Psychiatric Disorders Linked to Trauma Essay

Psychiatric Disorders Linked to Trauma Essay

Select a client whom you observed or counseled that suffers from a disorder related to trauma. Then, address the following in your Practicum Journal:

  • Describe the client (without violating HIPAA regulations) and identify any pertinent history or medical information, including prescribed medications.
  • Using the DSM-5, explain and justify your diagnosis for this client.
  • Explain whether any of the therapeutic approaches in this week’s Learning Resources would be effective with this client. Include expected outcomes based on these therapeutic approaches. Support your approach with evidence-based literature.
  • Explain any legal and/or ethical implications related to counseling this client.

NOTE

PLEASE WRITE THE ABOVE ON THE FOLLOWING SB HEADINGS

  • Describe the client that you counseled that suffers from a disorder related to trauma
  • Pertinent history or medical information, including prescribed medications.
  • Using the DSM-5, explain and justify your diagnosis for this client.
  • Explain whether cognitive behavioral therapy would be effective with this client.
  • Expected outcomes based on this therapeutic approach. Support your approach with evidence-based literature.
  • Explain any legal and/or ethical implications related to counseling this client Psychiatric Disorders Linked to Trauma Essay.

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Describe the client that was counseled and suffers from a disorder related to trauma.

Susan is a 69 year-old retired teacher who has been referred for psychiatric assessment and treatment. She reported that she has widespread pain in hips following a bad fall that she had two years ago that required surgery. She is very bitter that despite losing her husband to a workplace accident when she was 36 years of age, she strived to offer her two children the best possible parental care that included good education that meant she was left with little savings for her retirement. Despite her efforts, her children have abandoned her and left her to live on her own with no contact or even financial help. Given her advanced age and since hiring help is expensive, she has been left to live on her own thereby becoming an easy target for robbers. In fact, her fall came about when she woke up having realized that robbers were in her house. The abandonment by her three children who haven’t seen her or even communicated with her in the last four years have resulted in her having a poor mood. She is even considering suicide and does not want her children to know about this since it would cause them to visit her out of guilt.

  • Identify any pertinent history or medical information, including prescribed medications.

Susan’s physician initiated Fluoxetine treatment to improve her mood while prescribing Fentanyl and Gabapentin for pain management. Osteopathy and physiotherapy had initially been started but were later discontinued since they did not have much benefit. An MRI check shows that she has a normal hip bones with no fractures or breaks, while blood tests do not show any remarkable abnormalities. Clinical exam shows that she has a lot of tender points. During her most recent visit, she reported suffering from anxiety and depression. Her pain medication has since been switched to Duloxetine while she is undergoing psychiatric treatment for post-traumatic stress disorder (PTSD) exhibited by the low mood, anxiety and depression. The PTSD treatment involved cognitive behavioral therapy (CBT) that entails weekly group sessions.

  • Using the DSM-5, explain and justify your diagnosis for this client.

Susan is suffering from low mood, anxiety and depression that resulted from PTSD. The PTSD was caused by abandonment by her family and the traumatic event when the robbery caused her to fall and hurt her hips. Following the robbery incidence and fear of being hurt by another robber as well as the abandonment by her family that makes her feel worthless, her lifestyle changed into an almost housebound women who relies on significant support from her neighbors to run errands. DSM-5 mentions that PTSD symptoms can be so debilitating and distressing that they cause anxiety, depression and changes in mood. That is seen in the present case, since the robbery incidence and abandonment by family members has caused Susan to detach herself from activities that she could previously conduct with ease, as seen in her not willing to leave the house and run errands. Besides that, she meets the condition for Criterion A in PTSD diagnosis since she was directly involved in a traumatic event as a victim of home robbery incident. During that event, she fell down and sustained hip injuries that required her to be hospitalized (American Psychiatric Association, 2013).

  • Explain whether cognitive behavioral therapy would be effective with this client.

CBT would be effective in addressing Susan’s PTSD. That is because it focuses on targeting the relationship between behavior, feelings and thoughts, while targeting the current problem event as it changes patterns of feelings, thoughts and behaviors that led to the symptoms. This means that using CBT would change how she associates objective reminders of the robbery incident, its meanings and responses to cause healthy functioning (Wheeler, 2014). For instance, getting her to understand that although the she was the victim of a robbery incident and has not had contact with her three children in years, it does not imply that her life does not have much value and she should contemplate suicide. Instead, she should consider this as a life event and find ways of making the best of her life by engaging in enjoyable activities that keep her busy Psychiatric Disorders Linked to Trauma Essay.

  • Expected outcomes based on the therapeutic approach.

The expected outcome is that Susan would stop associating the experience of the robbery incidence and abandonment by her family with existing beliefs of about herself and others. This would see her stop seeing herself as a worthless individual who is of no value to her family. Instead, she would consider the robbery incident as an abnormal event whose possibility of occurring again would be minimized if she secured her home. Also, the abandonment by her family should be viewed as her three children failing to appreciate the sacrifices that she made and the effort she put into parenting. That means that her belief would change from associating her bad experiences with having made mistakes, to simply accepting that these experiences are oddities (Wheeler, 2014).

  • Explain any legal and/or ethical implications related to counseling this client.

Counseling this client has an inherent ethical implication since the therapist would have to question whether to abuse the client’s trust and confidentiality expectations by reporting to her children that she is contemplating suicide. If she fails to involve her children, then the patient’s mood could still remain down thus failing to eliminate her justification for considering suicide. On the other hand, if the therapist violates the trust that the patient placed in her as well as confidentiality expectations, then the children are likely to respond positively and establish contact with their mother to eliminate the suicide ideation (Gunn & Taylor, 2014). As such, the ethical concern is whether the therapist should respect the client’s request that her family should not be informed about her suicide ideation thus increasing the possibility that she would commit suicide, or violating the trust and confidentiality by involving the children to save her life.

References

American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

Gunn, J. & Taylor, P. (2014). Forensic psychiatry: clinical, legal and ethical issues (2nd ed.). Boca Raton, FL: CRC Press.

Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (2nd ed.). New York, NY: Springer Publishing Company Psychiatric Disorders Linked to Trauma Essay.

 

 

 

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