Stages of Developing a Psychiatric Treatment Care Plan

Stages of Developing a psychiatrical Treatment anxiety PlanA diligent had been admitted to an A E unit after committing deliberate self-harm. He had attempted to commit suicide by overdosing on some headache tablets. When that hadnt worked he slashed himself in several places using a kitchen knife. He arrived at the A E unit in an extremely distressed state.Why the psychologist was called inAlthough the unhurried clearly had very severe physical injuries a super psychosocial assessment revealed he was suffering from severe cordial problems. His symptoms seemed to suggest clinical depression that was so deep-rooted and severe it necessitated intensive and sustained psychotherapy. Thus, it was contumacious to immediately refer him to a clinical psychologist. This is consistent with professional guidelines, which comm curio that self-harm patients are referred for psychological intervention if an initial psychosocial assessment reveals an underlying psychological problem ( NICE, 2004, p.32). A clinical psychologist is formally trained to palm with non-homogeneous forms of psychopathology, including clinical depression, based on psychological theories and research (Davey, 2004, pp.713-714). In attachment to carrying out in-depth psychological evaluations, to identify underlying psychopathology (using a abundant variety of personality and neuropsychological tests, and clinical observation), the psychologist is trained to make a formal diagnosis, using set criteria. clinical psychologists and psychiatrists have very quasi(prenominal) training. However a clinical psychologist rather than psychiatrist was called in to deal with this case because the latter are primarily medical doctors, and hence typically use the medical model for dealing with psychological disorders. Psychosocial assessment suggested that this patient primarily required intensive psychotherapy rather than medication.Theoretical conceptsThe clinical psychologist relied upon Sigmund F reuds psychoanalytic theory in formulating a treatment political program (McMillan, 2001, pp.599-600). Freuds conceptualisations have had a massive impact on pop culture, and psychology and psychiatry in particular. Psychoanalytic theory posits that un certain conflict, oft emanating from childhood, and involving forbidden sexual and aggressive desires causes psychopathology. A distinction is made surrounded by the conscious(p) (awareness), preconscious (memories that are readily accessible), and unconscious (repressed memories of which a person whitethorn not even be aware). Superimposed against these levels of consciousness are deuce-ace comp peerlessnts of human personality the id (basic biological drives), the ego (restrictions imposed by outdoor(a) reality), and superego (conscience). The id operates at the subconscious level, while the ego and superego function at the preconscious and conscious levels. Perpetual and intense conflicts between the id and the other two com ponents can depict considerable anxiety and, if unresolved, mental health problems. Psychoanalysis places considerable tenseness on the sex drive, or libido. Humans are thought to go along through several stages of psychosexual organic evolution. Fixation at any one stage results in various emotional problems.What the psychologist didDuring the initial session with the patient the clinical psychologist immediately set up a good rapport with the patient. The priority was to assess the patients problem, and develop a comprehensive treatment invention with clear goals for recovery. After an initial session the patient underwent numerous sessions involving drop out association, a therapeutic form of psychoanalysis (McMillan, 2001, pp.167-168). During this procedure, the psychologist encouraged the patient to talk whatever came to mind. Free association is considered to yield clues about the subconscious root of a patients problem. The patient spoke a lot about his childhood. Fro m snip to time the therapist probed with searching questions encouraging the patient to elaborate on particular statements made. During each session the psychotherapist maintained an empathic and non-judgemental demeanour, in order to facilitate a high degree of trust between himself and the patient. The patient attended weekly sessions over a six- month period. During the final month of therapy the clinician engaged in dream analysis, whereby the patient was asked to describe recent dreams in as much detail and with as much accuracy as possible.How the psychologists input was assessedBy the end of therapy it had gradually become clear that the patient had been experiencing intense homosexual desires ever since puberty. These urges had been repressed for years, in order to accommodate to social norms and his parents wishes for him to get married and have children. The patient wasnt conscious of these forbidden desires. The realisation made him feel much better, going a long way to explain why he had been feeling pathologically depressed, even suicidal. The impact of psychoanalytic therapy on this patient was assessed using a pre- and post-test experimental analysis (Coolican, 1994, pp.82-88). During his initial assessment of the patient the psychologist obtained baseline measures of psychiatric symptoms using the SCL-90-R (Derogatis, 1983), social functioning using the Social Adjustment outdo (Weissman, 1975), general adjustment in life, using the world(a) Assessment collection plate (Endicott et al, 1976), and episodes of self-harm, using the Suicide and Self-Harm Inventory (Sansone et al, 1998) during the previous six months. At the end of therapy the therapist administered the same battery of tests to gauge any improvements in the patients mental health. Statistical analysis comparing pre- and post-test data, using a t-tested for repeated measures (Coolican, 1994, pp.281-286) showed significant improvements on all criteria psychiatric functioning, and social/global adjustment, and frequency of self-harm.BibliographyCoolican, H. (1994) look for Methods and Statistics in Psychology, London, HodderDavey, G. (ed) (2004) Complete Psychology . London Hodder and StoughtonDerogatis, L.R. (1983) SCL-90-R Administration, Scoring, and Procedures Manual,II. Towson, Md, Clinical Psychometric Research.Endicott, J., Spitzer, R.L., Fleiss, J.L. Cohen, J. (1976) The Global AssessmentScale a procedure for measuring overall stiffness of psychiatric disturbance.Archives of General Psychiatry, 33, pp.766771.NICE (2004) Self-Harm The Short-Term Physical and psychological Managementand Secondary Prevention of Self-Harm in Primary and Secondary CareClinical Guideline 16. London National Institute for Clinical Excellence.McMillan, M. (2001) The dependableness and validity of Freuds methods of freeassociation and interpretation. Psychological Inquiry, 3, pp. 167-175.Sansone, R.A., Wiederman, M.W. Sansone, L.A. (1998) The Self-Harm Inventory(SHI) deve lopment of a scale for identifying self-destructive behaviors andborderline personality disorder. Journal of Clinical Psychology, 54, pp.973-983.Weissman, M.M. (1975) The assessment of social adjustment. Archives of GeneralPsychiatry, 32, pp.357365.