This work provides the research of the patient’s case who needs urgent psychotherapeutic treatment. The most efficient technique applied for the described below case is cognitive-behavioral therapy (CBT) which analyzes the unconscious processes influencing the normal functioning of the human body, causing different pathologies (Andrews et al., 2018). The current patients’ case also can require the applying of individual and group therapies. These tactics will support the disrupted process of the patient’s socialization. The problem has a psychiatric focus and requires an efficient treatment plan, which will be discussed in this paper.
Presenting Problem
The 52 years old woman complains of headaches, racing thoughts, and suicidal ideations. The symptoms started to develop one week ago and are now continuous. It was noted that the psychological trauma of losing the family members is the root cause of the increased anxiety. The patient also highlights excessive alcohol use and marijuana smoking. The patient describes her detrimental lifestyle as being caused by the COVID-19 pandemic implications.
Identifying Information
The patient lives alone and has no work because she was recently fired. The patient has significant signs of obesity and alcohol addiction. She has difficulties with maintaining healthy relationships with partners, colleagues, and family. According to her report, she has experienced physically and mentally abusive relationships. The recent decease of her family members due to COVID-19 caused the elevated feeling of guilt and psychological trauma. Thus, the patient’s problem was provoked by these events. However, the leading cause of the psychological difficulties is more complicated and rooted deep in the patient’s cognition. The past medical history includes diabetes, hypertension, depression, and anxiety. For now, the patient shows no other illnesses symptoms and takes no medications. The patient reports taking Zoloft in the past about six years ago, in conjunction with Trazadone at bedtime for sleep, however, stopped it because of marijuana smoking. She did not contact the primary care physician for more than three years. The patient has alcohol abuse and drinks 2-3 cups of coffee daily, aggravating her mental problems.
Psychosocial Summary
The patient has poor mental health and experienced physical and psychological abuse. The difficulties in communication with the partner and colleagues caused severe cognitive problems. The patient has no stable work and recently was fired for not showing at the workplace. She was open to conversation and is ready to work on the cognitive problems she faces. The patient has a degree in finance but considers such work as being not her calling. She reposts the good relationships with the family though she avoids visiting them for a long time. She takes the psychoactive substances, for now, has no problems with the law. The tragic events and severe life history affected the current mental state of the patient.
Diagnosis
- (F33.1) Major Depressive Disorder.
- (F43.12) Post Traumatic Stress Disorder.
- (F12.10) Cannabis abuse, uncomplicated.
- (F11.20) Generalized Anxiety Disorder.
- (F14) Cocaine Abuse.
Therapist’s Conceptualization of the Problem
In the current case, my guidelines include CBT, individual therapy, group therapy, whereas the main focus is primarily on the first type of treatment. CBT is oriented to reveal problems correlated with traumatizing psychological events and eliminate the negative consequences (Cristea et al., 2018). Through the number of practices, treatment strategies, and regular meetings with the therapist, the patient can overcome depressive and anxiety disorders. In such a complicated case, working with a patient with multiple mental conditions aggravated by cannabis, cocaine and alcohol abuse, my role is to help the woman overcome her own cognitive beliefs that interfere with her normal life. It is essential for her to understand the nature of fears and anxiety and accept her problems to reveal the core problems in her life.
Treating theoretically, the patient experiences the rejection of the moral problem describing the causes of such conditions as being correlated with the COVID-19. The issue itself dates back to abusive relationships and, probably, childhood, where the parents may have planted the root causes. I make this assumption based on the patient’s contradictive claim that she has good relationships with the family but has not visited them for a while. The patients being under the pressure of their sense of guilt and the negative partnership experience, usually have undeveloped self-esteem (Andrews et al., 2018). Moreover, the patient’s state is aggravated by the midlife crisis and the damaged process of self-identification.
Psychotherapeutic Plan
The cognition, including the mental affirmations and beliefs, shapes the behavior of the patients. Alcoholism, narcotic substances abuse, depression, and other dangerous behavior patterns in most cases are caused by the cognitively-dangerous perception of the world (Cristea et al., 2018). Therefore, the primary aim of psychotherapeutic treatment is to change the cognitive perception and patterns of the patient. It is essential for the patient to accept the real cause of her unsuccessful life and find the opportunity to change her position. The therapist must pay special attention to revealing the true causes of such a condition that the patient hides behind the COVID-19-involved challenges.
In this case, the CBT practices can be beneficial for the patient because they can help reveal the cognitive patterns and adjust them for the other positive affirmations. The most suitable CBT technique is behavior activation which includes activity monitoring with the therapist and activity scheduling (the patient’s self-analysis) (Wenzel, 2017). Through these techniques, the patient will be able to rate the emotions accordingly to the daily activities, which can contribute to allocating the morally-attractive activities or even work. The other cognition constructing technique will help the therapist find the genuine reason for fears and anxiety (Wenzel, 2017). The current case is more complicated than it seems at first glance because of the multiple disorders reported through the medical history. Therefore, it is essential to find the starting point of the patient’s mental problems. The therapist can only efficiently work with the patient on problem-solving during the individual therapy meetings. The prescribed Zoloft will contribute to the better implementation of the CBT, minimizing the depression symptoms and allowing the patient to explore herself more productively, without obsessive thoughts and anxiety.
Through the dialogue and specific practices, the patient will learn about her strong and weak points. However, she also needs to gain practical experience applying the methods in society. The socialization can be rebuilt only through the detailed analysis of the patient’s behavior in communication. In this case, only CBT and individual therapy are not enough to overcome communication challenges and complexes. Group therapy can contribute to the involvement of such experiences.
In this complicated case, the therapist needs to be consistent in practices and combine all the types of therapy and medicine to ensure efficient treatment. Mentioned above methods will help the patient go through all the psychological acceptance of herself and her problems. Moreover, the combination of approaches will allow her to develop the strategies to cope with hardships and find the activities making her happy. The therapist should be able to adjust the patient’s consciousness for taking responsibility and leading a normal life without obliterating her grief with addiction.
References
Andrews, L., Carpenter, J., Hofmann, S., Powers, M., Smith, J., & Witcraft, S. (2018). Cognitive behavioral therapy for anxiety and related disorders: A meta-analysis of randomized placebo-controlled trials. Depression and Anxiety, 35(6), 502–514.
Cristea, I., David, D., & Hofmann, S. (2018). Why cognitive behavioral therapy is the current gold standard of psychotherapy. Front. Psychiatry, 9(4), 1–3.
Wenzel, A. (2017). Basic strategies of cognitive behavioral therapy. Psychiatric Clinics, 45(7), 597–609.