Treatment Plan Charlotte Case Study

Charlotte Case Study

Part II

Treatment Planning

After taking into consideration the symptoms that Charlotte presents with, a primary diagnosis was made for Generalized Anxiety Disorder (GAD). In basic terms, GAD, as Patriquin and Mathew (2017) point out, “is characterized by excessive anxiety and worry about a number of events or activities (e.g., work, school performance, etc.), which an individual finds difficult to control” (47). The relevance of treatment cannot be overstated owing to the fact that this particular condition significantly interferes with the daily functioning of the person diagnosed with the same. It is on this basis that the treatment plan has been developed below.

1. Short-Term SMART Goal for Treatment

Week 1–3: Ensure that the client comprehends the limiting aspects of GAD and is fully appreciative of the need to embrace the relevant treatment interventions and strategies.

Techniques

Week 1: Discuss with the client her presenting symptoms and how they tie to GAD – i.e. in as far as worry deemed excessive as well as unfounded fears are concerned. Also ensure that the client is aware of the diverse manifestations of avoidance, hypervigilance, overarousal, tension, etc. and how they interact.

Week 2: Explore the relevance of the various treatment strategies in efforts to address avoidance, as well as anxiety and worry symptoms. Also highlight why treatment is instrumental in unnecessary avoidance elimination, overarousal reduction, and worry management.

Week 3: Suggest that the patient reads selected texts on this particular condition, treatment options available, and general outlook.

2. Mid-Range SMART Goal for Treatment

Week 4-6: Ensure that the client gets familiar with, and is able to apply the relevant calming skills to not only manage the symptoms of anxiety, but also minimize overall anxiety.

Techniques

Week 4 & 5: Introduce the relevant relaxation skills to the client. The said skills could be inclusive of, but they are not limited to; mindful breathing, cue controlled relaxation, muscle relaxation (progressive), applied relaxation, etc. These approaches, as Hayes-Skelton and Roemer (2013) indicate have proven effective in the treatment of GAD.

Week 4, 5 & 6 (continuous): After every session, ensure that the client is assigned homework with specific requirements to engage in relaxation exercises on a daily basis. In this case, there would be need to ensure that there is gradual application of the said relaxation exercises – i.e. in starting off with situations that do not provoke anxiety and then transitioning to situations that provoke anxiety.

Week 4, 5 & 6: Monitor progress and ensure that the relevant feedback is provided going forward.

1. Long-Term Smart Goal for Treatment

Week 7 – 12: Ensure that the client’s fearful as well as biased self-talk is identified, challenged, and eventually replaced with self-talk deemed empowering, realistic, as well as positive.

Techniques

Week 7 & 8: Seek to equip the client with the ability to embrace alternatives that are based on reality and are positive, in place of distorted messages. This happens to be in the realm of cognitive restructuring (Beard, 2011).

Week 9: Equip the client with the ability to challenge biases.

Week 9 – 12: Ensure that the client is able and capable of coping with fears that are irrational

Ethical and Legal Considerations

There are a number of legal as well as ethical considerations that could crop up in the case of Charlotte. It would be prudent to explore some of the ethical dilemmas I could encounter in my engagements with this particular client.

One ethical dilemma that could arise on this front relates to confidentiality. It should be noted that as Charlotte points out, her relations with family members is largely strained. Towards this end, as part of therapy, there may be need to reach out to the said family members so as to ensure that they advance her the relevant social and familial support that she needs or requires. However, Charlotte may not be in favor of such a move. Confidentiality is crucial in efforts to maintain trusting relationship with clients. For this reason, in the absence of Charlotte’s approval to rope in her parents, I would not be able to involve them. In seeking to address this challenge, I could attempt to engage Charlotte and clearly outline the benefits of roping in her parents – and the positive impact that this could have on her long-term recovery and wellbeing.

Yet another ethical dilemma that could be encountered in this case relates to autonomy. It is important to note that there are no guarantees that Charlotte would be appreciative of, or embrace the various treatment strategies proposed. To a large extent, the client cannot be forced to accept courses of action she happens to be against. One strategy I could deploy if this were to be a real-life concern is active communication with the client so as to address her concerns.

One own barrier I could encounter relates to ethical competence. Owing to the diversity of the society that we live in, we are bond to encounter clients from all walks of life and cultures. This essentially means that from time to time, we could encounter clients whose worldviews or perspectives differ from our own. For instance, Charlotte happens to be heterosexual. Although, I might not necessarily subscribe to her perspectives on sexuality, there is need to respect her choices and worldviews so as to guard against harmful stereotypes.

Social Change Implications

The current situation of the client was impacted by a number of barriers and systems. The said factors have been highlighted below

Sexual Orientation. Charlotte identifies as heterosexual. With the client being African-American, this is an issue that could be of particular interest on this front. This is more so the case given that past studies, as Glick and Golden (2010) indicate, have demonstrated that “African Americans tended to have less favorable attitudes toward homosexuality than white respondents” (114). The associated stigma could be contribute towards Charlotte’s worsening condition.

Familial Support: Charlotte lacks a supportive family framework. Her parents feel that she ought to be fending for herself at present. She feels unsupported and underappreciated, and believes that her parents favor her brother who has a more rewarding career. Charlotte is presently putting up with friends.

Employment: Charlotte lacks meaningful income. She does not have a job at present. Thus, she does not have the means to take care of her various needs and is at presently fully dependent upon the goodwill of friends.

As per the assessment above Charlotte would be better off with a meaningful source of income to take care of her basic needs. This is more so the case given that as Thomas, Jones, Scarinci and Brantley (2014) point out, “a variety of demographic characteristics (e.g., sex, ethnicity, low income) may be associated with depressive and anxiety disorders” (37). Family therapy could also be considered an effective approach towards the creation of a conducive familial environment for Charlotte’s mental health and wellbeing.