Ed.).  (2014).  Psychotherapy for the advanced practice psychiatric nurse:

A how-to guide for evidence-based practice.  New York, NY: Springer.

Overview: All students will read the following HPE case study related to discerning between research and non-research during program implementation. There are many blurred lines between research and evaluation, so careful consideration of research and non-research activity is essential to ensure ethical practices are carried out at the onset of the program implementation and evaluation process.

Case Study: The CDC funded 5 health departments to develop programs to provide HIV prevention and referral services to HIV-infected persons. The project objectives included increasing the proportion of HIV-infected persons who know their HIV serostatus as early as possible after infection, providing HIV prevention services to infected persons to reduce the risk of transmission to others, and assisting HIV-infected persons in accessing medical and other needed services. Grantees were encouraged to tailor their interventions to local circumstances, and the funding supported local evaluations of the effectiveness of the interventions in each site.

The grantees provided an array of services to a mix of target populations based on their location. The CDC’s perspective was that the primary intent of the program was to provide services targeted to local community needs, and the primary intent of the evaluations was to improve those services. Thus, the project was deemed to represent non-research by the CDC. However, it was anticipated that, as a secondary benefit, the projects also would provide information—or lessons learned—that might be useful elsewhere.

Although the CDC did not consider the evaluation component of the program to constitute research, some participating health departments differed in this assessment and sought institutional review board (IRB) oversight. At sites where local IRB review was invoked, implementation was delayed up to 1 year. Confusion over whether the program constituted human subjects research resulted in the loss of formative pilot data at 1 site when a local IRB determined that appropriate approvals were not in place. Also read: HIV Rates in Black Men

Assignment: After reading the case study, write a discussion that addresses the following:

· What are the potential ethical considerations in this scenario? What are the main risks for participants in the program?

· Explain the unintended consequences that may occur from the participants’ perspective if the evaluation of the program is deemed research and informed consent is obtained? How might this change impact the participants’ behaviors, attitudes, and/or trust in the program?

· What are the unintended consequences of labeling this evaluation as non-research? How might this impact the program or future programming?

· Which entity was correct in their assessment of the evaluation’s research status (i.e. was this research or non-research)?