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NR 605 Week 5 Assignment; Which Therapy Would You Choose? Worksheet Scenario 1 A 15-year-old client presents to the PMHNP for therapy. She reports persistent feelings of sadness for the last year. She has trouble sleeping and has lost 12 pounds in the last few months. She used to enjoy participating in choir and drama club at her school, but no longer enjoys her favorite activities. She is experiencing problems in her social relationships due to difficulty making friends and often feels lonely. Identify the client's ICD diagnosis. Identify and discuss one psychotherapeutic approach to address the client's problem. Provide an evidence-based rationale with support from at least one scholarly source for your choice of therapy. Describe at least three therapeutic techniques commonly used with the selected therapeutic approach. Discuss whether you would include psychopharmacology as part of the treatment plan. If yes, describe which medication(s) you might prescribe. If no, explain why
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Name: Carefully read the assignment guidelines and rubric. Review the scenarios provided in an announcement by course faculty. For each scenario, address the following.
Selected psychotherapeutic approach with rationale: Cognitive behavioral therapy has been shown effective in the treatment of depression, anxiety, eating disorder, substance use disorders and other many mental illneses as o monotherapy or in combination with medications. According to Ritvo et al. (2021), “Cognitive behavioral therapy is the best validated psychotherapy and in recent years has been co-ordinated with mindfulness meditation following strong evidence of the combined efficacy”(p.24380). CBT helps identify negative thoughts that may be contributing to depression, challenge them and teaches skills to cope and develop positive outlook on life. Therapeutic techniques to employ: Techniques like guided imagery, problem-solving skills and cognitive restructuring may be used in CBT. Guided imagery helps patient visualize realistic outcome. This gives hope and prevent disappointment. Problem-solving skills helps identify problem and develop solution to the problem. Cognitive restructuring is a technique used by therapist to help the patient identify and replace cognitive distortions with balanced thoughts. Psychopharmacology inclusion with rationale: CBT therapy may be more effective in combination with anti-depressants. SSRIs and SNRIs are the first line treatment for MDD. Citalopram and Escitalopram are the first line treatment for children and adolescents in treatment of depression in conjunction with CBT (Anvari et al.,2021). PMHNP should discuss benefits and risk with patient and family and
CBT is a choice of psychotherapy for patient with adjustment disorder. CBT is evidence- based psychotherapy which aim to identify and modify negative thought patterns. CBT teaches skills which improves Patient’s understanding of stressful event, integrate them into their global schemes and reorient their values and behaviors which as a result reduces anxiety and depression symptoms (Marco et al., 2021). Therapeutic techniques to employ: Cognitive restructuring helps the client identify and challenge distorted thoughts and beliefs. In this case, exposure therapy will be helpful. Gradually exposing the patient to the room he is avoiding and holiday’s celebration with his children helps him overcome his fear of his wife’s memory. Problem solving technique will help him develop coping mechanism to cope with his loss. Psychopharmacology inclusion with rationale: Psychotherapy is the main treatment for adjustment disorders. In this case scenario, I would prescribe antidepressants in assition to psychotherapy, in case CBT is not effective as a monotherapy. According to Strain (2019), Antidepressants are effective in managing symptoms of adjustment disorder. Citalopram 20mg 1 tablet OD
Scenario 3 A 32-year-old client presents to the PMHNP for therapy. She has been experiencing feelings of guilt and has had trouble concentrating since returning to work after the birth of her first child three months ago. She states that she is sad most of the time. She feels frustrated with her partner because she feels that he has not assumed responsibility for any additional household duties since the baby’s birth, leaving her feeling tired and discouraged. Diagnosis: Adjustment disorder with depressed mood Selected psychotherapeutic approach with rationale: CBT is appropriate treatment for adjustment disorder with depressed mood. This patient is experiencing feeling of guilt, frustration, tired, sadness and discourage after child birth. CBT helps identify negative thoughts, behaviors and beliefs that contributes to their state of distress(Liu et al., 2019). It also teaches coping skills to deal with stressful situation. Therapeutic techniques to employ: Cognitive restructuring helps the client identify and distorted thoughts and beliefs which may be contributing to her symptoms and replace with balanced thoughts and beliefs. Patient complains of feeling tired, relaxation techniques helps relax mind and body.
Bai, S., Kirk, M., Katz, J., Harber, L., Daskalakis, Z. (2021). Onlie mindfulness-based cognitive bahavioral therapy intervention for youth with major depressive disorders: Randomized controlled trial. Journal of Medical Internet Research, 23 (3), 24380-24380. https://chamberlain.primo.exlibrisgroup.com/permalink/01CUCON_INST/f6kb8f/cdi_doaj_ primary_oai_doaj_org_article_ea2caf10ae4742faa8334eeb697a Strain, J. J. (2019). The adjustment disorder diagnosis, its importance to Liaison psychiatry, and its psychobiology. International Journal of Environmental Research and Public Health, 16 (23), 4645-
https://chamberlain.primo.exlibrisgroup.com/permalink/01CUCON_INST/f6kb8f/cdi_doaj_ primary_oai_doaj_org_article_7453dea73b1d4457bbf346696ea975b