Assignment: Therapy for Clients with Impulsivity, Compulsivity and Addiction

Assignment: Therapy for Clients with Impulsivity, Compulsivity and Addiction

Assignment Therapy for Clients with Impulsivity, Compulsivity and Addiction

Addiction is classified as a mental condition in the diagnostic and statistical manual of mental disorders (DSM-5). A person who is unable to either physically or psychologically stop engaging in a particular activity, consuming a specific substance, or getting involved in some kind of deep thoughts is said to be suffering from addiction (American Psychiatric Association, 2013). People with severe addiction often present with compulsivity and impulsivity. This paper will assess the therapeutic decisions that have been made when treating a 53-year-old Puerto Rican female patient with a co-morbid addiction comprising of alcohol use disorder and gambling disorder. Following the diagnosis of addiction, the psychiatric mental health professional (PMHNP) must identify and implement therapeutic interventions that will improve the existing symptoms.

A person who is unable to either physically or psychologically stop engaging in a particular activity, consuming a specific substance, or getting involved in some kind of deep thoughts is said to be suffering from addiction

The primary reason for choosing Naltrexone as the initial treatment option for Mrs. Perez is that it is one of the medications that have been approved by the FDA for the treatment of alcohol dependence. The drug is highly effective in preventing relapse in patients who are suffering from addiction (Loreck, Brandt, & DiPaula, 2016). The recommended route of administration of Naltrexone in intramuscular injection in the gluteal region.

250 mg of Antabuse (Disulfiram) given orally daily has not been considered because there is little evidence that it will reduce relapse rates in patients with addiction despite the fact that it has successfully been used in the past to treat alcoholism. The drug is also associated with negative side effects when used in patients with alcohol use disorder (Stahl, 2013). Again, although Campral (Acamprosate) is effective in treating alcohol dependence, it must be combined with counseling to generate the desired results (Stahl, 2014). Therefore, these two decisions are considered inappropriate in the current scenario.

Outcomes

The PMHNP is expecting to observe positive changes in Mrs. Perez’s behaviors after four weeks. Precisely, her interest in gambling should reduce significantly. Again, the patient’s rate of cigarette use and alcohol consumption should also reduce (Grant, Odlaug, & Schreiber, 2014). Basically, Naltrexone is expected to reduce her urge for gambling and drug use. At the end of four weeks, some of the expected results have been achieved but not all. For instance, Mr. Perez has not tasted alcohol since she began to use the prescribed drugs and her rate of gambling has reduced. However, she still spends a lot of money at the casino if she visits and she is still consuming cigarettes. The patient has also developed anxiety which did not exist before.

Decision #2

Selected Decision

Refer to a counselor to address gambling issues

Reason for Selection

Counseling has been considered as the second decision option because it works well when combined with medications in addressing gambling addiction. The counselor should seek to understand and address the specific factors that are driving Mrs. Perez to engage in gambling (Grant, Odlaug, & Schreiber, 2014). Valium is used to treat alcohol withdrawal and anxiety. The drug has not been added to the current medication because the anxiety that Mrs. Perez is experiencing is just a mere side effect of the drug already administered and does not warrant treatment at this point. Again, although Chantix is effective in reducing cigarette addiction (Stahl, 2014), it has not been considered because it is highly necessary that gambling addiction is addressed first considering the fact that Mrs. Perez only enjoys smoking when she is playing at the slot machines.

Outcomes

At this point, the PMHNP expects that Mrs. Perez’s symptoms will improve even further. Precisely, she should not consume alcohol, should not go to the casino, should not smoke, and she should not experience anxiety (Grant, Odlaug, & Schreiber, 2014). The results of the counseling match what the PMHNP was expecting to achieve. On returning to the clinic in four weeks, Mrs. Perez has reported that her anxiety has completely disappeared. She has even started to attend gamblers anonymous meetings. However, Mrs. Perez does not like her counselor despite the fact that she is feeling supported in the group.

Decision #3

Selected Decision

Explore the issue that Mrs. Perez is having with her counselor, and encourage her to continue attending the Gamblers Anonymous meetings.

Reason for Selection

At this point, it is evident that Mrs. Perez is positively responding to treatment. In this respect, there is a great need that she

continues with the counseling sessions. A choice to explore issues that Ms. Perez has with her counselor has been made as it will help to build a strong patient-therapist relationship. As such, the patient will be able to continue with counseling (Sadock, Sadock, & Ruiz, 2014). Additionally, continuing with gambling anonymous meetings will help to address Mrs. Perez’s urge for gambling. Encouraging Mrs. Perez to continue with counseling is not an appropriate choice as this may make her boycott the counseling sessions. Furthermore, discontinuing Vivitrol is not an appropriate choice as this may cause an alcohol relapse (Stahl, 2013; Stahl, 2014).

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The PMHNP’s expectations at the third decision point resemble those at the second decision point. Specifically, Mrs. Perez should not consume alcohol, should not go to the casino, should not smoke, and she should not experience anxiety at the end of four weeks. Additionally, she should relate effectively with her counselor (Grant, Odlaug, & Schreiber, 2014).

The actual outcomes perfectly match what the PMHNP was expecting to achieve. On returning to the clinic in four weeks, Mrs. Perez has reported that she does not consume alcohol, does not go to the casino, does not smoke, and she does not experience anxiety. Additionally, her relationship with her counselor is really good. These results indicate that Naltrexone injection in combination with counseling is effective in treating patients with a co-morbid addiction comprising of alcohol use disorder and gambling disorder.

Ethical Considerations

            Psychiatric mental health professionals must observe ethics and regulations that govern their profession whenever they are treating patients with gambling disorder and alcohol use disorder like Mrs. Perez. The ethical and legal considerations that have been made during communication and treatment include; respect for the patient’s autonomy by obtaining informed consent, maintaining politeness to strengthen the therapeutic relationship, and respecting the patient’s privacy rights (Sadock, Sadock, & Ruiz, 2014). These considerations have generated maximum therapeutic benefits for Mrs. Perez.

Assignment: Therapy for Clients with Impulsivity, Compulsivity and Addiction Conclusion

            In summary, gambling addiction is classified as a mental disorder and should be addressed with a maximum level of professionalism. Treating the condition may present a big challenge to PMHNPs, especially if it co-occurs with other addictive disorders such as alcohol use disorder. However, it is possible to achieve positive health outcomes when appropriate therapeutic options are chosen and implemented.

Walden University Nurs 6630 – week 8 assignment

I want you to answer the questions given to you (decision points one, two, and three) before you click on the option. The answers will be based on your decisions made and patient outcomes during the decision tree. I am looking for an essay that is long enough to cover the topic BUT short enough to keep my interest. I do not need you to tell me the treatment options available to you – I am very familiar with the cases. Remember this is a Pharmacology class that incorporates Pharmacotherapy and not a class on diagnosing disease. I want you to tell me why you selected an option (why is it the best option- using clinically relevant and patient specific data) AND why you did not choose the other options (with clinically relevant and patient specific data).

At each decision point stop to complete the following:

Decision #1

Which decision did you select?
Why did you select this decision? Support your response with evidence and references to the Learning Resources. Be sure to provide rationale and clinical evidence why you DIDN’T select the other treatment choices available
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?

Decision #2

Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources. Be sure to provide rationale and clinical evidence why you DIDN’T select the other treatment choices available
Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?

Decision #3

Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources. Be sure to provide rationale and clinical evidence why you DIDN’T select the other treatment choices available
Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?

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