Treatment Plan for Psychotherapy Essay

Assignment 1: Practicum: Decision Tree

For this Assignment, as you examine the client case study in this week’s Learning Resources, consider how you might assess and treat pediatric clients presenting symptoms of a mental health disorder. CASE STUDY LINK IS AT END OF DOCUMENT! ?

The Assignment:

Examine Case 2: You will be asked to make three decisions concerning the diagnosis and treatment for this client. Be sure to consider co-morbid physical as well as mental factors that might impact the client’s diagnosis and treatment Treatment Plan for Psychotherapy Essay.

At each Decision Point, stop to complete the following:

Decision #1: Differential Diagnosis
Which Decision did you select?
Why did you select this Decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this Decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #1 and the results of the Decision. Why were they different?
Decision #2: Treatment Plan for Psychotherapy
Why did you select this Decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this Decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #2 and the results of the Decision. Why were they different?
Decision #3: Treatment Plan for Psychopharmacology
Why did you select this Decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this Decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?
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Also include how ethical considerations might impact your treatment plan and communication with clients and their families Treatment Plan for Psychotherapy Essay.
NEED 3 evidenced based references

Here are a few that are provided to use:

McClelland, M., Crombez, M-M., Crombez, C., Wenz, C., Lisius, M., Mattia, A., &Marku, S. (2015).

Implications for advanced practice nurses when pediatric autoimmune neuropsychiatric

disorders associated with streptococcal infections (PANDAS) is suspected: A qualitative study.

Journal of Pediatric Health Care, 29(5), 442–452. doi:10.1016/j.pedhc.2015.03.005

PDF UPLOADED

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).

Washington, DC: Author.

Stahl, S. M. (2014). Prescriber’s Guide: Stahl’s Essential Psychopharmacology (5th ed.). New York:

Cambridge University Press.

HERES THE LINK TO THE CASE STUDY 2

https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6660/05/mm/decision_tree/index.html

Assignment 1: Practicum: Decision Tree

Introduction

The focus of this assignment is to make three decisions regarding the diagnosis and treatment for the client in case study 2. The first decision will be to make a differential diagnosis; second decision, treatment plan for psychotherapy, while the third decision will involve treatment plan for psychopharmacology. Additionally, the co-morbid factors that may affect the diagnosis and treatment of the client will also be taken into account. Finally, ethical considerations affecting the client’s treatment plan will also be discussed.

Decision #1: Differential Diagnosis

The selected decision is that the client’s diagnosis is obsessive-compulsive disorder. According to DSM-5 diagnostic criteria, symptoms of obsessive-compulsive disorder include; obsessions/compulsions characterized by persistent thoughts and urges and repetitive behaviors; spending a lot of time on the compulsions such that it impairs functioning; and that the compulsions cannot be attributed to any other condition (American Psychiatric Association, 2013). From the case study 2, Tyrel is obsessed with hand-washing because he fears that germs might make him sick again. His obsession with hand-washing has impaired his normal functioning as evidenced by Tyrel not attending school and playground. Tyrel is obsessed with the idea of his hands becoming contaminated and hand-washing relieves his anxiety and fear of getting sick. According toFenske et al (2015)the unrealistic mental act such as persistent hand washing for Tyrel is aimed to prevent or reduce anxiety or distress in individuals suffering from obsessive-compulsive disorder Treatment Plan for Psychotherapy Essay.

However, the client appears to be apprehensive especially socially as manifested by him avoiding school and stopping to play with his friend. This necessities further assessment.

Decision #2: Treatment Plan for Psychopharmacology

The selected decision is to start Fluvoxamine immediate release 25 mg orally at bedtime. The rationale for selecting this decision is because Fluvoxamine is an SRI that is approved by FDA for the treatment of obsessive-compulsive disorder (Stahl, 2014). Tyrel is 8 years and hence Fluvoxamine is appropriate to treat OCD. Additionally, evidence shows that Fluvoxamine is effective in the treatment of OCD and has minimal side effects (Pittenger& Bloch, 2014). Another reason for selecting this decision is because Fluvoxamine has sedation effects and hence it is best administered at bedtime rather than in the morning (Pittenger& Bloch, 2014).

With this decision, it was expected that there would be a significant reduction of the client’s symptoms of OCD. This will be manifested by a reduced obsession with hand-washing, reduced fear of becoming contaminated, as well as reduced anxiety. It is also expected that OCD symptoms will stop impairing the client’s functioning, for example,Tyrel will be able to attend school and play with his friend. This is because Fluvoxamine is expected to reduce OCD symptoms for the client (Ordacgi et al, 2016).

The outcome of the selected decision is comparable to the expected outcome. This is indicated by reduced OCD symptoms for the client as manifested by reduced hand-washing and reduced anxiety. In addition, the client’s school attendance has improved and he also went to play with his friend, unlike before.

Decision #3: Treatment Plan for Psychopharmacology

The selected decision is to augment treatment with cognitive behavioral therapy (CBT). The rationale for selecting this decision is that evidence shows that CBT is an effective psychotherapy to treat for obsessive compulsive disorder (Moody et al, 2017). CBT achieves this by equipping individuals with OCD skills that alter maladaptive emotional reactions by changing their thoughts, feelings, behaviors, and actions (Kaczkurkin&Foa, 2015) Treatment Plan for Psychotherapy Essay.

By selecting this decision, it was expected that symptoms of OCD for the client would further reduce because CBT has been shown to be effective treating OCD. Secondly, it was expected that the anxiety and nervousness present in the client would reduce and that his social life would significantly improve. This is because CBT will make Tyrel aware of his anxiety thoughts and help him to exchange these thoughts with more positive ones (Twomey et al, 2015). This will lead to a change in Tyrel’s attitude and hence influence behavior change and he will start socializing which will be manifested by improved school attendance, attending playground, and playing with his friend.

The actual outcome of the selected decision and the expected outcome are comparable. This is because it was expected that symptoms of OCD would reduce for Tyrel and that his social life will improve. The actual outcome was that OCD symptoms reduced and Tyrel’s school attendance improved and he also started socializing with his friend.

Ethical Considerations

The client is a minor and hence issues of autonomy, informed consent or confidentiality might impact the treatment plan (Parsapoor et al, 2014). For instance, Tyrel’s parents will have to be involved whenever making any decision concerning his treatment. However, even though Tyrel is not in a position to give informed consent, it would be necessary to for him to assent to treatment (Parsapoor et al, 2014) Treatment Plan for Psychotherapy Essay.

Conclusion

Client’s diagnosis is obsessive-compulsive disorder because Tyrel manifests most of symptoms in OCD. The second decision is to start Fluvoxamine at bedtime because Fluvoxamine has been shown to be effective in treatment of OCD and since the medication has sedation effects, it should be administered at bedtime. The third decision would be to augment medication treatment with CBT because CBT has been shown to be effective in improving OCD symptoms.

References

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

Fenske J, Ketti P & Arbor A. (2015). Obsessive-Compulsive Disorder: Diagnosis and Management. Am Fam Physician. 92(10):896-903.
Kaczkurkin A &Foa E. (2015). Cognitive-behavioral therapy for anxiety disorders: an update on the empirical evidence. Dialogues ClinNeurosci. 17(3): 337–346.

Moody T, Sheen C et al. (2017). Mechanisms of cognitive-behavioral therapy for obsessive-compulsive disorder involve robust and extensive increases in brain network connectivity. Transl Psychiatry. 7(9): e1230.

Ordacgi L, Mauro M &Fintenelle L. (2016). Management of obsessive-compulsive disorder with fluvoxamine extended release. Neuropsychiatr Dis Treat. 1(5): 301–308.

Parsapoor A, Parsapoor M, Nima R &Fariba A. (2014). Autonomy of Children and Adolescents in Consent to Treatment: Ethical, Jurisprudential and Legal Considerations. Iran J Pediatr. 24(3): 241–248.

Pittenger C & Bloch M. (2014).Pharmacological treatment of obsessive-compulsive disorder.PsychiatrClin North America. 2 37(3): 375–391.

Stahl, S. M. (2014). Prescriber’s Guide: Stahl’s Essential Psychopharmacology (5thed.). New York: Cambridge University Press.

Twomey C, Gary O & Byrne M. (2015).Effectiveness of cognitive behavioural therapy for anxiety and depression in primary care: a meta-analysis. Family Practice. 32(1), 3–15. Treatment Plan for Psychotherapy Essay

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