Anxiety Disorder in an Adolescent: Specific Phobia (Claustrophobia)

Discussion: Clinical Supervision Clinical Supervision is an essential component of your development as a psychiatric mental health nurse practitioner. It provides an opportunity for professional collaboration as you share experiences with and gain insights from colleagues. For this Clinical Supervision, consider a client whom you do not think is adequately progressing according to expected clinical outcomes. Anxiety Disorder in an Adolescent: Specific Phobia (Claustrophobia).   Learning Objectives Students will: Analyze clients presenting for treatment of anxiety disorders Evaluate effectiveness of therapeutic approaches for clients diagnosed with an anxiety disorder To Prepare: Review this week’s Learning Resources concerning treating patients with anxiety disorders. Reflect on a child or adolescent client you are currently counseling or have previously counseled at your practicum site who has been diagnosed with an anxiety disorder. Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click submit, you cannot delete or edit your own posts and cannot post anonymously. Please check your post carefully before clicking Submit! By Day 3 Post a 3- to 5-minute Kaltura video in which you do the following: Describe the client. Note: Do not use the client’s actual name. Explain your therapeutic approach with the client, including the perceived effectiveness of your approach. Identify any additional information about this client that may potentially impact expected outcomes.Anxiety Disorder in an Adolescent: Specific Phobia (Claustrophobia).

The client is a 15 year-old adolescent African American female with a diagnosis of specific phobia (claustrophobia). This diagnosis was confirmed after she met the DSM-5 diagnostic criteria for specific phobias (Sadock et al., 2015; APA, 2013). She had been having symptoms of the condition since her childhood, but the diagnosis was only officially made four weeks ago. Her symptoms have now become so severe that she cannot be in an elevator even if there are other people with her. The decision had been taken to start her on psychotherapy first, with the option of adding off-label sertraline (Zoloft) if psychotherapy alone fails (Stahl, 2017). According to the DSM-5, the prevalence of specific phobias among 13-17 year-olds is 16% (APA, 2013). The evidence-based psychotherapeutic treatment she was put on is cognitive behavioral therapy or CBT.

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            CBT is concerned with changing the way a client thinks. This is because how one thinks in a pathophysiologic sense affects their behavior. This way, irrational thoughts result in behavior that would otherwise be regarded as abnormal (such as the fear of enclosed spaces that this client has). CBT is therefore about cognitive remodelling or re-engineering (Corey, 2017). My therapeutic approach with the patient is to offer weekly CBT sessions on an individual basis with the client. This has been going on for the past three weeks. CBT is known to be effective as the non-psychopharmacologic therapy of choice for managing specific phobias such as claustrophobia (Corey, 2017). For this reason, it is expected that this teenager will respond to the treatment even though it is still early days. Additional information about this client that may impact her treatment is that she was sexually and physically abused as a child and this compounds her anxiety disorder.

References

American Psychological Association [APA] (2013). Diagnostic and Statistical Manual of Mental Disorders (DSM-5), 5^th ed. Author.

Corey, G. (2017). Theory and practice of counselling and psychotherapy, 10^th ed. Cengage Learning.

Sadock, B.J., Sadock, V.A., & Ruiz, P. (2015). Synopsis of psychiatry: Behavioral sciences clinical psychiatry, 11^th ed. Wolters Kluwer.

Stahl, S.M. (2017). Stahl’s essential psychopharmacology: Prescriber’s guide, 6th ed. Cambridge University Press. Anxiety Disorder in an Adolescent: Specific Phobia (Claustrophobia).