BANDALAN, Robie Mae S.

BSN—3A

Bipolar Disorder

Situation: TOM – A client experiencing fluctuations in mood. During his gap year, at the age of
18, Tom experienced a manic episode followed by a period of depression. He recovered from
this and was stable throughout university until his final exam period, where he experienced
increasingly elevated mood. This led to his hospitalization and was followed by a period of
depression. One month after his discharge from hospital, Tom returns for a session of
psychological therapy.

1. Assessment
a. Bipolar Disorder mhGAP master chart assessment
i. Px experienced a manic episode followed by a period of depression.
ii. Px experienced increasingly elevated mood upon his final exam
iii. Px have a known prior episode of mania but now followed by a period of
depression.
iv. Px not currently manic or depressed but has a history of mania.
• Is the person in a manic state?
• The following are applicable to the client:
o Increased talkativeness
o Distractibility
o Inflated self-esteem
• Does the person have a known prior episode of main but has depression? Yes
• Look for presence of concurrent conditions
o The client has alcohol use or drug use disorders
• Is the person not currently manic or depressed but has a history of mania? Yes
• Is the person in a special group?
o The client is adolescent
2. Intervention
a. Cognitive behavioural therapy (CBT) – is based on the idea that feelings are
affected by thinking and behaviour. This intervention is used for the px since he
is experiencing a current situation where it results to him involving negative
doings.
• Identifying troubling situations or conditions
• Become aware of own thoughts, emotions and beliefs about these problems
• Identify negative or inaccurate thinking
• Reshape negative or inaccurate thinking
BANDALAN, Robie Mae S. BSN—3A

3. Process Recording

Clinical Psychologist Patient Analysis

Verbal Nonverbal Verbal Nonverbal Themes Therapeutic
techniques
Nice to see Smile. Has a I’m okay Smiles. Nod Content: Questioning,
you again, notebook, and took a Oriented to active
Tom. How talks to the deep breath. person listening
are u today? patient with
eye contact
So, I Has a pen in Well, it was a Doesn’t Content: Accepting,
understand hand, the few months maintain eye Oriented to Broad
that um since notebook is ago now and contact. person openings,
I was seeing on the lap. yeah, I've General
you a while Nods. done quite leads, Placing
ago that well for a event in time
you’re in a number of or sequence
hospital years so look
again. so can at that under
u tell me control yeah
more about
what
happened
before that
Did you take Has a pen in yeah because Doesn’t Content: Giving
Ritalin (?) hand, the it was just maintain eye Agreeing to information,
notebook is that it was contact. the
on the lap. that that was Explains with substance he
Nods. necessary at facial used.
Maintains the time expression. Mood: Firm
eye contact. and sure
Interaction:
He was
confirming
about taking
the medicine.
How it had Has a pen in well it sort of Doesn’t Content: Encouraging
affect you hand, the increased my maintain eye described description of
BANDALAN, Robie Mae S. BSN—3A

notebook is confidence at contact. feelings and perceptions—

on the lap. the time I will explains with perception asking the
Nods. everything gestures. how it affects client to
Maintains was going on him verbalize
eye contact. I was what he or
becoming a she
lot more perceives.
productive
yeah lot
more
competent a
lot I was
working
harder my
brain was
working
faster and so
I yeah my
minimum
momentum
was building
up and up
throughout
the period
yeah and so
it was I was
relishing it
otherwise
yeah do not
work and

so does that Has a pen in yeah well for Doesn’t Content:

mean to you hand, the me it was it maintain eye Described
then to be notebook is was my full contact. and
about times on the lap. time so I explains with expressed his
it sounds like Nods. spent I spent gestures. feelings.
you put quite Maintains three years
a lot of eye contact. that I was in
BANDALAN, Robie Mae S. BSN—3A

pressure on control I was

yourself you doing well I
been doing didn't know
really well at that it wasn't
uni and and really part of
you know my life at the
this was it time I didn't
this was the really talk to
time what any of my
did it mean friends about
to you to be it um but
feeling like then I yeah I
that kind of started to
more awake just thought
and more grow into it
energized and I took
maybe the
opportunity
to yeah enjoy
this time and
so it didn't
really reach
its peak until
after my
exam types
was still I was
still
functioning
throughout
my exams I
have since
found out
that I didn't
get the
results so I
wanted to
BANDALAN, Robie Mae S. BSN—3A

what do you Has a pen in I thought Doesn’t Content: Exploring,

think that hand, the that I was maintain eye Described General
was notebook is working contact. and leads,
on the lap. harder don't explains with expressed his
Nods. have it was gestures. feelings.
Maintains misjudged Mood:
eye contact. her thing and Sadness,
so yeah I regret,
didn't inferior
perform too
the best of
my ability
and when it
came to the
to the exams
and sorry I
didn't
achieve and I
didn't
achieve the
first time and
and