HolisticMental Health Paper
HolisticMental Health Paper
ThisHolistic paper will discuss the effect of PTSD on an inpatientwar-veteran who was admitted at the Coatesville Veterans AffairsMedical Center, Coatesville, PA. On August 11, 2016 during myclinical term at the center, I met with him and we had a talk. Myintention was to discuss his physical, psychological, intellectual,social, and spiritual aspect of life, as well as the impact of thetreatments he was receiving at the center.
Thisis a 33 year old Caucasian male vet who experienced Operation IraqiFreedom between 2008 -2014. He came in voluntarily through the SATUUnit (Building 8- meaning that he was having an addition issue) onAug 11, 2016, with chief complaint of severe stress, anxiety, anddifficulty falling asleep. After lab work and screening were done, hewas diagnosed with PTSD, opioid dependency, Cocaine Dependency, SleepApnea, and Smoking Dependency, Allergic Rhinitis, Tinnitus, and dreyeye. X-ray study result was not available during this visit.
Thefollowing are the codes present in his body.
291.89-Induced anxiety disorder
291.89-Induced mood disorder
291.1-Induced persisting amnestic disorder
291.2-Induced persisting dementia
291.5-Induced psychotic disorder, with delusions
Uponmeeting him, he gave me a doubtful look, which is common in peoplewith this condition (as if he was asking himself, why I wanted totalk to him). While he was in that mood, I took the opportunity toassess his appearance. The first thing anybody would observe abouthim is that he is tall (approximately about 6’ 7’ tall) andbuilt. He appeared well groomed with a sense of good hygiene as helooked and smelled clean. After few seconds, he gave me a friendlyface and said to me, “They said you want to talk to me?” and Iresponded, “yes.”
Hehad good moods during the session we had together. He became a littleloud with little head and hands movements while describing how somebehaviors of civilians in public places, especially at shoppingcenters disturb him. He expressed how proud he is to have served inthe army he carries a happy countenance. Talking about his planafter leaving the VA center, he said he has money and will be leavingwith his elder brother in Philadelphia PA
Helooks like somebody who likes talking. He talks with full attention.His speech was clear, organized, and well-constructed. From his talk,one could conclude that he was oriented in person, time, and place.
Hisanxiety comes from multiple stress factors. He said that he isfeeling bad for his friends that were killed during his deployment inIraq he has multiple injuries he sustained from bomb fragmentsduring multiple operations such as shot on his back, his shoulder,which caused him to have a reconstructed clavicle bone. His stressesescalated after his girlfriend called off their relationship while hewas receiving medical treatment for his injuries.
Thenurse told me that he was having some difficulties at the unit withstaff members when he just came in but he has improved a lot. He usedto complain of being instigated by people.
Heis on the following medication
Gabapentinfor pain and anxiety, Naltrexone Inj. for alcohol abuse therapyadjuncts opioid antagonists, CPAP machine for respiration, prazosinfor hypertension. Fish oil for supplements, trazodone (Desyrel) asneeded for depression, anxiety, sleep and pain, Trzanidine at bedtime as needed for muscle spasm, artificial teas for dry eyes,acetaminophen as needed for pain and fever, and he is on random UrineDrug Scan check.
Aboveall, due to the high level of alcohol dependency this is also whatis prescribed for more medication. These drugs will reduce withdrawalsymptoms during detoxification. They will also help him stay soberduring the long process of recovery.
Drugsmost often used to treat withdrawal symptoms in the process ofdetoxification include:
Antianxietymedicines (benzodiazepines such as diazepam), which heal withdrawalsymptoms such as delirium tremens (DTs).
Seizuredrugs reduce or ease severe withdrawal symptoms duringdetoxification.
Drugsused to help one stay sober during recovery include:
Disulfiram(Antabuse), which will force him with sickness to his stomach when hedrinks.
Naltrexone(ReVia, Vivitrol), which will affect the pleasure he gets fromdrinking.
Acamprosate(Campral), which may lower his craving for alcohol.
Topiramate(Topamax), which may help him treat alcohol problems.
BDneeds to be encouraged to adhere to his doctor’s directions for hismedication, reminded of the importance and reasons for abstainingfrom illicit drugs and alcohol, as well as the importance of seekingmedical follow-up and evaluation.
Thebest approach I would give to this client is counselling. Thecounselling style labeled here combines the client-centered approachdefined by Egan, well known health writer with the motivationalinterviewing style established by Miller and Rollnick (Schacter,Gilbert, & Wegner, 2011). It will encourage him to explore hisconcerns through open-ended queries and empathic feedback.
Thiswill include taking all the prescribed drugs to help him effectivelyrecover from his serious depression (Schacter, Gilbert, & Wegner,2011). This will also help in raising the client’s confidence andhis ability to change in an intermediate step. The following are theinterdisciplinary steps I will use to approach my client:
The least number of sessions that I would wish my client to attend
. That the client should attend regularly he should be on time, and give advance notice if he is unable to meet these rations. I will try to prevent early drop-outs by contacting the client when he misses any of the first few sessions and encouraging him to attend the next one.
. The client should never come to sessions under the effect of alcohol or other drugs. This is ideal to avoid interference with their ability to concentrate on the sessions. If the client breaks this rule, he will be asked to abandon the session and encouraged to come next time, when he shall be sober.
. The identities discussed shall remain confidential and kept from any family member. This is to monitor the successiveness of the client.
AsI conclude, I would state that based on my observation, there is asignificant success on the treatment of depression, anxiety, andrelated stress factors caused by PTSD with the current therapyprovided at the Coatesville Veterans Affairs Medical Center,Coatesville, PA.
Schacter,Gilbert, & Wegner (2011). Psychology (2nd Edition), page 552,Worth Publishers