How to write a nursing psychotherapy essay Solved

How to write a nursing psychotherapy essay Solved

Reggie is a 42-year-old African American male recently referred for outpatient psychotherapy by his PCP. While he is in relatively good health, he admitted to his doctor that he has been drinking alcohol excessively again over the last three months. Reggie had a problem with alcohol when he was in his twenties, but with the help of AA and his first male partner, he was able to cease drinking for the last 19 years. Reggie admits that it has not always been easy for him to abstain, but he is committed to trying again. He has attended AA meetings but has not been able to maintain complete sobriety. On average, he has one or two drinks nearly every evening. His partner, Bob, has a zero-tolerance policy for Reggie’s drinking and has moved in with a friend rather than deal with Reggie’s promises to stop. Reggie is worried that Bob may not come back. Reggie does not want to end up like his father, who drank himself to death at the age of 56. His father and mother divorced when Reggie was only 15. Reggie’s only sister had a serious addiction to benzodiazepines and spent 28 days in a rehab center. She is clean now but also abuses alcohol on occasion.
Questions: Remember to answer these questions from your textbooks and clinical guidelines to create your evidence-based treatment plan. At all times, explain your answers.
Summarize the clinical case.
What is the DSM5 diagnosis? Identify the rationale for your diagnosis using the DSM5 diagnostic criteria.
According to the clinical guidelines, which one pharmacological treatment is most appropriate to prescribe? Include the medication name, dose, frequency and rationale for this treatment.
According to the clinical guidelines, which one non-pharmacological treatment would you prescribe? (exclude psychotherapy modalities) Include the risk and benefits of the chosen rationale for this treatment.
Include an assessment of medication\’s appropriateness, cost, effectiveness, safety, and potential for patient adherence.
Use a local pharmacy to research the cost of the medication. Use great detail when answering questions 3-5.

SOLUTION TO THE CASE STUDY

Summary Of The Clinical Case

Reggie is a 42-year-old African American male patient. Despite being in good health, he reports consuming excess alcohol during the previous three months, which prompted his primary care physician to refer him to the outpatient department for psychotherapy. Reggie has always had a problem with alcohol consumption that started while he was in his twenties. Being in a relationship with his male partner and attending Alcoholics Anonymous (AA) meetings helped him stop drinking alcohol for the past 19 years. The past three months have seen him relapse and unable to maintain the sobriety journey. He reports consuming an average of one to two alcoholic drinks almost every other evening, thus pointing to alcohol use disorder.

The patient admits to quitting drinking by attending Alcoholics Anonymous (AA) meetings but has been unsuccessful. Also, he admits abstaining from alcohol consumption is challenging; however, he is committed to trying and become sober again. His partner Bob moved out and stayed with a friend because he could not deal with Reggie’s alcoholic behaviours, such as promising to stop but never committing to his promises. There is a positive alcohol use disorder in the patient’s family. The father died at the age of 56 due to excessive alcohol consumption. On some occasions, his sister, who was severely addicted to benzodiazepines and spent 28 days in a rehabilitation Centre, abuses alcohol. Reggie witnessed firsthand the devastating effects of excessive alcohol use when his parents separated when he was 15 years, and he fears that Bob might not get back to him and end up like his father.

What Is the DSM5 Diagnosis

Alcohol use disorder

Identify The Rationale for Your Diagnosis Using the DSM5 Diagnostic Criteria

Alcohol use disorder refers to the prolonged use of alcohol. The criteria according to DSM 5 in making this diagnosis is a destructive habit of substance use that results in clinically substantial impairment or distress and is characterized by the occurrence of two or more of the following events during 12 months: sustained substance use despite ongoing or recurring social or interpersonal issues brought on by or made worse by the impacts of the drug having there is a constant desire or futile attempts to reduce or regulate drug consumption (McHugh, 2019). Also, continuous use of the substance Despite being aware of recurring bodily or psychological issues probably brought on by or made worse by the substance. For this case, Reggie qualifies to be diagnosed with AUD. He continues to use alcohol despite knowing the consequences of alcohol; when his parents separated and his father died, Bob left him because he could not deal with him, and he is committed to sobriety, but he has not been able to stop.

Pharmacological Treatment Is Most Appropriate to Prescribe? Include The Medication Name, Dose, Frequency and Rationale for This Treatment

Disulfiram 250mg per oral daily for 1-2 weeks. It prevents the metabolism of alcohol, leading to acetaldehyde, a harmful consequence of alcohol metabolism in the body, being produced in greater quantities. This byproduct produces unpleasant symptoms in excess, including nausea and skin flushing.

The patient should be educated to abstain from alcohol while taking disulfiram due to the adverse effects of disulfiram alcohol reactions, such as optic neuritis and psychotic reactions. Also, they should be warned to avoid alcohol 12 hours before taking the drugs and up to 2 weeks after the last dose (Stokes & Abdijadid, 2019). This will promote patient safety and enhance treatment adherence. The cost of Disulfiram 250mg oral tablet ranges from 40-60 $ for 30 tablets depending on the pharmacy you visit.

Non-Pharmacological Treatment Would You Prescribe? (Exclude Psychotherapy Modalities) Include the Risk and Benefits of The Chosen Rationale for This Treatment

Intervention is a proven method of treating alcoholism with the process aimed at increasing the need for therapy and maintaining sobriety (Tucker, 2020). It entails persuading patients that they are accountable for their behaviour and reminding them of the substantial disadvantages alcohol has caused. The psychiatrist utilizes the chief complaint, such as a partner leaving to explain the effects of alcohol and convince the patient that abstinence can be achieved with determination. The cost of the intervention process is usually $5000 depending on the facility. Insurance services such as Medicare and Medicaid can be used to cover the expenses.

 

 

References

McHugh, R. (2019). Alcohol Use Disorder and Depressive Disorders. Alcohol Research: Current Reviews, 40(1). https://doi.org/10.35946/arcr.v40.1.01

Stokes, M., & Abdijadid, S. (2019, April 10). Disulfiram. Nih.gov; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK459340/

Tucker, J. (2020). Epidemiology of Recovery From Alcohol Use Disorder. Alcohol Research: Current Reviews, 40(3). https://doi.org/10.35946/arcr.v40.3.02

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