Nursing. Treatment - Assignment Example

? Please use this document to help you organize information about the couple and to begin formulating your treatment plan and interventions. The goalis to get a large amount of fairly complex information into a succinct format so that you can directly relate it into the best treatment for the couple. You may fabricate some of the details for the assignment (e.g. Date of Birth). In addition to the required assignment for this class, you can make use of this document to prepare for supervision and case presentations. Feel free to change it to make it work for you. I. IDENTIFYING INFORMATION PSEUDONYMS or INITIALS Ben Katie DOB & AGE Early 40s Early 40s GENDER Male Female OCCUPATION Writer/engineer House wife RELATIONSHIP STATUS Working but potentially at risk. FAMILY CONSTELLATION Strong-family bond. LANGUAGE SPOKEN TOGETHER English LANGUAGES SPOKEN English English CULTURAL/ETHNIC IDENTIFICATION American culture American culture HOME ENVIRONMENT Organized, but sometimes troublesome. CLINICAL SETTING Partially established for the main time. OTHER IDENTIFYING INFORMATION With supportive friends. Couple has undergone series of counseling activities. NAMES & AGES OF CHILDREN Josh, 12 and Erin, 10 PREVIOUS MARRIAGES/LONG-TERM RELATIONSHIPS Only married to Katie Only married to Ben COMMITMENT LEVEL (1-10) 8 8 II. REASON FOR REFERRAL (include specific requests of individual therapists and each partner’s reasons for entering therapy at this time) Therapists: Husband and wife at this time require the opportunity to receive the right counsel concerning the status of their relationship. They have been together for fifteen years, but now their relationship is shaken and put to the test. Their individual differences are something that they need to realize at this point, and these are something worth pondering about, because they need to realize that they cannot be the same at all times in their opinion, stand, and taste and so on. Each of them must realize that they each individual is entirely different and needs the appropriate words to eliminate the probable confusion that they might have in each of them for now. Each of them might think of different things at certain point, and this is something that the couple should learn to understand. Each of the couple requires the opportunity to be exposed to understanding the reality about being a husband and a wife, that each individual role has certain deeper responsibility that should be employed. Husband: The need to be understood and not the other way around is an essential consideration prior to preventing conflict with wife. Wife: The opportunity to understand husband and wife roles, and knowing how to eliminate the tendency to dominate in a relationship, and erase poor concepts that both partners are not willing to employ. III. HISTORY (add sections as needed, but keep it brief) GENERAL COUPLE HISTORY The couple has been together in marriage for 15 years. The husband and wife have substantial experience in being together at this point, both positive and negative things, good and bad experiences, in goodness and in health, better and worse case scenarios, and so on. The couple has established a strong foundation in their relationship, and both the husband and wife are hesitant to show to their two children the real score behind their relationship. TREATMENT HISTORY & EACH CLIENT’S PERCEPTION OF Tx OUTCOME The husband, together with his wife underwent couple of clinical counseling regarding the aspects that touch the married life. The husband experienced conflict management program, sexual-related matters, and family-related counseling activity. The husband’s perception of the outcome at some point was positive, for it is something in line with his expectation. Technically, it is the same treatment history that the wife experienced, because they resolve the matter together with her husband. The perception of the outcome, just like the husband was positive, because it is a product of what they believe was the right thing to do. CONCERN #1 The wife has been employing concepts or ideas that the husband is not willing to accept or exercise. Date of Onset September 2013 Intensity Requires a remarkable attention at this time, for it has the potential to lead to separation. Frequency This is most often to take place. Duration It lasted for more than three years now. Anything that exacerbates concern Constant quarrel or argument that will always lead to emphasizing one’s past mistakes. Each client’s explanation The husband is determined to consider the point that his wife has become so possessive, at some point. The wife is determined in her belief that her husband is not willing to understand her point of views. CONCERN #2 The husband is most likely misunderstood by his wife, which in return will result the same level of response from the husband or even worst. Date of Onset September 2013 Intensity This is something that will always ignite quarrel and has the potential to break the marriage bond. Frequency This is most often to take place. Duration It lasted for more than three years now. Anything that exacerbates concern The inability of the wife to give what the husband is expected of her, because of probable misunderstanding of concepts along the way. Each client’s explanation The husband believes to be misunderstood in most of the time by his wife. The wife believes that her husband is not willing to understand her and is trying to set roles for themselves, which she believes she ended up to play with the inferior one. IV. CLINICAL ASSESSMENT COUPLE STRENGTHS Couple has become so open with communication, and both husband and wife are after of establishing the welfare of their children. FAMILY STRENGTHS Parents of the couple have established ideologies within the husband and wife, which can lead to strong marital bond. Children are sensitive to relationship of their parents, which provides a balancing act to establish the family at the right way. PSYCHOSOCIAL STRESSORS Events at the workplace, ideas and interaction with friends, family ideologies, past experiences STAGE(S) OF DEVELOPMENT From birth to maturity stage, most specifically in the presence of environmental influence. HISTORY OF & CURRENT AFFAIRS It started as a mere practice of freedom of speech, but it strongly resulted to misconceptions and failure to establish meaningful level of understanding on the part of the couple. INTERACTION WITH LEGAL SYSTEM Not remarkable so far at this point. INTERACTION WITH MD The husband has not yet possibly considered this option so far at this point. The wife has not yet possibly considered this option so far at this point. ATTEMPTS TO RESOLVE CONCERNS & LEVEL OF SUCCESS The couple considers the option to establish more time with their children and for themselves. They ended up separated for a while and then reconsidered coming together to give each other a chance to start anew. There was an indication of potential success at some certain level. MEDICATIONS & DOSAGES Not remarkable. Not remarkable. ALCOHOL & SUBSTANCE ABUSE (current & historical) No indication of alcohol and substance abuse. No indication of alcohol and substance abuse. DOMESTIC VIOLENCE (current & historical) Domestic violence is not remarkable. No sign of it in the first place. V. LEGAL & ETHICAL CONSIDERATIONS CRISIS MANAGEMENT ISSUES The couple, considering past experience of counseling activity has the greater strength to manage the crisis that is going through right now. DIVERSITY CONSIDERATIONS Raised in the same culture and almost the same ideologies, the couple may not find hard time to consider the issue of diversity. SCOPE OF PRACTICE Couple has the knowledge to experiment with their relationship, thus the scope of practice is somewhere at a good standing. SCOPE OF COMPETENCE Couple has established competence to employ whatever is necessary due to prevailing knowledge. ETHICAL CONSIDERATIONS There is established moral and ethical standard for both the husband and the wife. The children have substantially adopted this one. LEGAL CONSIDERATIONS Legal considerations may not be necessary for now, but in a worst possible case, it is a positive option to take. VI. DIAGNOSIS – USE DSM 5 (American Psychiatric Association, 2000). Name: Ben Jordan Name: Katie Jordan Personality disorder (maladaptive coping skills) Stressor-related disorder Conduct disorder (angry irritable mood – oppositional defiant disorder) Personality disorder (maladaptive coping skills) Stressor-related disorder Conduct disorder (argumentative/defiant behavior – oppositional defiant disorder) In general, there is a strong presence of emotional problem. In general, there is a strong presence of emotional problem. VII. ASSESSMENT (include as many assessment devices as appropriate, a thorough clinical interview can count as one assessment if that is the preferred assessment method in your theory) DEVICE #1 Clinical interview Rationale In the case of the couple, history is necessary to be unveiled, thus an interview is necessary to discover the necessary assessment. DEVICE #2 General psychological test Rationale This is to uncover if there are potential psychological problems involved. DEVICE #3 Personality test Rationale This is to understand the personality of each individual and to find a way on how each one can adjust. VIII. THEORETICAL ORIENTATION (provide at least 1 and a maximum of 3) OREINTATION #1 Solution-focused (talking therapy) Rationale At this point, conversation is necessary, and this will lead the clients to provide the kind of future they want to establish for themselves. ORIENTATION #2 Emotional-focused therapy Rationale Currently, the clients are strongly driven by their emotion, and employing a psychotherapy by focusing on their emotions will lead to possible solution of problematic emotional state. ORIENTATION #3 n/a Rationale n/a IX. DEVELOPING THE TREATMENT PLAN (at least 3 Sx’s and provide at least one preliminary short-term goal and one long-term goal for each Sx. Make the short-term goals build toward the long-term goals) SYMPTOMS SHORT-TERM GOALS LONG-TERM GOALS Irritability Acceptance and understanding Patience and acceptability Defiant behavior Acceptance and understanding Willingness to appreciate other’s ideas. Stressor vulnerability Low-level anxiety, low level vulnerability to environmental and psychosocial stressors. Anxiety-free life, environmental-and-psychosocial-stressor-free life Maladaptive coping skills Willingness to adopt new ideas. Strong will to adopt new ideas. Nothing follows Nothing follows Nothing follows X. CASE CONCEPTUALIZATION (tied to your therapeutic orientation(s) - how do you make sense of this couple’s symptoms? What circumstances (intrapsychic, physical, interpersonal, environmental, FoO, etc.) cause the symptoms/diagnosis to persist? What will best help this couple return to premorbid functioning? No more than 500 words long, please. The following, as stated earlier are the couple’s symptoms: irritability, defiant behavior, stressor vulnerability, and maladaptive coping skills. These are all symptoms that require appropriate conversation and emotion-digging activities. For this reason, the chosen theoretical orientations, solution-focused (talking therapy) and emotional-focused therapy, will provide the opportunity to establish the fundamental process for healing. Mostly, it is interpersonal, physical and environmental circumstances that usually trigger the symptoms to prevail. For instance, the constant arguments are just results of emotional instability, as a vital component within the interpersonal level. The physical distance also provides the opportunity for couples to undergo some conflicts. Finally, their ideologies acquired from the environment have clearly established the essential foundation of their various beliefs and views, which at some point will lead to the clash of their characters or personalities. The couple will be restored to a highly ordered condition when both the husband and wife are to be exposed to short-term and long-term goals for correcting the above-mentioned symptoms via solution-focused and emotional-focused related therapies. XI. REFERRALS & RECOMMENDATIONS (provide at least one of each) REFERRAL #1 Psychological and personality tests. REFERRAL #2 n/a REFERRAL #3 n/a RECOMMEND’N #1 Must undergo exercises coming from experts’ advice. RECOMMEND’N #2 n/a RECOMMEND’N #3 n/a XII. PROGNOSIS & RATIONALE The couple will most likely to survive the crisis, knowing that both the husband and wife have essential strengths that if properly used in the treatment process will lead to remarkable transformation. XIII. POTENTIAL COUNTERTRANSFERENCE (both positive & negative) & HOW YOU MIGHT HANDLE IT COUNTERTRANSFERENCE HOW YOU WILL HANDLE IT Sentiments Be as objective as possible. Potential bias By eliminating pre-conceived notions, the therapist’s mind and emotional status will be set to a neutral mode. Emotional attachment By considering that the work is a professional activity, being devoid of conceived emotional attachment to the clients will be exercised. Reference American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed.,text rev.).doi:10.1176/appi.books.9780890423349. Read More