Practicum: Decision Tree Essay.

Posted: December 15th, 2022

Practicum: Decision Tree Essay.

The client in the case study presented with complaints about sleep difficulties, fatigue, sadness, concentration problems, and a feeling of emptiness. The client also reported that there are times she feels normal and very energetic. Accordingly, this assignment will provide a differential diagnosis for the client and also discuss the treatment decisions for the client. In addition, the ethical considerations that may affect the communication and treatment plan for the client will be discussed.Practicum: Decision Tree Essay.

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Decision Point One
The diagnosis for the client is cyclothymic disorder. The reason why cyclothymic disorder was selected is that the client meets the diagnostic criteria for the disorder. The DSM-5 diagnostic criteria stipulate symptoms of cyclothymic disorder to include both depressive and hypomanic episodes that do not meet the diagnostic criteria for major depressive disorder or hypomania. In addition, in cyclothymic disorder, there is no history of mania, hypomania or depressive episodes. The distress caused by the symptoms should impair an individual’s occupational or social functioning (American Psychiatric Association, 2013). For the diagnosis of cyclothymic disorder, the person should experience mood cycling for a period of more than two years. The client in this case study exhibits symptoms of cyclothymic disorder like erratic sleep problems, periods of emptiness and sadness, and periods of being overly energetic and hyperactive; the symptoms have persisted for more than two years and therefore the symptoms meet diagnostic criteria of cyclothymic disorder.Practicum: Decision Tree Essay.
With the selected diagnosis, the expectation was that MSE would confirm the diagnosis of cyclothymic disorder and lead to the correct treatment for the client.Practicum: Decision Tree Essay.
Decision Point Two
The second decision is to arrange to see the client every three months for routine follow-up. The rationale for this decision is to ensure that the client is routinely and adequately examined in order to confirm or rule out the diagnosis. According to Kilbourne et al (2018) at times it may be difficult to identify the exact mental disorder causing the symptoms and hence taking time and effort to ensure an accurate diagnosis can be helpful in helping determine the suitable treatment.
By selecting the decision to have the client undergo routine follow-up, the hope was that this would help in monitoring and comprehensive assessment for the client, and hence identify the exact mental disorder causing the symptoms for this client. This is because some symptoms manifest similarly in various mental disorders and hence a routine check-up would help determine the exact mental disorder (Kilbourne et al., 2018).
The outcome of this decision was that after twelve weeks, she reported that she did not feel any different. The symptoms continued to follow the same pattern. Just like it was expected, the symptoms followed the same pattern and hence this confirmed the earlier diagnosis of cyclothymic disorder. A comprehensive routine check-up is important in order to identify the exact mental disorder causing the manifesting symptoms (Kilbourne et al., 2018).Practicum: Decision Tree Essay.
Decision Point Three
The third decision is for the client to begin cognitive-behavioral therapy (CBT). The reason for choosing CBT is due to the efficacy of CBT in the treatment of cyclothymic disorder. CBT identifies unhealthy and maladaptive beliefs, feelings, and behaviors and replaces them with more adaptive and healthy thinking patterns and therefore leading to behavior modification (Totterdell et al., 2014). Moreover, through CBT, it is possible to identify the triggers for the symptoms and thus educate the client on how to avoid such triggers. The client will also be taught stress management and coping strategies to enable her to handle any stressful or upsetting events in her life (Sadock et al 2015).Practicum: Decision Tree Essay.
By selecting this decision, the expectation was that the depressive and hypomanic symptoms exhibited in the client would decrease. This is due to the CBT’s efficacy in changing the maladaptive thinking pattern and feelings and replacing them with a more adaptive and healthy thinking pattern. Additionally, through CBT, the client would be taught how to identify triggers to the symptoms and stress coping skills (Totterdell et al, 2014).Practicum: Decision Tree Essay.
Ethical Considerations
Informed consent and autonomy are major issues likely to affect the treatment plan for this client. Symptoms like hypomanic episodes can impair the judgment of the client and thus she may not be able to make rational treatment decisions (Richa et al., 2018). Therefore, it may be difficult to obtain informed consent from the client. Likewise, symptoms such as grandiosity and aggression during the hypomanic episodes can make the client uncooperative during treatment and this brings in the issue of autonomy (Perugi et al, 2017).Practicum: Decision Tree Essay.
Conclusion
The diagnosis for the client is cyclothymic disorder because the symptoms she is presenting meets the diagnosis of the disorder. The second decision is to arrange to see the client every three months for routine follow-up. This would help in correctly confirming the diagnosis. The symptom pattern was the same and this confirmed the diagnosis of cyclothymic disorder. The last decision was, therefore, to have the client undergo CBT in order to alter the maladaptive thinking pattern, into a more positive and healthy thinking pattern; this leads to symptom remission. Informed consent and autonomy are the ethical issues likely to affect the client’s treatment plan.Practicum: Decision Tree Essay.

At each Decision Point stop to complete the following:

https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6670/05/mm/decision_tree/index.html
Decision #1: Differential Diagnosis

Which Decision did you select? I chose Cycloyhymic Disorder

Why did you select this Decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this Decision? Support your response with evidence and references to the
Learning Resources.
Explain any difference between what you expected to achieve with Decision #1 and the results of the Decision. Why were
they different?Practicum: Decision Tree Essay.

Decision #2: Treatment Plan for Psychotherapy
I chose Arrange to see Stefanie every 3 months for routine follow-up

Why did you select this Decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this Decision? Support your response with evidence and references to the
Learning Resources.
Explain any difference between what you expected to achieve with Decision #2 and the results of the Decision. Why were
they different?

Decision #3: Treatment Plan for Psychopharmacology
I chose Begin Coganitive Behavior Therapy

Why did you select this Decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this Decision? Support your response with evidence and references to the
Learning Resources.
Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were
they different?Practicum: Decision Tree Essay.
Also include how ethical considerations might impact your treatment plan and communication with clients and their family

RESOURCES

https://eds-a-ebscohost-com.ezp.waldenulibrary.org/eds/pdfviewer/pdfviewer?vid=1&sid=e6c23e40-1c1d-4873-8ea5-be890d118cf6%40sessionmgr4008

https://www.mdedge.com/psychiatry/article/66320/bipolar-disorder/bipolar-disorder-or-something-else

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

Gabbard, G. O. (2014). Gabbard’s treatment of psychiatric disorders (5th ed.). Washington, DC: American Psychiatric Publications.Practicum: Decision Tree Essay.