Review of Initial Treatment Plan
Eliza suffers from situational anxiety based on the DMS IV criteria for diagnosis (Diagnostic and statistical manual of mental disorders: DSM-IV. 1994). In this case, Eliza approached for treatment and recovery. She accepted that she suffered from depression, stress, and anxiety due to her sudden change in life, specifically her movement into college and life without her parents. The initial treatment plan focused on determining the reasons for low self-esteem, assessing her relationship with her parents to determine how they may have impacted psychological issues that Eliza suffers at the present day. The initial treatment goal was to prevent and control triggers/stressors that could eliminate or alleviate the symptoms of depression, anxiety, and stress. The treatment comprises of one-on-one talk therapy which has been proven to be clinically effective among patients with situational anxiety (MacKenzie, 1991). Group therapy is highly recommended for Eliza since it would not only help her share her feelings and achieve personal treatment goals but also indicate possible alleviation of symptoms of stress and depression (Meyer, et al. 2016).
Examine the case and propose why the changes occurred.
The initial treatment only comprised of one-on-one therapy coupled with visualization strategies and emotional maintenance. However, Eliza would require a combination of more than one psychotherapy and pharmacotherapy to ease down her symptoms and help her live a continued quality of life. Since Eliza may only feel anxious and stressed on specific occasions, it is advised that she has a routine exercise regimen. Exercise of any kind helps relieves tension and makes the body active. She can perform yogic exercises, cardiovascular exercises such as running, jogging, or cycling. Swimming can also help in relieving stress and anxiety. Cognitive behavioural therapy (CBT) is highly recommended for patients like Eliza. It helps in motivating, encouraging, and self-assessing one’s ability to cope and tackle with a situation. Unlike the conventional one-on-one talk therapy, CBT is known to help manage depression and anxiety disorders. A support group or the use of her friends and family members would help Eliza feel comfortable, motivated, and secure. Since her new college friends and environment are considered as potential triggers of anxiety, providing a social group or support group within the same environment could help relieve her stress symptoms
Reassess the effectiveness and validity of the treatment plan
Exercises are known to alleviate the symptoms of anxiety and considered as a useful alternative to pharmacological treatment (Stonerock, Hoffman, Smith, & Blumenthal, 2015). Based on a recent meta-analysis published in Cognitive Therapy and Research journal, a team of researchers proved that CBT is safe, effective, and feasible for the treatment and management of anxiety and depression disorders among children and young adults (Hofmann, Asnaani, Vonk, Sawyer, & Fang 2012). Since Eliza is 18-years old and based on positive evidence from current literature, CBT is sought to be an effective and valid treatment option. In a recent systematic review, a team of experts state that CBT is an ideal treatment option to manage anxiety disorders among youth. It prevents the use of pharmacological approaches and the use of antidepressants that may have long-term side-effects (Seligman & Ollendick 2011). Since Eliza is young and has accepted her condition, a support group would help her share her feelings and thoughts. The support group system has been in use for over 5 decades keeping in mind its long-term positive effects (Wolgensinger 2015). Thus, CBT, physical exercise, and support group therapy are considered as an effective, feasible, safe, and valid treatment option for Eliza. Her parents should also actively participate in her treatment plan for better and faster health improvement/outcomes. In a recent study, a team of researchers reported that parental accommodation plays a key role in the treatment of anxious youth. The rate of anxiety and depressive symptoms reduced significantly while parents were around (Kagan, et al. 2016).
Discuss how the treatment plan needs to be adjusted to address the changes in the situation
Since Eliza suffers from situational anxiety, her treatment plan should be modified to an extent that prevents or controls trigger factors. Eliza is known to be aware of her condition and has proactively managed her condition till date. However, new friends and the new college environment may increase her anxiety and depressive symptoms. In such cases, the support group (comprising of select few friends) would motivate and help her. The support or social group would encourage Eliza to cope with her anxiety, interact with her while low, and help her socialize with other people. Her parents would contact her on skype or phone and help Eliza share her feelings, thoughts, and perceptions towards the new college, friends, and overall environment. Her parents and friends would act as her direct point of contact and support system. Physical exercise and CBT are additional forms of treatment that could help further reduce symptoms of anxiety and depression (Garber & Weersing 2010).
Justify the changes both ethically and legally. Determine what the changes (obstacles) mean to the treatment plan
Most of the treatment options such as group support and CBT often involve ethical concerns such as the fear of increase or exacerbation of patient symptoms, poor safety of patient, high dropout rates, and no defined boundary between patient and therapists. Eliza many not necessarily benefit from the treatment plan but would require regular monitoring and alterations. The extent of exposure to treatment such as CBT may lead to post-traumatic stress disorder (PTSD) in Eliza (Altis, Elwood, & Olatunji. 2015). It is both ethical and legal to assess Eliza’s overall psychological and physical well-being during the treatment plan. The one-on-one talk therapy may not have helped Eliza causing her to suffer from PTSD which is why a combination of exercise, support/social group, and CBT was involved in the treatment plan.
References
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