Final Project Part II Care Plan

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Kenyatta University School of Economics *

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PSYCHIATRI

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Nursing

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Nov 24, 2024

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1 Final Project Part II Care Plan Student’s Name Professor’s Name Institutional Affiliation Course Name Due Date

2 Final Project Part II Care Plan Care Plan for Michael Interventions and Referrals Cognitive Processing Therapy (CPT) I recommend that Michael enroll in a 12-session Cognitive Processing Therapy program with a licensed CPT therapist. CPT is one of the best evidence-based treatments for veterans with PTSD caused by traumatic events. The purpose of CPT is to assist Michael in healing from his traumatic experiences so that they no longer trouble him or hurt his beliefs and actions. CPT accomplishes this through education, documented trauma reports, and cognitive restructuring targeted at sticking areas (Bohus et al., 2020). Michael will learn how PTSD is maintained by avoiding triggers and acquiring the ability to question negative thinking patterns like self-blame. Coping mechanisms and emotional control are among the lessons covered in CPT. Research continuously demonstrates that CPT enhances functioning, results in long-term remission, and lessens PTSD and associated mental health problems (Bohus et al., 2020). CPT is a trauma- focused treatment suited for Michael's PTSD resulting from his military deployments since it is mainly intended for sexual assault and battle trauma. CPT may aid rehabilitation by confronting Michael's traumatic experience in a nurturing setting. Referral to a PTSD specialist I will contact Michael with a therapist or psychologist specializing in combat-related PTSD. By doing this, Michael will be guaranteed trauma-informed care from a medical professional specializing in evidence-based treatments for post-traumatic stress disorder in veterans. A specialist will be knowledgeable of military culture and skilled in managing the symptoms that often follow combat events, such as emotional numbness, avoidance,

3 hypervigilance, and flashbacks (Bohus et al., 2020). I will take action to assist Michael in locating a nearby PTSD expert who is qualified for VA benefits or is covered by his health insurance plan. Studies indicate that psychotherapy from professionals skilled in treating PTSD in veterans improves their symptoms and overall functioning. Michael's chances of recovery will be maximized if he gets access to a specialized physician. Service dog Michael and I will work together to apply for a psychiatric service dog trained to assist those with PTSD and war trauma. In addition to reminding him to take his medicine, awakening him from nightmares, and helping him mingle more comfortably in public, the dog can support Michael in times of need. Taking care of the assistance dog may help instill a feeling of accountability and purpose in Michael. Numerous studies demonstrate that veterans' PTSD symptoms, depression, sleep issues, drug abuse, and overall quality of life improve when they engage with psychiatric service dogs. Michael can manage his PTSD issues more independently and avoid crises by having a trained service animal that he is connected to. This non- pharmaceutical technique has the potential to assist in stabilizing and promoting his recovery extensively. Anger management classes Michael spoke of regular irritation and angry outbursts, classic signs of post-traumatic stress disorder in veterans. I recommend Michael to a licensed anger management expert for one- on-one therapy or group programs that teach techniques for recognizing triggers, managing responses, and healthily expressing emotions. Enhancing Michael's relationships and lowering conflict may be achieved by teaching him coping skills for controlling his rage and expressing his demands. Thanks to the group structure, Michael may also practice social interactions with

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4 others who face similar challenges. Students in anger management classes learn relaxation methods, cognitive restructuring, and appropriate boundary establishing to help them become more self-aware and equipped to avoid reacting aggressively. Michael's capacity for emotional control and his tolerance for irritation may rise. Addiction support group Since Michael admitted to regularly using alcohol as a coping mechanism for his PTSD symptoms, I will advise him to join Alcoholics Anonymous or another recovery support group. A structured program such as a 12-step or SMART recovery group may assist Michael in kicking destructive drug use behaviors. Michael may find inspiration, camaraderie, and guidance from people overcoming addiction, which will help him maintain his recovery. Support groups encourage responsibility by discussing setbacks and achievements (Factor et al., 2019). They also provide healthy coping and stress-reduction techniques as an alternative to drug abuse. Improving Michael's sense of community and lowering his isolation from others who have gone through similar things will help him heal. I will assist him in finding secular or spiritual support groups in his area that align with his principles and needs. Cultural Responsiveness Michael's identity as a male veteran will be considered for all interventions and referrals. The service dog group works only with veterans, and the PTSD specialist will have experience with battle trauma. There will probably be other veterans in the anger management and addiction support groups that Michael can identify with. However, it is essential not to generalize about Michael because of his military experience. It is important to consider his interests and values in addition to his veteran status when selecting a therapeutic style, therapist, meeting venue, and

5 kind of support group. I will keep evaluating the interventions to make sure they are appropriate for Michael's cultural identities and are accessible. Community Resources I will put Michael in touch with HUD-VASH housing vouchers offered by the Department of Housing and Urban Development and the VA to meet his safe housing requirement. I will put Michael in touch with veteran job training programs like the VA's Vocational Rehabilitation and Employment (VR&E) services and state workforce development organizations to help him find work. Michael is also eligible for various services from the local VA, such as disability compensation and healthcare. Food banks, mental health charities, and veteran support groups are a few more community options. Suppose there are gaps in Michael's region. In that case, I suggest creating more accessible housing for veterans, helping them find employment, providing free transportation to appointments, and organizing leisure activities to lessen their social isolation. Monitoring First, Michael and I will meet every two weeks to thoroughly examine Michael's symptoms and the effectiveness of the intervention. Monthly appointments are possible once the first steps are taken. A formal examination using approved tools such as the PHQ-9 and PCL-5 every three months should occur. In between visits, I will also be accessible for phone calls in times of distress. Based on his improved symptoms and growing self-sufficiency after six months, we can determine if Michael is prepared to be released from treatment. I will follow up nine and twelve months after discharge to ensure no lapses. Contingency Planning

6 We will review the treatment plan and consider more advanced care options, such as intense outpatient or partial hospitalization programs if Michael's health worsens. I will assist Michael in employing healthy coping mechanisms from counseling and support groups if fresh trauma triggers or housing loss occur while he receives emergency temporary housing assistance. I will put Michael in touch with public assistance programs and disability benefits if he has financial difficulties. If you've had significant relationship losses or social isolation, you may need to temporarily increase the frequency of your appointments or attend more support groups. I aim to avoid significant crises by continuously evaluating Michael's requirements and modifying necessary actions. Reflection When I spoke with Michael, I followed several significant ethical guidelines that govern interactions in the human services sector. Beneficence, autonomy, secrecy, nonmaleficence, fairness, respect for others, and honesty were the main ethical principles that I adhered to. Being benevolent is behaving with kindness, generosity, and compassion for the good of others. I demonstrated beneficence by getting to know Michael, listening to him with empathy, and designing a strengths-based care plan that was customized to meet his objectives. My goal was to provide trauma-informed care focusing on his healing and well-being. Autonomy is honoring the choices made by customers for themselves. I highlighted Michael's autonomy by emphasizing his abilities, soliciting his opinions, and making choices based on his preferences. I was not there to make decisions for him; my job was strengthening his choices. This is consistent with the ideas of human agency. Preserving personal client information acquired through a professional engagement is a confidentiality component. Before disclosing any information, I got Michael's permission and

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7 made sure it was a private place. As a required reporter, I also had to reveal that secrecy has to be violated if Michael puts himself or others at risk. To be non-maleficent is to prevent damage. I upheld this by not passing judgment, assigning blame, or creating anxiety. Since Michael's trauma history has left him susceptible, one of the central tenets of his therapy must be "no harm." Justice is the advocacy of treating others fairly. Michael's justice-oriented strategy makes him confident that he can access all veteran benefits and support. My responsibility is to fight stigma and remove obstacles to his support and rehabilitation. Respect is essential when working with clients, and I showed respect for Michael by communicating with him in a non-discriminatory and trauma-informed way. I showed respect by concentrating on his advantages rather than his shortcomings. Retaining trust, establishing limits, and being transparent are all part of maintaining professional integrity. Legal requirements like HIPAA and informed consent laws are also crucial. To make sure Michael made an educated choice, I gave him information about my position, the care planning process, and his access to and control over his health information. Failing to comply may break federal laws, necessitating legal assistance from the agency and supervisor consultation. I complied with the standards of professional human services, which include informed consent, openness, defined professional limits, and confidentiality policies. By following these procedures, I could keep Michael's privacy safe, concentrate on his requirements without prejudice, and ensure that everyone was on the same page about the collaborative process. Without these procedures, the connection could have been detrimental or ineffectual. There may have been dangerous disclosures, improper aspects, and a decline in objectivity. Informed consent was seen to be immoral and to have damaged confidence. Ultimately, using professional

8 techniques and standards produced a setting where Michael felt appreciated, understood, and at ease asking for assistance. In the future, I can do better in several aspects of my professional practice, such as getting Michael's consent before changing the subject of the interview. To ensure transparency, I may also be more upfront about my position, the agency's role, the goal of the interview, and the stages involved in the procedure. Furthermore, I want to continue augmenting my cultural competency, meaning that my interventions consider every facet of Michael's identity and community. Maintaining ethical standards and human services principles promotes a therapeutic partnership that aids clients' rehabilitation. My commitment to promoting the well-being of clients through beneficence, autonomy, fairness, respect, and compassion has been reinforced by this experience.

9 References Bohus, M., Kleindienst, N., Hahn, C., Müller-Engelmann, M., Ludäscher, P., Steil, R., Fydrich, T., Kuehner, C., Resick, P. A., Stiglmayr, C., Schmahl, C., & Priebe, K. (2020). Dialectical Behavior Therapy for Posttraumatic Stress Disorder (DBT-PTSD) Compared With Cognitive Processing Therapy (CPT) in Complex Presentations of PTSD in Women Survivors of Childhood Abuse. JAMA Psychiatry , 77 (12), 1235–1245. https://doi.org/10.1001/jamapsychiatry.2020.2148 Factor, R. S., Swain, D. M., Antezana, L., Muskett, A., Gatto, A. J., Radtke, S. R., & Scarpa, A. (2019). Teaching emotion regulation to children with autism spectrum disorder: Outcomes of the Stress and Anger Management Program (STAMP). Bulletin of the Menninger Clinic , 83 (3), 235–258. https://doi.org/10.1521/bumc.2019.83.3.235

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Final Project Part II Care Plan

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