BIOPSYCHOSOCIAL ASSESSMENT IDENTIFYING INFORMATION (Age/Gender/Race): Nygo Hgo is a twenty-four year old Burmese female. PAYOR: Medicate insurance company will be paying for her services. Since she is considered economically poor, she has benefits through medicate. PRESENT PSYCHIATRIC ILLNESS/SYMPTOMS (Including current and past psychosocial stressors. Present psychiatric illness included depression and anxiety. Current and past psycho social stressor are the lack of respect from her community, moving to the United States, drug abuse and lack of funds which lead her to a down spiral. BASIC NEEDS & CONCERNS (Include transportation & housing concerns): Basic needs that Nygo needs are reliable transportation, better housing, English classes, counseling …show more content…
• Screen for and detect COD: June 21 2015 • Determine severity of mental and substance use disorders: June 21 2015 • Determine appropriate care setting (e.g., inpatient, outpatient, day-treatment): June 21 2015 • Determine diagnosis: June 27 2015 • Determine disability and functional impairment: June 27 2015 • Identify strengths and supports: June 27 2015 • Identify cultural and linguistic needs and supports: June 27 2015 • Identify additional problem areas to address (e.g., physical health, housing, vocational, educational, social, spiritual, cognitive, etc.): June 27 2015 • Determine readiness for change: June 27 2015 • Plan Treatment: June 27 2015 The twelve-step process was completed of a period of seven days June 21 to June 27 History of Withdrawal Symptoms: None Reported X AM alcohol/drug use Agitation Shakes Hallucinations High Blood Pressure X Suicidality Vomiting Violence Seizures Excessive Sweating Nausea X Anxiety Insomnia DT’s X Depression Other: ___________________________ History of Intoxification: X None Reported Blackouts Bumps/ Bruises Chest or Heart Pain Distended Abdomen Hallucinations High Blood Pressure Liver
Co-occurring disorders are common with most client cases that are presenting with a substance use disorder. Rosa is presenting with a history of several suicide attempts, alcohol use disorder, Post traumatic Stress Disorder (PTSD), and Borderline Personality Disorder (BPD). The client’s most severe symptoms are anger, fear, and shame. It is these symptoms that are complicating her life, causing distress, and self harming behaviors. Additionally, her treatment history is limited since she does not finish her therapy sessions.
Pt. is currently in Phase 7 of the tx program. Pt. has been able to maintain abstinence from mood-altering substances, her drug screen results has shown no evidence of ongoing BZP use. During the recent quarter, Pt. has maintained a positive balance in his AMS account. Pt. maintained his full-time employment status and self-reported that he has no issues or concerns with his current financial status. Pt. remains at 130 mg.
Goal: Cm met with client for weekly follow up I: CM greeted client and followed up on last week’s session. CM reintegrated goal of the Harm Reduction program was to provided a referral for housing. Intern discussed plan of action to help manage the Client’s access to VA benefits and referral for VASH. Intern validated the progress the client is making and his interest in doing well.
• In alcoholic cirrhosis, the portal vein becomes scarred and blocked, causing an increase in hydrostatic pressure. Which leads to an increase in hydrostatic pressure in the capillaries. Alcoholic cirrhosis also causes the liver to under produce albumin. This lowers osmotic pressure in the vasculature, enhancing filtration out of the
Presenting Problem: Kwalon is currently residing in the home with his grandmother and receiving outpatient services. He is no-compliant in school and probation rules. Kwalon has engaged in negative and delinquent behaviors. He endorses continued problems with fragility of affect, frequent tearfulness, explosive frustration, and intrusive negative thoughts. He describes a sense of hopelessness about his environments.
Pt is 43 years old AA female who decided to return to OMHC after the program that she attended, Universal Counseling, was closed down. Initial admission to OMHC was around 2012. Pt has been diagnosed with PTSD, Bipolar, and Anxiety Disorder in the past. Her depressive episodes started at the age of 13 and after she was sexually assaulted by distant uncle. She later developed aggressive behavior around late teen and was involved in numerous arrests, starting the age of 18.
The novel Buzzed is a book written by three authors that talk about the most popular drugs in today’s world and what they do to our bodies. These authors include Scott Swartzwelder who is a professor of Psychiatry at Duke University School of Medicine, Cynthia Kuhn, who is a professor of Pharmacology at Duke University School of Medicine, and Wilkie Wilson, who is a professor of Prevention Science at Duke University. Buzzed, based on the current psychological and pharmacological research provides a reliable look at not only the use but also the abuse of the popular legal and illegal drugs. The first part of this book includes chapters on each of a total of 12 kinds of drugs which include alcohol, caffeine, enactogens, hallucinogens, herb drugs,
1. Have began the process of updating the forms for Psychiatric Evaluations as well as the forms to document follow-ups visits (Medication Management). The purpose is to improve the flow of information, simplify its use, assure the appropriate content, and facilitate arriving to the appropriate billing codes. 2. Met with all extended providers, as well as doctors to continue to ensure consistency in the delivery of quality care and the utilization of best practices, Participation in the MACRA/MIPS on a weekly basis 3.
Triggers, warning signs, and crisis planning are the components of the process, and require interdisciplinary work from the patient, nurse, doctor, counselor and other support staff. As with every human being, stress is a normal part of life. How we cope with those stressors is the difference between mental illness and mental wellness. With patients with substance-abuse issues, their coping mechanism is their substance of choice. So it is important to identify those stressors early on, identify early warning signs, look for inevitable situations where the patient feels like everything is falling apart, and most of all, prevent them from using.
Ms. Lewis was referred by Maricopa county correctional health services to receive an evaluation for potential to transfer to the mental health unit. She was serving a 10-year sentence for manufacturing and possession of illegal substances. She had served 1-year of her sentence and reported symptoms of anxiety, obsessive rumination, and sleep disturbances. Notification of Purpose and Limits of Confidentiality Upon arriving for her appointment, the Informed Consent and confidentiality agreement was discussed both verbally and in writing with Ms. Lewis. The purpose of evaluation was reviewed along with mandated reporting laws and danger to self (DTS) and danger to others (DTO).
The articles main focus is to examine older youth within the foster care system and their reaction to psychological instability. The different stages of growth throughout the child/children life and what might have been the trigger to offset a change. A lot of mental disabilities are cause from a combination of dramatic factors (sexual assault, abandonment as a child, neglect) drugs, and/or alcohol. The method in which was used to gather data was Diagnostic interview Schedule for DSM-IV.
It is successful, proven by the more than 1,900 registered nurses who have successfully completed it. A nurse with a substance use problem should show a lifestyle change supporting continuing recovery and should produce at least 24 consecutive months of clean, random tests of body-fluids to complete the Diversion Program. Nurses with a mental illness should also show they can identify both symptoms and triggers of the disease and should be able to take action immediately to prevent the disease from escalating. The Diversion Program is successful mainly because of the close monitoring of the participants for at least three years but more importantly, is attributed to the support, guidance and encouragement the nurses receive from other nurses.
In the United States, many people are without health care insurance due to having a financial crisis. Most elderly, the disabled, and lower-income families can contest to being without health care coverage at all. Not being able to afford or have healthcare insurance occurs because medical insurance is very costly. Selecting the right health care insurance can greatly impact a person life expectancy. With the help of government support programs, many people can have the choice of healthcare insurance.
Phase One (Sessions 1 through 3) • The session 1 and 2 consists of the assessment of the client’s clinical problems and background information. Questions relate to her clinical problems, including (a) the nature of her problems (depression and difficulty with making decisions), (b) reason of seeking psychotherapy, and (c) previous attempts to deal with the problems. For the background information, the client’s histories are assessed in the areas of intimate/family relationship, educational/vocational activities, past history of psychological treatment, and physical condition. Session 3 primarily consists on the further functional assessment around her coping skills (e.g., avoidance) in the areas of interpersonal relationships. Phase Two
The patient is a 53 year old male who presented to the ED via EMS intoxicated and reporting suicidal thoughts. The patient denies homicidal ideations and symptoms of psychosis. The patient endorses depressive symptoms including: tearfulness, isolation, and insomnia. During the time of the assessment the patient is awake, alert, cooperative, and clam. the patient reports that he had been drinking to 2 pints of alcohol earlier during the day.