Week Six Discusson Post and Responses HSBE

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Psychology

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Jan 9, 2024

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Discussion Six Response In the literature for this week, we learn about a 14-year-old, biracial female of African and Irish American background named Dani. This individual is currently residing with her patients in a middle-class suburban area. We know she is the youngest [of three children] and the only one in the house. The parental history tells us that the parents were married 25 years ago and that her father works in the creative arts. Second, he has nontraditional work, leading him to work overnight, sleeping well into the mid-day. The family's mother is an executive, working long hours and limiting interactions. Medical history showed a history of sickle—cell anemia in early childhood and multiple hospitalizations due to this in childhood. The current health trajectory is stable and devoid of any concerning episodes in two years. In the reports In the reports given by Danis Patents, there has been a change in middle school in Danis's demeanor and presentations. Before that, Dani was significantly open and easygoing, with hobbies in singing and peer/family activities. When asked, Dani has declined any current problems regarding drug or substance use but admitted to episodic usage of drinking with social instances. According to Dani, the current state of the family is tense, and the patient's differences with the patient's treatment, the father being more accessible and letting Dani do what they want, and the mother being controlling. The interpersonal relationships with Danis's brother are "cool," and their sister is "not cool." In the past, Dani's parents have tried, without success, counseling for the maladaptive behaviors presented at the recommendation of the school. Some of the concerning behaviors included argumentative behaviors [particularly authority figures when confronted], physical altercations with peers, attention problems, mood dysregulation, and sexual behaviors with males. A teacher witnessed the sexual behavior, with Dani being intimated with a male peer in the bathroom. When at home, physical threats mixed with argumentative are common [directed at patients]. Drinking when patients are out of town is standard, along with sleep instability [sleeping during the day, waking at night]. When the first meeting was indicated, there were clear signs of agitation, frustration, and argumentation during the intake. Due to these conditions, Dani opposed discussing the issues presented, externalizing the situation, and blaming the problems on her patients and herself. Dani's mother voiced apparent frustration for not showing her the recent tattoo Dani got by utilizing a fake ID that was illegally pursued. When discussing the outcomes of the treatment, the mother wanted to have a vision for the benefit of her daughter, hoping for attitude change and improvement. Individual and family therapy will be provided for seeing the family in distress.

The family dynamic, in this case, is essential. When meeting with Dani individually, there is a dynamic shift after her sister leaves for college. Seeing that her patients have stopped being present, Dani believes that her patients are only current when her sister is in town. Due to that, spending time with herself has caused her behavior to be investigated. Dani expressed the comparisons she and her sister would get in social circles. Dani stated that her sister is the "A student" and that the teachers would often compare each other, making her feel judged and unsuccessful. During the conversation in the family meetings, the father left concerned about Danny's behavior, concerning them to be a phase of teenage maturing. During the meetings, the parents disagreed, blaming both parties for their daughters' behaviors at school and home. Being mindful that this family realities state that they are both a biracial family and raising mixed- race children needs to be addressed. When discussing therapeutic approaches, their family history and the role of acculturation and assimilation to the social norms and environments from which the respective family of origin comes are to be addressed. While discussing their child's behavior, educating both parents and psychoeducation about race and social development along with class privilege could be utilized in helping them understand their child's barriers and difficulties being faced. When discussing the therapeutic approaches that would benefit this family, we must consider Dani's impulsivity toward risky decision-making; not only does this mitigate hope for a bright future, but it is also an external and internal stressor for the entire family, and due to the stress the negative cognitions are heightened, leading to more adverse comorbid symptoms such as depression and need for "distractions" such as self-harm behaviors (Flahertly et al., 2018). It is the normative understanding that teenagers struggle with mood stability and communication within family dynamics due to the need for power and control (Zastrow et al., 2018, p.400). Due to this outcome, most teenagers do not understand the consequences of their risk- taking behaviors and their correlation to relationships with others (Casey et al., 2015). Dani's behavior demonstrates the consequences that can result in family conflict, the strain on her parent's marriage, safety compromise, illegal alcohol use, and also financial issues that can be consequently constructed from these issues. According to Identity VS Role Confusion by Erickson, teens can struggle with the question of "Who am I?", furthering questions regarding their physical appearance, career aspirations, education, sexual activity, political and social views, and interpersonal dynamics (Zastrow et al., 2018, p. 323). at this stage, the exploration can expand with their self-identity and self- concept. People who need help to integrate these many roles and challenges may have difficulty coping with conflicts in their interpersonal lives, leading to significant role confusion (Zastrow et al., 2018, p.323 & NAMI, 2023). Understanding the consequences of failure to resolve conflict at this stage

may lead to withdrawal further into social isolation or becoming lost in the crowd mentality, therefore increasing the risk of suicidal ideation or intent. Thus, making the situation exacerbated Dani's circle of friends. While being bicultural and multicultural, Danny must wrestle with the questioning of how and to what extent they will identify with their cultural norms surrounding the social and cultural etiquette and norms of their family. Clearly, in the study about Dani, he is hanging out with individuals who are not only drinking alcohol but consuming significant levels of alcohol. With its high level of alcohol consumption, negative peer pressure can lead to a higher chance of risk in decision-making (Zastrow et al., 2018, p. 205). Alternatively, they are engaging in poor behaviors that would qualify as problematic and cause distress alone or in the presence of their own family. Utilizing an environment that supports and accepts the individual for differences can increase adaptive behaviors in the self, mitigating self-harm tendencies ( Flahertly et al., 2018). Bluth & Eisenlohr-Moul (2018) showed that mindfully approaching the developmental tasks of adolescence is already tricky and not easy to complete as a child. However, it is almost not uncommon for it to trigger various psychological problems in children, which can be highly exaggerated by substance use and mental health issues; however, when engaging in mindfulness and practices that encompass that can mitigate the effects of substance use, risk-taking behaviors, and other adverse consequences. When understanding the theoretical frameworks for cognitive skills in the arts and their association with thinking in adolescents, these frameworks often develop around adolescent years and continue to grow in other developing areas (Zastrow et al., 2018, p. 289). When Dani is crying out and showing that her emotions are becoming intolerable, this can be perceived as high-risk behavior often associated with impulsivity and damaging interpersonal relationships. Furthermore, high-risk behaviors can include physical self-harm, riskless behavior, and impulsivity (Flahery et al., 2018). Physical self-harm can be cutting, burning, pulling out hair, or any other bodily harm. Likewise, self-harm behaviors can lead to severe illnesses associated with post-traumatic stress disorder, eating disorder, borderline personality disorder, and depression (NAMI, 2023). When all of these expenditures have been done, an individual may feel that self- harm or suicidality may be the only option to get out of the stressor or perceived distress. Dialectical Behavioral Therapy, Cognitive Behavioral Therapy, and Psychodynamic therapy may help the individual with the issues that Danny presents in the case study (NAMI, 2023). DVT would be the most influential treatment option for high-risk behaviors. DBT can utilize skill training to control intense emotions, mitigate self-destructive behaviors, and improve interpersonal relationships. Cognitive behavioral therapy may also be used with Danny and their family in talk therapy. Specific areas of emotional regulation, interpersonal effectiveness, psychoeducation on drug and alcohol misuse, and sense of self could be utilized. Marriage counseling and parental skills in therapy sessions could be used for her parents.

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