Practicum Journal Entry Essay Discussion Paper
Paranoid schizophrenia is a disorder that can considerably affect a person’s quality of life. Understanding how to diagnose and treat this disorder can be difficult but when done correctly, a client will be provided with the chance to function and succeed in familial, social, and professional environments. This paper seeks to describe the client’s pertinent history, explain the diagnosis using DMS-5, explain whether cognitive behavioral therapy would be effective with this client, and describe any legal or ethical implications related to counseling this client Practicum Journal Entry Essay Discussion Paper.
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Description of the Client
Client is a 56-year old, Caucasian female from Texas. Reports maintain that her religious preference stays Protestant. The client is married with three biological children. She is provided with family and outpatient individual therapy. Due to her diagnosis of schizophrenia and her aggressive behavior, the client has been getting services because she was not consistent with medicine. She also receives family therapy to deal with communication issues and behaviors. For the last three years, the client has been undergoing individual and family therapy. Her diagnosis is paranoid schizophrenia and when she stops taking her drugs, she has a history of being depressed and aggressive. She always claims that her husband is “envious of me” or “he wants to see me fall.” Such delusions have intensified the client’s interpersonal problems, contributing to numerous verbal altercations towards his family. She has continued to battle her mental health symptoms throughout the past two years, especially with delusions of paranoia, disorganized speech, anxiety thoughts, depression, and a complete lack of knowledge into her mental disorder Practicum Journal Entry Essay Discussion Paper.
It is important to acknowledge that the disorganized speech symptoms of the client have improved in the past few months, even though she continues to suffer from the other mentioned symptoms, especially paranoid delusions. As per the client, she physically assaulted her brother when she was psychotic. The client has mentioned in the past that her sister was on hyperactivity counseling and a quick temper. The father and brother of the client all created a fictitious narrative in order to prevent the client from getting prosecuted after she mistakenly shot her sister (who was 17 at that time). They stated that her sister was the victim of a drive-by shooting. The sister sustained a significant brain injury as a consequence of the accident and has subsequently needed full in-home care. Reports show that after this occurrence the client was found dealing with heavy emotions of guilt. The current regimen of medications includes Zyprexa 20 mg at bedtime, Trileptal 300 mg twice daily, and Invega 12 mg regular. As observed through client actions and confirmed by her spouse, the client was consistent with the medication regimen Practicum Journal Entry Essay Discussion Paper.
Cognitive Behavioral Therapy
Cognitive-behavioral therapy (CBT) is applied both in family and individual therapy with the client and her spouse. The client has been undergoing therapy for her aggressive outburst, medication regimen non-compliance, communication issues with her partner, and behavior management. The therapist will use CBT to provide the necessary education. The therapist and client will focus on replacing ways of living that do not function well with working ways of living and understand the elements of paranoia and anger episodes. The expected outcomes of CBT are that the client will gain more control over her life and learn ways to decrease depression, paranoia, and anger episodes Practicum Journal Entry Essay Discussion Paper.
DSM-5: Diagnostic Criteria
Throughout the treatment process, the practitioner’s main responsibility is to uphold the dignity and to promote the well-being of clients. The application of DSM-5 is useful for clinical treatment, as it provides guidance for practitioners worthy of paranoid schizophrenia management. As per the DSM-5, in order to be diagnosed with paranoid schizophrenia a person must demonstrate at least two of the typical symptoms for a period of six months. Symptoms include but are not confined to disorganized behavior, disorganized speech, hallucinations, and delusions (Kendler, 2017). The diagnosis criteria for paranoid schizophrenia will be established for at least one to six months as it assists differentiate paranoid schizophrenia from other psychiatric illnesses, like bipolar disorder (American Psychiatric Association, 2013)Practicum Journal Entry Essay Discussion Paper.
Legal and Ethical Implications
Counselors should consider the main legal and clinical problems involved in managing mentally ill patients. Firstly, counselors should consider the medical interests that come under counseling. A patient has the privilege to treatment, confidentiality, practical qualifications, informed consent, and therapeutic guidelines (Wheeler, 2014). This includes how practitioners should counsel patients about their situation, and how they should educate them about their risks. Furthermore, practitioners may check whether such patients are accessible, or should they be admitted involuntarily (Zhang, et al., 2015) Practicum Journal Entry Essay Discussion Paper.
Ethical practices are intended to incorporate legal and therapeutic practices, which in certain cases may overlap. Such approaches may undermine the autonomy of clients with paranoid schizophrenia while at the same time become clinically effective, thus gaining a sense of self-efficacy and trust in the client’s counselor (Wheeler, 2014). In the treatment of this client, the informed consent of both the client and the counselor was involved. The therapy is intended to reaffirm the interpersonal correlation between the two.
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References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
Kendler, K. S. (2017). The clinical features of paranoia in the 20th century and their representation in diagnostic criteria from DSM-III through DSM-5. Schizophrenia bulletin, 43(2), 332-343.
Townsend, M. C., & Morgan, K. I. (2017). Psychiatric mental health nursing: Concepts of care in evidence-based practice. FA Davis.
Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (2nd ed.). New York, NY: Springer Publishing Company.
Zhang, S., Mellsop, G., Brink, J., & Wang, X. (2015). Involuntary admission and treatment of patients with mental disorder. Neuroscience bulletin, 31(1), 99-112 Practicum Journal Entry Essay Discussion Paper
To Prepare:
Analyze nursing and counseling theories to guide practice in psychotherapy
Develop goals and objectives for personal practicum experiences
Create timelines for practicum activities
Develop diagnoses for clients receiving psychotherapy
Analyze legal and ethical implications of counseling clients with psychiatric disorders
Develop diagnoses for clients receiving psychotherapy
Evaluate the efficacy of cognitive behavioral therapy for clients
Analyze legal and ethical implications of counseling clients with psychiatric disorders
Some resources
Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (2nd ed.). New York, NY: Springer Publishing Company.
Select a client that you observed or counseled this week.
(Client) is a 56 year old paranoid schizophrenia victim, also suffers depression. Note: onlinenursing writer, you can improvise about the client history, background, ect. Practicum Journal Entry Essay Discussion Paper
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Then, address the following in your Practicum Journal: include an introductory paragraph.
In this (paper) journal entry you will:
Describe the client (without violating HIPAA regulations) and identify any pertinent history or medical information, including prescribed medications.
Using the DSM-5, explain and justify your diagnosis for this client.
Explain whether cognitive behavioral therapy would be effective with this client. Include expected outcomes based on this therapeutic approach. Support your approach with evidence-based literature.
Explain any legal and/or ethical implications related to counseling this client.