When dealing with a pediatric case, especially when it comes to dealing with adolescents. Given the fragile nature of their developmental stage, their treatment needs to be carefully planned. In a clinical situation where the patient is a young girl who is experiencing active suicide ideations. Accompanied by thoughts of hanging herself using a telephone knife. She says that she has imaginary friends whom she prefers talking to instead of her non-imaginary friends. Although she knows that they are not real she sometimes appears sad, has poor eye contact and demonstrates poor social skills. She also reported having feelings of worthlessness, helplessness and hopelessness. Her mother is quite protective of her, but her father has had issues with addiction.
The developmental tasks of the family are the growth responsibilities that arise at certain stages in the family. In the family, the duties of the adolescents are to become independent and develop their identity. The adolescent is a difficult stage of the youth and the family as well. Linda has become more dependent on her parents, especially her mother rather than becoming more independent. The developmental tasks of an adolescents also include exploring different attitudes towards the life of a family, child bearing, and attain the necessary knowledge for home management and bringing up the children. Another task is the ability to participate responsibly while at home with friends and in the society as well develop moral values and proper behavior
Linda does not seem to have achieved any of the above tasks. Often adolescents affected by depression fail to have slow or in some case stunted development.
Parental alcoholism has an effect on the elaboration of the adolescent as well as the proper functioning of the family. The extent of the effects is dependent upon the coping skills and the self-worth that the teenage places for themselves (Garrison, 2016). They also tend to exhibit anti-social behavior (Garrison, 2016). They are either too forceful or too passive. They do not form friends quickly; they are withdrawn in classrooms and social settings. Research also shows that there is a significant relationship between having an alcoholic parent and having a mental health illness as an adolescent. Depression is an effect of living with a dysfunctional family, particularly when the parent is violent or has an addiction problem (Garrison, 2016). Households with a parent who is addicted or with violent tendencies are likely to be dysfunctional. They have difficulties relating to healthy families do: often the children have to take up roles that are meant for their parents. The children may also experience stunted growth as a defense mechanism of the parental addiction. Children from dysfunctional families experience high levels of psychological distress compared to those from healthy functioning families. They also tend to undergo higher rates of juvenile delinquency, they lack proper care and attention and tend to act out. Children from families with addicted fathers tend to turn to drug and substance abuse. Parental substance abuse is a strong predictor of the use of the drug in the adolescents.
In this case, the caregivers recommended the use of medical treatment for the patient accompanied by therapy and the removal of the child from the home environment for some time to help with the recovery. This proposal was presented on the basis that a new environment would help her recover or develop new social skills. The interview techniques worked, although the patient did not speak as much (M A Plant, 2005). Her mother spoke on her behalf and answered most of the questions. The interview techniques did not work as expected. The patient was reluctant to give a family overview she was still afraid, despite attempts by her parents and her caregivers to make her at ease.
The first step during the interview was to introduce the caregiver to the patient, the parents or the guardians. During this stage, the caregiver created an easy going conversation with the patient about school, teenage activities including hobbies and other school activities the patient may be interested in (M A Plant, 2005). However, at this step the caregiver failed to bring the patient out of her shell in that she kept nodding and shrugging her shoulders rather than giving clear answers. The patient refused to respond to the questions, and the parent had to interject and give the relevant information on her behalf. In a different case involving a teenager or an adolescent, I would change the setting of the interview to an open location where the patient would feel more comfortable. I would also ask the parent to leave the room after the initial introductions. In the first place, I would request the patient to introduce themselves as well as the guardians that are accompanying them (M A Plant, 2005).
The family systems theory establishes that the family is best understood by conceptualizing the family as a complex, compelling and changing selection of parts, subsystems and family members (Hammond, Cheney & Pearsey, 2016). The application of this approach views treatment as wholesome. It seeks to treat the patient’s whole family rather than the specific adolescents. In this case, this approach is used while trying to mend the relationship between the Linda and her parents. By showing them that their relationship can be improved, the aim is to ease all of them back into their developmental tasks. This intervention method involves the associating with all the family members and engaging them in the recovery processes. Talking to the mother about standing up to her husband and asking him to commit himself to a rehabilitation facility is part of the proposed intervention method (Hammond, Cheney & Pearsey, 2016).
The care plan for the patient and the family would involve medical and non-medical interventions (Hammond, Cheney & Pearsey, 2016). The medical interventions include giving her antidepressants which will elevate her moods and help her to associate with other people pleasantly. It will also help with her anti-social behavior and help her cope with her school life. The proposed non-medical approach for Linda would include individual, family, and group therapy. The individual therapy will help her reestablish herself and achieve all the developmental steps as expected for her age. The family therapy will help them improve their relationship with a family. Developing their relationship will provide a stable home for Linda to recover and grow up in a support group for adolescents dealing with depression. A support group may help Linda open up about her issues and relate with others on the same level as she claims relating to her imaginary friends.
There is a prevalence of adolescents who suffer from depression, especially those who are from disturbed families. Treating adolescents suffering from depression takes special care because they are not typically receptive to help. They tend to be hostile towards their caregivers or their parents. There are special techniques that should be applied when it comes to dealing with pediatric patients. A proper plan of care is essential to getting through to the patient and ensuring that they recover without any chance of recurrence. It would also help in equipping her with coping skills to prevent recurrence.
References
Garrison, B. (2016). How teens cope with addicted parents. Udel.edu. Retrieved 22 March 2016, from http://www.udel.edu/PR/Messenger/05/03/how.html
Hammond, R., Cheney, P., & Pearsey, R. (2016). Sociology Of The Family : 03 Sociological Theories Of The Family. Freesociologybooks.com. Retrieved 22 March 2016, from http://freesociologybooks.com/Sociology_Of_The_Family/03_Sociological_Theories_Of_The_Family.php
M A Plant, M. (2005). The effects on children and adolescents of parents' excessive drinking: an international review. Public Health Reports, 104(5), 433. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1579958/
