James Jensen is a 55-year-old artist. He is on VA disability benefits and cannot work. He has two grown children and was recently divorced after 20 years of marriage. He was diagnosed with bipolar disorder after an incident of drunk driving 10 years ago. He has since joined Alcoholics Anonymous and treats his bipolar with medication. The divorce has caused him to sink into a depression.He lives alone in the home where he raised his children with his ex-wife. He is independent in all ADLs, including driving and community mobility at an ambulatory level. He has lost interest in his artwork and is gaining weight rapidly from inactivity. He loves the outdoors, especially hiking and fishing, but has recently lacked the motivation to go. He has a few close friends in the arts community, and his children visit him often.James saw his therapist for a routine medication check. The doctor is concerned with his weight gain and depressed state and is increasing cognitive behavioral therapy and adjusting his antidepressant. He has referred James to you, a CTRS at the outpatient mental health VA facility, to help him reach his goals. James’ provider shares the following information from his most recent visit:
Significant past medical history: Disability discharge VA due to mental health. Patient has a history of alcohol abuse. Mood stabilized with medication. Patient has a tendency to self-medicate. Lithium used as requires patient to complete routine blood work.
Medications: Lithium 600 mg orally in the morning and at nighttime. Lurasidone (Latuda) 40 mg orally once a day.
Cognition/perception: Current depressive state due to social situation. Vacillates between mania and depression. Maintained with medication. Patient reports high level of sadness and lack of motivation. Patient tends to stop medication when mood elevates.
Physical Examination: WNL”
Client Goals
1.Increase social supports
2.Learn techniques to cope with stress
3.Increase exercise to maintain healthy weight
- Create a treatment plan for James Jensen, using evidence-based practice to guide your decision on appropriate interventions following the DENT problem-solving method
a. Define the problem: Clearly identify and articulate the specific problem or challenge that needs to be addressed. This involves understanding the current situation, desired outcomes, and any constraints or limitations (1 paragraph)
b.Explore possible solutions: Generate a range of potential solutions or approaches to solving the problem. Encourage creative thinking and consider different perspectives or alternative options.(1 paragraph)
c. Narrow down options: Evaluate the potential solutions and select the most feasible and effective ones. Consider the advantages, disadvantages, and potential risks associated with each option.(1 paragraph)
d. Take action: Implement the chosen solution or solutions. Develop a plan, allocate resources, and set specific goals and timelines for execution. (1 paragraph)
2.What assessment would be most appropriate for you to give to James? (1 paragraph: Question 2 and Question 3)
3.What factors must be considered when planning James’ intervention?
4.What is your PICO question? (1 paragraph: Question 4 and Question 5)
5.What outcomes do you anticipate from your treatment plan?
6.How will you evaluate the outcomes of your treatment plan? (1 paragraph: Question 6 and Question 7)
7.What contraindications should you consider in James’ treatment? (1 paragraph)
8.What recreational activities would be appropriate considering James’ interests, goals, and current functioning level?” 1 paragraph)
