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NRNP - 6645 Psychotherapy with Multiple Modalities

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Overall post-traumatic stress disorder (PTSD) is a disorder that develops in certain individuals who have experienced a shocking, scary, and or a dangerous experience that has left scars too fearful to forget. As we all know, fear triggers many split-second changes in the body to help defend against danger scenarios and propel certain actions that it deems fit would cause rescue from the situation. This episode known simply as “fight-or-flight” response is a typical reaction meant to shield an individual from harm in frightful circumstances Of note., 95% of individuals will experience a variety of reactions after a life- altering trauma episode, but most people will recover fully from initial symptoms without any external help or re-direction. The individuals who keep experiencing trauma as a result of an experience, will be diagnosed with PTSD. People who have this disorder usually feel stressed or frightened, even when there is no danger lucking around. All criteria met : Some signs of PTSD are persistent thoughts about a past event, persistent negative emotional thoughts, extreme thoughts of fear, fear, horror, anger, guilt, or shame. “Markedly diminished interest or participation in significant activities” (Adler et al., 2006; Glind et al., 2013). These patients are currently experiencing chronic signs of PTSD, from being married to an abusive man and from having a sister that was sexually abused by their father. Another significant factor of PTSD verbal aggression, unsanitary home, and economically depressed lifestyle. These factors are current in “moms” behaviour. Her verbal aggression has also contributed significantly to her estrangement from her children. Adjustment disorder refers to an unexpected strong behavioral or emotional reaction that occurs as a result of an identifiable stressful life change or that occurred within the past three months. It can present in multiple forms and behaviors, these can include the feeling of hopelessness, sadness or persistent stress. This can also include physical symptoms occurring after one undergoes through a stressful event in life. Overall, adjustment disorder primarily deals with mood, while acute stress disorder deals with environmental stimulation (Harvard Medical School, 2017). Psychological symptoms such as anxiety, low mood, irritability, emotional ups and downs, poor sleep, poor concentration, wanting to be alone etc are some symptoms. Fundamental issues coping with daily activities, mental abilities and general day-to-day activities are some challenges of having this disorder.

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Walden University NRNP - 6645 Psychotherapy with Multiple Modalities
Week 2 June 13, 2022 2
Family Assessment and Psychotherapeutic Approaches
Historian: Mother and daughter (Self)
Language: English
Name: Non- listed Gender: Both female (mother and daughter) Age: 40 years old and 23 years old. Chief complaint — “I am in so much pain, nobody can help me and nothing is helping me manage the pain. I want my mom to be more peaceful, I want her to lower her expectations and accept a lot of things about life, I have a sense that my mom is holding me back from all I could be doing”. I just want them to spend time with me, I am very lonely, and I get depressed when I am lonely. I hate spending time with my mother, I hate her house, she has two dogs and I do not like those at all, I do not like their hair on my body and I do not like touching them. Do you believe I cannot even eat in her house, everything smells like dog, and it is very uncomfortable for me”.
History of present illness (HPI) — This patient is a 40-year-old Iranian American female. She is here today to be seen for complex family dynamic issues as it relates to her and her five children. She was seen with her 23-year-old daughter who detailed the multiple issues as
it relates to her relationship with her mom and siblings. They are here for evaluation of trauma related issues as it relates to abuse by her husband and their father. Mom is currently struggling with trauma related issues from being married and also struggling with adjusting to the norms and principles of America which can be called Adjustment disorder at this time Per self report, one of her daughters was raped and abused by her biological father and this has left a dent in the way the family relates with their dad. There has been difficulties FAMILY ASSESSMENT AND PSYCHOTHERAPEUTIC APPROACHES 3
relating to one another, difficulties relating to their father, difficulties relating to the issues of traditional Iranian family becoming “Americanized”, issues with spending time with their mother, their lack of privacy and distrust overall. Overall, this is a complex family unit and there are multiple conflicts active and ongoing at the same time. The biggest issue has to do with the mother of the house becoming sick, and having multiple surgeries to fix her foot which has left her almost dependent. The second issue is the rape allegation. One of the daughters alleged that her biological father raped her., this has left the family traumatized and unforgiving.
Thirdly, there is the issue of the of a mother desperately trying to hold unto her traditional
Iranian beliefs and traditions. For example, in Africa and the Middle East, it is believed that children are to stop their lives to care for their parents if they need that help. In America, the tradition is to employ a capable nursing facility or a private nurse to do the caring. These are very
different standards. In this case, her children are urging her to do more for herself and for her health, to not solely depend on them or wait on them. Overall, there are major unresolved conflicts going on that are trauma related, depression, physical health etc. Some physical signs noted during the assessments were fidgeting, excited. There are also signs of hyperactivity, impulsivity, irritability, lack of restraint, and persistent repetition of words.
There is no notice of difficulty focusing, issues with paying attention or short attention span. Past psychiatric history — In the scenario, mom mentioned depressive episodes, there was however no mention of medically diagnosed psychiatric conditions like depression. They denied suicidal ideations. They also denied the use of illicit drugs/ alcohol, prior serious mental or psychiatric breakdown, or mania. No prior reports of psychiatric inpatient hospitalizations to report either.

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Subido en
18 de junio de 2023
Número de páginas
18
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2022/2023
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