practicum journal

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Running head: WEEK 5 JOURNAL ENTRY 1

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Running head: WEEK 5 JOURNAL ENTRY 1

Client Information

The client is a 28 -year old Caucasian male army veteran with an anxious appearance, and he dressed appropriately for his age. He worked in a body shop as a mechanic and experienced a recent death with his younger brother. The younger brother committed suicide, and he is experiencing the anger stage in stages of grief. He mentioned when he gets anxious or depressed a sense of anger rushes inside him, which he can control most of the time. His anxiety and depression have affected his work since he arrived to work late a few times. He was recently written at work up for being tardy, even though he called in that he was running late. He approached his supervisor about the situation in an assertive calmly manner and found that the manager was not too receptive of his explanation. Therefore, he opened up with the manager about his recent loss and his struggle with post-traumatic stress disorder since he was discharged from the military. The supervisor was able to empathize with the veteran about the loss and mentioned he would take back the write up for being tardy from his record. The client has goals he would like to achieve and is an avid bodybuilder and enjoys working on vehicles of all types. He was excited to report he has been six months alcohol-free, and also mentioned he does not want to take any medications. He recently received a medical marijuana card and started using at the recommendation of his psychiatrist and has noticed it is helping with his moods at night and sleep. He has no thoughts of suicide or thoughts of harming anyone else.

Diagnosis

The diagnosis I gave the client using the criteria in the DSM-5 is Posttraumatic Stress Disorder (PTSD) 309.81 (F43.10). The criteria for PTSD is witnessing a traumatic event, sleep disturbances, and a decrease in the desire with certain activities they once enjoyed (APA, 2013). The client saw his bother shooting himself in the head three months ago and cycles between anxiety and depression. He catches himself bargaining with his thoughts on things he could have done to prevent the experience. The traumatic experience has affected his appetite and sleep patterns to the point he stopped exercising for about four weeks. However, he noticed he needs weight lifting to distract himself from his thoughts and feelings and recently started up again. According to Wheeler (2014), symptoms of PTSD must be present for a minimum of one month after the traumatic event with varying duration of symptoms depending on the individual.

Therapeutic Approach

Practitioners need to be able to assess and treat clients with PTSD since many individuals have experienced life-changing traumatic experiences. Cognitive-behavioral therapy (CBT) is the treatment of choice with exposure therapy producing the most efficient results in improving symptoms. Researchers have seen the most improvements once 40 minutes or more of prolonged exposure (Kerin, 2018). There is a multiple steps process for the practitioner to successfully implement prolonged exposure therapy. The steps range from developing an alliance, ID the trauma, collaboration with the therapist, processing memories, and so on. (Ghafoori & Shahrzad, 2012). The goal is to decrease sensitivities to thoughts or situations that can cause fear to debilitate everyday experiences. Hence, repeatedly exposing the individual to the fear causing stressor can lead to overcoming the fear itself.

Legal and Ethical Implications

Treatment options must be explained in a precise manner to the client with the collaborative setting of goals that will be obtained. According to Wheeler (2014) clients should be advised about their rights and confidentiality in the treatment process and be given a contract to sign which includes this information., Mental health professional need to know both the professional and legal ethics that direct their practice and should commit to memory. Such values and standards. (Cottone & Tarvydas, 2016). As a practitioner, it is essential to have the wisdom and knowledge to avoid unethical and inept practices that put the client at risk. Therefore, the practitioner should stay updated with the latest research in the treatment of the mental health diagnosis while collaborating with the client.

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WEEK 5 JOURNAL ENTRY 1

References

American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (DSM-5) (5th ed.). Arlington, VA: American Psychiatric Publishing.

Psychotherapy (4 ed.). New York, NY: Springer Publishing Company.