Discharge Summary Essay

Tags: obsessive compulsive disorder treatment plan substance abuse therapeutic alliance

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1. What behaviors would indicate that the client is sustaining at a healthy baseline?

    

The therapies mentioned in Eliza’s case will be instrumental in stabilizing her behavior; if they are conducted regularly. Cognitive behavioral therapy is effective in stabilizing several factors that cause problems for Eliza in her life. Eliza’s problems including anxiety, obsessive compulsive disorder, trauma sensitivity, and eating disorder can be addressed and cured in several therapy sessions. Stability of these factors can be an indication of Eliza’s health based on evaluation.

     

CBT has presented promising outcomes when applied early to forestall mental disorders.  The method consists of education relating to trauma reactions, training on relaxation, restructuring of beliefs related to fear, imaginary exposure to memories that are traumatic, and exposure to situations avoided. A number of controlled studies have indicated that 5 sessions a week that run for one and a half hours can reduce the 6 months’ incidence of disorder from 67% to 15% (WHO, 2004).



2. How would you determine if Eliza met her treatment goals?



I will monitor the goals using the outcome rating scale, also called ORS and the Session Rating Scale. These are measures that are designed to monitor the progress of treatment and therapeutic alliance. The ORS is provided at the beginning of the therapy session. It is reviewed and scored with the client during the session. The SRS, on the other hand, is only reviewed as necessitated by concerns that arise. Both SRS and ORS apply visual analogue scales. Each of them comprises four items. There are descriptive anchors at the end of a line of 10cm. The patient marks the point where they think they fall on that line. The measurement from the left side, thus, marks the score for the given item. ORS is used to measure overall functioning, including interpersonal, individual and social function.

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SRS on its part is used to assess the feeling of a patient towards regarding the process of therapy, approach, goals and topics. It is also used to assess the patient’s satisfaction level with the session that just ended (Goodman, McKay, & DePhilippis, 2013).



3. What factors would determine if the treatment needed to be reevaluated, extended, or possibly referred to another clinician or setting?



Refractory anxiety management requires reevaluation of the patient at first. It should include diagnosis. There should also be interplay of biological factors, stress related and cognitive factors. Coping strategies that are inadequate on the part of the patient and family members should be revised. Initial treatment doses and the duration for such administration must be checked (Bystritsky, Khalsa, Cameron, & Schiffman, 2013).



At the onset, Intensive Cognitive Behavioral Therapy in combination with sufficient trial of SSRIs or SNRIs or application of both may be necessary for refractory anxiety treatment. Thereafter, treatment may proceed to combining SSRIs with typical neuroleptic or antiepileptic agents; more so if there is suspicion of psychotic disorder or bipolar disorder. There might be need to recommend partial hospitalization in centers with intense CBT and management of medication (Bystritsky, Khalsa, Cameron, & Schiffman, 2013).



4. Based on your assessment of current symptomology, does your client, Eliza, need wraparound services, outpatient references, and/or step-down services? 



The wraparound service is a highly visible and compelling approach for working with the youth and those with intensive needs. It provides a platform through which service provider teams converge to plan, create and implement strategies to meet or achieve….....

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Bibliography


Bodek, H. (2010). CLINICAL DOCUMENTATION AND RECORDKEEPING. New York State Society for Clinical Social Work, Inc.

Bruns, E. (2008). The Evidence Base and Wraparound. The Resource Guide to Wraparound.

JCAHO. (2002). Communicating Unanticipated Adverse Outcomes. Patient Safety.

Lee, D. M., & Davis, C. (2010). Skill Building in recovery. Change Companies.

Bystritsky, A., Khalsa, S., Cameron, M., & Schiffman, J. (2013). Current Diagnosis and Treatment of Anxiety Disorders. P.T., 41-44.

Goodman, J., Mckay, J., & Dephilippis, D. (2013). Progress Monitoring in Mental Health and Addiction Treatment: A Means of Improving Care. Professional Psychology: Research and Practice, 231 -- 246.

WHO. (2004). Prevention of Mental Disorders: EFFECTIVE INTERVENTIONS AND POLICY OPTIONS. France: World Health Organization.

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