Obsessive Compulsive Disorders.

Posted: November 1st, 2022

Obsessive Compulsive Disorders.

***Select an adult or older adult client with an obsessive-compulsive disorder you have seen in your practicum.***

Describe the HPI and clinical impression for the client.

Recommend psychopharmacologic treatments and describe specific and therapeutic endpoints for your psychopharmacologic agent. (This should relate to HPI and clinical impression.)Obsessive Compulsive Disorders.

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Recommend psychotherapy choices (individual, family, and group) and specific therapeutic endpoints for your choices.

Identify medical management needs, including primary care needs, specific to this client.

Identify community support resources (housing, socioeconomic needs, etc.) and community agencies that are available to assist the client.

Recommend a plan for follow-up intensity and frequency and collaboration with other providers.

Obsessive-Compulsive Disorders
Introduction
Obsessive-compulsive disorders are typified by various obsessions and compulsions. Obsessions are characterized by persistent and intrusive thoughts, impulses, and urges that lead to significant distress and anxiety. On the other hand, compulsions are the repetitive behaviors and actions an individual performs to respond to the obsession in order to reduce anxiety and distress (Chowdhury et al, 2016). This paper will discuss a treatment plan for a client, presenting with obsessive-compulsive disorder.Obsessive Compulsive Disorders.
HPI and Clinical Impression
The client Mr. AB, presented with complaints regarding excessive worry and fear of contamination by germs and becoming sick. The client reported that he has always been calm but ever since he had an almost fatal food poisoning be has become overly careful and concerned about contamination and becoming sick again. As a result, he spends so much time washing hands using detergents after touching anything. His hands had become so red and the skin on the hands had started peeling because of excessive washing. His condition has significantly affected the relationship with his fiancée because he also fears touching her would contaminate him. This is really distressing him. The client stated that the excessive fear and worry about germs had affected him a lot such that he had started experiencing mood changes, anxiety, and sleep problems. As per the DSM-5 criteria, the client manifests symptoms of obsessive-compulsive disorders as exhibited by his obsession with fearing contamination and germs and the consequent compulsive behavior of washing hands (American Psychiatric Association, 2013).Obsessive Compulsive Disorders.

Psychopharmacologic Treatment
Sertraline: Sertraline is the recommended medication for the client. The mediation is an SSRI whose efficacy in treating OCD has been shown. The mechanism of action of sertraline is by increasing the level of serotonin in the brain which improves the moods and hence treats OCD symptoms (Pittenger et al, 2014).The medication also has a good safety profile and many individuals tolerate it without major side effects and thus the medication is suitable for long-term treatment of OCD (Pittenger et al, 2014).
Psychotherapy Treatment
Cognitive Behavioral Therapy (CBT): CBT has been shown to help individuals with OCD to identify the unrealistic thoughts and the ensuing response, and change them into a more realistic and positive thinking pattern. The client will also be taught to identify the worries as obsessions and keep a diary regarding the obsessions and the interpretations (Moody et al, 2017). After the client is able to recognize his compulsions and obsessions as being maladaptive thoughts and behaviors associated with OCD, the suitable behaviors to invalidate the maladaptive thinking pattern can be initiated (Antonio &Necci, 2016). The client will thus be able to recognize and re-evaluate his beliefs about the likely consequences of performing or not performing the compulsive action and this starts to eliminate the compulsions (Antonio &Necci, 2016).Obsessive Compulsive Disorders.
Medical Management Needs
According to Chowdhury et al (2016), people with OCD often have other comorbidities. Accordingly, it will be important to assess the client in order to determine if there could be other associated comorbidities such as substance abuse disorder and panic disorder. Moreover, there is a risk for suicide in people with OCD and therefore the client will be monitored closely (Chowdhury et al, 2016). It will also be important to educate the client about the importance of adhering to the treatment.Obsessive Compulsive Disorders.
Community Support Resources & Community Agencies
The relevant support resources and agencies for this client include the reading resources and local support groups. Therefore, the client will be referred to the local support group so that he can get encouragement and moral support from people experiencing the same mental disorder. The reading resources will provide him with the necessary information about his condition, and how to manage the symptoms and avoid any triggers.
Follow-Up Plan and Collaboration
The follow-up plan for the client will include the client attending the clinical review after four weeks in order to evaluate the treatment progress, response to the prescribed regimen, and also assess if the client is tolerating the medication well. The health care practitioners who will be involved in the treatment and management of this client include the PMHNP, pharmacist, and social worker. A good collaboration between the involved healthcare practitioners will be important in order to facilitate the provision of holistic care (Holm et al, 2018).
Conclusion
The diagnosis for this client is OCD as exhibited by the obsessions and compulsive behavior (handwashing) towards the obsessions. The prescribed treatment choices for the client are sertraline for medication and cognitive behavioral therapy as the psychotherapy. The medical management needs are, monitoring the client for the risk of suicide, assessing for other comorbidities, and monitoring the adherence to treatment. The client will be referred to the local support group to get moral support and encouragement. He will also be provided with reading resources and instructed to attend review after every four weeks.Obsessive Compulsive Disorders.