Comprehensive Treatment Plan for Hoarding Disorder

The client seemed absent-minded, strongly attached to irrelevant things, unconcerned, had an extreme level of anxiety and nervousness, and had no shame. These physical presentations give an impression of a mental-related issue, particularly a hoarding disorder. The client had and valued a huge possession of irrelevant things and felt no threat about them, exhibiting extreme anxiety and nervousness with no explanation. The patient had a challenge in maintaining concentration and attention and the problem of effectively processing information and extreme emotions while making decisions.

Long-Term Goal

Group Cognitive Behavioral Therapy (GCBT) is an effective evidence-based treatment for patients with HD and has a longer-lasting effect on the wellness of the patient. Patients under this mode of treatment exhibit success in managing the disorder and returning to normalcy. This method aims to help restore the client’s mind to achieve standard behavioral patterns. CGBT reduces HD symptoms, making the patient live a normal life like any other human being by refraining from accumulating many irrelevant things. It also reduces functional impairment in patients, thus allowing them to freely go about the normal activities they used to before and restoring their moods where they no longer experience anxiety and nervousness. In addition, GCBT helps the patient withdraw from social isolation, interact freely with others, and embrace peer support among other patients experiencing the same challenge (Chandler et al., 2019). The patients can attain freedom from loneliness by interacting with others since they realize they are not going through it alone.

Short-Term Objectives

Identifying and managing factors contributing to HD is one of the short-term treatment objectives for reducing depression which is a common severity HD symptom, especially in patients of old age. These factors must be identified and respective measures put in place to counter them from causing further harm to the patient. Identifying and managing the causes of depression reduces its severity by 50% (Weiss et al., 2020). Caregivers of the patient must be advised on how to handle such circumstances.

During diagnosis and assessment of the patient, it is important to conduct further investigation to check for any comorbidity likely influences HD and develop an effective treatment plan. These other illnesses will be treated independently or with HD and thus reducing the possibility of severe complications. This will also help the medical personnel handling the patient evaluate an appropriate way of care. About 20% of patients with HD experience severe cases of anxiety symptoms that trigger suicidal thoughts; identifying and managing the causes helps in reducing the incidence (Archer et al., 2018). Mental-related cases are very sensitive; they must be handled with care.

An HD patient can be introduced to hypnotherapy to help manage psychological, emotional, and physical behavior. This therapy aims to trigger positive changes in a patient’s way of doing things and mental state. It is a preparation process of overcoming the addictive habit of hoarding unuseful things and anxiety. This mode of HD treatment initiates a self-realization process in the healing journey. It is a short-term goal treatment method since it has a temporary effect and must be repeated over time. Hypnotherapy has a success rate of 39.2% implying that it reduces hoarding behavior by an equal percentage. (Yager, 2018). Complementing it with other methods makes it an effective method of treatment.

Interventions

Psychotherapeutic is the appropriate intervention for a short-term objective of treatment. This involves the patient and a psychologist having one-on-one conversations about the HD condition and finding an appropriate way to resolve the condition (Davidson et al., 2019). Recent research places current psychotherapeutic modalities as an effective treatment for HD. It will help the patient overcome their negative experiences and anticipate positivity in the coming days. Psychotherapy enables the patient to explore moods and behaviors in a calm environment and determine what they want in life.

Holistic therapy addresses HD-related behaviors from several aspects, such as spiritual, mental, physical, and emotional. The psychotherapeutic approach enables the patient to have a deeper understanding and self-evaluation of oneself (Kinchen & Loerzel, 2018). Humanistic therapy is a psychotherapeutic approach that embraces the essence of being a true self to be able to live a contented life. It enables a patient in a position to view the world in a unique way that will influence the way of thinking. This will impact the choice-making and actions taken (Renger & Macaskill, 2021). On the other hand, behavioral therapy views behavior as learned and unlearnt. This, therefore, gives an HD patient a sense of believing that some weird behaviors, such as holding worthless things, can be unlearnt (Zhang et al., 2018). The three therapy approaches are under psychotherapy and can be used for the patient based on the results of the cognitive model evaluation. The theoretical interventions are interrelated and thus need incorporation into the treatment plan.

Individual and family therapy are appropriate modalities for this case. The patient has to undergo the therapy as an individual and then involve the family later. The essence of involving the family is to offer the required support system as the caregivers and to understand the keen’s condition. Engaging outside providers is controversial but equally important even without the patient’s consent, who might not be in the right state of mind to make an informed decision. There is no absolute privacy in medicine; the clinician is better positioned to recommend or consult for the best care services the patient needs. In some instances, such as billing, an invoice is sent to the insurance companies to claim for payments (Wisk et al., 2018). The invoice has detailed information regarding the money in question.

Evaluation

The expected outcomes of holistic therapy include stress reduction and effective coping skills, prevention of relapse, better overall health, spiritual connection to nature, and increased self-esteem and sense of identity. In humanistic therapy, the patient is expected to have learned and developed problem-solving and self-soothing skills, which will play a crucial role in battling stress and anxiety. It also boosts self-esteem and promotes positivity when approaching things in life. On the other hand, behavioral therapy raises self-esteem by focusing on making solutions, boosts the development of positive thoughts about life, improves the way the patient communicates with other people and creates good relations, which becomes a support system. Behavioral therapy is also very important in managing anger that can easily lead to relapse. All these interventions apply to anybody irrespective of gender, age, race, disability, ethnicity, religion, sexual orientation, or social-economic status; they work for everyone.

The efficacy of evidence-based client assessment treatment is based on relevant data. Medical personnel incorporates scientific and local information in creating treatment plans, thus achieving the best outcomes, unlike non-evidence-based treatment methods. This method is appropriate for a patient with comorbidities since it is easy to develop and a comprehensive evidence-backed treatment plan. Training professionals on EBPs boost their knowledge, attitudes, clinical acumens, and skills. Additionally, training and use of various evidence-based psychotherapies enable care providers to be familiar with their trends and in-depth understanding of what is happening in the clinical field. Evidence-based treatment is quality, affordable, and accountable since they have a guideline. The care providers are also up to date with the emerging trends in the field (Cook et al., 2017). Generally, patients put under this plan receive better care compared to those on non-evidence-based care.

Ethics

The potential medical dilemma is the disclosure of another underlying condition to a specialist. The patient may have a terminal illness contributing to his anxiety that he may be dying anytime soon. If the patient is not willing to open up about it or he is not in a capacity to mentally, the therapist will be compelled to engage a specialist without consent. A comprehensive medical plan will be developed, and the patient will be put in care. In such circumstances, saving life and ensuring the patient’s well-being are very important. Caregivers took a vow to save lives, and it will be ironic and inhuman to watch someone die, yet they have all it takes to save the life. They are to take action in the best interest of the patient’s life and health (Haahr et al., 2021). The United States constitution legalized treatment without consent when saving lives in an emergency (Olejarczyk & Young, 2022). Emergency Medical Treatment and Active Labor Act (EMTALA) protects and resolves the ethical dilemma of confidentiality and treatment without consent.

References

Archer, C. A., Moran, K., Garza, K., Zakrzewski, J. J., Martin, A., Chou, C.-Y., Uhm, S. Y., Chan, J., Gause, M., Salazar, M., Plumadore, J., Smith, L. C., Komaiko, K., Howell, G., Vigil, O., Bain, D., Stark, S., Mackin, R. S., Eckfield, M., … Mathews, C. A. (2019). Relationship between symptom severity, psychiatric comorbidity, social/occupational impairment, and suicidality in hoarding disorder. Journal of Obsessive-Compulsive and Related Disorders, 21, 158–164. Web.

Chandler, A., Fogg, R., & Smith, J. G. (2019). Effectiveness of group cognitive behavioral therapy for hoarding disorder: Evaluation of outcomes. Journal of Obsessive-Compulsive and Related Disorders, 21, 144–150. Web.

Cook, S. C., Schwartz, A. C., & Kaslow, N. J. (2017). Evidence-based psychotherapy: Advantages and challenges. Neurotherapeutics, 14(3), 537–545. Web.

Davidson, E. J., Dozier, M. E., Pittman, J. O. E., Mayes, T. L., Blanco, B. H., Gault, J. D., Schwarz, L. J., & Ayers, C. R. (2019). Recent advances in research on hoarding. Current psychiatry reports. Web.

Haahr, A., Norlyk, A., Martinsen, B., & Dreyer, P. (2019). Nurses experiences of ethical dilemmas: A Review. Nursing Ethics, 27(1), 258–272. Web.

Kinchen, E. V., & Loerzel, V. (2018). Nursing students’ attitudes and use of holistic therapies for stress relief. Journal of Holistic Nursing, 37(1), 6–17. Web.

Olejarczyk, J. P., & Young, M. (2022). Patient rights and ethics – statpearls – NCBI bookshelf. National Library of Medicine. Web.

Renger, S., & Macaskill, A. (2021). Developing the foundations for a learning-based humanistic therapy. Journal of Humanistic Psychology, 002216782110076. Web.

Wisk, L. E., Gray, S. H., & Gooding, H. C. (2018). I thought you said this was confidential?—challenges to protecting privacy for teens and young adults. JAMA Pediatrics, 172(3), 209. Web.

Yager, E. K. (2018). Comparing overall success rates of cognitive-behavioral therapy, eye movement desensitization and reprocessing, dialectical behavior therapy and hypnosis. Journal of Psychology Research, 8(6). Web.

Zhang, C.-Q., Leeming, E., Smith, P., Chung, P.-K., Hagger, M. S., & Hayes, S. C. (2018). Acceptance and Commitment Therapy for Health Behavior Change: A contextually-driven approach. Frontiers in Psychology, 8. Web.

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