The patient is a 24 year old female who presented to the ED via LEO after an altercation with her fiance. The patient reports suicidal and homicidal ideations. The patient denies symptoms of psychosis. The patient reports that she has a vague memory her reason for being in the ER.
During the time of he assessment the 4X oriented and calm. The patient reports that yesterday 1/21/16 she started drinking around 11:00 am because she was feeling depressed. The patient reports depressive symptoms as: irritable, tearfulness, isolation, sadness, fatigue, hopelessness, and worthlessness. The patient reports around 3:00 PM getting into an argument with her fiance. The patient expresses that she does not remember much about the altercation, however her
fiance recorded it and her mother also saw what occurred. The patient reports times when she has elevated energy. The patient reports not being about to sleep unless she use marijuana, which she reports smoking daily. The patient reports throwing her daughter hamster into the wall and breaking her fiance front tooth. TACT tried to contact the patient's fiance, however he was unable to answer because he was at work and gets off at 7:am in the morning. The patient's mother was contacted and reports that the patient had made multiple suicidal statement and homicidal gestures towards her fiance. The mother reports the patient behavior usually happens twice a month. Further, she reports that the patient states she was going to harm herself into the bathroom tub and cut her wrist or use her car to kill herself. The patient mos recent drug screen tested positive for marijuana and cocaine. The patient denies cocaine use and reports it might have been in some marijuana she smoked a week ago at a party. Due to an increase in depressive symptoms, suicidal ideation with a plan, poor insight, poor judgement, poor impulse control, history of attempts, harm to others, patient does meet criteria for IVC and inpatient hospitalization. TACT consulted with Dr. Gentry and it was recommended to refer for inpatient hospitalization for safety and stabilization. TACT assisted the ED doctor in completing IVC paperwork. TACT will search for appropriate placement.
DSS received a report of physical abuse, physical neglect and substantial risk of physical abuse on March 3, 2017 alleging there is chaos in the home. After returning with his brothers from their cousin’s house, the boys had to go to bed. The reporter stated that Xzavia banged on his mother’s bedroom door on three separate occasions wanting something to eat. The first time he was told to go back to bed and a popping noise was heard. The second time Ms. Kimberly Dawkins grabbed Xzavia by the head, shook him little and told him to go back to bed. The third time Ms. Dawkins grabbed Xzavia, threw him on the bed, got a gun, held him down and pointed it at him. Reporter states there was no clip in the gun. Ms. Dawkins was reported being upset and it was reported that she left the home for twenty minutes but came back. It was reported that while Ms. Dawkins was gone, Xzavia was very upset and he was crying and Tyzhaun stared punching holes in the wall. It was reported that Xzavia says he wanted to die and that Atmorris went and got a knife, stated to Xzavia, “You want to die?”, here’s the knife and the two older brothers, Tyzhaun and Atmorris left the house and Xzavia chased them. It was reported that Xzavia was outside crying and he spent the night with the neighbor.
A problematic pattern of alcohol use leading to clinically significant impairment or distress, as manifested by at least two of the following, occurring within a 12-month period:
Mary has suffered with her illness for over 10 years. She has previously been diagnosis with a Cluster B type Personality Disorder. Mary comes across as narcissistic, self-engrossed and can be very demanding at times. Mary suffers from anxiety and is prone to panic attacks in relation to her PD diagnosis. At times Mary has been known to make ...
The Addition Severity Index is a well-known and widely used tool for use in treating alcoholics and other addicts. It is an approximately 45 to 60 minute long interview comprised of questions about the patient’s life. The interview covers eight subscales focusing on many different parts of a person’s life which helps to provide a comprehensive understanding of their life. The severity is scored on a ten point scale ranging from no problem or treatment indicated to extreme problem, treatment absolutely necessary. The scale helps the interviewer determine the seriousness of a client’s problem and to plan an effective course of treatment. The ASI can also be found in a self-administered paper-and-pencil form and an interactive CD-ROM multimedia version for the computer (Maleka, 2004). This test has been found to be reliable by most but some others do not agree. It is difficult to say whether or not the test is a reliable and valid measure of treatment due to the complexity of the questions. Once a client’s psychosocial needs are identified it is easier to find treatment suitable for that client. There are some problems with the test such as it is not properly designed to cover such a wide population (Maleka, 2004). Other problems include irrelevant questions for alcoholics and other drug users, difficulty remembering relevant information, and lying and exaggerating information for the best interest of the patient (Maleka, 2004). Use of the ASI can be found to be particularly problematic when used with the homeless or double-diagnosis patients. The ASI can be used in a wide range of treatment settings including clinical, research, and administrative. This comprehensive evaluation is a useful tool that helps professionals understand the
One day, I went to the superior court in Boston and to the District court. One of the cases that I observed at the Superior court was a case of assault and battery that happened at a train station on August 2014. an African American male who pushed a young male on a train track at South Station MBTA. During the court session, everyone gathered together to hear the assault and battery case that take place at the train station.
An attending physician statement completed by Ann Nichols, LMFT, dated 08/03/2017, indicated that the claimant had difficulty sustaining her job performance. She had panic attacks, psychomotor agitation, and poor concentration. She was relieved of work duties for 3-6 months.
In the disease of alcoholism, there are many psychological effects on the person. It can cause depression, anxi...
Sarah reports that she has been having depressive symptoms such as sadness, weight loss, inability to sleep, and mood changes. Client also reports substance abuse. She reports that she feels sad most of the time and that she has had a hard past. She reports having anxiety most of the day and has a hard time functioning. Client reports that she was gang raped and suffers from flashbacks and severe mood changes. Client reports that no matter what she
Jane had not slept for 72 hours and had poor diet and was observed not to be drinking fluids. Jane has a diagnosis of Bipolar
The patient is a 78-year-old gentleman who is brought to the emergency room because of increasing confusion. Evidently the daughter has taken to the bank to get some money when the daughter try to assist him to put his money in his pocket he became aggressive and combative and began to swing at her with his cane and then walked off. She was the unable to find for approximately 4 hours. When he was found he was brought to the emergency room. In the emergency room the patient was placed initially in observation status. Despite being treated in observation with fluids he remained confused and somewhat aggressive and it was determined that the patient required acute inpatient hospitalization. His medical history is significant for hypertension,
Certain practical issues need to be considered by the clinician during the assessment of MDD, (Dozois & Dobson, 2009). Depressed individuals tend to express their problems in a detailed manner when they are aware of what is expected from them during initial phase of assessment. Warning depressed clients about the possible interruptions at the initial phase along with providing them rationale helps to improve the effectiveness of the assessment (Dozois & Dobson, 2009). As depressed individuals tend to commit cognitive bias (Dozois & Beck, 2008), it is necessary to determine the actual impairment by evaluating patient’s daily routine in terms of different areas of functioning. Each diagnostic criteria needs to be addressed in number of ways (Shea, 1988). Sometimes, the patient describe their symptoms in more idiosyncratic way. So, the clinician needs to translate those concerns in to the nosological system (Dozois & Dobson, 2009). Bolland & Keller (2009) emphasize the need to assess the number of previous episodes and their duration because this information is one the predictor for risk of subsequent relapse (Solomon et al, 2000). Dozois & Dobson (2009) have reported to rely upon information related to previous episode carefully as the client may commit the reporting bias. The reporting bias can be reduced by ensuring that the patient understands the time frame to which he or she refers (Dozois & Dobson, 2009) and providing contextual cues to the patient’s memory (Shea, 1988). The information related to previous treatments, medical history, patient’s motivation for change, etc. may help in identifying resources for change (Dozois & Dobson, 2009). It is also helpful to assess client’s strengths which will help in formulating...
The patient seems to have general worry about many things, mostly tied to driving, but it has become multifaceted now to all aspects of her life. She has been suffering with this for at least 6 months.
Cecile has met some criteria that might qualify her as having alcohol use disorder (AUD), such as severe drinking over long period of time, strong desire to use alcohol, and a negative attitude of life (Dvorak, Pearson, & Day, 2014). The alcohol use disorder identification test (AUDIT) will allow us to determine if Cecile has alcohol-related disorder. Moreover, AUDIT has been shown to be reliable method of identifying AUD in experiments (Aalto, Alho, Halme, & Seppa, 2011). Nevertheless, the alcohol detoxification treatment plan can also be one of the methods that could be beneficial for Cecile. The detoxification program will help to determine whether Cecile has mild or severe disorder. It will also help to minimise the harmful effects of alcohol any further on her body.
Per Reporter: Wendy received a text from Jennifer the morning of 3/1/18, asking for prayers because Theresa (maternal grandmother) put her hands around David's neck. Theresa called shortly after stating that there was a physical altercation with her and David the night of 2/28/18. There was also a verbal altercation amongst David and Jennifer. The altercation stemmed from the insurance called about dropping coverage and having repairs done. While under the influence David began yelling screaming at Jennifer. Theresa attempted to intervene and David spit in Theresa's face, which prompted the physical altercation. David pulled out a box cutter, punched holes in the wall trying to get to Theresa. Nick (David's co-worker) had to hold David back
Maddie’s first patient, W.W., was a 68-year-old male admitted on 11/2/16 for hospital acquire pneumonia. The patient did not have a code status. The patient received a chest x-ray and a sputum culture that resulted as gram positive, confirming his pneumonia. Maddie experienced a rapid response initiated for this patient when he become dsypneic and tachycardic during a transfer. Upon her report of his integumentary system assessment to me, Maddie noted that the patient had a small knick on his chin from when his son had shaved his face the day before that was still bleeding due to the patient receiving aspirin daily. The possibility of discharge was being discussed but was most likely hindered by the need for a rapid response. Her second patient, B.S., was a 41-year-old male that was admitted on 10/30/16 for an upper gastrointestinal bleed. Upon report Maddie found out that the patient had vomited blood the day prior. An esophagogastroduodenoscopy was ordered for the patient, it showed that he had an esophageal ulcer and a CT scan of his abdomen showed chronic liver insufficiency. Maddie noted that the patient’s hemoglobin and hematocrit were low as a result of this