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St. Catherine University *

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Psychology

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Dec 6, 2023

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Case Study 1: Dr. Sally McKenzie 1. Which of these mental health disorders do you believe Dr. McKenzie best exhibits (your choices: Major Depressive Disorder, Schizophrenia Spectrum Disorder, Anxiety, Borderline Personality Disorder)? No citations or support needed for this question. Dr. McKenzie is exhibiting signs of schizophrenia spectrum disorder. She believes people are out to get her, others are interfering with her ability to succeed, and “they” are poisoning her. This leads me to believe she is experiencing paranoid and delusional thoughts. 2. What behaviors, thoughts or symptoms does Dr. McKenzie exhibits that suggest this mental health disorder? Dr. McKenzie is exhibiting delusional thoughts even though she doesn’t believe she is. Her thoughts are persecutory or paranoid in nature, meaning she believes people are conspiring against her (Bonder, 2022). She believes people are poisoning her, out to get her, and interfering with her ability to succeed. Her behavior of standing in the middle of a snowstorm with only pajamas to protect her is bizarre and points to “the inability to evaluate the environment correctly” which is a characteristic of schizophrenia spectrum disorder (St. Catherine University OTA Program, 2023, slide 2). Dr. McKenzie’s trouble with answering questions or concentrating during her therapy sessions indicates that she has some cognitive symptoms of schizophrenia spectrum disorder. 3. Of the symptoms you identified, which might cause Dr. McKenzie’s problems in her work as a pharmacist? How might an OT practitioner help Dr. McKenzie with the symptoms you identified? With Dr. McKenzie’s cognitive symptoms of trouble concentrating, I would suspect major difficulties with accuracy while performing her pharmacy occupations. But work is a vital intervention when OT practitioners work with patients with schizophrenia. Patients with schizophrenia spectrum disorders have communicated that their quality of life is improved based

on their activity, social interactions, and finances. Practitioners may use cognitive remediation, cognitive behavioral therapy, and supported employment (Bonder, 2022). Using Dr. McKenzie’s work as an intervention may be beneficial because she could support the needs for quality of life while working on her therapy. Case Study 2: Lashay Mitchell 1. Which of these mental health disorders do you believe Ms. Mitchell best exhibits (your choices: Major Depressive Disorder, Schizophrenia Spectrum Disorder, Anxiety, Borderline Personality Disorder)? No citations or support needed for this question. Please explain why you believe your answer is correct. Lashay Mitchell is exhibiting signs of Major Depressive Disorder because of the many recent changes in her performance at work, her socialization, and in her overall mood. 2. What behaviors, thoughts, or symptoms does Ms. Mitchell exhibit that you identify as problematic? Please explain your answer in detail using course content and information from the case study. Your response to this question should convince the reader that your chosen diagnosis is correct. Ms. Mitchell went from being appreciated by her supervisor for her regular attendance and dedication to hard work to missing several days and having poor productivity with several errors. These are behaviors consistent with someone who has lost focus and the ability to think and concentrate, a symptom of someone having a major depressive episode (St. Catherine University OTA Program, 2023). She has refused invitations to socialize with friends and has not seen her family in two months. She often excuses herself by claiming she is too tired or doesn’t feel like it. As Ms. Mitchell used to enjoy socializing with friends and visiting her family frequently, this behavior shows a diminished interest or pleasure in these kinds of activities; this and her often-

cited excuse of fatigue or loss of energy are also symptoms of a major depressive episode (St. Catherine University OTA Program, 2023). She has been discovered crying at work at least three times in the last three months and denied the significance; this exhibits a depressed mood as well as feelings of worthlessness and are symptoms of a major depressive episode. These are five different symptoms to classify Ms. Mitchell has had a major depressive episode, as the symptoms have been continuing for three weeks to two months and impairing her social, occupational, and quality of life; it is characteristic of Major Depressive Disorder (St. Catherine University OTA Program, 2023). 3. Of the symptoms you identified, which might affect her daily occupations? How are the daily occupations you named impacted by her symptoms? Be sure to include what symptoms will impact what daily occupation and why you think that. 1. Use your OT Practice Framework. You may also reference the Thomas Occupation-Based Activity Analysis textbook. How might an OT practitioner help Ms. Mitchell with her daily occupations? Please explain your responses using course content and case study information. HINT: Think about all the areas of occupation and how those could be impacted by the symptoms you identified Many of Ms. Mitchell’s symptoms of her major depressive disorder or MDD will affect her daily occupations. Her depressive disorder impacts Ms. Mitchell’s environmental factor of support and relationships. According to the Occupational Therapy Practice Framework, the support and relationships factor can be defined as “people or animals that provide practical physical or emotional support, nurturing, protection, assistance, and connections to other persons in the home, workplace, or school or at play or in other aspects of daily occupations” (American Occupational Therapy Association, 2020, p.10). Ms. Mitchell is no longer allowing others to help support her or build relationships with her. We learned that she enjoys going to visit family as well as going to the movies on weekends. As a result of her major depressive disorder, Ms. Mitchell isn’t participating in these activities any longer. She refuses invitations to socialize with friends and no longer visits her family. This will affect her mental health immensely and lead her

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to lose many relationships. When Ms. Mitchell refuses to socialize with friends, she also affects her IADL of play, leisure and social interaction. She is no longer going to the movies or getting together with friends to have fun. Another symptom Ms. Mitchell displays is not showing up to work. This is directly affecting her daily occupation of work. This prevents her from making money, maintaining a routine schedule, interacting with coworkers, etc. According to the practice framework, job performance and maintenance may include “creating, producing, and distributing products and services; maintaining required work skills and patterns; managing time use” (American Occupational Therapy Association, 2020, p.33). Interventions by the OT practitioner can include helping Ms. Mitchell create a routine and follow through with that routine. Following a routine encourages clients with MDD by rebuilding their confidence in their daily tasks. The routine should include attainable goals to rebuild the client’s self-esteem and confidence. References

American Occupational Therapy Association (2020). Occupational therapy practice framework: Domain and process (4th ed.). American Journal of Occupational Therapy, 74 (Suppl. 2), 10-33. https://doi.org/10.5014/ajot2020.74S2001 Bonder, B. R. (2022). Psychopathology and function (6th ed.). SLACK. St. Catherine University OTA Program. (2023). VA/MN OTA1140 psychosocial approaches. Module 2: Common mental health clinical conditions addressed by OT. https://stkateonline.instructure.com/courses/4116/pages/module-2-common-mental- health-clinical-conditions-addressed-by-ot?module_item_id=78359

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