Which Decision did you select?

The Assignment:

Examine Case 1. You will be asked to make three decisions concerning the diagnosis and treatment for this client. Be sure to consider co-morbid physical as well as mental factors that might impact the client’s diagnosis and treatment.

At each Decision Point, stop to complete the following:

  • Decision #1: Differential Diagnosis
    • Which Decision did you select?
    • Why did you select this Decision? Support your response with evidence and references to the Learning Resources.
    • What were you hoping to achieve by making this Decision? Support your response with evidence and references to the Learning Resources.
    • Explain any difference between what you expected to achieve with Decision #1 and the results of the Decision. Why were they different?
  • Decision #2: Treatment Plan for Psychotherapy
    • Why did you select this Decision? Support your response with evidence and references to the Learning Resources.
    • What were you hoping to achieve by making this Decision? Support your response with evidence and references to the Learning Resources.
    • Explain any difference between what you expected to achieve with Decision #2 and the results of the Decision. Why were they different?
  • Decision #3: Treatment Plan for Psychopharmacology
    • Why did you select this Decision? Support your response with evidence and references to the Learning Resources.
    • What were you hoping to achieve by making this Decision? Support your response with evidence and references to the Learning Resources.
    • Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?
  • Also include how ethical considerations might impact your treatment plan and communication with clients and their families.
  •  Note: Support your rationale with a minimum of three academic resources. While you may use the course text to support your rationale, it will not count toward the resource requirement.Decision Point One

    Attention Deficit Hyperactivity Disorder, predominantly inattentive presentationsentation

    RESULTS OF DECISION POINT ONE

    ·  Client returns to clinic in four weeks

    ·  You selected Attention deficit hyperactivity disorder, predominantly inattentive presentation. Based on this choice, outline the remainder of the diagnostic evaluation that you will conduct on this child and their parents. Be sure to include standardized assessment instruments that you would administer

    Decision Point Two

    Begin Strattera 25mg orally daily

    RESULTS OF DECISION POINT TWO

    ·  Client returns to clinic in four weeks

    ·  Katie’s parents seem absolutely delighted upon their return stating that Katie is paying more attention in school, but note that there is still room for improvement

    ·  They are somewhat concerned however about some sedation that she experiences following the medication. They report that Katie has been becoming more uncooperative with medications as she feels ‘sleepy’ after taking them

    · Her parents are also concerned about her decrease in appetite since starting the medication

    Decision Point Three

    Discontinue Strattera and begin Adderall XR 10mg orally daily

    Guidance to Student

    In response to the first choice, although decreased appetite is a side effect of Strattera, it does not address the parents’ concerns about Katie’s sedation, which can occur with Strattera use. It may help with residual inattention symptoms, however, if the medication is creating such negative side effects, compliance may become an issue.

    CBT has some evidence of efficacy in treating ADHD symptoms, however, augmenting the medication is not going to effectively address the concerns that Katie’s parents have raised regarding side effects.

    Discontinuing Strattera and beginning Adderall XR would be the most appropriate strategy in this case as changing agents may alleviate the unfavorable side effects, and may treat symptoms more effectively.

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