Posted: September 7th, 2024
Clinical Supervision
Clinical Supervision
Introduction
The case study of a 39-year-old female patient presents an opportunity to recommend treatment for a patient. The 39-year-old female with generalized anxiety disorder requires treatment using both psychotherapy and pharmacology. The methods include mindfulness therapies, cognitive behavior therapy, relaxation techniques, grounding exercises, and antidepressants. The purpose of the paper is to examine a case study of a patient with GAD and recommend appropriate interventions.
Clinical Supervision
The selected patient is a 39-year-old female with generalized anxiety disorder. She presents with diverse symptoms such as worrying, anticipating disaster, and overly concerned about family and work. Excessive worry undermines the ability to concentrate or undertake daily duties. The patient started showing signs of excessive worry after her husband of 15 years was diagnosed with cancer. The family had no income and they did not know how to survive. The husband died 6 months ago and by the time she was brought to the clinic by a friend, she had been thrown out of the house due to rent arrears. Her main cause of worry is the future of her children.
The best therapeutic approaches include mindfulness therapies, cognitive behavior therapy, relaxation techniques, and grounding exercises. Mindfulness therapy is effective in increasing awareness of everyday experiences to reduce anxiety (Maron & Nutt, 2017). Cognitive behavior therapy is effective in helping patients to change their thinking patterns. For example, CBT helps patients with GAD to relax, change their behavior, find hope, and develop rational thought processes (Hoge et al., 2018). The therapy is effective since it demonstrates that there is a bright future despite the current challenges (Maron & Nutt, 2017). The approach is effective to ensure the client has hope for better days of financial recovery. Relaxation techniques are important for patients with GAD since they help them reduce stress. The techniques include deep breathing, body massage, music, and art therapy, guided imagery, mindfulness meditation, yoga, and repetitive prayer (Hoge et al., 2018). The approaches are effective in taking away stressful thoughts. Grounding exercises include playing a memory game, counting numbers to relax, laughing, and visualize the best experiences in life (Mennin et al., 2018). The patient will be referred to a counselor or psychotherapist for the psychotherapeutic approaches. For instance, it will be important to attend at least 10 to 12 sessions.
The last therapeutic approach necessary for the treatment plan includes antidepressants. Studies show that combining pharmacology with psychotherapy improves the recovery of patients. Escitalopram (Lexapro) 10 mg once daily orally is an effective dose that can help the patient to reduce anxiety (Mennin et al., 2018). The patient should come back to the clinic after every four weeks for further evaluation. During the evaluation, a practitioner will make the necessary changes to the medication.
The additional information that can aid in the treatment of the patient is vital in providing patient-centered care. One of the challenges is that she lives with a hostile mother-in-law who believes she is the reason for the death of her husband. The two have been living together since the death of her son. The best approach is to connect her with the organizations that provide housing options for patients with mental conditions (McDowell et al., 2018). Living in a safe and healthy environment will reduce the risk of mental problems. Another step is to connect her to employers who can hire her services. She is an accountant and had quit her job at a local bank to take care of her children and mother-in-law.
Another challenge is that she has no friends who come to see her. She lost many friends who were chased by the grandmother who accused them of having a hand in the death of the son. It is important to evaluate the mental condition of the mother-in-law who seems depressed. She needs to join a support group to find solace (McDowell et al., 2018). The additional information will improve the treatment process and improve the recovery.
The patient is at the preparation and action stages of the Prochaska and DiClement model. The model shows that the action stage requires another important step of maintaining positive behavior (Javadi & Ghorbani, 2019). The client needs to learn how to maintain the new behavior to eliminate the risk of worry. For instance, she needs to step time away from the mother-in-law who makes her feel like a loser. She can ask her sister to continue taking care of her mother-in-law as she takes time to be alone in a new environment. Another recommendation is to measures the level of worry at every health clinic (Javadi & Ghorbani, 2019). The practitioner should identify the instances of worry and if the rate is abating or increasing. For instance, the hamilton anxiety scale test is effective in measuring the level of worry and severity of the symptoms.
Conclusion
The case study of a 39-year-old female patient with generalized anxiety disorder presents an opportunity for clinical supervision. The patient presents with diverse symptoms such as worrying, anticipating disaster, and overly concerned about family and work. Appropriate treatment methods include mindfulness therapies, cognitive behavior therapy, relaxation techniques, and grounding exercises. The approaches are important to address the severe symptoms that can undermine the quality of life.
References
Hoge, E. A., Bui, E., Palitz, S. A., Schwarz, N. R., Owens, M. E., Johnston, J. M., … & Simon, N. M. (2018). The effect of mindfulness meditation training on biological acute stress responses in generalized anxiety disorder. Psychiatry Research, 262, 328-332.
Javadi, Z., & Ghorbani, M. (2019). The effectiveness of Mindfulness-Based Cognitive Therapy (MBCT) on the improvement of sleep quality in patients with generalized anxiety disorder. The Horizon of Medical Sciences, 25(2), 117-126.
Maron, E., & Nutt, D. (2017). Biological markers of generalized anxiety disorder. Dialogues in Clinical Neuroscience, 19(2), 147.
McDowell, C. P., Dishman, R. K., Vancampfort, D., Hallgren, M., Stubbs, B., MacDonncha, C., & Herring, M. P. (2018). Physical activity and generalized anxiety disorder: results from The Irish Longitudinal Study on Ageing (TILDA). International Journal of Epidemiology, 47(5), 1443-1453.
Mennin, D. S., Fresco, D. M., O’Toole, M. S., & Heimberg, R. G. (2018). A randomized controlled trial of emotion regulation therapy for generalized anxiety disorder with and without co-occurring depression. Journal of Consulting and Clinical Psychology, 86(3), 268.
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