Assignment: Decision Tree A Woman with a Personality Disorder

Assignment: Decision Tree A Woman with a Personality Disorder

Assignment Decision Tree A Woman with a Personality Disorder

 

Personality disorders refer to a group of chronic mental illnesses that present with unhealthy and inflexible patterns of thoughts and behaviors (Angstman & Rasmussen, 2011). The disorders are linked to problematic relationships and work as well as trouble handling everyday stresses and problems. The disorders are challenging to manage due to limited research on pharmacological treatments that can handle them. The purpose of this paper is to review a case study of a 32-year old Hispanic female named Rhonda who presents to the clinic with life stressors and characteristics that align with personality disorders. The paper will follow a decision tree to evaluate the client, establish the appropriate diagnosis and treatment plan and outline the ethical considerations that guided communication and treatment plan with the client.

Decision Point 1: Differential Diagnosis

Selected Decision

The selected decision is antisocial personality disorder (APD).

Reason for Selection

Click here to ORDER an A++ paper from our MASTERS and DOCTORATE WRITERS: Assignment: Decision Tree A Woman with a Personality Disorder

According to the case study, Rhonda states that her friends have abandoned her yet she goes the extra mile to help them. She states

her problem stems from a breakup with a boyfriend who was initially good but turned out to be a “monster” (Laureate Education, 2017a). Her subjective report outlines that she has a risky, insecure, unstable social and financial livelihood. She has not cleared college, cannot sustain her job, has no children, she steals, has been incarcerated for various offenses, and has been caught with controlled substances and engages in fights.  She reports that as a child she was impulsive and she portrays paranoia that other people are to blame for her situation because they are jealous of her. All these align with the DSM-5 criteria for antisocial personality disorder. According to DSM-5, patients with APD violate physical and emotional rights of others, have no stability in job and home life, are irritable and aggressive, lack remorse, are deceitful, have a childhood diagnosis of conduct disorder and have consistent irresponsibility, recklessness, and impulsivity (Rojas & Widiger, 2017).

The patient could be diagnosed with borderline personality disorder (BPD) since she has some symptoms that point towards BPD. She portrays poor impulse control like reckless and self-endangering behaviors, has unstable interpersonal relationships, mood swings characterized by unprovoked and intense anger and poor self-image (Rojas & Widiger, 2017). However, she does not portray efforts to avoid abandonment and rejection or recurring suicidal behaviors which rule out BPD.  A histrionic personality disorder is also rejected because the patient does not exaggerate emotional expression, portray provocative and inappropriate sexual behavior, engage in theatricality and self-dramatization or try to be the center of attraction.

Expectations

The clinician expects to make an accurate diagnosis to help in coming up with a concrete treatment plan or any other appropriate interventions that suit the client. Research shows that early detection, accurate diagnosis and right treatment of a mental disorder results in reduced distress and better quality of life for the patient and the family (Parker, 2019). The clinician also expects that the set intervention will enhance the patient’s interpersonal and social functioning. Nevertheless, APD is a serious diagnosis that requires one to rule out other disorders. The clinicians feel that the patient should undergo a psychological evaluation to confirm the diagnosis.

Decision Point 2: Treatment Plan for Psychotherapy

Selected Decision

The selected decision is a referral to a psychologist for psychological testing.

Reason for Selection

The decision is made because ASD is a complex and challenging disorder that has limited treatment options and hard to manage. As outlined above, the patient’s symptoms almost coincide with a borderline personality disorder. Generally, a psychiatric symptom can occur in more than one psychiatric disorder, which makes it essential to make an accurate diagnosis (Parker, 2019). Accuracy will help in the formulation of the most effective treatment that will result in remission. Psychological testing will help in exploring the client’s behavior, feelings and thoughts and ruling out other mental disorders.

Haldol 5mg orally daily is avoided because there is no FDA approved medication for treating antisocial personality disorder (Fisher & Hany, 2019). Additionally, psychodynamic psychotherapy is also rejected because it does not work for APD patients who most of the time initiate therapy only when mandated by the court. APD patients lack the motivation to change their behaviors as a necessity for psychodynamic psychotherapy to be effective.

Expectation and Results

The clinician expected that the psychologist will offer a definitive diagnosis. The clarity would help in recommending the ideal intervention that would help the patient handle her symptoms.

Difference in Expected and Actual Results

In line with expectations after four weeks, the psychologist’s report outlines that the patient underwent a comprehensive psychological battery to clarify her diagnosis (Laureate Education, 2017a). The psychologist found out that Rhonda has traits of multiple personality disorders. Nevertheless, she scores higher on antisocial personality traits pointing towards ASD. A notable presentation is that the client is upset by the report but verbalize that she came to the clinic to get better.

Decision Point 3: Treatment Plan for Psychopharmacology

Selected Decision

The selected decision is a referral to a group-based cognitive-behavioral therapy.

Reason for Selection

Group CBT is selected because it uses behavioral, cognitive, relational and group procedures to enhance the participants coping skills and amend interpersonal and relational problems that patients may be experiencing (Van den Bosch, Rijckmans, Decoene & Chapman, 2018). The patient already understands their behavior and is motivated to improve which means that CBT will instill social techniques necessary to effect positive changes. The group setting will allow the patient to discuss her symptoms with people facing similar problems and issues. The use of dialectical behavioral therapy is avoided due to the lack of evidence-based support on its effectiveness on patients suffering from APD (Fisher & Hany, 2019). Similarly, a lack of evidence on the effectiveness of Latuda among APD patients leads to its rejection. FDA has not approved any medication due to the likelihood of misuse and diversion of prescribed medications.

Expectation and Results

The clinician expects to see a a reduction in the patient disease symptoms. She should have better social techniques, coping skills and her interpersonal and relational problems should reduce.

Difference between Expected and Actual Results

The patient presented as expected.

Ethical Considerations

Patients with antisocial personality disorder are challenging to handle because they are emotionally unstable, excessively demanding, interpersonally inappropriate and manipulative. Clinicians should be mindful of personal feelings and the likelihood of developing countertransference when handling the patients (Conlin & Boness, 2019). It is ethical to ensure that the patient is comprehensively assessed and evidence-based interventions are used. Any treatment offered should alleviate symptoms and improve patient quality of life. For the current patient, she was handled with care. For her diagnosis to be clarified she was referred to a psychologist after DSM-5 indicated she had APD. Additionally, group CBT was selected due to its ability to help the client while the use of medication, psychodynamic psychotherapy dialectical behavioral therapy were avoided because they lacked approval and sufficient evidence support.

For assignments that need to be submitted to Lopes Write, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me.

Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes.

Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own?

Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for tips on improving your paper and SI score.

Late Policy

The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies.

Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances.

If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect.

I do not accept assignments that are two or more weeks late unless we have worked out an extension.

As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.

Communication

Communication is so very important. There are multiple ways to communicate with me:

Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class.

Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.

Important information for writing discussion questions and participation

Welcome to class

Hello class and welcome to the class and I will be your instructor for this course. This is a -week course and requires a lot of time commitment, organization, and a high level of dedication. Please use the class syllabus to guide you through all the assignments required for the course. I have also attached the classroom policies to this announcement to know your expectations for this course. Please review this document carefully and ask me any questions if you do. You could email me at any time or send me a message via the “message” icon in halo if you need to contact me. I check my email regularly, so you should get a response within 24 hours. If you have not heard from me within 24 hours and need to contact me urgently, please send a follow up text to

I strongly encourage that you do not wait until the very last minute to complete your assignments. Your assignments in weeks 4 and 5 require early planning as you would need to present a teaching plan and interview a community health provider. I advise you look at the requirements for these assignments at the beginning of the course and plan accordingly. I have posted the YouTube link that explains all the class assignments in detail. It is required that you watch this 32-minute video as the assignments from week 3 through 5 require that you follow the instructions to the letter to succeed. Failure to complete these assignments according to instructions might lead to a zero. After watching the video, please schedule a one-on-one with me to discuss your topic for your project by the second week of class. Use this link to schedule a 15-minute session. Please, call me at the time of your appointment on my number. Please note that I will NOT call you.

Please, be advised I do NOT accept any assignments by email. If you are having technical issues with uploading an assignment, contact the technical department and inform me of the issue. If you have any issues that would prevent you from getting your assignments to me by the deadline, please inform me to request a possible extension. Note that working fulltime or overtime is no excuse for late assignments. There is a 5%-point deduction for every day your assignment is late. This only applies to approved extensions. Late assignments will not be accepted.

If you think you would be needing accommodations due to any reasons, please contact the appropriate department to request accommodations.

Plagiarism is highly prohibited. Please ensure you are citing your sources correctly using APA 7th edition. All assignments including discussion posts should be formatted in APA with the appropriate spacing, font, margin, and indents. Any papers not well formatted would be returned back to you, hence, I advise you review APA formatting style. I have attached a sample paper in APA format and will also post sample discussion responses in subsequent announcements.

Your initial discussion post should be a minimum of 200 words and response posts should be a minimum of 150 words. Be advised that I grade based on quality and not necessarily the number of words you post. A minimum of TWO references should be used for your initial post. For your response post, you do not need references as personal experiences would count as response posts. If you however cite anything from the literature for your response post, it is required that you cite your reference. You should include a minimum of THREE references for papers in this course. Please note that references should be no more than 5 years old except recommended as a resource for the class. Furthermore, for each discussion board question, you need ONE initial substantive response and TWO substantive responses to either your classmates or your instructor for a total of THREE responses. There are TWO discussion questions each week, hence, you need a total minimum of SIX discussion posts for each week. I usually post a discussion question each week. You could also respond to these as it would count towards your required SIX discussion posts for the week.

I understand this is a lot of information to cover in 5 weeks, however, the Bible says in Philippians 4:13 that we can do all things through Christ that strengthens us. Even in times like this, we are encouraged by God’s word that we have that ability in us to succeed with His strength. I pray that each and every one of you receives strength for this course and life generally as we navigate through this pandemic that is shaking our world today. Relax and enjoy the course!

Hi Class,

Please read through the following information on writing a Discussion question response and participation posts.

Contact me if you have any questions.

Important information on Writing a Discussion Question

• Your response needs to be a minimum of 150 words (not including your list of references)
• There needs to be at least TWO references with ONE being a peer reviewed professional journal article.
• Include in-text citations in your response
• Do not include quotes—instead summarize and paraphrase the information
• Follow APA-7th edition
• Points will be deducted if the above is not followed

Participation –replies to your classmates or instructor

• A minimum of 6 responses per week, on at least 3 days of the week.
• Each response needs at least ONE reference with citations—best if it is a peer reviewed journal article
• Each response needs to be at least 75 words in length (does not include your list of references)
• Responses need to be substantive by bringing information to the discussion or further enhance the discussion. Responses of “I agree” or “great post” does not count for the word count.
• Follow APA 7th edition
• Points will be deducted if the above is not followed
• Remember to use and follow APA-7th edition for all weekly assignments, discussion questions, and participation points.
• Here are some helpful links
• Student paper example
• Citing Sources
• The Writing Center is a great resource