Jane Sullivan Case Study

Answer

Jane Sullivan Case Study

            The purpose of this paper is to analyze the provided case titled Jane Sullivan Case Study and identify intervention measures and resources for Jane and James (her son). Jane had lost her husband about two months ago while she was four months old for her current pregnancy and she appears devastated by it. In response to this case study, the scope will include identification and discussion of her diagnosis; biggest concern; pharmacological and non-pharmacological interventions with consideration of pregnancy; interventions for James, and available military and community resources. Both Jane and James are in need of urgent intervention.

Diagnosis

According to the American Psychiatric Association (APA) (2013) criteria, Jane is diagnosed with an adjustment disorder. Adjustment disorder occurs within three months of experiencing a known stressor(s). Adjustment disorder is conceptualized as a maladaptive reaction to known stressor (Zelviene & Kazlauskas, 2018). The condition is characterized by occurrence of identifiable emotional o behavioral symptoms. These symptoms include hopelessness, sadness, feeling isolated, low moods, worrying, loss of self-esteem, disruptive behaviors, anger issues, anxiety, feeling trapped,  difficulty concentrating, insomnia (APA, 2013). Jane presents with symptoms such as a low mood, poor self-care and care of her son (James), low self-esteem, emotional pain, and nightmares. During history, it was observed that she could easily shed tears on remembrance of her deceased husband who was not aware about her pregnancy when he was deployed to Afghanistan.

Biggest Concern

            My biggest concern for Jane is that she overly nervous and anxious about the possibility of being expelled from the military base, were she used to live with her, now deceased, husband (Jake). She currently lives with James and she is expecting another baby in about five months from the moment. This excessive worried and nervousness may lead to development of depression and anxiety. Worrying may have made Jane avoid physical exercises and poor sleep quality. Lack of physical exercises and poor sleep quality may increase her risk for developing depression and anxiety (Islam et al., 2020).  Besides, she stands a risk of developing post-traumatic stress disorder (Pappa et al., 2020). Jane requires immediate intervention so as to improve her psychological resilience and improve her coping capacity. Interventions may include education and counseling (Pappa et al., 2020).

Pharmacological Interventions

            Drugs that were initially developed and designed for management of depression and anxiety have been recommended for management of adjustment disorder (Stein, 2018). Jane can be administered a combination of an antidepressant (mianserin at a dose of 60 mg/day), tianeptine sat a dose of 37.5 mg/day, and a benzodiazepine (alprazolam at a dose of 1.5 mg/day). Tianeptine has both anxiolytic and antidepressant properties (Stein, 2018). These drugs needs further review since they may have potential adverse effects that may threaten Jane’s pregnancy.

Pharmacological Interventions with consideration of Pregnancy

            Jane’s four months pregnancy should be taken into consideration before medication administration. She should be administered medications that are safe for both herself and the fetus. According to Drug and Lactation Database (2018), mianserin has not been approved for marketing and use in the United States by the U.S. Food and Drug Administration. Besides, it has been indicated to reduce breast milk production in lactating mothers. Therefore, this drug will be removed from the medication list (Drugs and Lactation Database, 2018). Use of tianeptine during pregnancy may lead to development of neonatal abstinence syndrome (Bence et al., 2016). Therefore, tianeptine is too removed from the list of recommended medications. Similarly, use of Xanax (alprazolam) during pregnancy may lead to adverse effects. Jane is at the second trimester of pregnancy. Use of the drug during second and third trimester may lead withdrawal symptoms in newborns and floppy infant syndrome (Stubblefield, 2017). Therefore, Jane will not be administered any medication with consideration of potential adverse effects.

Non-Pharmacological Interventions

            Different non-pharmacological interventions are available for Jane. Divergent treatments such as low-intensity psychological interventions and cognitive behavioral therapy, which have been identified as potential treatment options for management of adjust disorder. Low-intensity psychological interventions include bibliography, self-help therapy, support groups, mindfulness, behavioral activation, e-mental health interventions, relaxation, and mediation (Winter et al., 2020). Divergent strategies can help Jane reduce her stress level, improve her coping strategy to the emotional pain due to grief, and/or help her to remove or reduce the stressor from her mind. Metacognitive therapy may also be put into practice in this case since the intervention is indicated for treatment of rumination, metacognitive beliefs, exacerbation of stress, and worry. Metacognitive therapy can also help in reduction of anxiety and depression symptoms (Winter et al., 2020).

Intervention for James

            James is 18 months old and his physical, emotional, and social needs should be taken into consideration. During assessment, James appeared to lack trust to or fearful of strangers. According to Erik Erikson’s (1968) theory of psychosocial development James is struggling with the trust versus mistrust stage 1 of psychosocial development. He seems to be on the mistrust stage of psychosocial development. This is a critical problem that may affect development of his personality. The mother should be educated on the need of socializing her children and her neighbors; especially with other children in the neighborhood. Besides, she needs to be emotionally available for her son and help him to feel secure and safe so as to develop a sense of trust to the world around him (Erikson, 1968).

Available Resources as a Military Wife

            There are a number of resources supportive resources that are available for Jane and her son given that she is a military wife. Resources such as New Navy Gold Star Program, Survivor Outreach Services, Long Term Assistance Program, and Air Force Families Forever are available for Jane and her family. These resources will help sort out Jane’s housing and accommodation concerns and provide a range of comprehensive services. Besides, they can help her to cope with grief. These resources can provide a range of long-term services that can be of much benefit to the family (Military on Source, 2020).

Available Community Resources

            A number of community resources are available for Jane and her son. It includes Bereaved Parents USA, Compassionate Friends, and Ethan’s House. These resources can help her cope with her grief as well as improve treatment outcomes for adjustment disorder (GriefNet.org, 2020). In addition, BO’s Place can help her and her son with multiple free-of-charge grief support services (GriefNet.org,ss 2020).

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