Answer in APA format with 2 citations per paragraph treat each answer as a separate work or file and each work or file need separate references. 300 word each answer Support your posts with specific references to the Learning Resources given in this work. Be sure to provide full APA citations for your references. Treat each work, file or answer as a separate work and each work or answer needs separate references. Be sure to support your postings and responses with specific references to the resources and the current literature using appropriate APA format and style

SOCW 90 wk5 response to students and a video for the professor

Learning Resources to be used as references to support your answer.

Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

Required Readings

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

  1. “Depressive Disorders” (pp. 155–188)

  2. “Assessment Measures” (pp. 733–748)

Campbell, P. (2006). Beating the blues: New approaches to overcoming dysthymia and chronic mild depression. Mental Health Practice, 10(3), 25–26.

Note: You will access this article from the Walden Library databases.

Working with individuals: The case of Sam (PDF)

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

  1. “Bipolar and Related Disorders” (pp. 123–154)

Balázs, J., Benazzi, B., Rihmer, Z., & Rihmer, A. (2006). The close link between suicide attempts and mixed (bipolar) depression: Implications for suicide prevention. Journal of Affective Disorders, 91, 133–138.

Note: You will access this article from the Walden Library databases.

Kessler, R. C., Merikangas, K. R., & Wang, P. S. (2006). Prevalence, comorbidity, and service utilization for mood disorders in the United States at the beginning of the twenty-first century. Annual Review of Psychology, 3, 137–158.

Prevalence, comorbidity, and service utilization for mood disorders in the United States at the beginning of the twenty-first century by Kessler, R.C., Merikangas, K.R., & Wang, P.S., in the Annual Review of Clinical Psychology, 3. Copyright 2007 by Annual Reviews. Reprinted by permission of Annual Reviews, Inc. via the Copyright Clearance Center.

Rusner, M., Carlsson, G., & Brunt, D. (2009). Extra dimensions in all aspects of life: The meaning of life with bipolar disorder. International Journal of Qualitative Studies on Health and Well-Being, 4, 159–169.

Note: You will access this article from the Walden Library databases.

Zeek I need to comment on what this video explains to social workers PLEASE

Work #1 video

Work #1 Answer in APA format with 2 citations per paragraph treat each answer as a separate work or file and each work or file need separate references. Support your posts with specific references to the Learning Resources given in this work. Be sure to provide full APA citations for your references. Treat each work, file or answer as a separate work and each work or answer needs separate references. Be sure to support your postings and responses with specific references to the resources and the current literature using appropriate APA format and style.

Work #1 Give a positive critic for the video and explain the videoBottom of Form

Jan Ivery Walden Instructor Manager

Types of Depression and Bipolar Disorders Video Attachment

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Total views: 32 (Your views: 5)

Welcome to Week 5!

While reviewing bipolar and depressive disorders there are other conditions that we also need to consider when assessing clients. As if diagnosis was not complicated enough! I have included another link from the Khan Academy (the produced the video I posted in Week 3) that provides an overview of depression and bipolar disorders for adults and children.

Depression and Bipolar Disorders in the DSM 5: https://www.youtube.com/watch?v=eSXZwk8axmI

Have a great week…….

Dr. Ivery

SOCW 90 week 5 response to students posted discussion for discussion #1

Work #2 Answer in APA format with 2 citations per paragraph treat each answer as a separate work or file and each work or file need separate references. Support your posts with specific references to the Learning Resources given in this work. Be sure to provide full APA citations for your references. Treat each work, file or answer as a separate work and each work or answer needs separate references. Be sure to support your postings and responses with specific references to the resources and the current literature using appropriate APA format and style.

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Respond to at least two colleagues who presented a different diagnosis. Discuss the differences and similarities in your choice of criteria, focusing in particular on Other Conditions that may be a Focus of Clinical Attention.

Work #2 Michele Munzner

RE: Discussion 1 – Week 5 Attachment

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Total views: 25 (Your views: 3)

My diagnosis for Sam is:

F33.0 Major Depressive Disorder, recurrent, with anxious distress, with mild severity

Z59.9 Unspecified housing or economic problem

Z60.0 Phase of life problem

Z60.2 Problem related to living alone

The onset of Sam’s initial major depressive disorder with psychotic features was after the September 11, 2001 terrorist attacks (Laureate Education, 2016). Prior to this, Sam maintained steady employment. Sam’s depressive symptoms were stable, so he stopped counseling, however, continued to receive medication management from a psychiatrist (Laureate Education, 2016). Sam returns to the counselor for increased feelings of depression due to his daughter moving out and experiencing empty next syndrome, decreased socialization, adjustment issues to living alone, feelings of loneliness, and periods of anxious feelings (Laureate Education, 2016). The diagnosis of F33.0, Major Depressive Disorder, is based upon the following diagnostic criteria (American Psychiatric Association [APA], 2013):

· and are a change in functioning.

. A1 – Depressed most of the day nearly every day as evidenced by self-report of increased feelings of depression (Laureate Education, 2016)

. A2 – Anhedonia: Loss of pleasure in activities as evidenced by decreased socialization and no peer Criteria A has been met with 5 symptoms and are present for 2-weeks contacts other than his daughter (Laureate Education, 2016).

. A6 – Fatigue and loss of energy as evidenced by his limited activities of reading and listening to the radio (Laureate Education, 2016).

. A7 – Feelings for worthlessness or excessive or inappropriate guilt as evidenced by increased issues with his financial concerns about being able to maintain his apartment after his daughter moved out (Laureate Education, 2016).

. A8 – Diminished indecisiveness as evidenced by not wanting to visit his daughter for feelings of intruding on her lifestyle change with her boyfriend (Laureate Education, 3016).

· Criteria B has been met as evidenced by impairment with his social area of functioning (Laureate Education, 2016).

· Criteria C has been met as the increased feelings of depression occurred prior to the physiological effects of taking his previously prescribed medications of Cogentin and Ativan causing an altered mental status (Laureate Education, 2016). The recent hospitalization for a collapse in the street could have been caused by a seizure resulting from a side effect of Wellbutrin, however, his neurological testing was negative suggesting there was not seizure activity (Laureate Education, 2016).

There are multiple other conditions that may be a clinical focus of attention in Sam’s case. Sam is experiencing potential housing and economic issues as evidenced by his concern over being able to maintain his rent resulting in the use of code Z59.9 (APA, 2013 & Laureate Education, 2016). Sam is experiencing both a phase of life problem and a problem related to living alone as his daughter recently moving out and having to live alone after having lived with her for quite a long time resulting in the use of codes Z60.0 and Z60.2 (APA, 2013 & Laureate Education, 2016).

The assessment measures used in the DSM-5 explains well the dimensions from none through severe to rate the level of severity (APA, 2013). This information was helpful in determining the severity of Sam’s depression. Additionally, the measure for psychosis symptoms is very illuminating, however, not appropriate to Sam as he is not currently experiencing psychotic symptoms (APA, 2013 & Laureate Education, 2016). The scoring of the assessment is well described and provides documentation for impaired capacity (APA, 2013). Sam has already been declared disabled due to his depressive disorder, so this information, while informative is not helpful during the evaluation (APA, 2013 & Laureate Education, 2016).

References:

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders

(5th ed.). Arlington, VA: American Psychiatric Publishing.

Laureate Education. (2016). Working with individuals: The case of Sam. Retrieved from

https://class.waldenu.edu/bbcswebdav/institution/USW1/201830_27/MS_SOCW/SOCW_6090_WC/readings/USW1_SOCW_6090_WK05_Sam.pdf

SOCW 90week 5 Rubric

10.8 (27%) – 12 (30%)

Discussion posting fully addresses all instruction prompts, including responding to the required number of peer posts. 12 (30%)

Points Range: 10.8 (27%) – 12 (30%)

Discussion posting demonstrates an excellent understanding of all of the concepts and key points presented in the text(s) and Learning Resources. Posting provides significant detail including multiple relevant examples, evidence from the readings and other scholarly sources, and discerning ideas 9 (22.5%) – 10 (25%)

The feedback postings and responses to questions are excellent and fully contribute to the quality of interaction by offering constructive critique, suggestions, in-depth questions, additional resources, and stimulating thoughts and/or probes. 5.94 (14.85%)

Points Range: 5.4 (13.5%) – 6 (15%)

Postings are well organized, use scholarly tone, contain original writing and proper paraphrasing, follow APA style, contain very few or no writing and/or spelling errors, and are fully consistent with graduate level writing style.

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SOCW 90 week 5 response to students posted discussion for discussion #1

Work #3 Answer in APA format with 2 citations per paragraph treat each answer as a separate work or file and each work or file need separate references. Support your posts with specific references to the Learning Resources given in this work. Be sure to provide full APA citations for your references. Treat each work, file or answer as a separate work and each work or answer needs separate references. Be sure to support your postings and responses with specific references to the resources and the current literature using appropriate APA format and style.

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Respond to at least two colleagues who presented a different diagnosis. Discuss the differences and similarities in your choice of criteria, focusing in particular on Other Conditions that may be a Focus of Clinical Attention

Work #3 Katie Morad

RE: Discussion 1 – Week 5 Attachment

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Total views: 20 (Your views: 2)

Discussion 1: Using the DSM-5 and the Z Codes (ICD-10-CM)

The clinical diagnosis for Sam is as follows:

F33.3 Major Depressive Disorder, recurrent episode with psychotic features with anxious distress

Z60.0 Phase of Life Problem

Z60.2 Problems Related to Living Alone

T50.905A Initial Encounter

High Blood Pressure

Migraines

Sam began displaying his depressive symptoms with psychotic features after the September 11th attacks, prior to that he did not display this baseline (Plummer, Makris, & Brocksen, 2014). While it was clear that Sam had major depressive disorder with psychotic features, due to his self-reports and various testimonies by counselors and psychiatrics who followed the diagnostic criteria of said diagnosis, a more dimensional approach could have been taken. An assessment measure known as cross-cutting system measures can detect subtle changes in different organs that can facilitate diagnosis and treatment (American Psychiatric Association [APA], 2013). The measures within cross-cutting systems measures are administered initially and over time (APA, 2013). The adult version of the cross-cutting measure consists of 13 domains that range from depression, anxiety, and mania, to psychosis, memory, and dissociation (APA, 2013). This would be helpful in Sam’s case as it would assess his recent memory less. The World Health Organization Disability Assessment Schedule, Version 2.0 (WHODAS 2.0) is another measure to help with the accuracy of diagnosis. WHODAS 2.0 assesses the ability to perform in certain areas (APA, 2013). WHODAS 2.0 is a measure that can help an individual with a medical condition and is self-administered (APA, 2013), this would be useful to address Sam’s high blood pressure and migraines. Both the cross-cutting systems measures and the WHODAS 2.0 would be useful measures in Sam’s case.

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).

Arlington, VA: American Psychiatric Publishing.

Plummer, S.-B., Makris, S., & Brocksen, S. M. (Eds.). (2014). Social work case studies: Concentration year.

Baltimore, MD: Laureate International Universities Publishing [Vital Source e-reader].

SOCW 90week 5 Rubric

10.8 (27%) – 12 (30%)

Discussion posting fully addresses all instruction prompts, including responding to the required number of peer posts. 12 (30%)

Points Range: 10.8 (27%) – 12 (30%)

Discussion posting demonstrates an excellent understanding of all of the concepts and key points presented in the text(s) and Learning Resources. Posting provides significant detail including multiple relevant examples, evidence from the readings and other scholarly sources, and discerning ideas 9 (22.5%) – 10 (25%)

The feedback postings and responses to questions are excellent and fully contribute to the quality of interaction by offering constructive critique, suggestions, in-depth questions, additional resources, and stimulating thoughts and/or probes. 5.94 (14.85%)

Points Range: 5.4 (13.5%) – 6 (15%)

Postings are well organized, use scholarly tone, contain original writing and proper paraphrasing, follow APA style, contain very few or no writing and/or spelling errors, and are fully consistent with graduate level writing style.

SOCW week5 discussion #2 response to students posted discussion

Work #4 Answer in APA format with 2 citations per paragraph treat each answer as a separate work or file and each work or file need separate references. Support your posts with specific references to the Learning Resources given in this work. Be sure to provide full APA citations for your references. Treat each work, file or answer as a separate work and each work or answer needs separate references. Be sure to support your postings and responses with specific references to the resources and the current literature using appropriate APA format and style.

Bottom of Form

Respond to at least two colleagues in one of the following ways:

· Offer an alternative suggestion that has not been previously discussed for how your colleagues, as social work professionals, might respond to clients with suicidal ideations.

· Explain any gaps in the action plans your colleagues described for working with clients who express suicidal ideations.

Work #4 Jared Taylor

RE: Discussion 2 – Week 5 Attachment

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Total views: 11 (Your views: 1)

A Brief Review of an Article on Suicide Intervention

The article selected for this post is entitled Applied Suicide Intervention Skills Training: Evidence in Support of the ASIST 11 Program (Living Works Education, 2013). Applied Suicide Intervention Skills Training (ASIST) is designed for gatekeepers (Suicide Prevention Research Center, 2013)—those such as clinical providers who are in an ideal position to identify a persons at risk of suicide (Matthieu, Cross, Batres, Flora, & Knox, 2008). The article (Living Works Education, 2013), begins by describing the purpose of the article and providing an outline. This is followed by a section entitled the Evidence in Support of the Need for ASIST Training. Indeed, the need for ASIST is presented strongly by identifying barriers such as referral and the need for immediate attention to traditional approaches dealing with those who are suicidal.

After providing a ratiocination of need for ASIST training, a description of ASIST is provided. This section notes that ASIST has a different approach than other gatekeeper suicide prevention programs. It is stated that ASIST’s approach can be thought of as “helping persons-at-risk find their pathway through suicide to safety” (Living Works Education, p. 3). LivingWorks Education notes that ASIST is composed of three phases: 1. Connecting with suicide, 2. Understanding choices, 3. Assisting life. Each of these three phases is accompanied by two objectives. Connecting with suicide is accompanied by exploring invitations, and asking about suicide. Understanding choices is accompanied by the objectives of first hearing their story and then supporting turning to safety. Lastly, assisting life is accompanied by developing a safeplan and confirming actions.

There are three more sections which follow the description of ASIST. These three sections highlight the evidence for the principles, the model, and the training methods. Indeed, ASIST is an evidence based suicide prevention intervention (LivingWorks Education). The principle section of the paper notes the support for principles such as the safety first priority and taking a safety assessment instead of a risk assessment. Certainly, this is a strength based approach that augments the strengths of a situation instead of the weaknesses. As such, it aligns with social works strength based systems focus (Zastrow and Kirst-Ashman, 2015). The evidence for the model of ASIST highlights the evidence for its three phases. This includes reviewing the objective steps such as the evidence that supports the importance of exploring invitations and developing a safeplan in the prevention of suicide. The last section of the article reviews the evidence in support of the ASIST training methods. Indeed, this is important as clinical expertise in the delivery of evidence based practices is essential to the impact (Titler, 2008). This section reviews the support for its training methods which are composed largely of experiential training in small groups. LivingWorks Education notes that “less than one-fifth of ASIST training is devoted to direct instruction or lecture” (p.8). This research based method not only enhances learning but allows the learners practical experience.

How I might Respond to a Client with Suicidal Ideation: Needed Protocols

If a client were to express suicidal ideation, I would likely respond using the ASIST priciples and model. That is, I am going to first connect by exploring the suicidal ideation and asking if the person is thinking about suicide (Gould, Cross, Pisani, Munfakh, & Kleinman, 2013). Asking the person if they are considering suicide is empowering to the individual and is the first step to not only uncovering the consideration of suicide but to helping that individual (Matsakis, 2007; McGregor & Viger, 2017). Bringing up that one is thinking of suicide can be uncomfortable and asking about suicide creates an outlet for the person to discuss their ideation further (Willer, 2014). After connecting, I would work to understand where my client is coming from in regards to his thoughts of suicide. I am going to show concern, acceptance and actively listen to what they share (Matsakis, and McGregor & Willer). Letting people express their pain and providing accurate empathetic listening is key to the healing process (Corey, 2017). Evaluation of the client’s safety would also be made (LivingWorks Education). Knowing how safe the client is will be key to the next steps. Despite the safety or risk the client is in, I am then going to work to establish a safety plan (LivingWorks Education). As LivingWorks notes, creating a safety plan is superior to referral for there may be many barriers.

To utilize the approach above, there would need to be agency protocols to allow for the individual to be addressed in the present. For instance, if time with the client is up and there are other patients, agency protocol would need to be made where a client with suicidal ideation recives attention from the primary therapist or another therapist before being dismissed. If for some reason time spent with a suicidal client were to disrupt another clients appointment, there would also need to be some consideration for that client. This may be as simple as giving that client a discount or a free no notice cancellation for future use.

Emotional Responses to a Clients Expression of Suicidal Ideation

My first emotional response would be concern for my client. I have worked with hundreds of clients who have expressed an active consideration of suicide and thus I am comfortable in helping them. I would likely be happy as well. This is not because my client is suicidal, but because they are asking for help by telling me of their suicidal ideation. The last thing I would want would be for the client to not tell me and leave carrying some overwhelming burden.

References

Matthieu, M. M., Cross, W., Batres, A. R., Flora, C. M., & Knox, K. L. (2008). Evaluation of gatekeeper training for suicide prevention in veterans. Archives of Suicide Research, 12(2), 148-154. doi:10.1080/13811110701857491

Matsakis, A. (2007). Back from the front: Combat trauma, love, and the family. Baltimore, MD: Sidran Institute Press.

McGregor, C., & Viger, R. (2017). Quebec suicide prevention handbook: A reference for fieldworkers and all citizens. Retrieved from https://books.google.com

Suicide Prevention Research Center. (2013). Comparison table of suicide prevention gatekeeper training programs. Retrieved from http://www.sprc.org/sites/default/files/migrate/library/SPRC_Gatekeeper_matrix_Jul2013update.pdf

Titler MG. The Evidence for Evidence-Based Practice Implementation. In: Hughes RG, editor. Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Rockville (MD): Agency for Healthcare Research and Quality (US); 2008 Apr. Chapter 7.Available from: https://www.ncbi.nlm.nih.gov/books/NBK2659/

Willer, J. (2014). The beginning psychotherapist’s companion. Retrieved from https://books.google.com

SOCW 90week 5 Rubric

10.8 (27%) – 12 (30%)

Discussion posting fully addresses all instruction prompts, including responding to the required number of peer posts. 12 (30%)

Points Range: 10.8 (27%) – 12 (30%)

Discussion posting demonstrates an excellent understanding of all of the concepts and key points presented in the text(s) and Learning Resources. Posting provides significant detail including multiple relevant examples, evidence from the readings and other scholarly sources, and discerning ideas 9 (22.5%) – 10 (25%)

The feedback postings and responses to questions are excellent and fully contribute to the quality of interaction by offering constructive critique, suggestions, in-depth questions, additional resources, and stimulating thoughts and/or probes. 5.94 (14.85%)

Points Range: 5.4 (13.5%) – 6 (15%)

Postings are well organized, use scholarly tone, contain original writing and proper paraphrasing, follow APA style, contain very few or no writing and/or spelling errors, and are fully consistent with graduate level writing style.

SOCW week5 discussion #2 response to students posted discussion

Work #5 Answer in APA format with 2 citations per paragraph treat each answer as a separate work or file and each work or file need separate references. Support your posts with specific references to the Learning Resources given in this work. Be sure to provide full APA citations for your references. Treat each work, file or answer as a separate work and each work or answer needs separate references. Be sure to support your postings and responses with specific references to the resources and the current literature using appropriate APA format and style.

Bottom of Form

Respond to at least two colleagues in one of the following ways:

· Offer an alternative suggestion that has not been previously discussed for how your colleagues, as social work professionals, might respond to clients with suicidal ideations.

· Explain any gaps in the action plans your colleagues described for working with clients who express suicidal ideations.

· Work #5 Michele Munzner

· RE: Discussion 2 – Week 5 Attachment

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·

· Total views: 11 (Your views: 3)

· The article, Motivational Interviewing in the Assessment and Management of Suicidality, discussed the use of motivational interviewing (MI) in conjunction with the Collaborative Assessment and Management of Suicidality (CAMS) to address brief interventions (Zerler, 2009). MI explores patient ambivalence in a client-centered manner using a goal-oriented approach (Zerler, 2009). The CAMS provide a clinical approach for the identification, assessment, treating, and following of suicidal risk factors (Zerler, 2009). The author described that the discussion of suicide is uncomfortable for many people and that diverts individuals at risk of suicide to a local crisis center, most often the emergency department. Additionally, Zerler (2009) cited that a crisis evaluation is done to provide an evaluation to identify risk and protective factors to determine if the patient can be discharged with a safety plan or requires an admission to a higher level of psychiatric care. Using MI allows the clinician can aid the patient in preserving autonomy while providing the self determination of the patient to recognize that they do have the capacity to make good choices while dealing with their bad feelings (Zerler, 2009). The author cited that there is a high degree of ambivalence regarding death within the suicidal population and MI can aid in the promotion of readiness for change (Zerler, 2009). The goals of MI are to promote readiness for a safety plan, facilitate patient cooperation, and secure the patients safety plan participation (Zerler, 2009). The process of MI uses open ended questions, affirmations, reflections, and summaries (OARS) to facilitate autonomy and self-efficacy while exploring their ambivalence (Zerler, 2009). The article provided an excellent case illustration using this action plan. Zerler (2009) further explained that suicide is very rarely uncomplicated but a myriad of interpersonal issues, such as negative conditions, conflicts in relationships, long-term illness, and economic stressors. Zerler (2009) cited that in his professional practice he has used MI and CAMS in more than 100 assessments with reduced rates of involuntary commitments as well as voluntary inpatient hospitalizations based on discharge data.

· As a social work professional, I use MI when engaged with a patient who expressing suicidal ideation. When encountering a patient with SI, I attempt to build a rapport with the client to elicit their risk and protective factors. I further explain to them that because of their SI, they are to be placed on suicide precautions. In the hospital setting, this includes a 1:1 situation with the patient being assigned a sitter. This protocol needs to be in place for the safety of the patient. Additionally, all items that could potentially be used to harm oneself are removed, such as sharps containers. The patient would need to be cleared by a mental health professional to identify and facilitate a safe discharge. The patient can engage in a safety plan and be provided with outpatient resources, voluntarily be admitted to a psychiatric facility, or involuntarily be admitted to a psychiatric facility if deemed appropriate. I have worked for two hospital systems and these protocols are in place at each facility.

· Emotionally, working with suicidal patients can be exhaustive. When I first started working on a geri-psych unit my concept of suicidal ideation was “what can be so bad that you believe this is your only option”. After working with SI patients and hearing their stories and the depth of emotion that they display when describing their life circumstances, I began to understand why some of them thought suicide was their only option. I would often feel sadness and frustration. When the revelation of active suicidal ideations occurs, I move past any emotional response I may feel and enter crisis mode to elicit information from the client and then process the situation with a co-worker. Having a trusted co-worker, supervisor, or other social work professional to speak with is very helpful.

· Reference:

· Zerler, H. (2009). Motivational interviewing in the assessment and management of suicidality.

· Journal of Clinical Psychology, 65(11), 1207-1217. doi:10.1002/jclp.20643

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· SOCW 90week 5 Rubric

·

· 10.8 (27%) – 12 (30%)

·

· Discussion posting fully addresses all instruction prompts, including responding to the required number of peer posts. 12 (30%)

· Points Range: 10.8 (27%) – 12 (30%)

·

· Discussion posting demonstrates an excellent understanding of all of the concepts and key points presented in the text(s) and Learning Resources. Posting provides significant detail including multiple relevant examples, evidence from the readings and other scholarly sources, and discerning ideas 9 (22.5%) – 10 (25%)

·

· The feedback postings and responses to questions are excellent and fully contribute to the quality of interaction by offering constructive critique, suggestions, in-depth questions, additional resources, and stimulating thoughts and/or probes. 5.94 (14.85%)

· Points Range: 5.4 (13.5%) – 6 (15%)

·

· Postings are well organized, use scholarly tone, contain original writing and proper paraphrasing, follow APA style, contain very few or no writing and/or spelling errors, and are fully consistent with graduate level writing style.

Bottom of Form

SOCW 04 wk5 discussion 1 response to students posted discussion

Learning Resources to be used as references to support your answer.

Required Readings

Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

Dando, H. H., & Finlon, C. J. (2003). Social work in an interdisciplinary HIV/AIDS program. In B. I. Willinger & A. Rice (Eds.), A history of AIDS social work in hospitals: A daring response to an epidemic (pp. 229–238). New York, NY: Haworth Press.

Note: Retrieved from Walden Library databases.

Sherman, R. O. (2013, March 14). Why interdisciplinary teamwork in healthcare is challenging [Blog post]. Retrieved from http://www.emergingrnleader.com/why-interdisciplinary-teamwork-in-healthcare-is-challenging/

Beder, J., & Postiglione, P. (2013). Social work in the Veterans Health Administration (VA) System: rewards, challenges, roles and interventions. Social Work in Health Care, 52(5), 421–433.

Note: Retrieved from Walden Library databases.

Berkman, B. J. (2011). Seizing interdisciplinary opportunities in the changing landscape of health and aging: A social work perspective. Gerontologist, 51(4), 433–440. Retrieved from http://gerontologist.oxfordjournals.org/content/51/4/433.full.pdf

Seizing interdisciplinary opportunities in the changing landscape of health and aging: a social work perspective by Berkman, B. J. in The Gerontologist, 51/4. Copyright 2011 by the Gerontological Society. Reprinted by permission of Oxford University Press via the Copyright Clearance Center.

Deja, K. (2006). Social workers breaking bad news: The essential role of an interdisciplinary team when communicating prognosis. Journal of Palliative Medicine, 9(3), 807–809.

Note: Retrieved from Walden Library databases.

Mental health diagnosis in social work: The case of Miranda. (2014). In Plummer, S.-B., Makris, S., & Brocksen S. M. (Eds.). Social work case studies: Concentration year (pp. 5–6, 95–96). Baltimore, MD: Laureate Publishing. [VitalSource e-reader] Mental Health Diagnosis in

Social Work: The Case

of Miranda

Miranda is a 35-year-old, Scottish female who sought counseling

for increased feelings of depression and anxiety. Her symptoms

include constant worry, difficulty sleeping, irritability, increased

appetite, unexplained episodes of panic, feelings of guilt and

worthlessness,

and feelings of low self-esteem. She denied any

suicidal/homicidal ideation but verbalized feelings of wanting to be

dead. She maintained these thoughts were fleeting and inconsistent.

She reported an increase in alcohol consumption, although

clarified it was only when she felt anxious. She denied any blackouts

or reckless/illegal behavior while drinking. She denied any

other drug use.

Miranda works in the fashion industry and reported that she is

very well liked by her peers and clientele. She is regularly chosen

to train other staff members and comanage the store. However,

she is often given a heavier workload to compensate for coworkers

who are unable to perform at the expected level of her employer.

Miranda stated that she has trouble saying no and feels increasingly

irritable and frustrated with her increased workload.

Miranda has been married to her husband for 3 years, and they

have no children. She reported that both her mother and father

have a history of mental illness. Miranda’s parents are divorced,

and when they separated, Miranda chose to live with her mother.

Miranda’s mother remarried a man she described as “vicious and

verbally abusive.” Miranda stated that her stepfather called her

names and told her that she was worthless. She said he made

her believe that she was sick with chronic health issues and many

times forced her to take medicine that was either unnecessary

or not prescribed by a doctor. Eventually he asked Miranda to

leave her mother’s home. Miranda stated that her mother was

well aware of her stepfather’s behavior but chose not to intervene,

stating, “He is a sick man. Just do what he says.” She denied any

physical or sexual abuse in the home.

SOCIAL WORK CASE STUDIES: CONCENTRATION YEAR

6

In order to treat Miranda’s symptoms, we first addressed the

need for medication, and I provided a referral to a psychiatrist. The

psychiatrist diagnosed her with panic disorder and major depressive

disorder and prescribed appropriate medications to assist her

with her symptoms. Miranda and I began weekly sessions to focus

on managing her boundaries both at work and with her family.

We discussed her behavior around boundary setting as well as

the possibility of enlisting her husband as a support person to

encourage and promote healthy boundaries. We also discussed

unresolved issues from her childhood. This approach enabled

Miranda to gain insight into the self and how her maltreatment as

a child affected her functioning in the present time. This insight

enabled Miranda to validate her feelings of anger, frustration, and

sadness about her upbringing and further give herself permission

to set appropriate boundaries in her relationships. We also

discussed the need for relaxation and stress management. Miranda

was able to identify that she used to enjoy cycling and running but

had not been engaging in them because of the demands at work.

After discussing the importance of self-care, Miranda began to

exercise again and set a goal to enter local running and cycling

events to encourage herself to continue.

After 1 year of therapy, Miranda decided to taper down her

medication, which was monitored by her psychiatrist. She has

chosen to remain in therapy weekly to monitor her mood as she

decreases her medication. Miranda’s overall presentation has

improved greatly. With the use of medication, behavioral therapy,

relaxation techniques, and psychodynamic therapy, Miranda’s

affect presents as stable and her symptoms of depression are

gone. Miranda is a client that is able to verbalize the benefits of

treatment in helping her gain insight and empower herself to validate

her own emotional needs. She has been a highly motivated

patient who enjoys the safety of being able to express her thoughts

and feelings without judgment.

APPENDIX

95

Reflection Questions

The social worker in each of the cases answered select additional questions as follows.

Practice

Mental Health Diagnosis in Social Work:

The Case of Miranda

  1. What specific intervention strategies (skills, knowledge, etc.) did you use to address this client situation?

I referred the client to a psychiatrist. I used behavioral therapy, relaxation and stress management techniques, and psychodynamic and structural family theories to address underlying issues from childhood.

  1. Which theory or theories did you use to guide your practice?

I used psychodynamic and structural family theories to address adult survivors of child abuse in order to help Miranda connect to the effects of her stepfather’s maltreatment, regain her sense of self, and recognize the unhealthy functioning in her present relationships and daily living.

  1. What were the identified strengths of the client(s)?

Miranda was motivated, identified goals well, and had a supportive husband.

  1. What were the identified challenges faced by the client(s)?

Miranda reported a mental health history.

  1. What were the agreed-upon goals to be met to address the concern?

The initial goal was to decrease symptoms of anxiety and depression. As therapy progressed, the greater goal became gaining insight into Miranda’s childhood to allow for more self-care and stress management.

  1. How can evidence-based practice be integrated into this situation?

Miranda’s case is a great example of the benefit of a combination of medication and talk therapy for overall improvement of emotional and mental health.

SOCIAL WORK CASE STUDIES: CONCENTRATION YEAR

96

  1. Is there any additional information that is important to the

case?

It is important to note that prior to seeing me for treatment,

Miranda had been to several psychiatrists who misdiagnosed

her with borderline personality disorder and bipolar

disorder specifically based on the fact that she was female

and had a history of abuse. She had been given a series of

medications that were ineffective due to misdiagnosis. When

Miranda came in for the first session she was very distrusting

of psychotherapy as well as medication. My ability to create

a safe and trusting environment was of the upmost importance

in order for Miranda to get well and work with her

underlying issues.

  1. Describe any additional personal reflections about this case.

Miranda’s case is a great example of the need for a thorough

mental health history, mental status exam, as well as family

history of mental health issues and relationships. With individuals,

it is important to ask critical questions that reflect mood

and affect presentation as well as history of drug and alcohol use,

family dynamics, and any past history of abuse. There is almost

always a reason for a patient’s mood deregulation. A proper evaluation

session allows for accurate diagnosis and treatment planning

as well as letting you, the social worker, know if this is a case

that will fit within your practice.

Social Work Supervision: Trauma Within Agencies

  1. What specific intervention strategies (skills, knowledge,

etc.) did you use to address this client situation?

This was a difficult tragedy to deal with, and it was difficult

to know how to proceed. I had contacted the county (who

funded the agency) for help. The people I contacted at

the county did not know what to do and were of little help

because, as they stated, they had never dealt with death of a

staff member. I turned to my senior staff, and we as a group

came up with a plan to notify each client in the most sensitive

way possible. In addition, the use of another agency and our

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First Edition

Mitchell, P., Wynia, M., Golden, R., McNellis, B., Okun, S., Webb, C. E., … Von Kohorn, I. (2012). Core principles & values of effective team-based health care [Discussion paper]. Washington, DC: Institute of Medicine.

Mitchell, P., Wynia, M., Golden, R. (2012, October). Core principles & values of effective team-based health care. Retrieved from the Institute of Medicine, National Academy of Sciences website: http://www.iom.edu/~/media/Files/Perspectives-Files/2012/Discussion-Papers/VSRT-Team-Based-Care-Principles-Values.pdf

Partnership for Health in Aging. (2011). Position statement on interdisciplinary team training in geriatrics. An essential component of quality healthcare for older adults. Retrieved from http://www.americangeriatrics.org/files/documents/pha/PHA_Full_IDT_Statement.pdf

Document: Wiki Assignment Instructions (PDF)

Optional Resources

CSWE Gero-Ed Center. (2013). Interdisciplinary teamwork teaching module. Retrieved from http://www.cswe.org/CentersInitiatives/GeroEdCenter/Programs/MAC/GIG/35813/36975.aspx

Robin P., Bonifas, R. P., & Gray, A. K. (2013). Preparing social work students for interprofessional practice in geriatric health care: Insights from two approaches. Educational Gerontology, 39(7), 476–490.

Work #6 Answer in APA format with 2 citations per paragraph treat each answer as a separate work or file and each work or file need separate references. Support your posts with specific references to the Learning Resources given in this work. Be sure to provide full APA citations for your references. Treat each work, file or answer as a separate work and each work or answer needs separate references. Be sure to support your postings and responses with specific references to the resources and the current literature using appropriate APA format and style.

Bottom of Form

Respond by Day 5 to at least two different colleagues’ postings in one or more of the following ways:

· Identify and share additional challenges your colleague might encounter when working with the team.

· Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

Work #6 Cara Colantuono

RE: Discussion – Week 5 Attachment

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Main Post:

It wasn’t until the 1990’s and 2000’s when the collaborative efforts of interdisciplinary teams were considered essential (Berkman, 2011). Instead of having healthcare professionals function in a parallel environment, interdisciplinary philosophy explains the collaborative efforts regarding a patient’s treatment and discharge planning (Sherman, 2013). The conceptualization of evolving interdisciplinary teamwork means a greater respect and inclusive effort of engaging medical social work into the healthcare system.

In healthcare, patients may encounter endless healthcare professionals all hosting a different intellectual model of healthcare and agenda for treatment (Deja, 2006). Some of the roles may include nursing, hospitalist physicians, cardiology, psychology, gastroenterology, neurology, trauma, emergency medicine, physical medicine, and interventional radiology. Each has specific expertise and levels of engagement. For example, a cardiologist would only join a treatment team once consulted by the hospitalist physician. Typically, the cardiology team would not be interested in the psychosocial components of the patient and thus would have no input into the discharge planning.

Healthcare professionals need to embrace communication, respect, and flexibility to successfully engage in an interdisciplinary team (Mitchell, et al., 2012). If communication is compromised than the efforts for safe and timely treatment is affected. In addition, without respect and flexibility, teams from alternative disciplines may feel intimidated or pressured to make suggestions and provide healthy insight into the patient’s care.

Challenges exist in all theories, practices, and methods of constructive patient care. When engaging in interdisciplinary teamwork, social workers may encounter difficulties around mutual respect, being heard, and patient safety (Sherman, 2013). Social workers may be viewed as having less clinical knowledge when compared to their teammates, including nursing and physicians, and as a result, could be left out of treatment decisions. Furthermore, because of social work’s history of being financially valued less and having served as an assistant to the physicians, there may be a lack of, not only clinical respect, but also power and position within the team. These issues can make it hard for medical social workers for feel heard and appreciated in their role.

References

Berkman, B. J. (2011). Seizing interdisciplinary opportunities in the changing landscape of health and aging: A social work perspective. Gerontologist, 51(4), 433–440.

Deja, K. (2006). Social workers breaking bad news: The essential role of an interdisciplinary team when communicating prognosis. Journal of Palliative Medicine, 9(3), 807–809.

Mitchell, P., Wynia, M., Golden, R., McNellis, B., Okun, S., Webb, C. E., … Von Kohorn, I. (2012). Core principles & values of effective team-based health care [Discussion paper]. Washington, DC: Institute of Medicine.

Sherman, R. O. (2013, March 14). Why interdisciplinary teamwork in healthcare is challenging [Blog post]. Retrieved from http://www.emergingrnleader.com/why-interdisciplinary-teamwork-in-healthcare-is-challenging/

SOCW 90week 5 Rubric

10.8 (27%) – 12 (30%)

Discussion posting fully addresses all instruction prompts, including responding to the required number of peer posts. 12 (30%)

Points Range: 10.8 (27%) – 12 (30%)

Discussion posting demonstrates an excellent understanding of all of the concepts and key points presented in the text(s) and Learning Resources. Posting provides significant detail including multiple relevant examples, evidence from the readings and other scholarly sources, and discerning ideas 9 (22.5%) – 10 (25%)

The feedback postings and responses to questions are excellent and fully contribute to the quality of interaction by offering constructive critique, suggestions, in-depth questions, additional resources, and stimulating thoughts and/or probes. 5.94 (14.85%)

Points Range: 5.4 (13.5%) – 6 (15%)

Postings are well organized, use scholarly tone, contain original writing and proper paraphrasing, follow APA style, contain very few or no writing and/or spelling errors, and are fully consistent with graduate level writing style.

SOCW 04 wk5 discussion 1 response to students posted discussion

Work #7 Answer in APA format with 2 citations per paragraph treat each answer as a separate work or file and each work or file need separate references. Support your posts with specific references to the Learning Resources given in this work. Be sure to provide full APA citations for your references. Treat each work, file or answer as a separate work and each work or answer needs separate references. Be sure to support your postings and responses with specific references to the resources and the current literature using appropriate APA format and style.

Bottom of Form

Respond by Day 5 to at least two different colleagues’ postings in one or more of the following ways:

· Identify and share additional challenges your colleague might encounter when working with the team.

· Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

Work #7 Yvonne Francis

RE: Discussion – Week 5 Attachment

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In every structural setting, teamwork plays an integral role in the accomplishment of the desired goal. The philosophy behind teamwork in health care settings can be attributed to the fact that “the interprofessional teamwork is an essential ingredient for reducing duplication of effort, improving coordination, enhancing safety and therefore, delivering high quality of care” (Clark & Dinka, 2000). Therefore, teamwork is important because it enables team members to work in conjunction with others for the success of the team for the best result of clients. A patient once told me that she loves to be attended to by a team of doctors under the same umbrella because it’s systematic, where the “right-hand knows what the left hand is doing.” “The concept of a functional unit is particularly important because it allows for a continuously evolving core operation for evaluation, feedback, and improvement (p. 56). As businessman and philanthropist Andrew Carnegie once said, “teamwork is the fuel that allows common people to attain uncommon results.” Therefore, more can be accomplished when teams come together for the sole purpose of getting things done and producing results. Although there may be differences of opinions and sometimes disagreement and frustrations with team members, in a way is it healthy because this allows their input to be heard and be valued.

Team healthcare delivery improves communication and networking, which are essential for comprehensive and effective treatment planning and patient care. The types of teams are multidisciplinary teams: members of different disciplines work together but function independently, with minimal coordination or consultation with each other regarding care. They are hierarchically organized, and leadership and decision making are not shared. Interdisciplinary teams are composed of providers from different disciplines who collaboratively and interdependently plan, implement and evaluate outcomes of the care provided to patients and families Decision making and leadership are shared. Transdisciplinary teams are comprised of professionals from different disciplines who teach, learn and work together across traditional disciplinary or professional boundaries and where roles and responsibilities are shared. (Werth, 2010).

A key success in interdisciplinary teamwork is an understanding of the unique knowledge, skills, and abilities that each discipline brings to the team (Berkman, 2011). With that being said, interdisciplinary practice is essential because “the purposes are to promote collaboration eliminate redundancies of work, improve communication links, fully use the knowledge and skills of all professions, and develop standards of practice that address the role of each healthcare professional (Werth, 2010).

One of the challenges of interdisciplinary practice is to uncover or create a common language through which the various discipline can interact and a tolerance for ambiguity (Chchem, et al., 2008). Medical social work continues to express concern that the field has not yet gained the acknowledgment of other health professional groups that its clear role is being chiefly responsible for addressing the psychosocial correlates of health problems. Instead of being allowed to perform as clinicians, medical social workers perform as clerks, resulting in professional stagnation which in turn erodes the credibility of the medical social worker as a member of the interdisciplinary treatment team and calls into question the status of social work as a bona fide profession (Crowles & Lefcowitz, 1995). Medical social workers are also skilled and qualified like a physician to diagnose a patient’s social problems and offer clinical recommendations, yet, the physician has the authority to reject the recommendation made by the medical social worker.

References

Clark P., & Dinka, T. (2000). Health Care Teamwork: Interdisciplinary Practice and

Teaching. Greenwood Publishing Group.

Werth, J. (2010). Counseling Clients near the end of life: A practical guide for mental

health professionals. Springer Publishing Company.

Berkman, B. J. (2011). Seizing interdisciplinary opportunities in the changing landscape

of health and aging: A social work perspective. Gerontologist, 51(4), 433–440.

Retrieved from http://gerontologist.oxfordjournals.org/content/51/4/433.full.pdf

Crowles, L., & Lefcowitz, M. (1995). Interdisciplinary expectations of the medical social

worker in the hospital setting. Retrieved from

https://doi.org/10.1093/hsw/20.4.279

Chchem, R., Hibbert, K., & Deven, T. (2008). Radiology education: The scholarship

teaching and learning. Springer science & Business Media.

SOCW 90week 5 Rubric

10.8 (27%) – 12 (30%)

Discussion posting fully addresses all instruction prompts, including responding to the required number of peer posts. 12 (30%)

Points Range: 10.8 (27%) – 12 (30%)

Discussion posting demonstrates an excellent understanding of all of the concepts and key points presented in the text(s) and Learning Resources. Posting provides significant detail including multiple relevant examples, evidence from the readings and other scholarly sources, and discerning ideas 9 (22.5%) – 10 (25%)

The feedback postings and responses to questions are excellent and fully contribute to the quality of interaction by offering constructive critique, suggestions, in-depth questions, additional resources, and stimulating thoughts and/or probes. 5.94 (14.85%)

Points Range: 5.4 (13.5%) – 6 (15%)

Postings are well organized, use scholarly tone, contain original writing and proper paraphrasing, follow APA style, contain very few or no writing and/or spelling errors, and are fully consistent with graduate level writing style.

Work #8 Answer in APA format with 2 citations per paragraph treat each answer as a separate work or file and each work or file need separate references. Support your posts with specific references to the Learning Resources given in this work. Be sure to provide full APA citations for your references. Treat each work, file or answer as a separate work and each work or answer needs separate references. Be sure to support your postings and responses with specific references to the resources and the current literature using appropriate APA format and style.

Additional Codes? Attachment

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Good evening everyone! Additional Codes? Attachment

Work #8

Now that you have had a chance to review how your classmates have assessed Sam’s case history, were there any codes you did not initially consider in your initial post? If so, what would you add to your diagnosis?

Thanks,

Zeek this is my posted discussion from which you are going to do work #8

cheraldo Sweatt

RE: Discussion 1 – Week 5 Attachment

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My diagnosis for Sam resonates with:

Z60.2 Problem related to living alone

Z59.9 Unspecified housing or economic problem

F33.0 Major Depressive Disorder, recurrent, with anxious distress, with mild severity

Z60.0 Phase of life problem

The commencement of Sam’s first intense depressive disorder with serious psychotic characteristics was after the 2001, September 11 attacks. Before this particular incident, Sam was privileged to have a stable and well-paying job. What’s more, is that Sam’s symptoms of depression were stable, he stopped the counseling prescribed to all the victims of an event that may otherwise bring about Post Traumatic Stress Disorder (such as a terrorist attack). All the same, Sam continued to receive drug and medication management from a reputable psychiatrist (Kessler, Merikangas & Wang, 2007). At some point in time Sam went back to his counselor for increased feelings of depression as a result of his daughter moving out and for him to go through empty next syndrome, adjustment issues to living alone, dwindled socialization, feelings of loneliness, and bouts of fretful feelings. The finding or diagnosis of F33.0, Major Depressive Disorder, is grounded in the diagnostic criteria shown below (American Psychiatric Association [APA], 2013):

· Criteria A has been encountered with five warning signs and are existing for 14 days and are an alteration in functioning.

· A1 – Depressed for the entirety of the day as shown by self-report of heightened feelings of depression.

· A2 – Anhedonia: A lack of pleasure in activities as shown by reduced socialization and no affiliations to his peers. The only contacts he had were those of his daughter.

· A6 – Loss of energy and fatigue as demonstrated by his restricted actions of listening to the radio and reading.

· A7 – A lack of the sense of self-worth or too much guilt that is otherwise inappropriate as shown by increased issues and financial concerns tied to not being capable of maintaining his apartment the moment his daughter moved out of his place.

· A8 – Reduced assertiveness and indecisiveness as shown by not being comfortable to pay a visit to his daughter; to him, he saw that as an intrusion to the personal life of his daughter and her boyfriend.

· Criteria B has been realized as proven by weakening with his social circle (contact with his peers) and area of operation.

· Criteria C has been realized as the heightened feelings of despair came about before the psychological effects of using his earlier on prescribed drugs of Ativan and Cogentin bringing about a changed state of his mind. The latest hospitalization because of fainting on the sidewalk could have been as a result of a seizure consequential of a side effect of Wellbutrin, all the same, the results of his neurological tests were negative, and this is a suggestion that there was no seizure activity (Laureate Education, 2016).

There are myriad other conditions that may be worthy of clinical attention in the case of Sam. It cannot escape our notice that Sam is going through potential economic and housing issues as evidenced by his anxiety over being able to pay up his rent culminating to the utilization of code Z59.9 (American Psychiatric Association, 2013). Sam is also going through a problem that has got to do with living in solitude because his only daughter moved out. This brings about a need for him to live alone irrespective of a long time that they have lived together and preempted the use of codes Z60.2 and Z60.0 (Laureate Education, 2016). The entirety of assessment measures utilized within the DSM-5 gives well-defined explanations of the measurements from none, through severe to rate the level of severity (Kessler, Merikangas & Wang, 2007). The information at the predisposition of health professionals was very insightful in finding out the seriousness of Sam’s depression. In addition to that, the measurement of any symptoms that would show psychosis proved to be very illuminating, nevertheless, not applicable to the case of Sam as he is not going through psychotic symptoms at the moment. The test results of the assessment are well laid out and offer credentials for reduced capacity (Working with individuals: The case of Sam., 2014). As a result of his depressive disorder Sam is deemed a case of disability, and therefore all the information (informative as it was) never proved to be of assistance in the course of the evaluation.


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