15 Dec This synthesized case study is designed for the specific needs of a client presenting with a mental health disorder. It also allows you, as a practitioner and scholar, to integrate theory an

Running head: GUIDED IMAGERY AND PROGRESSIVE MUSCLE RELAXATION

1

Case History

Patrice Scope

SWK/5013

Capella University

Instructor: Natasha Houston

10/22/2

Mental Status Examination

Diagnosis with substance-induced depressive disorder necessitates that the depressive episodes be associated with ingestion of a substance and to begin within a month after use of the substance. The disorder is said to be with onset during intoxication when the symptoms are developed during intoxication and the criteria are met (Farré et al., 2020). Substance-induced depressive disorder is distinguished from primary depressive disorder or substance use disorder by considering the onset, course, and other factors associated with the substance use.

Mental Health History

Olly is a 30-year-old African American married woman with three children. The client has been referred to the clinic for by her professor who is concerned because of her social impairment, and alcohol consumption leading to a decline in her performance. Olly has been struggling with getting out of bed and does not enjoy studying or being at home with her family. The client sleeps more than ten hours a day and isolates herself from her family. Olly drinks all the time and claims that she feels worthless and fatigued despite resting. The patient has been previously diagnosed with alcohol use disorder when she was 16 and 24 years and depressive disorder when she was 24.

Olly’s father took her to family counseling as a teenager after her first DUI when she was 16 years old. Olly claims that the treatment was time wasting since she was not an alcoholic and drinking was not her problem. Olly began drinking shortly after her mother left them when she was 14 years old. She claimed that drinking with her boyfriend made her feel better. The second instance was after the birth of her first child. She began drinking because of her guilt for not being with her baby because of work. Olly lost her job because of drinking and she could felt overwhelmed when she had her second child. The client attempted to take her life by consuming Wellbutrin with alcohol. She was admitted to hospital and began attending AA meetings which improved her condition.

Family History

Olly claims that she grew up with loving and hard working parents. The patient states that her mother left them when she was 14 years old and that was when she began drinking. Olly lived with his father who took her for treatment after her first DUI. The patient claims that her father died two years ago because of drinking himself to death. The client also has a sister who moved out of state years ago. They only communicate over the phone occasionally because they are not close. Olly receive support from her AA members and the church as she claims they help her to get up in the morning.

Mental Status Examination

Olly is presenting the symptoms of agitation and nervousness. The patient is late for her appointment and she appears disheveled. Olly is wearing baggy clothes and has unkempt hair. The client is oriented to time, place, and person. The patient appears to be competent. The client is cooperative and answers the interview questions accurately. The patient’s tone and pitch is appropriate as she cries because she feels frustrated that she has to sacrifice her studies to support her family. The patient’s thoughts flow logically, demonstrated in her responses to open-ended questions.

The client does not have auditory or visual delusions and she does not exhibit distorted thinking. Olly claims that she feels worthless and fatigued almost every time throughout the entire day. The client reports that she can only get through the rest of her day when she is drinking. The patient has insight into her difficulties because she understands her problems at home are contributing to her drinking and depression. The client appears sad because of her marital problems which have affected her performance in school. The patient does not currently exhibit suicidality and is not on any medication. The patient is consuming alcohol.

Diagnosis

The patient is suffering from Alcohol-induced depressive disorder. The depressive disorder is associated with intoxication causing impairment in occupational, academic, and social areas of functioning consistent with Criterion E of the DSM-5 (Jiang et al., 2020). The client drinks and is depressed to the extent that she is unable to care for her children or perform well in school. The client’s peers in school do not want to work with her because she is only concerned with drinking. Criterion D requires that the symptoms incur inclusively during the course of delirium (Wang et al., 2020). Olly drinks throughout the entire day as she claims it enables her to cope.

Conclusion

Substance-induced depressive disorder can either occur during intoxication or during withdrawal depending on when the depressive episodes present. The patient is suffering from alcohol-induced depressive disorder since the symptoms exhibited are consistent with the diagnostic criteria for the condition. Moreover, the patient had been previously diagnosed with depression and substance use because of excessive alcohol consumption. The client cannot cope through the day unless she ingests alcohol.

Reference

Farré, A., Tirado, J., Spataro, N., Alías-Ferri, M., Torrens, M., & Fonseca, F. (2020). Alcohol induced depression: Clinical, biological and genetic features. Journal of Clinical Medicine, 9(8), 2668. http://hdl.handle.net/10230/48650

Jiang, Y., Liu, Y., Gao, M., Xue, M., Wang, Z., & Liang, H. (2020). Nicotinamide riboside alleviates alcohol-induced depression-like behaviours in C57BL/6J mice by altering the intestinal microbiota associated with microglial activation and BDNF expression. Food & function, 11(1), 378-391. https://pubs.rsc.org/en/content/articlehtml/2019/fo/c9fo01780a

Wang, P., Guo, P., Wang, Y., Teng, X., Zhang, H., Sun, L., … & Liang, H. (2022). Propolis Ameliorates Alcohol-Induced Depressive Symptoms in C57BL/6J Mice by Regulating Intestinal Mucosal Barrier Function and Inflammatory Reaction. Nutrients, 14(6), 1213. https://doi.org/10.3390/nu14061213

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Running head: GUIDED IMAGERY AND PROGRESSIVE MUSCLE RELAXATION

1

Social Work for Mental Health

Your Name

Department of ABC, University of ABC

ABC 101: Course Name

Professor (or Dr.) Firstname Lastname

Date

Social Work for Mental Health

Adjustment disorder with depressed mood is also referred to as situational depression and can only be diagnosed if the recurring depressive symptoms are resulting from onset of stressors. Some of the symptoms include aggressive behavior, agitation or irritable mood and feelings of hopelessness (Jones, 2021). The theories used to aid the client in the recovery process are cognitive behavior theory and attachment theory. The intervention method selected is cognitive behavior therapy (CBT). Clients with depression respond positively to CBT treatment (Williams, 2019). Cognitive behavioral therapy aids patients in understanding their thought processes leading to the behaviors exhibited, making them realize they have control over the outcomes.

Differential Diagnosis

The primary diagnosis for the patient is Adjustment disorder with depressed mood. The patient’s symptoms are consistent with Criteria A which requires presence of emotional or behavioral symptoms in response to an identifiable stressor occurring within three months on onset. The patient appears agitated and nervous during the interview and she began drinking when her mother left them at 14, when she got her first child at 22, when she got her second child, and when her husband was fired and demanded that she quit school for him to look for a new job. The symptoms are also consistent with Criteria B2 because they affect her social and occupational functioning areas. The patient is unable to perform well in school and her peers do not want to work with her.

The second most probable diagnosis for the patient is major depressive disorder. The diagnosis for the condition requires that the individual have one of the two symptoms to meet Criteria A of the DSM-5; depressed mood, or loss of interest or pleasure. The client should feel hopeless or empty most of the day nearly every day based on requirements for Criteria A1. The patient claims during the interview that she feels worthless and overwhelmed because everyone needs something. The patient also has no pleasure in her activities which is consistent with Criteria A2 as she states that most of the days she does not want to get out of bed. The symptoms have been occurring for the past six months meeting the two-week duration stated under Criteria A. The symptoms also cause impairment in her social and occupational areas of functioning consistent with Criteria B. She does not want to go home after school and goes to the bar instead. The client’s peers do not want to work with her because she wants to meet in the local bar. However, the disorder is ruled out because the symptoms are only recurrent during the onset of psychosocial stressors in the patient’s life consistent with Criteria A of the adjustment disorders.

Another probable diagnosis for the patient is alcohol-induced depressive disorder. Criteria A requires that the persistent mood disturbance is marked by diminished pleasure in almost all activities. The client’s peers claim that she is never engaged in learning and is more worried about what to drink next. The patient claims that only when drinking does it get her through the day indicating the disorder with onset during withdrawal. The patient’s impairment in social and occupational functioning areas is also consistent with Criteria E. Her peers do not want to work with her. The diagnosis is ruled out because the symptoms preceded the onset of the substance use, persisting a month after cessation based on requirements of Criteria C of substance-induced depressive disorder.

Social Work Theories

The therapeutic intervention that should be used is cognitive behavioral therapy (CBT) (Cissé, 2022). The theory of cognitive behavior is used by social workers to aid the client to reframe their negative or limiting behaviors (Morrise, 2020). The patient will be guided stepwise to understand her behavior and the thought processes leading up to it. The attachment theory will also be used to understand the behavior of the patient’s six-year old daughter. The theory claims that development of healthy attachments gives a child confidence to meet the world and when broken the child develops maladaptive behaviors (Joseph-Micliz, 2020). The patient’s six-year old had no interest in making friends or doing well in class. She is also very quiet and keeps to herself. The child should also be treated with CBT before development of the mild depression to severe.

Conclusion

CBT helps individuals to alter their negative thinking and adopt positive ones by reflecting on their cognitive processes, to change their behaviors. The patient is diagnosed with adjustment disorder with depressive mood because her depressive episodes occur on the onset of psychosocial stressors. Other possible diagnoses that were ruled out are major depressive disorder and substance-induced depressive disorder. Attachment and cognitive behavior theories are used to develop the intervention plan. The intervention recommended to the patient and her family is CBT.

References

Cissé, G. S. (2022). Understanding Mothers’ Perceived Competence to Impact Their Infant’s Mental Health: An Action Research Study (Doctoral dissertation, Capella University). https://www.proquest.com/openview/f6d49bdc911755ff137b0c3e47f037fe/1?pq-origsite=gscholar&cbl=18750&diss=y

Jones, L. (2021). Mental Health Professionals Interactions with Adolescent Suicide Clients (Doctoral dissertation, Capella University). https://www.proquest.com/openview/e014c12b653433f8f0f77a6592593b7a/1?pq-origsite=gscholar&cbl=18750&diss=y

Joseph-Micliz, N. (2020). Licensed Clinical Social Workers: Examining Change in Knowledge and Value of Mental Health Stigma (Doctoral dissertation, Capella University). https://www.proquest.com/openview/19daced8dd9a5751a0528ea3712c3df5/1?pq-origsite=gscholar&cbl=18750&diss=y

Morrise, T. J. (2020). School Social Work-Teacher Collaboration to Ensure Inclusive Education for EBD Students (Doctoral dissertation, Capella University). https://www.proquest.com/openview/8a5389df9e2fab7aa94a631756529214/1?pq-origsite=gscholar&cbl=18750&diss=y

Williams, K. A. (2019). Vicarious Trauma of Licensed Social Workers in Mental Health: Action Research (Doctoral dissertation, Capella University). https://www.proquest.com/openview/ccccaf323c04a09683d3531687fa42c5/1?pq-origsite=gscholar&cbl=18750&diss=y

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Running Head: Pepper Family Case Study 1

Pepper Family Case Study 15

Pepper Family Case Study

Instructor Name

Course

Date

Client's demographical information

Olivia Pepper is a 30-year-old African American woman who is married with three children (ages 2, 6, and 8). Olivia is a Baptist and is receiving several financial need scholarships which allows her to attend school without working. She has two residential treatments, once as an adolescent for alcohol use and the second when she was 24 for depression and alcohol use. She has had two DUI's, one at 16 and the second at 22. Olivia has previously taken Zoloft and Wellbutrin, and has gone to family counseling as a teenager. Olivia is currently pursuing her Master’s degree and has a 3.8 overall GPA. She has been referred to the University Counseling Center from her professor for erratic behaviors, which include failing two classes and having a sporadic attendance, being late, and smelling of alcohol on more than one occasion. Olivia's peers have reported that she wants to meet at the local bar and is never engaged in learning.

Olivia grew up with loving parents who worked hard. Her mother left when she was 14 and that is when she started to drink. She has been in a “funk” on and off her whole life and reports that most days she just doesn’t want to get out of bed and face the day. She is overwhelmed and sleeps 10-12 hours a day, isolates herself from her family, and avoids going to school. She has attempted suicide once with a drug overdose on Wellbutrin with alcohol. Olivia is currently attending AA meetings regularly and reports that church and AA help her get out of bed in the morning. She has started to drink again and sneaks drinks into her lemonade so that her family does not know. Her husband is angry and wants her to quit school, and Olivia is concerned for her 8-year-old daughter who is exhibiting similar behaviors as her.

Olivia's demographic information paints a vivid picture of her life. She has faced many challenges in her life, from her mother leaving when she was 14 to her father passing away two years ago from drinking. She is under a lot of stress with having to care for her three children and still trying to pursue her degree. She has dealt with depression and alcohol use, attempted suicide, and has had two, (DUI's Shenoy,2019). Olivia has had to find different coping mechanisms to get her through her day, and while church and AA have been helpful, she has resorted to drinking again, which is causing her to struggle in her classes. Her family dynamics are strained with her husband wanting her to quit school and her 8-year-old daughter exhibiting similar behaviors. It is clear that Olivia is in need of support and guidance to help her get through the current struggles that she is facing.

Analysis of the Client's presenting problem

Olivia is struggling with depression and alcohol misuse. She is currently failing two of her courses and her attendance has been sporadic. According to her professor, she has been smelling of alcohol after lunch and is not engaged in learning, and instead is more interested in what is next to drink. Her intake paperwork reveals that she has a history of alcohol misuse, two residential treatments for alcohol use and depression, and two DUI's.

Olivia has reported that she feels overwhelmed and exhausted all the time, and has difficulty getting out of bed and facing her day. She is sleeping 10-12 hours a day and is isolating herself from her family. She also reports that her husband was recently fired from his job, which has caused a great deal of stress in the home and has led to him asking her to quit school and work until he finds a new job. She has reported that she has been in a "funk" her entire life and has experienced feelings of worthlessness. She has a history of alcohol misuse, which she began engaging in as a coping mechanism after her mother left when she was 14. She has also attempted suicide in the past due to her depression and alcohol misuse, which has caused her to seek help in the form of attending AA meetings.

Olivia is currently exhibiting a number of signs and symptoms of depression, including feelings of worthlessness, difficulty getting out of bed and facing her day, sleeping 10-12 hours a day, and isolating herself from her family. She has also reported that she is struggling with alcohol misuse, which is likely a maladaptive coping mechanism to deal with her depression. Her two DUI's and two residential treatments for alcohol use and depression are further evidence of her struggles with alcohol. Additionally, her husband's recent job loss has likely exacerbated her depression and alcohol misuse, leading to her current difficulty with her studies.

Overall, Olivia is presenting with depression and alcohol misuse. Her current symptoms of depression and alcohol misuse are likely a result of her past experiences, her current situation, and her maladaptive coping strategies which she has employed to deal with her symptoms. Additionally, her husband's recent job loss and the resulting stress it has caused is likely further exacerbating her symptoms.

Client's diagnoses using the DSM-5-TR

Olivia presents with a constellation of symptoms that are consistent with a diagnosis of Major Depressive Disorder, Recurrent, Moderate. According to the DSM-5-TR, this is a mental disorder characterized by five or more of the following symptoms, present during the same two-week period and reflect a change from previous functioning; at least one of the symptoms must be either; depressed mood or loss of interest or pleasure: depressed mood most of the day, nearly every day, markedly diminished interest or pleasure in all, or almost all activities most of the day, nearly every day, significant weight loss when not dieting, or weight gain, or decrease or increase in appetite nearly every day, insomnia or hypersomnia nearly every day, psychomotor agitation or retardation nearly every day, fatigue or loss of energy nearly every day, feelings of worthlessness or excessive or inappropriate guilt nearly every day, diminished ability to think or concentrate, or indecisiveness, nearly every day, recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide, (Himes,2020).

In addition, Olivia meets criteria for Alcohol Use Disorder, Moderate. According to the DSM-5-TR, this is a pattern of alcohol use leading to clinically significant impairment or distress, as manifested by at least two of the following, occurring within a 12-month period: Alcohol is often taken in larger amounts or over a longer period than was intended, there is a persistent desire or unsuccessful efforts to cut down or control alcohol use. A great deal of time is spent in activities necessary to obtain alcohol, use alcohol, or recover from its effects. Craving, or a strong desire or urge to use alcohol. Recurrent alcohol use resulting in a failure to fulfill major role obligations at work, school, or home. Continued alcohol use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of alcohol (Himes,2020). Important social, occupational, or recreational activities are given up or reduced because of alcohol use. Recurrent alcohol uses in situations in which it is physically hazardous. Alcohol use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by alcohol.

Olivia also meets criteria for Post-Traumatic Stress Disorder, Mild. According to the DSM-5-TR, this is a mental disorder that can occur in people who have experienced or witnessed a traumatic event. It is characterized by avoidance of stimuli associated with the trauma, increased arousal, and negative alterations in cognitions and mood. Symptoms include the following: exposure to traumatic event involving actual or threatened death, serious injury, or sexual violence, persistent re-experiencing of the traumatic event, such as flashbacks or nightmares, avoidance of reminders of the trauma, such as people, places, conversations, or activities, persistent negative alterations in cognitions and mood, such as negative beliefs about oneself or the world, or persistent inability to experience positive emotions, increased arousal, such as difficulty sleeping, hypervigilance, exaggerated startle response, or problems with concentration, (Borlaug,2020).

Assessments used to approach the diagnosis

The first assessment that should be used to approach the diagnosis of Olivia is the Patient Health Questionnaire-9 (PHQ-9). The PHQ-9 is a depression scale that evaluates the severity of depression and can help diagnose major depressive disorder. It is a nine-item self-report that asks questions about the frequency of symptoms experienced over the past two weeks. The score from the PHQ-9 can range from 0-27 and can help to determine the severity of depression, (Borlaug,2020).

The second assessment is the Alcohol Use Disorders Identification Test (AUDIT). This is a 10-item self-report questionnaire that evaluates the severity of alcohol consumption. The AUDIT assesses the quantity and frequency of alcohol consumption, the problems associated with alcohol use, and the alcohol related consequences. The score from the AUDIT can range from 0-40 and can help to diagnose any level of alcohol use disorder (Raskin,2022).

The third assessment is the Attention Deficit Hyperactivity Disorder (ADHD) scale. This is a seven-item self-report questionnaire that evaluates the presence of symptoms associated with ADHD. The score from the ADHD scale can range from 0-14 and can help to diagnose any level of ADHD (Raskin,2022).

In addition to the assessments listed above, it is also important to obtain a thorough family history, a mental status exam, and any other relevant information that can help to provide a better understanding of Olivia's situation. It is also important to note any co-occurring diagnoses such as anxiety or substance use disorders.

The assessments listed above can help to identify any issues Olivia may be facing and can provide a better understanding of her current mental health. It is important to use a combination of assessments to gain a comprehensive understanding of Olivia's situation and to provide the best treatment possible, (Bradley,2022).

Mental health theory application

In this case, cognitive theory is one of the mental health theories that could be applied to Olivia’s situation. Cognitive theory focuses on the individual’s thoughts and beliefs and how they affect behavior. According to cognitive theory, Olivia’s thoughts and beliefs about herself, her life, and her abilities are impacting her behavior in a negative way. She believes that she is not capable of completing her degree and is overwhelmed by her current life situation. This is leading her to make poor decisions, such as drinking and isolating herself from family and friends. (Bradley,2022)

The cognitive theory suggests that by changing her thought patterns, Olivia can change her behavior. To do this, she needs to identify her negative thought patterns and replace them with more positive, realistic thoughts. For example, instead of believing that she is incapable of completing her degree, she can focus on her past successes and the progress she has made. She can also focus on the positive aspects of her life, such as her loving family, and create concrete plans to help her achieve her goals.

By using cognitive theory, Olivia can begin to challenge her negative thoughts and develop more positive, healthier beliefs. This will help her to make better decisions and move forward with her life in a more positive direction. With the help of her therapist and other supportive individuals, Olivia can take the steps necessary to make positive changes in her life and move towards her future goals, (Torous,2018).

Treatment interventions

The treatment intervention in this case would be a Cognitive Behavioral Therapy (CBT) approach with a focus on self-regulatory strategies. This approach is designed to help the client identify and modify maladaptive thoughts and behaviors that are associated with her current struggles. The client's strengths include her intelligence, drive, and dedication to her studies. She also has a strong interest in helping those in similar circumstances to her own. Her weaknesses include her self-regulatory abilities, her tendency to isolate herself, and her high stress levels. Her social support systems include her husband, her children, her faith, and her peers at school.

The long-term goal of the treatment intervention is for Olivia to increase her self-regulation skills and to have better control over her emotions and behaviors so that she can successfully complete her studies and achieve her goals. Additionally, she should be able to manage her stress levels and find healthier coping strategies for her negative emotions

The short-term goals and treatment objectives are to identify and modify Olivia's maladaptive thoughts and behaviors that are associated with her current struggles, (Torous,2018). This includes identifying her triggers and helping her develop better coping strategies when faced with them. Additionally, she should learn how to manage her stress levels, control her emotions, and become more engaged in her studies. She should also learn to recognize and regulate her alcohol use. Finally, she should become more social and develop healthier relationships with her peers and family. (Torous,2018)

Treatment Timeline

Time

Description

Week 1.

Intake assessment Psychoeducation on substance use, depression, anxiety and stress</p Our website has a team of professional writers who can help you write any of your homework. They will write your papers from scratch. We also have a team of editors just to make sure all papers are of HIGH QUALITY & PLAGIARISM FREE. To make an Order you only need to click Ask A Question and we will direct you to our Order Page at WriteEdu. Then fill Our Order Form with all your assignment instructions. Select your deadline and pay for your paper. You will get it few hours before your set deadline. Fill in all the assignment paper details that are required in the order form with the standard information being the page count, deadline, academic level and type of paper. It is advisable to have this information at hand so that you can quickly fill in the necessary information needed in the form for the essay writer to be immediately assigned to your writing project. Make payment for the custom essay order to enable us to assign a suitable writer to your order. Payments are made through Paypal on a secured billing page. Finally, sit back and relax. Do you need an answer to this or any other questions? Order Plagiarism Free Answer Here Do you need help with this question? Get assignment help from WriteEdu.com Paper Writing Website and forget about your problems. WriteEdu provides custom & cheap essay writing 100% original, plagiarism free essays, assignments & dissertations. With an exceptional team of professional academic experts in a wide range of subjects, we can guarantee you an unrivaled quality of custom-written papers. Chat with us today! We are always waiting to answer all your questions. Click here to Place your Order Now