RESPONSE 1
Respond to at least two colleagues who selected a different theory from the one you selected. Explain how another systems theory, that neither you nor your colleague has previously discussed, might be applied to the course-specific case study your colleague selected.
Colleague 1: AnnaVi
Case Background
Matt and Keith are homosexual males that adopted two children, ages 7 and 3. The couple decided to attend counseling due to a conflict in parenting styles. The adopted children have special needs. Jackson, the oldest child shows behavior problems that result in aggression and was later diagnosed with ADHD (Plummer, Makris & Brocksen, 2014). The younger child, Ellery was born with a cleft palate, deformity to the jaw and is blind. She often has trouble with breathing and swallowing her food due to the deformities to her lip and jaw (Plummer, Makris & Brocksen, 2014).
The couple struggles with Jackson’s behavioral problems as well as the Ellery’s medical issues. Due to the demands of parenthood, Matt and Keith struggle to spend quality time with one another. More importantly, both Matt and Keith have opposite parenting styles that often lead to disagreements.
Conflict Theory
According to Robbins, Chatterjee, & Canda (2012), “Conflict also helps to define the nature and structure of relationships between conflicting parties” (p. 73). Coser suggests that realistic conflict occurs from “specific demands” (Robbins, Chatterjee, & Canda, 2012). As both sides struggle to find balance, the need for rearrangement and accommodation is needed between Matt and Keith to resolve their conflicts. Coser’s realistic conflict ends in a less violent confrontation rather than a violent, hostile one. I find Sower’s take on conflict relating to Matt and Keith, as Sower describes conflict as a transaction. Matt and Keith often argue and disagree due to the specific demands of parenting as both find difficulty finding an equal balance.
Social Work Skills
The social skills necessary to manage between conflicting couples include applying Narrative therapy and EFT to allow each couple to illustrate their own perspective of the conflicts present in their home. The use of narrative therapy allows the couple to identify their values and strengths that are necessary to the functions of the household. EFT is often used in couples as an approach to explore feelings, emotions and perspective to what happened in the relationship.
The social worker may also provide resources where education can be provided on ADHD and medical issues that Ellery suffers from. The use of empathy and remaining neutral is also important in managing conflict. The ability to ask open-ended questions that contribute to Matt and Keith’s understanding of the problems are present and ability to manage the visits without escalating into major arguments, fights or one person storming off.
Plummer, S.-B., Makris, S., & Brocksen S. M. (Eds). (2014). Social work case studies: Concentration year. Baltimore, MD: Laureate International Universities Publishing [VitalSource e-reader].
Robbins, S. P., Chatterjee, P., & Canda, E. R. (2012). Contemporary human behavior theory: A critical perspective for social work (3rd ed.). Upper Saddle River, NJ: Allyn & Bacon.
Colleague 2: Lea
Case Background:
The Case of Matt and Keith (Plummer, Makris, and Brocksen, 2014), describes the some of the conflicts that can arise when parents are faced with parenting children with disabilities. In this case, Matt and Keith find themselves so consumed with caring for their children’s special needs that they have neglected the care of their relationship. Furthermore, the men have had difficulty locating professionals who can support them in caring for their son, diagnosed with ADHD when he was four years old.
The conflicts these parents and their family face are numerous. Some are at the forefront of their day to day lives. For example, they are working to address their son’s behavior problems, but they are also dealing with their daughter’s medical issues (cleft palate). They also face the conflict that comes with becoming parents, such as, less time doing things alone or as a couple as well as navigating different/opposing parenting styles. Furthermore, they are a gay couple, which comes with its own set of issues. In this case, both men have left their Catholic background (possible faith-based support) to worship in a church is inclusive of non-traditional relationships and families. The men have sought therapy previously, but found that the therapist focused on the ADHD aspect of their family, but not on how to make their family work or their opposing parenting styles.
Applicable Conflict Theory:
Lewis Coser described “conflict” as unifying or “binding” individuals or groups together that, if used realistically, can function as a safety valve to release tension and avoid hostility (Robbins, Chatterjee, and Canda, 2012). The conflict faced by Matt and Keith are not insurmountable, as they are committed to their relationship and their family. This “realistic” conflict is evidenced by their initiative to seek assistance individually and as a family.
Because of the nature of the couple’s non-traditional makeup, a post-structuralist conflict theory may be an appropriate approach to applying social work skills with this family. Post-structuralism challenges universal ideals and grand structures. What is considered “normal” or “the norm” is only deemed so because of social constructs (Wendt and Seymore, 2010). Post-structuralism is not meant to be a “one size fits all” approach. Wendt and Seymore purport that the social workers employing a post-structuralist approach to treatment must understand the difference between “empowering” and “taking power” if she is going to serve her clients successfully. The authors describe “empowering” as the act of being given power while “taking power” suggest the idea that power is a property that one can take control over and own. The couple in the case needs to take back the control and power in their relationship. Additionally, their son needs the opportunity to take power over his disability.
Social Work Skills:
As a social worker involved with this family, I would assist this family in finding and using services as an aid to building a stronger family relationship, a team environment between parents, and a professional network to turn to for support. Like the worker in the case study (Plummer, et. al., 2014), I would look at solution-based interventions to apply to each of the couple’s concerns: Finding expert care for their son’s ADHD, finding respite so that the couple can care for their relationship, and seeking/providing individual, as well as family counseling. Assisting the family in taking power over their situation will serve to “bind” them closer together as a couple and a build a stronger family unit.
References:
Plummer, S.-B., Makris, S., & Brocksen S. M. (Eds.). (2014). Social work case studies: Concentration year. Baltimore, MD: Laureate International Universities Publishing .
Robbins, S. P., Chatterjee, P., & Canda, E. R. (2012). Contemporary human behavior theory: A critical perspective for social work (3rd ed.). Upper Saddle River, NJ: Allyn & Bacon.
Wendt, S., & Seymour, S. (2010). Applying Post-structuralist Ideas to Empowerment: Implications for Social Work Education. Social Work Education, 29(6), 670-682. doi:10.1080/02615470903342093
RESPONSE 2
Respond to two of your colleagues’ posts by:
· Offering an alternative medication and strategy to address client hesitations and support the psychiatrist’s recommendation
· Offering additional support for the suggested drug and the strategy to address client hesitations and support the psychiatrist’s recommendation
· Detailing current research that corroborates or refutes this drug and explain how this might impact a physician’s choice of this drug
Colleague 1: Dawn
The Benefits and Limitations of Antidepressant Medications
Antidepressants are effective often times doctors will prescribe them when a patient has observed signs of depression. Given the patient all the information to decide if they chose to try the medication and which medication is the right one for them. It may take a while to discuss with the patient to be open to the idea of taking a medication. Help the patient understand the reasoning for the medication and explain how it can change the way they are feeling.
There are many medications when treating depression and this certain serotonin reuptake inhibitors is the least restrictive medication that can treat it (Antidepressants: Selecting one that’s right for you, 2011). First the least restrictive would be better for the patient. Prozac, (Selfemra) is a common antidepressant that can treat medication with manual side effects such as dry mouth (Antidepressants: Selecting one that’s right for you, 2011). There are benefits since there is a generic version it may cost less for the patient, little side effects, no withdrawal affects and no dependency (Selective Serotonin Reuptake Inhibitors, n.d.). Limitations of Prozac it may take longer for the effects of the medication to work (Selective Serotonin Reuptake Inhibitors, n.d.). Sometimes the anxiety may increase at first, when discontinuing the medication you can get flu-like symptoms (Selective Serotonin Reuptake Inhibitors, n.d.). Biochemical imbalance sends more supply of neurotransmitter serotonin to other cells (Selective Serotonin Reuptake Inhibitors, n.d.).
Supporting the psychiatrist’s with clients and helps them figure out the most appropriate pharmaceutical approach for them (Helping Clients Understand the Role of Medication, 2016). Help navigate the discussion when a psychiatrist recommends a medication to a hesitant client. They are lacking the awareness of the stability the medication can give them if they give it a chance (Helping Clients Understand the Role of Medication, 2016 ). A medical social worker can make goals and have the main goal for them to try the medication work them up with education and understanding of the medication so they will give it a chance (Helping Clients Understand the Role of Medication, 2016 ). Balancing advocacy to the patient and the psychiatrist is one of the key roles as a social worker.
References
Antidepressants: Selecting one that’s right for you. (2011). Retrieved from http://www.mayoclinic.org/diseases-conditions/depression/in-depth/antidepressants/art-20046273
Helping Clients Understand the Role of Medication. (2016). Retrieved from http://www.bhevolution.org/public/perspectives_201202.page
Selective Serotonin Reuptake Inhibitors (n.d.). Retrieved form http://www.anxirties.com
Colleague 2: Fatima
Citalopram is a SSRI that is used to treat depression. It functions by blocking the reuptake of 5-HT by neurons (Lichtblau, 2011). The medication can take anywhere from two to four weeks to take effect. Once the medication starts to have a therapeutic effect, it should be taken for at least six months to prevent relapse. Even though it is a non habit forming drug, patients should also taper themselves off the medication instead of an abrupt stop to prevent withdrawal. Compared to MAOIs and TCAs, citalopram has lower toxicity and fewer side effects because of its ability to specifically block reuptake of 5-HT without affecting other receptors (Lichtblau, 2011). However, high levels of 5-HT in the brain, spinal cord and GI tract can also cause problems (Lichtblau, 2011). Some of the side effects include nausea, diarrhea, vomiting, weight loss, changes in sex drive, heavy menstrual periods, and excessive tiredness (National Institute of Mental Health, 2008).
According to Preston, O’Neal, and Talaga (2017), a change in physiological symptoms is currently the most reliable way of determining if a patient is experiencing depression. Without knowledge of these symptoms, one may not realize how depression is negatively affecting the individual. Preston et. al (2017) also state that in eighty percent of the cases, medicine is effective in treating the physiological symptoms of depression. If a client is hesitant to take medication, they should be informed of the physiological changes they are experiencing as a result of their depression and the high likelihood that medication will help bring them back to normal functioning. In the case of citalopram, the patient should understand that although it is not guaranteed that it will help them specifically, it is a good place to start. Depending on the type of depression the patient is experiencing, one should also inform them about the risk of relapse if recovery is not achieved. Also, medication is not a replacement for psychotherapy. If the patient engages in both forms of therapy, they will have a better experience with recovery.
Lichtblau, L. (2011). Psychopharmacology demystified. Clifton Park, NY: Delmar, Cengage Learning.
Preston, J. D., O’Neal, J. H., & Talaga, M. C. (2017). Handbook of clinical psychopharmacology for therapists (8th ed.). Oakland, CA: New Harbinger.
RESPONSE 3
Respond to two of your colleagues’ posts from a different group who posted to a different Depression Case Study by:
o Offering an alternative medication to address the major symptoms identified that indicate depression
o Detailing current research that corroborates or refutes this drug and explain how this might impact a physician’s choice of this drug
o Offering another strategy that might address the challenges that may arise in the initial stages of treatment
Colleague 1: Dawn
Group B Depression Case Study for Paulette
The Role of Mental Health Professionals in the Initial Stages of Psychopharmacological Intervention
Paulette major symptoms that show depression Paulette is not interested in her usual activities anymore and has low energy. Her recently eating habits she may feel stress so she is eating more with her recent weight gain. A medication that might be prescribed to treat Paulette depression could try Lamictal because I would suggest she should not take a medication that could cause seizures even though it was 10 years from her last one. This medication is to treat epileptic seizures, therefore, it would be safe when it came causing her to have a seizure (What is Lamictal, 2017) Lamictal also treats mood episodes in adults (What is Lamictal, 2017).
A mental health professional should explain to the client and give them the awareness of medication and related side effects about the medication that they are prescribed (Effects of Psychiatric Drugs, n.d.). They should explain the truth about these psychiatric medications and discuss the pros and cons of the medication to make sure the reason for taking them outweighs the side effects (Effects of Psychiatric Drugs, n.d.).They should educate what to expect and explain the important information before taking these medications and what to avoid and most of all do not stop using any medication suddenly to follow the directions when taking it.
A potential challenge that might impact the client in the first stages of psychopharmacological intervention the medication does not work. The medication side effects become increasing difficult such as excessive thoughts of suicide. This reason will outweigh any reason for taking the medication. Another potential challenge is if other symptoms arise and you realized they are misdiagnosed and the medication should be changed.
One strategy a mental health professional might use to discuss challenges that arise in the first stages of treatment would be to ween them off of their medication and watch them closely. Then decide what medication would be a better fit.
References
Effects of Psychiatric Drugs. (n.d.). Retrieved from http://medicalwhistleblowernetwork.jigsy.com/psychiatric-drugs-side-effects-
What is Lamictal? (2017). Retrieved from https://www.drugs.com/lamictal.html
Colleague 2: Aisha
The major symptoms in John’s case that indicate depression is his change in eating, sleeping, feelings of guilt and loss of interest. In the DSM V the diagnosis criteria for depression includes; having a depressed mood nearly every day, noticeable decline in interest or pleasure, weight loss, insomnia, loss of energy and feeling of worthlessness or guilt (American Psychiatric Association, 2013)
The medications I would use in John’s case are venlafaxine(Effexor) and bupropion(Wellbutrin). John main concern about taking medications is not being able to perform sexually (Preston, O’Neal & Talaga, 2017). Bupropion is a medication I would choose, because it has fewer sexual side effects (Preston, O’Neal & Talaga, 2017). After going over different antidepressants, there is not one medication that is superior to the other (Preston, O’Neal & Talaga, 2017). I believe one of the concern when prescribing antidepressant is based on the side effects. The other medication that I would choose is venlafaxine because it can be adjusted to improve Johns treatment (Lichtblau, L. (2011). According to Lichtblau (2011) “the efficacy of most antidepressants does not change as the dose is escalated, raising the dose of venlafaxine improve efficacy” (p.29)
As mental health professionals, our role in raising client’s awareness is to educate them. John learned about anxiety medications from his friends and their experience with them. Their experiences caused John to have doubts about anxiety medications. As mental health professional, I would let John no that not everyone responds to medication the same. The challenges that John may have is being consistent with taking the medication and patient. The first stage of treatment is when the individual first start taking the medication, which can be from 6 to 8 weeks before individual is asymptomatic (Preston, O’Neal & Talaga, 2017). The strategies I would use to address challenges is to encourage John to keep up with his dosage and log them down daily along with how he was feeling. I would also suggest John continue coming to counseling to discuss his progress and concerns about the medication.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
Lichtblau, L. (2011). Psychopharmacology demystified. Clifton Park, NY: Delmar, Cengage Learning.
Preston, J. D., O’Neal, J. H., & Talaga, M. C. (2017). Handbook of clinical psychopharmacology for therapists (8th ed.). Oakland, CA: New Harbinger.
