Diagnosis from Diagnostic and Statistical Manual of Mental Health Disorders, DSM-5 and justification

The most likely DSM diagnosis for the patient is Major Depressive Disorder, recurrent episode, severe with psychotic features.

I diagnosed the patient with Major Depressive Disorder, recurrent episode, severe, with psychotic features because of the symptoms she is exhibiting like being sad, anxious, depressed most of the time, cutting self ,suicide attempts by overdose on acetaminophen. He continues to be withdrawn to self. According to the American Psychiatric Association (2013), this diagnosis can be specific if the patient exhibits signs of anxiety, with melancholic features; or mixed with atypical features and mood-incongruent psychotic features. Also, if the patient has during the same 2-week period shown five or more of the following symptoms: In the case study the patient continues to manifest

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Depressed mood example, feeling sad, empty, or hopeless (most of the day, nearly every day) 

 clearly diminished or loss of interest or pleasure in all, or almost all, activities most of the day, nearly every day

-Feelings of worthlessness as stated by patient after the breakup.

-Fatigue and loss of energy nearly every day

-Insomnia nearly every day.

-Recurring and persistent suicidal ideation without or a suicide attempt or a precise plan for committing suicide.
The above symptoms enumerated are based on what is specific on the patient from the list in the DSM-5 because this is what the patient presents with (American Psychiatric Association, 2013). Also, Oyama and Piotrowski (2013), states that depression is mostly used to express diverse feeling.

Explain group Therapeutic Approaches you might use with this Client

CBT is the treatment modality I will use to treat the client through cognitive restructuring and positive self-talk to eliminate negative thoughts. It attempts to correct cognitive distortions, particularly negative conceptions of one’s self.

Possible ways of coping with these feelings discussed along with activities that may help to reduce the symptoms.

Explain Expected Outcomes for the client based on these Therapeutic approaches

Open Communication with therapist and staff about depression

Improved sleep patterns

Reduced Anxiety

Legal and/or ethical implications related to counseling each client

            Ethically both the child and parents should be involved in the child’s healthcare decisions. According to Vitello (2013the parents give legal consent for treatment and thus the physician ought to carry the parent along with treatment plans, and medication management. Communication is important because any misunderstanding between parent and prescribers’ instruction can be harmful to the child. Effective communication between the parent and the provider is important because the parent is accountable to guarantee that the child is medicated as ordered and to report any adverse effect. Purnell (2014) advices that understanding communication styles, the cultural variances and values, and other communication competencies is important to be acquainted with the patients from different cultures.  


American Psychiatric Association. Task Force on DSM-IV. (2013). Diagnostic and statistical      manual of mental disorder: DSM-IV. Washington, D.C.: American Psychiatric.

Oyama, O. P., & Piotrowski, N. P. (2013). Depression. Magill’s Medical Guide (Online Edition).

Purnell, L. D. (2014). Guide to culturally competent health care. F.A. Davis.

Vitello, B. (2013). How effective are the current treatments for children diagnosed with    manic/mixed bipolar disorder? CNS Drugs, 27(5), 331-333. doi:10.1007/s40263-013-     0060-3 https://mym.cdn.laureate-  media.com/2dett4d/Walden/NURS/6630/02/mm/therapy_for_pediatric_clients_with   mood disorders/1.html

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