PSYCHOEDUCATION, PSYCHOPHARMACOLOGY, AND NURSING CARE AND INTERVENTIONS WHEN WORKING WITH CONSUMERS WITH MENTAL HEALTH ISSUES IN REGARDS TO THE CASE STUDY
Table of Contents
Paul is in a condition where he is switching between jobs since he left the defence force. He feels almost dysfunctional in his family, and does not seem to get along with any of his employers. The constant travel between jobs have made him even more reckless, resulting in use of substances such as hallucinogens and increasing number of drugs. He seems to feel unstable and feels stuck in a dysfunctional marriage that is on the verge of breaking apart. His recent diagnosis with bipolar disorder makes it everything even worse, leading towards the state of impatience to find any jobs that would actually make him happy.
The condition of Paul is consistently deteriorating with his increasing substance abuse with hallucinogens and drinking habits. He feels even more reckless since he is yet to find a job that would make his actually happy and bipolar disorder on the top of that makes everything even worse. He seems not to be able to control his emotions, especially in the place of professions and therefore he is finding himself in situation that is making him reckless and impatient and be in constant conflicts with the employers, something that is resulting in his switching between the jobs. The manic depression that he has recently been diagnosed with is deteriorating everything worse, as he feels his emotions are to be travelling between the ranges of depressive lows and the manic highs, something that is making him emotionally very unstable and to stay socially functional per say.
For the bipolar disorder for Paul, it has been decided by the RN is that the ideal pharmacological treatment for him considering his currently condition and situation and all the additional factors into account, he will be going through a systemic treatment (White et al. 2020). This treatment would include medications, continued treatment and day treatment programs, substance abuse treatment and finally hospitalisation on the arrival of any potential emergency (Baandrup et al. 2021). The primary focus would be medication and would entail mood stabilizers, antipsychotics, antidepressants, antidepressants-antipsychotics, anti-anxiety medicines. Mood stabilizers such as divalproex sodium, Lithium, valproic acid or even Lamotrigine. The antipsychotics would include olanzapine, quetiapine, aripiprazole, lurasidone, or even asenapine (Meuldijk et al. 2021). Antidepressants-antipsychotics such as the combination of antidepressant fluoxetine and Symbyax would be provided for it to work as a depressive treatment and mood stabiliser. Anti-anxiety medications such as the benzodiazepines would be provided to Paul to ensure that the anxiety and his sleeping hour is well-improved but will be used for short time basis (Zyto et al. 2020).
With the consistent use of substance in Paul is likely to cause even worse distress and with that the diagnosis of his bipolar is most likely to put him in situations where the conflicts and clashes are common occurrences (Baandrup et al. 2021). This alone would put him is further distress and would potentially put him in legal violation at workplace or even at his home, something that would potentially get him jail time or even financial fines and all, sorts of reputation as a previous defence officer and would ruin his career for potentially getting any jobs or have a career of his own in the near future. Excessive usage of hallucinogens and drinking is what would like to cause an overwhelming amount of ethical abnormally and would most likely to cause an increasing amount of mental and physical distress something that is extremely unethical (Higgins et al. 2020).
For the nursing intervention, the RN has decided to provide a consistent psycho education to Paul to ensure that he is aware of the situation and is able to convey wilfully and properly to his family members, Besides the aspect of psychoeducation, the aspect of CBT or Cognitive behavioural therapy would be implemented to treat Paul and he would be medically assessed (Gelkopf, Mazor & Roe, 2021). Using the CBT, he would be placed in environments for a healthy discussion on family-focused therapies, identify the negative and unhealthy behavioural developments and habits and would also help him identify the exact aspects that in fact triggers his bipolar experiences (Baandrup et al. 2021). By breaking down into smaller parts, Paul would be assisted with the aspect of CBT to overcome his problems in a much more positive manner. Use of CBT is conducted to enable the alternative thinking ability in Paul something that would help him assess himself effectively (Arjadi et al. 2018).
CBT therapy would be implicated for Paul to ensure that he is able to identify all the necessary strategy that he ca potentially use to cope with any emerging distress and all sorts of distressing and bipolar situations (Zyto et al. 2020). By enabling him to have the ability to think alternatively would help improve the situation in a much better manner and it would potentially increase the aspect of how he is able to involve in a self-assessment for coping with the bipolar highs and manic lows (Wilson, Hurley, Hutchinson & Lakeman, 2020). Reduction of psychological distress would be a consistent outcome with the involvement of the CBT and would allow Paul to effectively indulge in the alternative thinking and identify the negative thoughts that have been affecting for all these times and putting him in situations where he is not supposed to (White et al. 2020).
A multi-disciplinary team would comprise of a set of skilled and competent individuals with the consultation of everybody considered where the RN, the psychiatric nurses, clinical psychologists, the social workers, and even the occupational therapists would be involved (Moran et al. 2020). With the involvement of the MDT the holistic approach would be involved and would be initiated and with that the aspect of looking a different department in a much more integrated manner instead of focusing on departments such individually or looking into matter separately (Meuldijk et al. 2021). By educating Paul and his patients about all sorts of affects such as the recurrences, relapses, risk of morbidity with Paul’s diagnosis, etc, it would alone help to effectively evaluate the therapeutic efficacy and would help improve the overall development and understand the situation much better in a collective manner. This involvement of the family members would also help Paul feel much more involved and would allow him to effectively open up (Jonathan et al. 2021).
In order to treat BD patient like Paul, the MDT would effectively combine techniques, here the establishment of multidimensional treatments would be established. The establishment of the multidimensional treatment would be developed based on the establishment of interventions method that has been previously considered that is the CBT (Higgins et al. 2020). For Paul, based on the interventions, the problems that Paul is essentially experiencing would be defined ad addressed and with that all the necessary objectives and health outcomes would duly be achieved (Hidalgo-Mazzei et al. 2018). With the possible establishment of the multiaxial diagnosis, the aspect of listing the problems would be executed and with that and with that the determining the modalities of the treatments would be conducted accordingly (Gelkopf, Mazor & Roe, 2021). The therapeutic engagement and the level of patient’s involvement would help have subsequent evaluation of the overall of progress. This alone would facilitate the determination of the efficacy if the intervention method that has earlier been proposed and would be ideally indicated and would be involved with the overall improvements (Baandrup et al. 2021). The aspect of psychotherapy and focused group therapy and with the involvement of the family therapy the MDT team would be able to assess and evaluate the situations and provide the necessary treatments to Paul, accordingly (Arjadi et al. 2018).
The overall situation of Paul would be improved using the intervention method proposed by te RN and with the aspect in a proper MDT team, his situations and medical developments would be assed in a much better manner. The aspect of overall improvement of the consistent sense of involvement of Paul and as well as his family would help the treatment process trod find perspectives and also would help the treatments to get proceeded in a much better and systematic manner. The involvement of the MDT would team would also improve the situations to find effective developments, accurate assessments and an effective progression of the medical evaluation accordingly.
Arjadi, R., Nauta, M. H., Scholte, W. F., Hollon, S. D., Chowdhary, N., Suryani, A. O., … & Bockting, C. L. (2018). Internet-based behavioural activation with lay counsellor support versus online minimal psychoeducation without support for treatment of depression: a randomised controlled trial in Indonesia. The Lancet Psychiatry, 5(9), 707-716. Retrieved from: https://www.sciencedirect.com/science/article/abs/pii/S2215036618302232
Baandrup, L., Rasmussen, J. Ø., Mainz, J., Videbech, P., & Kristensen, S. (2021). Patient-Reported Outcome Measures in Mental Health Clinical Research: A Descriptive Review in Comparison with Clinician-Rated Outcome Measures. International Journal for Quality in Health Care. Retrieved from: https://academic.oup.com/intqhc/advance-article/doi/10.1093/intqhc/mzab001/6066323?login=true
Gelkopf, M., Mazor, Y., & Roe, D. (2021). A systematic review of patient-reported outcome measurement (PROM) and provider assessment in mental health: goals, implementation, setting, measurement characteristics and barriers. International journal for quality in health care, 33(1), mzz133. Retrieved from: https://academic.oup.com/intqhc/article/33/1/mzz133/5803038?login=true
Hidalgo-Mazzei, D., Reinares, M., Mateu, A., Nikolova, V. L., del Mar Bonnin, C., Samalin, L., … & Colom, F. (2018). OpenSIMPLe: a real-world implementation feasibility study of a smartphone-based psychoeducation programme for bipolar disorder. Journal of affective disorders, 241, 436-445. Retrieved from: https://www.sciencedirect.com/science/article/abs/pii/S0165032718308486
Higgins, A., Murphy, R., Barry, J., Eustace-Cook, J., Monahan, M., Kroll, T., … & Gibbons, P. (2020). Scoping review of factors influencing the implementation of group psychoeducational initiatives for people experiencing mental health difficulties and their families. Journal of Mental Health, 1-14. Retrieved from: https://www.tandfonline.com/doi/abs/10.1080/09638237.2020.1714002
Jonathan, G. K., Dopke, C. A., Michaels, T., Bank, A., Martin, C. R., Adhikari, K., … & Goulding, E. H. (2021). A Smartphone-Based Self-management Intervention for Bipolar Disorder (LiveWell): User-Centered Development Approach. JMIR Mental Health, 8(4), e20424. Retrieved from: https://mental.jmir.org/2021/4/e20424/
Meuldijk, D., Wuthrich, V. M., Rapee, R. M., Draper, B., Brodaty, H., Cuijpers, P., … & Wijeratne, C. (2021). Translating evidence-based psychological interventions for older adults with depression and anxiety into public and private mental health settings using a stepped care framework: Study protocol. Contemporary Clinical Trials, 104, 106360. Retrieved from: https://www.sciencedirect.com/science/article/pii/S1551714421000963
Moran, G. S., Kalha, J., Mueller-Stierlin, A. S., Kilian, R., Krumm, S., Slade, M., … & Puschner, B. (2020). Peer support for people with severe mental illness versus usual care in high-, middle-and low-income countries: study protocol for a pragmatic, multicentre, randomised controlled trial (UPSIDES-RCT). Trials, 21, 1-15. Retrieved from: https://link.springer.com/content/pdf/10.1186/s13063-020-4177-7.pdf
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Zyto, S., Jabben, N., Schulte, P. F., Regeer, E. J., Goossens, P. J., & Kupka, R. W. (2020). A multi-center naturalistic study of a newly designed 12-sessions group psychoeducation program for patients with bipolar disorder and their caregivers. International Journal of Bipolar Disorders, 8(1), 1-9. Retrieved from: https://journalbipolardisorders.springeropen.com/articles/10.1186/s40345-020-00190-5
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