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Southern New Hampshire University DSM-5 Z Codes Trauma Comorbidity Discussion

 

Respond to two colleagues who chose a different area of focus in beginning treatment in the following ways:

Explain how the DSM-5 Z codes (other conditions that may be a focus of clinical attention) identified in each post influenced your and your colleague’s decisions.

Share any insights you gained from watching your colleague’s video.

Colleague 1: Britney L.

  • Provide the full DSM-5 diagnosis for the client. Remember, a full diagnosis should include the name of the disorder, ICD-10-CM code, specifiers, severity, and the Z codes (other conditions that may be a focus of clinical attention). Keep in mind a diagnosis covers the most recent 12 months.

309.28 (F43.23) Adjustment disorder with mixed anxiety and depressed mood, acute

Z. 630. Relationship distress with spouse or intimate partner

  • Explain the diagnosis by matching the symptoms identified in the case to the specific criteria for the diagnosis.

Criteria A: The development of emotional or behavioral symptom in response to an identifiable stressor(s) occurring within 3 months of the onset of the stressor (s).

  • Identify the first area of focus you would address as client’s social worker and explain your specific treatment recommendations. Support your recommendations with research.

The first area I would address with Marvin as a Social Worker would him acknowledging that he cheated on his wife and realized that he got HPV from being intimate with his colleagues, I would also incorporate Cognitive Behavioral Therapy (CBT) as a treatment plan, along with Psychotherapy, which is talk therpay because I would work on him with building up the courage to tell his wife that he cheated on her with a colleague. According to Vinopal twenty percent of men cheat compared to 13 percent of women. According to the U.S. General Social Survey men cheat, due to causal infidelity .

  • Explain how you would manage client’s diverse needs, including his co-occurring disorders.

I would encourage that Marvin attends a support group so he could share his story, and gain insight from other men on why he chose to have an affair on his wife with his colleague. Marvin has no co-occurring disorders.

  • Describe a treatment plan for client, including how you would evaluation his treatment.

A treatment plan for Marvin would include weekly therapeutic session twice a wee individually, then I would encourage couple’s session after Marvin needs are met pertaining to individual session. I would evaluate his treatment by using an assessment sheet on his moods, depression and anxiety using a rating scale. I would also evaluate his treatment plan by using stress management, coping skills and social support.

Colleague 2: Kimberly

The client is a 35-year-old African American man with an occupation of journalism and resides in Nashville, Tennessee. The client is in a marriage with his wife of two years and has no children. He has not had psychiatric help in the past and reports his maternal grandmother of having depression. The client was carried away and had sex with someone other than his wife during a business trip and has HPV. The client feels he does not relate to his wife and has not told her about the event taking place during the business trip and about having HPV.

995.85 (T74.01XA) Suspected partner neglect due to the client feeling they do not relate to his spouse and cannot open up to her. The client also shows signs of PTSD 309.81 (F43.10). Reason for this diagnosis is due to the feeling of sadness, having fatigue and headaches, which may have manifested from the flash backs, and guilt for not talking to his wife about the activity taken place during the business trip and contracting HPV. Another diagnosis is generalized anxiety disorder (300.02) (F41.1). The client shows symptoms of fatigue, distress, and rumination about the outcome of sharing about the event to his wife. The client feels he would “act out and maybe negatively impact” his wife and marriage with her.

The first area of focus I would address to the client is the importance of communicating to your spouse about an infection before having unprotected sex. To approach this, it is obvious the client does not have the courage to talk to his wife about the incident happening during a business trip. I would recommend therapy focusing on the client’s marriage and ways to avoid infidelity. The client having therapy with his wife may show teach them how “committed they are to the relationship” (GoodTherapy, n.d.). There is also an opportunity for the encouragement of talking about the strengths and the weakness of the relationship and recall patterns they would like to change. Another to address is the action of infidelity. Before it occurs, it may be helpful for the client to understand about an aspect of themselves they are trying fulfill, such as feelings of loneliness and trying to connect or low self-esteem (GoodTherapy, n.d.).

CBT may help manage with the flashbacks and the anxiety the client is exhibiting. CBT may be used to challenge the client’s thoughts about themselves and get into depth with themselves before performing an action with negative consequences (GoodTherapy, n.d.).

Along with marriage counseling, CBT, after 8 sessions, shows effectiveness with or without medication (Therapist Aid, n.d.). The Dyadic Adjustment Scale (DAS) can be used to measure the quality of a relationship between a couple. According to Huston (2017), the DAS has been used since 1976 and provides a good comparison of success rates now versus those from past decades.

References

GoodTherapy. (n.d.). Affair recovery. Retrieved from https://www.goodtherapy.org/learn-about-

therapy/issues/infidelity/recovery#:~:text=They%20may%20help%20the%20couple,also

%20help%20clarify%20the%20relationship.&text=Therapists%20can%20help%20peopl

e%20who,through%20feelings%20of%20self%2Dblame.

Huston, M. (2017, December 6). Couples therapy: does it really work? How to predict your

chances of success in couples counseling. Retrieved from

https://www.psychologytoday.com/us/blog/in-it-together/201712/couples-therapy-does-

it-really-work

Therapist Aid. (n.d.). Treating anxiety with CBT. Retrieved from

https://www.therapistaid.com/therapy-guide/cbt-for…