patient named Eliza

Part 1     Eliza, a patient aged eighteen, is enrolled at the City University and resides in a dorm with friends. The patient is currently seeking treatment for stress/anxiety and low self-image (Eliza Intake Document Provided by Customer). Eliza has not indicated any life stressors. Her father, Burt, drives a truck for a living, whereas her mom, Joan, is an elementary school secretary.

While the father-daughter relationship appears to be quite strong, Eliza appears to have issues that need working on, when it comes to her relationship with her mother. As of now, Eliza is not taking any mental health medication.  Psychosocial assessment forms a key component of all nursing evaluation, as it aids nursing professionals by informing the disorder management and patient care plan. Individuals usually display diverse kinds of surgical or medical issues.

Further, social or psychological aspects might impact their adherence to therapy and their recovery (Conducting a Page 85 Psychosocial Assessment). The rationale behind conducting a psychosocial evaluation is: explicitly articulating distinct issues in the individual’s life which may affect his/her psychological or physical wellbeing. In case of Eliza, I would employ the facts outlined in the patient intake document as the basis for carrying out a basic evaluation.

The evaluation would encompass the following elements: - The cause of patient visits or admission  - Medical history and medication consumed (medicine, dosage, prescribing physician, side effects or allergies, patient adherence to the treatment)  - Psychiatric history  - Present legal or forensic issues  - Social condition (housing status, family, religion, cultural background, finances)  - Abuse or violence (including incidents of abuse or violence related to any kids in the care of the individual, together with knowledge of reporting obligation) - The MSE or Mental Status Examination – an unbiased evaluation of behavioral, emotional, and cognitive aspects)  - Current functioning level  - Substance use  - Assessment of suicide risk I would carry out a preliminary standard Level 01 CCM (Crosscutting Measure) for ascertaining whether or not any extra problem areas emerge, which require dealing with (Writer Thoughts).

In case of further problem areas, I would need to dig slightly deeper and pose more questions in connection with the anxiety appearing to plague the patient in question.  Part 2 Eliza’s evaluation has corroborated the following facts about her condition. At the session’s commencement, Eliza claimed she had decided to undertake counseling as she was caught with alcohol at her alcohol-free university campus dorm.

With regard to the incident, she explains that her friends’ raucousness in her dorm caused the Resident Assistants to be called in. The girls landed in trouble when the RAs arrived and saw them with alcohol. Eliza asserts that she wasn’t drunk but only on a high, unlike her friends who were indeed drunk. She further added that the only reason she consumed alcohol that night was because the others were – she just went along, but not to the point of inebriation.

In her view, university was quite a life stressor (Eliza Psychosocial Document Provided by Customer). Additionally, Eliza claimed that she found it difficult to make friends and this was another stressor, besides the challenge of more taxing study requirements. She denied having any substance (alcohol/drug) issues, and remarked that she had, on one occasion in her high school days, tried marijuana, but disliked the way it made her feel, and subsequently decided not to try it again.

Eliza claimed she began drinking alcohol in her high school days; friends introduced her to it. She stated that she occasionally drank moderate quantities of alcohol with friends during weekends, and has always refrained from drinking excessively. She has also never experienced hangover symptoms. With regards to her leisure activities online, Eliza stated that she plays an online Massive Multiplayer game; she denied any pornography or gambling issues. She also denied any medical or mental health admissions to hospitals before this occasion.

While she did experience teasing, to some degree, at high school, she hasn’t been subject to any prior or current abuse or violence (Eliza Psychosocial Document Provided by Customer). Eliza does not display any suicidal or homicidal tendencies and identified herself as being an ‘agnostic’. As regards her family background, Eliza is an only child.

She considers her mom as somewhat “controlling”, while her dad is the “good guy.” She claims her parents bring frequent complaints to her with regard to their marriage’s current status. In the session, she also admitted to occasionally feeling like the mediator of the family, when living with her parents. Her family life appears to be problematic at present.

From the patient’s evaluation, one can conclude that Eliza has DSM (Diagnostic and Statistical Manual of Mental Disorders) Generalized Anxiety Disorder with ICD (International Classification of Diseases) 300.02 (F41.1)  Medications for anxiety disorder treatment present the following benefits (Effective Treatments for Anxiety – The Department of Psychology Community Clinic): - Effectiveness– About half the individuals consuming these medications experience some amount of symptom relief, at the least. - Easy availability– The medications are prescribed by healthcare professionals (usually psychiatrists), and are widely available.

- Convenient use– the tablet does all its work effectively inside the patient’s body. In Eliza’s case, Paxil will be prescribed. Cognitive Behavioral Therapy (CBT) represents a collection of psychological therapeutic methods which consider patients or clients’ active participants in the treatment of their psychological issues (Effective Treatments for Anxiety – The Department of Psychology Community Clinic). The approach is perceived as helpful if the client understands precisely what the treatment entails, and the rationale behind the employment of these specific treatment methods.

The methods employed by cognitive behavioral therapists have been tried and verified by innumerable research scholars with innumerable individuals diagnosed with anxiety issues. Thus, CBT would prove valuable in Eliza’s case.  Part 3 In Eliza’s case, I would employ LEVEL 2, Anxiety, Adult (PROMIS Emotional Distress, Anxiety, Short Form) with respect to CCM. GAD or generalized anxiety disorder represents a chronic, harmful and extremely comorbid psychiatric issue that is apparent in roughly 2.1 to 3.1 percent of the American population in any given one-year period.

While this disorder has been traditionally overlooked as compared to the remaining key anxiety disorders, increased focus and interest has been seen of late in GAD’s treatment and nature. The HAM-A (Hamilton Anxiety Rating Scale) represents an extensively utilized interview measure that was devised for assessing anxiety. While it antedates present GAD conceptualizations, the scale is capable of effectively evaluating numerous GAD-linked symptoms. It features subscales of somatic as well as psychic anxiety (Belxer and Schneier, 2006). The latter subscale that comprises items dealing with more subjective.