Week 4 discussion response to classmates

I NEED THIS TODAY BY 11PM

Please no plagiarism and make sure you are able to access all resources on your own before you bid. You need to have scholarly support for any claim of fact or recommendation regarding treatment. Grammar, Writing, and APA Format: I expect you to write professionally, which means APA format, complete sentences, proper paragraphs, and well-organized and well-documented presentation of ideas. Remember to use scholarly research from peer-reviewed articles that are current. Sources such as Wikipedia, Ask.com, PsychCentral, and similar sites are never acceptable. Each classmate’s post is listed so please respond separately.

Read your classmates’ postings. Respond to your classmates’ postings.

  • Respond to all colleagues by discussing the elements of the mini script that you liked, and why. What might you add or have said differently?

1. Classmate (K. Tri)

Betty it’s good to see you again. This is our second time meeting, last time we discussed your mood episodes and the different types of ways you feel. You shared that at times you don’t feel at your best, and it seem like things are falling apart one by one. I’m sorry that you’re not feeling well from day to day basis. Betty, how do you feel today at this present moment?  Do you feel that you have made improvements with your actions?  I have to be honest betty I am a little concern with your episodes and feel that we need to take father actions so that you could properly receive that help that you need. What I am mostly concerned about are your behavior during your episodes. According to the (2013) the essential feature of a manic episode is a distinct period during which there is an abnormally, persistently elevated, expansive, or irritable mood and persistently increased activity or energy that is present for most of the day, nearly every day, for a period of at least 1 week. This is what makes me concerned betty, you have been struggling with your modes and actions for several weeks now. You show signs of 4 to 5 symptoms that needs to be addressed. Would you agree to that?

Betty, I would like to refer you out to a psychiatrist to receive more assistance with you diagnoses. First, of all I feel you may need to be placed on medication to assist with daily living. Myself as a counselor it’s out of my scope to prescribe medication, but I could point you in the right direction. Secondly, I feel that since this is only the second time we have met I feel that this could be a major part of you begin whole again. This is what we call Collaborative behavior healthcare, With proper counsel and medication treatment I can see you raising above the stars to maintain a balance controlled life. Betty would you agree this maybe something you need? Great! In your first meeting I shared with you that I would never disclose your personal information unless I refer you to another professional or unless you agree too by signing. Another reason I would share your Release of information (RIO) if you are threaten to hurt yourself or someone. Would you sign on this dotted line so I could release your background to other professional to better serve you.

Reference:

Diagnostic and statistical manual of mental disorders: DSM-5. (2013). Washington, D.C.:

American Psychiatric Publishing.

2. Classmate (R. Haw)

rovide an explanation of why counselors refer clients to a psychiatrist for a psych eval (what is and what is not in our scope of practice).

When dealing specifically with bipolar disorder (as with other mental illnesses), it is important to understand that it is believed that most forms have biological as well as environmental origins, and therefore, treatment will be most effective with a combination of psychotherapy and pharmacotherapy (Sinacola, Peters-Strickland, & Wyner, 2020).  Given this, it is important that the counselor understand the importance of referring the client to a psychiatrist for further evaluation.  It is not within the mental health counselor’s scope of practice to suggest or prescribe medications.  According to the ACA Code of Ethics (2014), Section C.2.a states that counselors are to “practice only within the boundaries of their competence, based on their education, training, supervised experience, state and national professional credentials, and appropriate professional experience (p.8).  It is, however, within the mental health counselor’s scope of practice to recognize the effect that physical illness has on mental illness, and to subsequently refer the client to the appropriate medical professional (Sinacola et al., 2020). 

Explain what collaborative behavioral healthcare is.

The American Psychiatric Association describes a collaborative care model as one in which the primary care provider leads a team that includes psychiatrists, behavioral health managers, and other mental health providers to develop and implement a client care plan that is patient-centered, and is based on best practices to meet clinical goals (APA, 2020).

Include a description of two circumstances when a counselor would refer a client for a psych evaluation.

  1. A client exhibits signs and symptoms of Bipolar Disorder Type      1 – i.e. describes episodes of mania, depression, or mixed mood states      (Sinacola et al., 2020).
  2. A client exhibits signs and symptoms of Schizophrenia – i.e.,      reports experiencing hallucinations, delusions, or paranoia (Sinacola et      al., 2020).

Describe two circumstances when a counselor would use the Release of Information (ROI) signed by a client.

  1. When working as part of a collaborative care team to include      the client’s primary care provider, psychiatrist, and/or any other mental      health professionals involved in the patient’s care.
  2. When the client wishes to allow other people to have access      to their care plan, i.e. a spouse, child, etc.

Include an empathetic reflection to Betty:

Betty came to her second session with you describing what appear to be manic and depressive episodes. You have valid questions and concerns and want to get a formal psych eval.

How would you explain to Betty that you have concerns about her symptoms and want to refer her to see a psychiatrist for evaluation? Write out a mini script showing what you, the counselor, might say to Betty.

Betty, based on what you’ve described, I believe that you may be experiencing symptoms of Bipolar Disorder.  I can see that these symptoms are causing you significant distress, and I’m concerned about the possible long-term effects they could have on your mental and physical well-being.  I realize this may sound scary, but I want you to understand that this is a physical condition that affects your brain chemistry.  The good news here is that it is treatable.  The first thing we need to do, however, is to have you undergo a formal assessment to determine for sure if this is what is causing your symptoms.  Once we get that established, we can move forward with finding the treatment plan that works best for you.  So, are you open to a referral?  I’d be happy to help you set something up.

References:

American Counseling Association. (2014). ACA code of ethics. Retrieved from http://www.counseling.org/docs/ethics/2014-aca-code-of-ethics.pdf?sfvr

American Psychiatric Association. (2014). Learn about the collaborative care model. Retrieved from https://www.psychiatry.org/psychiatrists/practice/professional-interests/integrated-care/learn

Sinacola, R. S., Peters-Strickland, T., & Wyner, J. D. (2020). Basic psychopharmacology for mental health professionals (3rd ed.). Hoboken, NJ: Pearson.

3. Classmate (S. G-C)

Betty, your description of having mixed mood states leads me to believe we need to refer you to a psychiatrist for what is called a psychological evaluation. When a client shows signs of depression, anxiety, or mixed mood states such as yourself it is best to refer to a psychiatrist because through medical testing and assessments, they can help determine what is truly going on and help get you back on track (Sinacola, Peters-Strickland, & Wyner, 2020). As a counselor, diagnosing certain mental disorders and prescribing medications are outside of my scope of practice. However, you can still receive psychotherapy through collaborative behavioral healthcare, where you see both a psychiatrist for medication management and a therapist for counseling (Sinacola, Peters-Strickland, & Wyner, 2020).

If medications are prescribed, they can allow you to have relief from your symptoms so you can benefit from the counseling experience. Research has shown that clients that receive psychotherapy along with medication for mental disorders are more likely to be successful with medication compliance and are less likely to have a recurrence of the mixed mood episodes you have been dealing with (Miklowitz, 2020). To make sure we give you the best care I would like to use a Release of Information (ROI) form and get your permission to give information to the psychiatrist and receive information back (Charters, 2003). I would also like to include your primary care physician (PCP) to ensure there are no adverse reactions and that what the psychiatrist prescribes will comply with any other medications you receive from your PCP.

I can see that this is upsetting you, but you are not alone. It helps to include a family member or caregiver in the treatment plan to help you cope with this new way of managing everyday life; and I would need a ROI for that as well if you would like me or your psychiatrist to discuss your care and medications with whomever you designate (Charters, 2003). Also, joining a support group can help you understand what it is like to live this type of disorder and seeing that others share your type of symptoms can also normalize the experience for you.

 

Reference

Charters KG. (2003). HIPAA’s latest privacy rule. Policy, Politics & Nursing Practice, 4(1), 75–78.

Miklowitz, D.J. (2020). Psychotherapy in Addition to Medication Brain and Behavior Research Foundation. Helps Bipolar Disorder Patients Avoid Relapse and Manage Their Symptoms, Study Determines. Brain and Behavior Research Foundation. Retrieved December 22, 2020 from https://www.bbrfoundation.org/content/psychotherapy-addition-medication-helps-bipolar-disorder-patients-avoid-relapse-and-manage

 
 

Sinacola, R. S., Peters-Strickland, T., & Wyner, J. D. (2020). Treatment of Bipolar Disorder. In, Basic psychopharmacology for mental health professionals (3rd ed.). Hoboken, NJ: Pearson.

Required Resources

Sinacola, R. S., Peters-Strickland, T., & Wyner, J. D. (2020). Basic psychopharmacology for mental health professionals (3rd ed.). Hoboken, NJ: Pearson.

· Chapter 6, “Treatment of Bipolar Disorder”

Required Media

TED. (2017, February). Helen M. Farrell: What is bipolar disorder? [Video file]. Retrieved from https://www.ted.com/talks/helen_m_farrell_what_is_bipolar_disorder

Note: The approximate length of this media piece is 6 minutes.

TED. (2011, May). Joshua Walters: On being just crazy enough. [Video file]. Retrieved from https://www.ted.com/talks/joshua_walters_on_being_just_crazy_enough

Note: The approximate length of this media piece is 6 minutes.

Optional Resources

Brain and Behavior Research Foundation. (n.d.). Bipolar Disorder. Retrieved June 11, 2019 from https://www.bbrfoundation.org/research/bipolar-disorder

Depression and Bipolar Support Allliance. (n.d.). Retrieved June 11, 2019 from https://www.dbsalliance.org/

International Bipolar Foundation (n.d.). Healthy living with bipolar disorder book. Retrieved June 11, 2019 from http://ibpf.org/webform/healthy-living-bipolar-disorder-book

Psychopharmacology Institute (2019). Bipolar disorder treatment guidelines: A 2019 update. Retrieved on June 13, 2019 from https://psychopharmacologyinstitute.com/guidelines/bipolar-disorder-guidelines/

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