The client, Ben Wilson is a 22-year-old Caucasian male. He is 5’’9 tall and weighs 176 lbs. the client has a full orientation as he knows his name location and the date. He presents himself well and is well groomed. He is a Computer science expert by training but currently works as an assistant administrator in a vet clinic. Currently, the client lives in a private house with his father and an older sister.
Concerns and Problems
The client reports that the cats at the vet’s office have been whispering secrets to him. He, however, refuses to share the secrets with anyone claiming that the IRS agents are watching him to collect his students’ loans. He, however, states that he usually has a feeling of anxiety with no identifiable trigger or cause. He expresses his wish to learn to control his anxiety. The client believes that he is worthless and unemployable that why no one in the field wants to hire him. The client also reports that settling of the bills and other household chores normally causes a strain between his father and his sister. The client also expresses that he is would like to have a family in future but currently he is not dating. He admits that some of his friends have pointed out that he has had a behavior change lately.
Supports and Strengths
The client has the support of his father and sister whom they live together in a private house. He also reports that he has close friends whom he meets from time to time. The client is also well oriented as he knows his name, his location and is aware of the current date. He also presents himself as a clean well-groomed individual. The client is well aware of his condition and as he is aware of his anxiety problem and is willing to solve it. The client also reports that he is aware of his behavioral change as his friends already mentioned it to him. Furthermore, he has a good orientation to the current situation at his home as he acknowledges the strain the house bills place on the family causing a tension between his father and sister.
Diagnosis
The client experiences a variety of anxiety disorders that are characterized by persistent and excessive fear and worry. For instance, the patient has;
A panic disorder. The client experiences panic attacks which he cannot explain where they come from and for no reason at all (Grohol, 2018).
Social anxiety disorder. The client has a persistent irrational fear that he is being watched (Grohol, 2018). The fear causes the client not to function properly at work and in other social settings
The client experiences some personality disorders as he reports that some of his friends have noted his change of behavior. He also does not have a girlfriend though at one point he dated. The clients current stated has limited his intellectual capacity as he reports that cats whisper to him secrets when he is alone at the vet clinic. He also insists that the IRS agents are out seeking to collect his student loan and is not convinced that IRS does not collect student loans.
The client is allergic to any medication that contains penicillin. He also has hypertension and therefore takes 2mg Lozol per day in addition to a multivitamin.
The client has a variety of psychosocial and environmental problems that may affect the treatment, and prognosis of the disorders he is currently experiencing. For starters, the client experiences economic problems as he is concerned that the payment of the bills causes a strain in the relationship between his father and sister. He is also worried about his student loans as he is afraid to reveal the secrets of what the cat s tell him giving reasons that the IRS agents are watching him for his loan. The client also experiences occupational problems as he presents dissatisfaction with his current position as administrative assistant at the vet clinic. He asserts that nobody wants to employ him as a computer expert as he is worthless and unemployable.
The client falls within the range of 21-30 in the Global Assessment and Functioning Chart. His behaviors are considerably influenced by the delusion and hallucinations. He also exhibits poor judgment and has a difficulty in making logical communication. He, however, has friends but does not see them often. Also, he doesn’t have a girlfriend.
Treatment Recommendations
To treat the client anxiety and panic attacks, the clinician should recommend medication and psychotherapy. The doctor should recommend Cognitive Behavioral Therapy (CBT) to help treat the frequent panic attacks that the client experience. CBT is very efficient in the treatment of panic attacks and anxiety as it teaches the client the different ways of thinking, reacting and behaving to feeling that presents panic attack (Grohol, 2018). The attacks usually disappear once the client is able to react differently to the feelings and sensations of fear and anxiety that are prevalent during a panic attack. The benefits of CBT as a method of treating anxiety and panic disorders are usually evident after a period of between 12 to 16 weeks depending on an individual (Grohol, 2018).
During the CBT sessions, the clinician will take note of the problems, take notes of the client’s behavior and give the patient homework which assists him with behavior control practice. The CBT is essential as it will empower the client to be actively involved in his own recovery. At the end of the therapy sessions, that client will be able to control his thoughts, maintain a sense of self-control and confidence and learn some vital life coping skills.
The client will also undergo some medication. For instance, the client could use Selective Serotonin Reuptake Inhibitors (SSRIs). SSRIs are the first-line treatment for anxiety disorders (NHS UK, n.d.). However, some of the symptoms associated with SSRIs include insomnia, weight gain, and sexual dysfunction. The client will be put on SSRI dose of one tablet a day for four weeks before the first assessment to determine the effectiveness of the drug. If the effects are not visible the clinician will then gradually increase the dosage (Grohol, 2018). The client will be required to take the dose of SSRI for at least six months to prevent his condition from recurring once he stops the medication.
The client could also use Benzodiazepines for his anxiety management for short term with a daily dose of between 1.5mg to 6mg when used together with an antidepressant (Canadian Agency for Drugs and Technologies in Health, 2014). The drug is highly effective in promoting relaxation and also reduces muscle tension. However, its side effects include high dependence and tolerance to the drug.
References
Canadian Agency for Drugs and Technologies in Health. (2014). Short- and Long-Term Use of Benzodiazepines in Patients with Generalized Anxiety Disorder: A Review of Guidelines. Ottawa: Canadian Agency for Drugs and Technologies in Health. Retrieved April 6, 2018, from https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0070441/
Grohol, J. M. (2018, March 28). Symptoms " Treatments of Mental Disorders. Retrieved April 6, 2018, from https://psychcentral.com/disorders/
NHS UK. (n.d.). Selective serotonin reuptake inhibitors (SSRIs). Retrieved April 6, 2018, from https://www.nhs.uk/conditions/ssri-antidepressants/dosage/
