Question

A 17-year-old client with a diagnosis of Bipolar Disorder comes to a first session with her parents. The mother informs you that their daughter met with a psychiatrist who prescribed medication, but the family's faith prohibits her from taking it. The parents tell the therapist they have been trying to "rid her of her demons by praying and relying on our faith." You notice that the girl appears disheveled, is frequently distracted during the session, and seems agitated. What actions should the therapist take in this case:

A. Report the situation to CPS because client is a minor and she is not receiving proper treatment
B. Initiate involuntary hospitalization since the client is exhibiting clear signs of psychosis
C. Begin treatment with the client and maintain confidentiality due to religious exemptions with child abuse reporting
D. Explore the pros and cons of taking psychotropic medications with the parents and their daughter, while acknowledging their religious rights.

Answer 1

The therapist should discuss the pros and cons of psychotropic medications with both the 17-year-old client and her parents, considering the family's religious beliefs and the client's right to effective treatment. The therapist must weigh the client's well-being and safety against religious exemptions and legal mandates to avoid immediate drastic actions like CPS reporting or involuntary hospitalization.

Step-by-step explanation:

In the scenario where a 17-year-old client with Bipolar Disorder is accompanied by parents who refuse psychotropic medication due to religious beliefs, the therapist should navigate various factors, including the client's well-being, legal implications of treatment refusal, and respecting religious rights. Firstly, the therapist should assess the severity of the client's condition and whether the client is at risk of harm to herself or others.

Addressing option D, the therapist should engage in exploratory discussions with the family regarding the pros and cons of taking psychotropic medications for Bipolar Disorder. It is crucial to provide comprehensive information about the benefits of medication and the potential risks of untreated mental illness. Acknowledging the family's religious rights and beliefs, the therapist can facilitate an informed decision-making process while also exploring alternative or supplementary treatment options acceptable to the family, such as psychotherapy or other non-pharmacological interventions.

In this context, while maintaining professionalism and a supportive environment, the therapist must also be aware of state laws concerning child neglect and the standard of care for mental health treatment. The therapist should not immediately report to CPS or initiate involuntary hospitalization without thoroughly assessing the situation and considering the least restrictive alternative that can ensure the client's safety and well-being, while also respecting the family's religious beliefs. If the client risks significant harm due to lack of treatment, then options A or B may need to be considered following appropriate professional and legal guidelines.