QUESTION
Jane Sullivan Case Study
Use this as one of your sources!
Wheeler, K. (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (2nd
Today you are meeting with Jane Sullivan, a 32-year-old newly widowed woman who is four months pregnant. Jane was referred to you by her nurse midwife, who has been caring for Jane for the last two months.
Photo of Jane, cryingJane enters your office looking exhausted. Her 18-month-old son, James, has food on his face and in his hair. Jane’s shirt is ill-fitting and crumpled, her hair is pulled back with just a rubber band, and her jeans have food crusted on them. It goes beyond the typical “mother of a toddler” look.
She starts to cry as soon as she sits down in your office and then has a hard time composing herself. She runs her hand through her hair, seeming not to notice the rubber band falling out. You try to distract James with a toy, but he clings to Jane and buries his face in her legs.
When she finally stops crying, she tells you, “I’m so sorry. I am having such a hard time dealing with everything. My husband, Jacob, was killed in Afghanistan last month by a roadside bomb. I’d only found out I was pregnant a couple weeks before that and Jake didn’t even know yet…I…I must’ve gotten pregnant the night before he deployed. He’d only been gone for just three months.”
Jane takes a deep, shuddering breath and continues. “I’ve been having nightmares and barely eating.” She laughs and brushes at her jeans. “That’s from James’ lunch.”
James, who hasn’t left her legs, starts crying. While attempting to comfort him, she says, “We live on base. I don’t think I can stay there much longer, and I don't know where to go. I don't have the energy to find a new home and pack, and I just can't face it. Sometimes I think it would just be easier to pack the car with a few things and drive off when they tell me to leave.
"I just don’t know what to do with myself. I just wanna be with Jake. I don’t want to be with anyone else. Mari keeps asking me to come over, just for coffee, but I dunno, I never go.” Quietly, almost whispering, she says, “Actually, I’ve barely left the house except to see the midwife and now you. I have to protect the baby, since that’s all we’ve got left of Jake.”
Photo of James, cryingJames raises his tear-stained face. “Mommy? Where Dada?”
Jane digs in her purse and pulls out a crumpled piece of paper. “Hush, James. Here’s Daddy’s picture.” She wipes his face with a tissue and takes a few shuddering breaths.
“Back at the end of high school…you know how senior year is supposed to be the best year? Not for me. My daddy died. He was only 42, and I’d just turned 18. Supposed to be an adult and all I wanted was my daddy back. But at least I got to know him for 18 years. James and the baby won’t know their daddy at all!
“I had to see a counselor for a while back then, too. I missed a lot of school, but I graduated anyway. My teachers all understood that I was depressed. I kind of feel the same way now. Only I think it’s way worse, being pregnant and having a toddler.” She half laughs. “And I thought senior year was bad. What a child I was!
“And my Mom isn’t here to help. She died just before James was born. Breast cancer. Two years ago. I can’t even think about whether that might happen to me. I do have a sister; Bonnie lives out in Oregon. We were close before, but actually became even closer after Mom died. She was a big help giving me advice about James! But she’s going through a divorce and beginning life as a single mom herself! My nieces are eight, seven, and five. Can you believe it? This whole family has lost parent after parent after parent.”
Jane sighs deeply and goes quiet.
Directions
In your initial post, first share resources:
Find two relevant military and/or government resources that might be available to Jane as a recently widowed military wife. Include links where possible.
In your community, find two resources available for young widows, widowers, or families of veterans serving in or killed in combat.
In addition, answer one of the following questions from your perspective as Jane’s psychiatric nurse practitioner:
What is your biggest concern for Jane? What should be addressed first?
What therapy intervention would you suggest for Jane? Provide a rationale and evidence to support your answer.
Do you think James warrants any intervention? If so, what intervention(s) would you make? What developmental tasks, according to Erickson, are these recommendations based on? Provide a rationale and evidence to support your answer
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| Subject | Psychology | Pages | 6 | Style | APA |
|---|
Answer
Jane Sullivan Case Study
Nurses conduct psychotherapy under family therapy, counselors, and social workers disciplines. On the other hand, the success of psychotherapy is attained by explicit use of seen evidence to make clinical decisions of providing care to patients. In this essay, a review will be conducted on Jane Sullivan's case study to address several concerns. The essay will further outline critical issues to be addressed first, preferred therapy for Jane, and support rationale for interventions to solve problems affecting the patient concerning other family members.
Biggest Concerns from the Case Study
Jane Sullivan's case study expresses depression as the major issue that affects James and the unborn in extension. Using details provided from the case, Jane has lost her husband, other family members, and her residence is at stake. This situation has affected her normal life, and in extension, her 18-month-old son is also affected by this depression. Addressing this situation thus begins with depression management to bring back this family to a stable emotional state.
Issues to Address
The first issue to be addressed is identifying signs and symptoms that are likely to lead to depression in the patient. The case study presents persistence in sadness from family deaths, lack of sleep characterized by nightmares, and difficulty concentrating even when narrating issues to the physician (Mabey, 2015). Other signs to be collected include guilt on pregnancy and hopelessness on how to get a shelter that has led Jane to be empty.
Suggested Therapy Intervention
Evidence collected from Jane indicates that she is likely to suffer from postpartum and bipolar depression. Addressing this state will entail the administration of antidepressants and psychotherapy interventions that brings together cognitive and interpersonal therapies (Wheeler, 2014). In case there is no response by the patient to the above-recommended interventions, the patient will be placed under electroconvulsive therapy (ECT) because the situation may have been extreme.
Rational and Support for Therapy
According to the case presented, there is a mood shift from happiness to sadness by Jane. Conclusions from this habit are that the patient may have bipolar disorder. On the other hand, the patient is four months pregnant. Pregnancy may have also contributed to postpartum depression, as expressed in the case study. Therefore the management of this condition can be attained by two types of diagnosis that will address these forms of depression affecting the patient.
James Warrant Intervention
The case study presents how Jane's actions influence her 18 months old son. Sufficient evidence is thus collected to indicate that James has also been subjected to an environment likely to influence dysthymia. Addressing this type of depression requires psychotherapy to understand the child's cognitive behavior and interpersonal behaviors.
Treatment Task
In a review of Erickson's proposal, there are six steps to address depression in patients. The first plan is to know and review patient signs and symptoms. The second step is to explain to Jane that the condition can be addressed, while the third step is acquiring a correct diagnosis. The fourth step understands different depression treatments, while the fifth step brings in an assessment of depression treatment. Lastly, Jane and her son are given the best care for depression, given the evidence obtained.
References
Mabey, L. (2015). Psychotherapy for the Advanced Practice Psychiatric Nurse: A How-to Guide for Evidence-Based Practice. Journal of EMDR Practice and Research, 9(1), 71.
Wheeler, K. (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice