William Thompson is a 38-year-old, African American, Catholic who was recently married to Luli Kim. He was a captain in the military during the Iraq war. William is a lawyer specializing in finance law and in jeopardy because of alcohol and PTSD related concerns. He became homeless when he was unable to pay his mortgage. The patient stated, hitting some hard times and needed to move back in with his brother and his brother’s wife. He also stated, they say I have PTSD but that’s another story. William is a marathon runner, plays soccer, enjoys listening to jazz, and is a novice modern art collector.
According to the scenario given, the client William Thompson doesn’t have enough signs and symptoms nor enough information to officially diagnose him with PTSD. According to the DSM 5 criteria requirement, a person being diagnosed with PTSD must have been exposed to actual or threatened death, serious injury, or sexual violence either directly or by experiencing. The traumatic event also needs to be a recurrent event, involuntary, and intrusive. (DSM-5, 2020). Unfortunately our patient William Thompson does not meet those criteria-based on the information given and information available on patient clinical records.
Client Does Not Meet Criteria
As a future nurse practitioner, I will do the ethically right thing and not give my patient any diagnosis if they do not meet the criteria. I believe that labeling the patient based on family history and not on signs and symptoms is wrong. I will conduct a future mental health assessment of the patient to see what the right diagnoses are for the patient and how I can develop an effective treatment plan (Flanagan et al., 2016).
Goals of Treatment
According to the Psychiatric Association’s practice guidelines for PTSD goals of treatment should include managing signs and symptoms; preventing Comorbid related symptoms such as depression, insomnia, substance abuse, and pain; improve functioning; improve the sense of trust and safety; protect against relapse; and transfer experience into a constructive plan of safety, prevention, and protection (Szafranski et al., 2017). The most important goal of treatment for the patient will include preventing him from committing suicide or hurting those around. The safe of the client and others should always be a priority (Flanagan et al., 2016).
Care plan Options
As care providers, I will consider using psychotherapy with the client in conjunction with medication therapy that can manage signs and symptoms of depression, insomnia that might be preventing the client from completing his day today activities. Some medication that I will prescribe will include Zoloft to help with the mood and Ambien to help with insomnia, I will also make sure the client enroll in cognitive behavioral therapy (CBT).
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author. Retrieved from https://dsm-psychiatryonline-org.ezp.waldenulibrary.org/doi/full/10.1176/appi.books.9780890425596.dsm07
Flanagan, J. C., Korte, K. J., Killeen, T. K., & Back, S. E. (2016). Concurrent treatment of substance use and PTSD. Current psychiatry reports, 18(8), 70.
Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press *Preface, pp. ix-x
Szafranski, D. D., Smith, B. N., Gros, D. F., & Resick, P. A. (2017). High rates of PTSD treatment dropout: A possible red herring?. Journal of Anxiety Disorders, 47, 91-98.