Unit 6 Case Studies Analysis

Louis Lance and Ted Li

Period 4
12/14/15

Case Study #1
Diagnosis: Generalized Anxiety Disorder (GAD) is a common anxiety disorder that involves
chronic worrying, nervousness, and tension. The anxiety of GAD is a general feeling of dread
or unease that affects ones whole life. If one has GAD that person may worry about the same
things that other people do, but worry way more than most others. It differs from panic disorder
in that the person doesnt worry about the panic attacks themselves, and thus doesnt behave
differently because of the panic attacks.
Cognitive and Behavioral Therapy: The best form of therapy for generalized anxiety disorder
is Cognitive Behavioral Therapy. This therapy is generally short term and focuses on ways to
help a person get back to activities they avoided due to anxiety. CBT has five components
education, monitoring, physical control strategies, cognitive control strategies, and behavioral
strategies. In these five components a person learns how to distinguish between helpful and
unhelpful worries, what may trigger the anxiety, relaxation techniques to decrease fight or
flight, alter thinking patterns, and tackling your fears head on.
Group Therapy: Individual therapy is a recommended treatment. Many times people with GAD
may feel awkward discussing their anxiety in front of others, especially if the others are less
than accepting. A distinction should be made during an evaluation to differentiate GAD from
social phobia followed by an appropriate diagnosis of the individual. Putting someone who may
have had GAD or social phobia in group therapy wouldnt be the best because of the social
component in each. Putting a person into a group setting without some important skills
(relaxation, interpersonal, etc) being taught first may cause a disaster and/or early treatment
termination.
Support groups, containing many people with GAD problems, offer everyone in it support, ideas,
or suggestions that may help solve their problems/situations causing anxiety. Another option
would be Exposure therapy. This is when the group learns to face their fears and more than
likely reduce anxiety when the outcomes they fear dont come true.
Treatments: Medications like antidepressants may help. As well as Hydroxyzine, mirtazapine,
and nefazodone although these wouldnt be a go to or first-line treatment. Better if used
alongside serotonin-Norepine Reuptake Inhibitors.

Case Study #3
Diagnosis:
The patient has schizophrenia, previously classified as the disorganized type or hebephrenia.
Like those with schizophrenia, the patient has delusions, like stating that [her mother] is staying
young and I am growing old, while displaying disorganized speech (e.g. I dont know whether I
am a boy or a girl. Do you think I will ever get married and have a baby?) and extremely
disorganized behavior (inappropriate laughing and giggling). The symptoms are highly likely
not due to substance abuse, medication or a medical condition because they started when the
patients father had left the patient. It is also known through research that early parental loss or
separation (the patient is still a teenager at about 18 or 19) is a stress-inducing environmental
factor that may be involved in schizophrenia. Furthermore, a person with schizophrenia must
have at least been displaying the symptoms mentioned above for at least a month, with some
level of disturbance being present over six months (just like how during the preceding year
there had been a gradual disintegration of personality, and how She started to worry about a
year ago. My husband left and she began to think about him all the time.). The patients recent
failure at school is more proof that the patient is not functioning normally due to her
schizophrenia.
Cognitive Therapy:
When it comes to treating those with schizophrenia, the psychologist needs to accept that the
cognitive distortions and disorganized thinking of schizophrenia are produced, at least in part,
by a biological problem that cant be corrected through mere reasoning. Cognitive therapy can
only be successful if the psychologist accepts the patient's perception of reality, and determines
how to use this "misperception" to assist the person in correctly managing life problems. The
goal is not to "cure" schizophrenia, but to improve the persons ability to manage ones life, to
function independently, and to be free of extreme distress and other psychological symptoms.
Behavioral Therapy:
Behavioral therapy assumes that we learn from our failures and successes in managing
different types of problems to increase our ability to function in the world, a.k.a learning from
experience. In order to learn from experience, we must correctly analyze what was and what
was not effective in solving a problem. We can also "learn" ineffective or maladaptive responses
to problems, especially if those responses lead to immediate positive results despite not solving
the problems in the long run. The learning of maladaptive responses to problems is often the
result of making mistakes in assessing cause and effect. Since individuals with schizophrenia
often make incorrect assessments of cause and effect, they often do not learn as well from
experience because of their disordered and disorganized thinking. Thus cognitive therapy is
combined with behavioral therapy to teach those with schizophrenia the social skills they never
learned, and help them to understand when to apply those skills to problems in the world.
Group Therapy:
In cases where the illness isnt as debilitating, the person may be able to attend skills training.
This may help them learn how to perform basic societal functions such as: take care of

themselves, engage in productive activities, and in some cases, hold down a job. If the persons
medication works well enough to reduce symptoms, it is not unrealistic for the person to get a
job or be productive.
Biological Treatments:
Medication is not a cure for schizophrenia. Rather it works by reducing the psychotic symptoms
of schizophrenia such as hallucinations, delusions, paranoia, and disordered thinking. The goal
of drug treatment should be to reduce psychotic symptoms using the lowest possible dose.
Nonetheless, medication only treats some of the symptoms of schizophrenia. Antipsychotic
medication reduces psychotic symptoms, but is much less helpful for treating symptoms of
schizophrenia such as social withdrawal, lack of motivation, and lack of emotional
expressiveness. The typical antipsychotics are the oldest antipsychotic medications and have a
successful track record in the treatment of hallucinations, paranoia, and other psychotic
symptoms. However, they are prescribed less frequently today because of the neurological side
effects, which include restlessness and pacing, extremely slow movements, painful muscle
stiffness, and muscle spasms (usually of the neck, eyes, or trunk)
In recent years, newer drugs for schizophrenia have become available. These drugs are known
asatypical antipsychotics because they work differently than the older antipsychotic
medications. Since the atypical antipsychotics produce fewer side effects than the typical
antipsychotics, they are recommended as the first-line treatment for schizophrenia.
Unfortunately, these newer atypical antipsychotic medications have side effects that many find
even more distressing including
loss of motivation, feeling sedated, weight gain, and sexual dysfunction.
ECT (electroconvulsive therapy) - in this procedure an electric current is sent through the brain
to produce controlled seizures (convulsion). It may be used on patients with severe symptoms
or depression who either have not responded to other treatments or cannot take
antidepressants. It is also sometimes used for patients at high risk of suicide. Experts believe
that ECT triggers a massive neurochemical release in the brain, caused by the controlled
seizure. Side effects may include short-term memory loss (usually resolves rapidly). It is
important that the doctor explain clearly the pros and cons of ECT to the patient and/or guardian
or family member.

Case Study #14

Diagnosis:
The man in this situation is suffering from Dissociative Amnesia which is usually when an
individual shuts out certain info, from a stressful or traumatic event. This causes them to forget
important information, and memory loss is beyond normal when suffering with this. Thus it is
appropriate to diagnose the man as having dissociative amnesia because he found himself
unable to remember his name or anything about his identity, his present situation, or the events
leading up to [his attempt to commit suicide].

Amnesia is a symptom of other medical and mental disorders; however, the patterns of amnesia
are different, depending on the cause of the disorder. Amnesia associated with head trauma is
typically both retrograde (the patient has no memory of events shortly before the head injury)
and anterograde (the patient has no memory of events after the injury). The amnesia that is
associated with seizure disorders is sudden onset. Amnesia in patients suffering from delirium
or dementia occurs in the context of extensive disturbances of the patient's cognition (knowing),
speech, perceptions, emotions, and behaviors. Amnesia associated with substance abuse,
which is sometimes called "blackouts" typically affects only short-term memory and is
irreversible. In dissociative amnesia, in contrast to these other conditions, the patient's memory
loss is almost always anterograde, which means that it is limited to the period following the
traumatic event(s). In addition, patients with dissociative amnesia do not have problems learning
new information. This is similar to how the man had forgotten so much right after the traumatic
event, but was able to convey the fact that he had forgotten so much.
Cognitive-Behavioral Therapy:
For acute amnesia. In clients with acute presentation of amnesia it is first necessary to provide a
safe therapeutic environment In fact, researchers have demonstrated that sometimes simply
removing threatening stimuli and providing an individual with a safe environment has enabled
spontaneous retrieval of memory Barbiturates can be used to pharmacologically facilitate the
interviewing process. Most commonly used are sodium amobarbital and sodium pentobarbital.
No studies have empirically investigated the effectiveness of hypnosis in treating Dissociative
Amnesia. However, hypnosis has been used successfully in the recovery of dissociated and
repressed memories Once the amnesia has been reversed it is important to explore and identify
events that triggered the Dissociative Amnesia. The therapist should reinforce the use of
effective coping mechanisms and the clients failure to use dissociation as their primary coping
strategy
For chronic amnesia. Pharmacologically facilitated intervention is not recommended. Hypnosis
may be beneficial in recovering and working through traumatic memories at a pace comfortable
for the client. Reframing of the traumatic experiences can occur during the hypnotic process.
The goal of therapy is the integration of dissociated material. Treatment of chronic Dissociative
Amnesia is typically long-term
Psychotherapy is the primary treatment for dissociative disorders. This form of therapy can be
referred to in two other ways such as talk therapy, counseling or psychosocial therapy, and
involves talking about the disorder and any issues that may be related.
The therapist will work with the patient to help him/her understand the cause of his/her condition
and to form new ways of coping with stressful circumstances. Over time, the therapist may help
him/her talk more about the trauma he/she experienced, but generally only when he/she has the
coping skills and relationships with their therapist to safely have these conversations.

Group Therapy:
Family therapy: This form of therapy helps to teach families about the disorder and its causes, it
also helps family members notice symptoms of a recurrence.
Biological Treatments:
Although there are no medications that specifically treat dissociative disorders, your doctor may
prescribe antidepressants, anti-anxiety medications or antipsychotic medications to help control
the mental health symptoms associated with dissociative disorders.

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