Upon entering the room Mrs. R was smiling and seemed anxious to speak after cordially greeting me. I offered her a seat which she gracefully took and began a conversation which was a bit loud, but which could be controlled by responding in a quiet tone. She spoke extensive about her ex-husband, four children, job as a psychiatric nurse and her mother who was also a diabetic struggling with complications of the disease, but still supportive. Throughout the interview she was very talkative. Often, it was through injection that I was able to communicate in retrieving a history from this client.

After allowing Mrs. M to speak for about 45 minutes of the interview listening without interruptions she then addressed me directly to ask why she was referred emphasizing that she was a psychiatric trained advanced nurse. Immediately, I confirmed her expertise on the matter as she continued speaking and laughing to herself intermittently during the interview. At the same time she was reassured since she had such talent and expertise in the field it would make the evaluation much simpler since we understand each other from that perspective. After another 20 minutes listening the interview was over and Mrs. R left the office accompanied by her mother and eldest 19 year old son. Tests administered consisted of structuredclinical interview and mental status examination MSE.

The structured clinical interview was conducted in relation to diagnostic and statistical manual of mental disorders DSM 1V evaluating Axis I — V Disorders SCID-I Michael, Williams, Spitzer, Gibbon, Emphasis was, however, placed on Axis 1 and 11specifically measuring major mental and personality disorders. Suicide evaluation was conducted utilizing Beck Scale for Suicidal Ideation BSS. This test consists of a 19 item self-reporting scale preceded by five other screening items. These items focused on assessing Mrs.

All items adding up to 24 were given a credit based on the specific responses offered. Positive responses are signals for further investigation. She answered all the items accurately. The final score was 30 out of This is indicative of someone who is fully oriented to time and place even though talkative; occasionally silent and even talking to herself in the absence of anyone listening. Judgment and insight were normal. She independently conducted a coherent conversation about her life concerns and correctly answered questions asked. As such it can be concluded that from this cognitive screening no significant impairments were detected. In the structured clinical observations section of the interaction apart from her talkativeness she did not demonstrate any significant personality disruptions.

With reference to the Beck Scale for Suicidal Ideation BSS Mrs. M scored 0 indicative that there were no obvious suicidal tendencies. s performance on both the structured clinical interview and mental status examination MSE did not indicate any significant cognitive neither mental derangement in terms of memory. She distinctly recalled some great experiences with her husband during their marriage as well as irresponsible financial behavior which caused the divorcee. Since then she has had the responsibility of raising four children without a father in the home in the same way her mother did.

Vividly, she recalled losing her father very early in life and struggles her mother encountered in raising them without a father. Even though she has been very successful academically subsequently obtaining a great paying job still at times Mrs. Next Mrs. M was very concerned about type 2 diabetes diagnosis with hypertension complication. These were the same health conditions, which caused her mother to obtain early retirement. Obviously, these fears surfaced during daily interactions with her world now that she has three teenage boys and an adolescent 12 year old girl. Diagnostic impressions form the basis of therapy in both mental health and psychological interventions. As such, clinicians must be mindful of disconfirmatory, confirmatory, and alternative hypotheses when making a diagnostic impression.

Arguments have been that clinicians tend to apply disconfirmatory reasoning in testing hypotheses rather than confirmatory because the focused outcome is arriving at a plausible diagnosis and treatment intervention. Alternative hypotheses impressions leave the clinician with the issue of arriving at new or other classifying criteria, which matches neither confirmatory nor disconfirmatory. Both approaches were used in formulating this diagnostic impression since some impressions were falsified and other verified. Axis 1: Axis 1V: Health difficulty coping with future demands of everyday life accompanied by feelings of inadequacy. Recommendation 1: Guide Mrs. M into identifying new coping skills that can be used when memories of the past emerge and fears of future events tend to be overwhelming.

Recommendation Encourage Mrs. to extensively discuss one occurrence she fears most in the future. Recommendation 1V:- Client must to design and maintain a sleep schedule, especially during the night. Recommendation V: Encourage Mrs. M to participate in more group activities during the week after leaving work. Cochrane-Brink, K. Lofchy, J. Clinical Rating Scales in Suicide Risk Assessment. Elsevier Science Inc. Gorman, M. However, in most cases, the problem is not even ending the life of a patient, but the effect it has on the person who does it. In this article, the focus will be on a case where a patient suffering from a chronic mental illness, Read more Psychology Environment Environmental Issues Schizophrenia Patient Nursing Family Life Killing Time Mercy Mercy Killing 5 Pages Don't waste your time searching for a sample.

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Report On Mental Health. Introduction and reports intention In the past, dying was not a big issue. Environmental Issues. Mercy Killing. His father was a very strict military man and was not caring to CK and his siblings. Due to his military background, his father was very serious and hard on him and his other siblings. His mother on the other hand was a very business woman hence she did not spend enough time with them. She left CK in the care of his older siblings and the maid. CK was an a very cheerful young boy up until the onset of the issues he is facing currently. Despite having the same parents, CK bore close to no physical resemblance to his parents, siblings or other close relatives; he had unique facial features, was shorter and had darker skin compared to other family members.

His was a smart student and his teachers liked him. He suffered the usual childhood illnesses of chickenpox and ear and eye infections. As an adult, he experienced a lot recurrent stomach pains that were related to stomach ulcers. He started displaying symptoms associated with the onset of stomach ulcers six months ago and is currently receiving treatment. CK was a smart student who began school quite early. He was a one of the best students in English, and his mother always praised him on his good handwriting and mastery of English. He performed well in school and eventually graduated from high school with a decent degree of 81 percent.

He then joined Zayed University but due to family issues and some physical problems he did not attend lectures that led to him failing all his courses. CK is the youngest of seven children. He has two sisters and four brothers. His mother is a businesswoman who travels a lot whereas his father works with the military. His parents divorced immediately after he completed high school, and he has described their relationship as highly conflictual. He currently lives with his mother who is their primary caregiver. He stated that he was not close to both of his parents since his mother was always busy, and his father did not show concern for them. As a young boy he was very close to his elder brother who is the fifth born but they slowly grew apart as they grew up.

There were no reports of previous cases of psychiatric issues in the family. CK stated that he currently had a good number of friends and had no problem with making friends. It was of great concern that he met most of them through online gaming. It was evident from the tone of his voice and body language that he longed to have a close friend. He has been a social person since he was a small boy, and his teachers and friends in school liked him. During the interview, CK presented himself as polite and relatively cooperative. He was not well groomed and presented a disorganized appearance. His short stature and slim frame gave him a youthful look. During the interview, he was dressed in a hooded jacket and pulled it over his head and failed to maintain eye contact for the most part of the interview.

He was very withdrawn and shy and also quite defensive when it came to responding to questions. He was fidgety and displayed restless psychomotor behavior. His speech patterns were slow, and he often took long pauses before responding to the questions. He was easily distracted and evaded questions that made him uncomfortable. His thought form was not logic, and he tended to deviate from the subject topic quite easily. His insight and judgment seemed fair whereas his self esteem seemed low. CK displayed encumbered ability in his receptive language abilities. He required reread of the questions and was slow in giving his responses.

He requested breaks when the questions became challenging and displayed difficulty in articulating how he felt. He seemed more anxious to towards the end of the interview and kept asking about the time. When asked questions repeatedly, he became quite defensive and agitated. He displayed some anxiety when answering questions involving his family. This was evidenced by his fidgety and restless psychomotor behavior. The family is not very close with the mother constantly travelling due to work and an unconcerned father. The siblings are relatively close with some being closer to eachother than others. CK is the last born and does not have any resemblance to his family members. The problem that CK presents is his inability to focus on work and study.

A problem that arose after he had graduated from high school and joined Zayed University where he ended up failing all his courses. He then developed a dependency on online gaming and spends most his time; both day and night at the internet café playing. His dependency problem is interpersonal in nature and escalates whenever he has disagreements with his family. This problem has caused him to become withdrawn and verbally aggressive towards his family. His family in general has suffered the most difficulty since the onset of this problem with his mother shouldering most of the distress. He is very verbally aggressive towards his mother and since she pays his university fees she has suffered a lot of financial loss in terms of tuition payment. His mother and older siblings have tried to advise and to counsel him, but he has become more withdrawn and unresponsive.

The problem has become persistent for a period and is getting worse. His inability to focus on his studies has caused him to fail in all his courses. This has resulted in feelings of failure and withdrawn. Family and physical problems are contributing factors to his failure in school. He therefore sees his family as the source of his problem. In order to relieve his frustrations, he turned to online gaming that he formed an unhealthy dependency towards. This has also become a major distraction since he indulges in the games both day and night.

He feels like the family has no right to lecture him since he considers them the source of his frustrations. This leads to a continuous repetition of the same behavior. His mother is a successful well travelled businesswoman who believes in the value of working hard in order to attain success. His father on the other hand who believes in discipline and hard work. The family is focused on practical results and does not give room for expressing weakness.

Paper Types. This Assessment was written by one of our professional writers. You are free to use it as an inspiration or a source for your own work. R was referred by her primary care physician with a history of talkativeness accompanied by intermittent periods of silence; gazing aimlessly and loud excessive talking again. Family members reported that they would hear her speaking loudly when asleep and laughing, which is considered abnormal behavior. Further background information was obtained during intake and interview with Mrs. She migrated to United States of America at age 5 with her Jamaican parents. Her father died in a car accident when she was 10 years old.

R was raised after then by her mother along with her other three siblings one other girl and two boys. At 23 years old she was married and bore four children, three boys and one girl. This marriage ended after 5 years in divorce when she was 33 years old. R attended and graduated high school with honors. Immediately after graduation she enrolled at college after obtaining three scholarships. At college Ms. She disclosed no other significant history. R worked during high school placement as a transporter in a city hospital. After the second year at college she took a part time job as patient care technician at the same hospital to gain experience and earn some needed cash. Her performance with these patients was exceptional and after two years she was recommended forspecialization in psychiatric nursing.

Prior to being referred for psychiatric evaluation Mrs. worked on a psychiatric unit for over five consecutive years. For one year she did not due to developments in her personality which needed further evaluations. admitted that after her divorcee approximately nine years ago she was severely depressed, but never took it seriously. Prayer she confirmed helped her through that storm of her life because she has a strong belief in the divine. Her primary care physician, however, had her referred to a psychologist for evaluation and later was hospitalized for stress and difficulty in concentrating. There were no suicidal thoughts neither attempt.

Importantly, Mrs. R was diagnosed with type 2 diabetes and essential hypertension two years ago. Since then reports are that the blood glucose levels are with diet and 5mg Glipizide once daily. The blood pressure is controlled with 25mgs hydrochlorothiazide once daily. R had not been sexually active two years prior to her divorcee and after. Due to the trauma she endured during the later years of her marriage she expressed loss of interest in sex and men. Besides, during the interview Mrs. R communicated that she did not engage in sex before marriage and had one sex partner during that time. R was well groomed expressing politeness during the interview. Her straitened black natural hair was combed backwards with a neat bun at the lower center back of the head.

Moderate use of make-up was observed in the form of a small portion of lip gloss covering the somewhat dry lips. The body odor was pleasant with no pungent perfume or natural fumes. Upon entering the room Mrs. R was smiling and seemed anxious to speak after cordially greeting me. I offered her a seat which she gracefully took and began a conversation which was a bit loud, but which could be controlled by responding in a quiet tone. She spoke extensive about her ex-husband, four children, job as a psychiatric nurse and her mother who was also a diabetic struggling with complications of the disease, but still supportive. Throughout the interview she was very talkative. Often, it was through injection that I was able to communicate in retrieving a history from this client.

After allowing Mrs. M to speak for about 45 minutes of the interview listening without interruptions she then addressed me directly to ask why she was referred emphasizing that she was a psychiatric trained advanced nurse. Immediately, I confirmed her expertise on the matter as she continued speaking and laughing to herself intermittently during the interview. At the same time she was reassured since she had such talent and expertise in the field it would make the evaluation much simpler since we understand each other from that perspective.

After another 20 minutes listening the interview was over and Mrs. R left the office accompanied by her mother and eldest 19 year old son. Tests administered consisted of structuredclinical interview and mental status examination MSE. The structured clinical interview was conducted in relation to diagnostic and statistical manual of mental disorders DSM 1V evaluating Axis I — V Disorders SCID-I Michael, Williams, Spitzer, Gibbon, Emphasis was, however, placed on Axis 1 and 11specifically measuring major mental and personality disorders. Suicide evaluation was conducted utilizing Beck Scale for Suicidal Ideation BSS. This test consists of a 19 item self-reporting scale preceded by five other screening items. These items focused on assessing Mrs. All items adding up to 24 were given a credit based on the specific responses offered.

Positive responses are signals for further investigation. She answered all the items accurately. The final score was 30 out of This is indicative of someone who is fully oriented to time and place even though talkative; occasionally silent and even talking to herself in the absence of anyone listening. Judgment and insight were normal. She independently conducted a coherent conversation about her life concerns and correctly answered questions asked. As such it can be concluded that from this cognitive screening no significant impairments were detected.

In the structured clinical observations section of the interaction apart from her talkativeness she did not demonstrate any significant personality disruptions. With reference to the Beck Scale for Suicidal Ideation BSS Mrs. M scored 0 indicative that there were no obvious suicidal tendencies. s performance on both the structured clinical interview and mental status examination MSE did not indicate any significant cognitive neither mental derangement in terms of memory. She distinctly recalled some great experiences with her husband during their marriage as well as irresponsible financial behavior which caused the divorcee.

Since then she has had the responsibility of raising four children without a father in the home in the same way her mother did. Vividly, she recalled losing her father very early in life and struggles her mother encountered in raising them without a father. Even though she has been very successful academically subsequently obtaining a great paying job still at times Mrs. Next Mrs. M was very concerned about type 2 diabetes diagnosis with hypertension complication. These were the same health conditions, which caused her mother to obtain early retirement. Obviously, these fears surfaced during daily interactions with her world now that she has three teenage boys and an adolescent 12 year old girl.

Diagnostic impressions form the basis of therapy in both mental health and psychological interventions. As such, clinicians must be mindful of disconfirmatory, confirmatory, and alternative hypotheses when making a diagnostic impression. Arguments have been that clinicians tend to apply disconfirmatory reasoning in testing hypotheses rather than confirmatory because the focused outcome is arriving at a plausible diagnosis and treatment intervention. Alternative hypotheses impressions leave the clinician with the issue of arriving at new or other classifying criteria, which matches neither confirmatory nor disconfirmatory.

Both approaches were used in formulating this diagnostic impression since some impressions were falsified and other verified. Axis 1: Axis 1V: Health difficulty coping with future demands of everyday life accompanied by feelings of inadequacy. Recommendation 1: Guide Mrs. M into identifying new coping skills that can be used when memories of the past emerge and fears of future events tend to be overwhelming. Recommendation Encourage Mrs. to extensively discuss one occurrence she fears most in the future. Recommendation 1V:- Client must to design and maintain a sleep schedule, especially during the night. Recommendation V: Encourage Mrs. M to participate in more group activities during the week after leaving work. Cochrane-Brink, K. Lofchy, J.

Clinical Rating Scales in Suicide Risk Assessment. Elsevier Science Inc. Gorman, M. Gorman, E. Latta, M. British Journal of Psychology. Owen G. Taking Phenomenology Seriously.

This was evidenced by his fidgety and restless psychomotor behavior. Academic level High school Undergraduate Bachelor Professional. View full sample. M expressed a number of fears, but they all seemed jumbled or cumulated. Academic history Mrs. CK was an a very cheerful young boy up until the onset of the issues he is facing currently.

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