Therapeutic Skills for Work with People with a Mental Problem - Case Study Example

Heading: Critical Reflective Report Your name: Course name: Professors’ name: Date Introduction Camira, a 25 year old woman, seems to have a mental problem, as evidenced by her withdrawn, antisocial, anxious, fearful, slurred speech, and isolated nature. It is vital to have appropriate therapeutic skills in order to successfully work with her. Besides, her can case can be referred to a psychiatrist, clinical psychiatrist, and religious institution for specialized management. Additionally, suitable methods can be used to ensure her participation in the management of her case. What signs and symptoms is Camira presenting with? Camira shows signs relating to obsessions and compulsions, which implies that she tries to retain her normal self by doing things repeatedly. Besides, she displays symptoms and signs of fear ad apprehension during the interview session. She also seems to be antisocial, withdrawn, and isolated as she keeps to herself, especially when she dropped from school. This is evident in the fact she avoids any social contacts with other people. She feels like she is a failure, and at times thinks that life is not worth-living. Camira also has slurred speech, and maintains a poor eye contact during the interview session. Additionally, Camira is aware of her condition since she wants to be aided in looking for ways to change her life. She seems unprepared to start on any medication. What challenges may be encounter when assessing Camira? Justify your responses with evidence based literature? There are various challenges that are likely to be encountered during the Camira’s assessment. To start with, Bloch (2001, pp. 85-88) says that there is a probable challenge in getting the client to open up to the interviewer; non-communication. This is because of the fact she is antisocial. Her antisocial nature could lead to her refusal to cooperate with the assessor. As a result, it will be difficult to understand and identify her problem; hence failure to meet her needs. Secondly, Camira is withdrawn and isolated and this may pose a great challenge to her assessor. Her withdrawn and isolated character gives makes her fearful and timid in presence of other people, particularly her interviewer. The interviewer’s success in the assessment largely depends on the client’s cooperation, courage and willingness to participate in the session. In this case, the interviewer may find it hard to understand her problem because the client seems to be isolated (Bloch (2001, pp. 85-88). Thirdly, Camira’s nervousness might cause a problem in the assessment session. Camira’s is fearful because she sees herself as a failure in the family and society. Because she is nervous before the interviewer, it might be hard to express herself sufficiently to the interviewer. This can be challenging because the interviewer will fail to understand the client’s problem and offer appropriate help (American Psychiatry Association, 2000, pp. 429-440). Fourthly, the client’s slurred speech and distrust may pose a serious challenge to the interviewer during the assessment session. Slurred speech bars effective communication between the interviewer and interviewee; hence, causing non-communication. As a result, the interviewer will not adequately help the client due to little understanding of her problem (Bloch (2001, pp. 85-88),). List the health care concerns that you would focus on when working with Camira? Some of the health care concerns to be focused on when assessing Camira include: Appearance, attitude towards the interviewer, mood, affect, speech, thought process, thought content, insight, judgment, impulsivity, and reliability (Carlat, 2005, pp. 117-120). Which therapeutic communication skills would be useful when interacting with Camira? For effective interaction with Camira, it is vital to have therapeutic communication skills. First, Videbeck (2011, pp. 116-118) demonstrates that empathy is crucial in the effective therapeutic communication between the interviewee and interviewer. This is because it facilitates absolute understanding of the interviewee’s emotions and situations that supersede any calculated examination of the client. Therefore, it is critical that the interviewer develops a warm, understanding, and safe setting for the interview session. This also helps in the eradication of the client’s defensiveness in the assessment session. This skill is essential in that it makes the client to feel safe and realize that the interviewer is out to listen and understand her problem, rather than evaluate her. When the client can reduce her defensiveness, she can expose her emotions to a more profound level. Second, it is necessary for the interviewer has authenticity in order to succeed in the assessment session. It is also important to exhibit sincere emotions and thoughts in the therapeutic strategy and attaining insight into the client’s patient. This, however, needs the interviewer to be in contact with his feelings. Additionally, to the interviewer, this skill is indispensable in that it cultivates trust and proofs that he is not projecting himself as a greater force than the client’s (Patel, 2012, pp. 49-62). Third, Patel (2012, pp. 49-62) notes that unconditional positive regard is crucial in the successful interaction between the client and the interviewer. This implies that the interviewer should show the client that no matter what, respect between them is retained. This is done while the interviewer reveals his desire to help the client regain her normal health. This also gives the interviewer to assess and express his opinions on the client’s situation without being disregarded or criticized. Which 'therapeutic use of self' skills would you use when working with Camira? In order to work successfully with Camira, the interviewer will be required to have self therapeutic skills. To begin with, the interviewer will use silence so as to allow the client to control the discussion is she desires. In addition, the interviewer will offer acceptance, which implies conveying positive regard. Provision of recognition is also significant in the acknowledgement, and indication of awareness of the client’s situation. It is also vital to offer broad openings, which allow the client to choose the topic of discussion. It is also vital to make observations that involve verbalizing what is perceived or observed (Servellen, 2009, pp. 56-62). What is more, Boyd (2008, pp. 49-60) says that it is also crucial to motivate description of perceptions, which means asking the client to express what she perceives of her situation. It is also essential to motivate comparison of differences and similarities among interpersonal relationships, ideas and experiences. The interviewer will also ensure that the client knows whether there is a clear understanding of expressed statements during the session. What methods would be utilized to ensure that your therapeutic approaches would lead to Camira’s active participation in her assessment and planning and managing her care? To ensure that the therapeutic approaches used in the management of Camira’s condition, it is important to conduct follow-up activities. This includes, but is not limited to, making psychiatric clinic appointments to check on the patient’s progress; making home visits to the client so that she feels appreciated, cared for, and important; and making calls to inquire about her progress. These follow-up activities are essential in finding out the client’s compliance with her treatment, and ensuring her active participation in the management of her condition. Identify any risks and describe the management of any risks identified One of the risks involved in Camira’s case is the possibility that she might commit suicide because she wonders whether her life is worth-living. This is also because she feels she has not lived up to the societal expectations of a woman of her age. This risk can be managed by involving a psychiatrist who will manage her mental issues accordingly. A religious minister can also help her change her negative attitude towards life by encouraging and restoring her hope for life. There is also a risk about the client’s failure to comply with the management of her condition. This is because in as much as she recognizes the need for treatment, she is not ready to start her medication. This can be managed by involving parents in order participate in her management, for example, by reminding the client to take her medication. It can also be managed by talking to her about the importance of compliance, and consequences of non-compliance like worsening of her condition. What is your 'duty of care' regarding Camira's presentation? In Camira’s case, it is the interviewer’s duty of care to provide a solution to her problem, to the best of his ability. Since Camira is competent to make a medical decision, it is the interviewer’s duty to ensure that her problem is understood and addressed to the best of my ability. It is also essential that the interviewer treat the patient after obtaining an informed consent from her (Adshead, 1999, pp. 321-328). Besides, Adshead, (1999, pp. 321-328) says that it is the interviewer’s duty to provide appropriate solution, which cannot harm her safety and healthy. This implies the need for appropriate medication in terms of amount and duration. It is also my duty of care to make consultations with other relevant professionals in case of doubt, and consider proper medical prescriptions to the client. What referral pathways would you use to assist Camira? Validate why you would choose these referral agencies. To begin with, Camira can be referred to psychiatrist because she seems to have a mental issue. The psychiatrist is important in the examination, evaluation, and appropriate management of her situation. Secondly, the client can be referred to an occupational therapist who will effectively manage her withdrawn and isolated behavior through various ways, such as, support groups of people with similar condition. Support groups are vital in that it provides the members with an opportunity to share their experiences; hence, Camira’s overcoming of her isolated and withdrawn behavior. Thirdly, referring the client to a clinical psychologist is essential in this case. This will help in the assessment, diagnosis, and treatment of mental, behavioral, and emotional disorders among patients. In this case, clinical psychologist will aid in assessing, diagnosing, and treating emotional, mental, and behavioral disorders, such as, withdrawn and isolated nature. Fourthly, it is crucial to refer the client to religious institutions where she can access spiritual guidance and care. This is important in restoring the client’s faith and hope in life, as she currently sees life as meaningless. Conclusion Camira’s mental problem is evidenced by her withdrawn, antisocial, anxious, fearful, slurred speech, and isolated nature. Empathy, rapport, respect, encouraging, and honesty are some of the therapeutic skills to be used in handling her. Some of the referral agencies to be involved include psychiatrist, clinical psychiatrist, occupational therapist, and religious institution. Besides, there are risks involved in her case, and her therapist should consult with other specialists to provide appropriate care. References Adshead, G. (1999). Duties of psychiatrists: treat the patient or protect the public? Advances in Psychiatric Treatment, 5(2), 321-328. http://apt.rcpsych.org/content/5/5/321.full.pdf American Psychiatry Association, APA. (2000). Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, (DSM-IV-TR). Washington, DC. American Psychiatric Association. Pp. 429-440. Bloch, S. (2001). Foundations of clinical psychiatry. Carlton South, Vic: Melbourne University Press. Pp. 85-88. Boyd, M.A. (2008). Psychiatric nursing: contemporary practice. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. Pp. 49-60. Carlat, D. (2005). The psychiatric interview: a practical guide. Philadelphia: Lippincott Williams & Wilkins. Pp. Pp. 117-120. MacKinnon, R.A., Michels, R. & Buckley P.J. (2006). The Psychiatric Interview in Clinical Practice. Amer Psychiatric Pub Inc. pp. 551-559. Patel, S. (2012). Manual of psychiatric nursing skills. Sudbury, MA: Jones & Bartlett Learning. Pp. 49-52. Servellen, G. (2009). Communication skills for the health care professional: concepts, practice, and evidence. Sudbury, Mass: Jones and Bartlett Publishers. Pp. 59-62. Videbeck, S. (2011). Psychiatric-mental health nursing. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. Pp. 116-118. Read More