week 5 paper

Ordinary People (1980)

Identifying Information: _Conrad will be the focus of the easy, Conrad had been going through a mental breakdown after the death of his brother he thinks that his parents to not like him and to be able to fight with alcoholism which in the long run affects his relationship with his parents. _

Presenting Problem: ___the problem that was being experienced in the movies was that Conrad was experiencing a mental breakdown where he was unable to relate with his people properly. The family experienced a lot of problem due to the death of one of them. Conrad was unable to keep up or rather cope up with the family with the demise of his brother, he became aggressive to other people and also his relatives and also his classmates in school.

Life Stressors: The life stressors that were disturbing Conrad was the loss of his brother, he was unable to cope up with the fact that he had lost his brother. This affected how he was going to relate with members of the society. The thought of not being loved by his mother further drives him into a deeper situation where he could not be able to control himself. His stress had taken another level since he was trying to keep up with the loss of his brother, and he knew that his mother did not love him.

There was no substance abuse

Addictions (i.e., gambling, pornography, video gaming)

In the movie of ordinary people there was no addiction that Conrad was suffering from.

Medical/Mental Health Hx/Hospitalizations:

Conrad was hospitalized in a psychiatric hospital where he was taken to be able to get rehabilitated so that he could be able to have a normal life and be able to interact with the parents well and also his schoolmates. He also had regular meeting with a counselor who was to help him to control his mental effect grief and his emotions.

Abuse/Trauma:

Conrad was traumatized with the relationship he had with his mother and he was able to show this physically through a heated argument he had with his mother, this left him traumatized and he knew that she did not love him. This affected him in the long run since he was engaged in a fist fight with one of his classmates. This physical abuse was a result of the trauma that he was subjected to.

Social Relationships: Conrad tried to have relationship with fellow student Jeannie, he was trying to improve his social relationship with people in which in the long run did not turn out as anticipated. He proved not to have a stable social relationship with other people, this is because he was engaged in a fist fight with one of his friends. The social relationship of Conrad was affected in that he was unable to maintain a proper relationship since he was struggling with himself. This had a long term effect of affecting his social relationship with other people in the society.

Family Information: Conrad came from a family of two where they were two sons and their parents. His only brother passed on after engaging in a boat accident. The mother suffers seriously after the death of his son that is Conrad’s brother. The father on the other hand tries to fight to have his family remain intact. The mother loved the late son and she is unable to bear the lost and after the pressure on her became too much she had to leave her family. Conrad and his father were left alone with their mother to fight the situation that they had found themselves in.

Spiritual: There has been no express show case of the religious or rather spiritual life of Conrad.

Suicidal: Conrad had been taken to a psychiatric hospital to be able to cope up or rather treat her for the suicidal thought that he had. He had tried to commit suicide after the death of his brother, this is because he was in the boat that was involved in the accident. Out of survivor guilt he wanted to take his life so as to be able to deal with the guilt.

Homicidal:

There were no homicidal incidents in the movie of the ordinary people

Assessment:

The assessment was based on a one-on-one interview the patient Mr. Conrad was also disposed to ignore or minimize behavioral considerations. In general, psychological indications are normally regarded as evidence of personal failure or individual weakness, such that even under normal conditions, Mr. Conrad at first was not likely to accept or entertain a behavioral clarification for his anguish. As such, the language I utilized to refer to his symptoms was consequently challenging, labeling patients with mental-like diagnoses or symptoms can estrange them as opposed to earning their trust then finally winning them over. As the primary care physician I was cognizance of and how deal with Mr. Conrad’s individual reservations regarding the preceding events and his condition. Such is relevant since the disgrace of mental breakdown can be prevalent and classically instigates in within the patient. Explicitly, no mental breakdown patient is at ease with promptly disclosing his tribulations to an outsider, particularly if it can end in being termed mentally unsuitable or senseless. As the primary care physician I needed to overcome my individual reservations to engage Mr. Conrad in self disclosure that can generate humiliation, anxiety, or shame. So I endeavored to create a situation that enables confession of personal and sensitive information concerning the brother’s demise and the culminating tense relationship between Conrad and the parent (particularly the mother). Effective interviewing accomplished this goal it equally helped in making the most of data gathering. In the same token, effective time management likewise relies on having the proficiency not simply to expedite albeit also too delicately reduce patient somatic preoccupation or self-disclosure. To collect the most accurate and all-inclusive information in the course of the checkup I utilized active listening and open-ended queries followed by well-thought-out analysis regarding specific events and symptoms that trigger or exacerbate Conrad’s situation. The open-ended queries afforded Mr. Conrad the chance to reveal things from his individual perspective, whilst active listening assisted in verifying and enriching the patient's assessment report. Active listening takes in intermittent response to the patient of what the therapist has taken as fact so as to determine and clarify what the patient has alleged. The technique helped to limit and readdress the subtle rambling of the patient during some of the initial sessions. Active listening simplified the integration of a wide-ranging database, and it similarly conveyed to Mr. Conrad my earnest endeavor to comprehend and to commiserate with his situation. My listening approach assisted in establishing confidence and a more concerted, problem-solving partnership between Mr. Conrad and I. Even though this was my general approach I utilized BATHE technique which was fitting in integrating effectual, time-limited psychotherapy in the course of a transitory session at my office. The general appearance and behavior posited that Mr. Conrad had a lot on his mind that affected him tremendously, at one session he was inebriated and had a hard time concentrating and responding to questions. His mood and affect was characterized by form of despair, irritable sentiments regarding the events of the accident; his affect seemed more drawn to hopelessness.

Initial Diagnosis (DSM):

At first getting information out of Mr. Conrad was a tasking affair, he was generally a difficult patient. But as his therapist, I understood his care would necessitate special attention that requires limit-setting and definition of explicit, reasonable expectations. As such depth and length of the meetings were wide-ranging, albeit it was important to note that the two of us ultimately benefitted from the enhanced relationship and diagnostic truthfulness that a detailed assessment would entail. At first, Mr. Conrad was incapable of stating undoubtedly why he had really come for the session. Such is not new issue; in fact it regularly happens in cognitive impairment and psychosis albeit might correspondingly be witnessed with intellectual debilities or even melancholy with severe somatic symptoms.

Initial Treatment Goals:

At first getting information out of Mr. Conrad was a tasking affair, he was generally a difficult patient. But as his therapist, I understood his care would necessitate special attention that requires limit-setting and definition of explicit, reasonable expectations. As such depth and length of the meetings were wide-ranging, albeit it was important to note that the two of us ultimately benefitted from the enhanced relationship and diagnostic truthfulness that a detailed assessment would entail. At first, Mr. Conrad was incapable of stating undoubtedly why he had really come for the session. Such is not new issue; in fact it regularly happens in cognitive impairment and psychosis albeit might correspondingly be witnessed with intellectual debilities or even melancholy with severe somatic symptoms.

Plan:

The scheduled therapeutic sessions with Mr. Conrad were on weekly basis in supportive-dynamic analysis with the incorporation of mental-behavioral procedures to address his mental breakdown and intense anxiety. A well-intentioned therapeutic cooperation was straightforwardly started and espoused at the point of intervention. Another pertinent area of the treatment entailed supporting of Conrad’s advancement in the direction improved emotional independence and psychological autonomy from his family and building of his individual sense of identity free from guilt and regret. Incase the psychotherapy was deemed ineffective; a combination of interventions was suggested entailing both psychotherapy and the use of medicinal interventions such antidepressants

______________________________ 29th November 2017

Montgomery D., Ph.D. Date

Clinical Psychologist

References

Dunlosky, J., Rawson, K. A., Marsh, E. J., Nathan, M. J., & Willingham, D. T. (2013). Improving students’ learning with effective learning techniques: Promising directions from cognitive and educational psychology. Psychological Science in the Public Interest, 14(1), 4-58.

Teasdale, J. D., Segal, Z. V., Williams, J. M. G., Ridgeway, V. A., Soulsby, J. M., & Lau, M. A. (2012). Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Journal of consulting and clinical psychology, 68(4), 615.

Wheeler, K. (2013). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice. p.625-712. Springer Publishing Company.