To analyze and apply critical thinking skills in the psychopathology of mental health patients and provide treatment and health promotion while applying evidence-based research.

Chapter 6, Case 1Trisha is a 28-year-old, unemployed white female. She is no stranger to therapy, having seen counselors for most of her teen and adult years. Her friends would describe her as a “wild woman” who takes no crap from anyone. She has held various part-time jobs for the last few years because she usually gets angry at her boss or coworkers and quits. While she has had a string of boyfriends over the years, she has been seeing one man for the last year or so. He too is unemployed and has both an alcohol and methamphetamine problem. She describes the relationship as “addictive and dysfunctional, yet exciting and hot.” Trisha is back in treatment at the urging of her parents, who describe her behavior as erratic and unpredictable. They also claim that she has periods where she “sleeps little and parties lots.” There were also several occasions in the last five years when she was so depressed she didn’t eat or want to leave the house. Her father also admits to periods of depression, and Trisha’s grandfather was diagnosed with manic depression, resulting in numerous hospitalizations in the 1950s and 1960s. Trisha’s only brother died in a car accident several years ago. He was drunk at the time, but she claims he had a long history of depression. Recently Trisha was arrested for disorderly conduct at a friend’s party. She had not slept for nearly 24 hours and was drunk and combative. When she was first approached by police, she solicited them for sex. They report that she was rather hyperverbal and hyperactive. They later had to investigate a complaint from local storeowners for bad checks she wrote in excess of $7,000.Questions:Remember to answer these questions from your textbooks and clinical guidelines to create your evidence-based treatment plan. At all times, explain your answers. 

1. Summarize the clinical case.
2. Create a list of the patient’s problems and prioritize them.
3. Which pharmacological treatment would you prescribe? Include the rationale for this treatment.
4. Which non-pharmacological treatment would you prescribe? Include the rationale for this treatment.
5. Include an assessment of treatment’s appropriateness, cost, effectiveness, safety, and potential for patient adherence.

 

1. Summarize the clinical case.

Trisha is a young female in her late 20's who has had a preexisting mental health condition since she was a child. She is unpredictable and has erratic behavior, leading her peers to nickname her a wild woman. Trisha is unstable and cannot hold a job placement for long due to constant disagreements with her boss. Trisha is an addict to alcohol, and she's a party girl. This behavior deprives her of enough sleep, which leads to disorderly conduct. Trisha's kin has a long history of depression, going back to her grandfather, diagnosed with manic depression in the 19^th century. Her brother also battled depression which resulted in him indulging in alcohol abuse.

Trisha is also reported to be involved in fraud because of complaints from store owners about failed payments. The case indicates a historical background of mental illness in the lineage of Trisha. Therefore, the behaviors of Trisha are not exceptional rather something she may be inherited from her forefathers. Her mental state and the continuous therapy and counseling she has undergone prove dysfunctional, hence a need for a more elaborate solution.

2. Create a list of the patient's problems and prioritize them.

1. Depression
2. Alcohol addiction
3. Insomnia
4. Hyper verbal
5. Hyperactive

3.       Which pharmacological treatment would you prescribe? Include the rationale for this treatment.

Pharmacological treatment is the use of drugs to suppress the depressant thoughts in a patient. This treatment method has side effects; hence it is advised not to overdose the patient and harm them rather than treat them. Depression in adults can be treated using effective antidepressants, and due to this, many patients use pharmacologic treatment. Most patients using antidepressants respond favorably. However, there are always side effects for using antidepressants (Villa, Ferrari & Moretti, 2018). Trisha would use these drugs but with a strict follow-up due to her history of alcohol abuse and erratic behavior. Antidepressants would be efficient in Trisha's case because the patient uses the medication for a while, and the doses are increased or regulated according to the patient's response.

Trisha has previously had therapy continuously since she was a teen, and her alcohol addiction can be associated with depression and the recent loss of her brother. Antidepressants are supposed to help correct the patient's mood; however, there is a delay in response of monoamines in the brain hence the need to be very careful and observant of the patient's reaction. Depression resulting from a neurochemical basis can be regarded as complex and not due to one specific factor. According to Trisha's case, she might have inherited the behavior from her forefathers (Villa, Ferrari & Moretti, 2018). Also, the sudden loss of her brother made her start drinking alcohol uncontrollably, or even because of her erratic behavior and influence of her current boyfriend.

4. Which non-pharmacological treatment would you prescribe? Include the rationale for this treatment.

The non-pharmacological treatment uses the systematic review of the patient's response to therapy without drugs. For Trisha's case (Farah et al., 2016), I would recommend Cognitive behavioral therapy (CBT) to help her have a different view in life and have positive thoughts. Evidence shows that CBT works well as antidepressants, and the lessons learned can be used beyond depression time. Therefore, CBT would most likely help her once and for all to leave depression behind with no side effects whatsoever.

A therapist sits down with a patient during CBT sessions and discusses breaking down the issues affecting them into smaller parts (Farah et al., 2016). Trisha has many issues with her personal life, and treating one specific issue would be an assumption of solving the whole problem. Cognitive-behavioral therapy would be the perfect fit for this case because of the numerous problems she is passing through. This method would aid her in relationships, whether in a job setting or her relationships.

5. Include an assessment of treatment's appropriateness, cost, effectiveness, safety, and potential for patient adherence.

The use of pharmacological treatment is very effective for the majority of patients. The only drawback is the side effects of using antidepressants for a long time. This calls for strict adherence to the prescription, and the caregiver should be very observant of any behavioral changes with the patient. The cost of this method of treatment is a bit expensive in contrast to non-pharmacological treatment. The safety of this method depends entirely on the patient's adherence to the psychiatrist's instructions on using those drugs.

Non-pharmacological treatment in mental illness is by far the most recommended mode of treatment because there is no use of drugs; therefore, no side effects to the patient. Evidence-based research indicates this method to be very effective if the root cause of the problem is understood. It is relatively cheaper because there is no use of drugs, and the lessons learned can be used in the future. There is no risk for non-pharmacological treatment because there is no use of drugs.