The rationale of this assignment was to precisely diagnose Marla and to discover causes and potential treatments for her disorder. Marla is a 42 year old Hispanic female who approach to the mental health clinic feeling “jumpy all the time,” complaining of having problem sleeping, and incidence an incapability to concentrate. (Joan Rachmel, syllabus description of final assignment) These symptoms are sourcing problems for her for executing job where she is working as an accountant. Upon initial look at her case a some different disorders approach to mind like PTSD, ADHD and depression with mania.
The process of clinical interview comprised of not merely observing Marla while she was in the office however also of a catalog of questions to assist her get better familiarized with Marla, her current and past situations. It in addition give an opportunity to endeavor to get to the base of what is sourcing her trouble to commence with and to perceive what her stress level is at work and home.
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A number of the questions posed to Marla in the starting were questions connecting to her symptoms. Marla was inquired regarding precisely what type of troubles she was facing and reacted with feeling extremely nervous all the time, not being able to sleep, and not being capable to concentrate at all. Further she was questioned when it approaches to sleep was she having trouble staying asleep, falling asleep, or both. She reacted with mostly falling asleep however staying asleep can be a difficult also. The subsequently she was asked was when did she started become aware of the symptoms and if she can approximate how extensive the symptoms had in reality been a problem. Her reply to this question was that she had for all time had several trouble with these symptoms however when she lately started her job as accountant she begin to notice them further than ever.
The subsequently set of questions were connecting to Marla and her family. Marla was inquired to explain how she feel growing up in expressions of a contented childhood or one that was depressing, anxiousness feelings, or something that might have been disturbing. She replied with the fact that she has for all time been a nervous person even as a child. She affirmed that her childhood was one that was untroubled and usual not anything traumatic other than of her parent’s divorce. She further told me that she forever had a few trouble with things in school being uninteresting to her and that she establish it extremely hard to concentrate on definite subjects and that irritated her. Marla as well informed me that she was for all time an extremely active child and the similar carries over to her adulthood. I in addition asked Marla concerning her pregnancy of mother and regarding her years of growing up and whether or not she talked, walked etc. on time, and the use of alcohol or drugs throughout pregnancy. She told me that she was on time in so far as delivery and that there was no employ of any type of substance throughout the pregnancy of mother. She as well told that she did all on time and had a moderately normal childhood other than being extremely active. I then inquired if any person else in her family experiences from alike problems and she reacted with the fact that her brother was detected with an anxiety disorder consequently then the issue came regarding substance abuse and whether or not anyone of her members of family were profound drinkers or employed any additional kind of drugs. With this query she told me that her father was detected with depression and was a drinker.
With the preceding few questions Marla gave me great insight by telling me her brother was diagnosed with an anxiety disorder and that her father was diagnosed with depression and was a drinker. I then began asking Marla regarding her present employment. I inquired her where she was at present employed and what type of things she was needed to do at work. Marla told me that she was an accountant and that she had simply been working for last two years. She told when she started become aware of the symptoms getting worse. She told me that she is working at a desk for 8+ hours a day and do numbers crunching in addition to working on taxes for people. She as well stated that it was type of a boring job since it was a recurring thing with not a great deal variation at all.
I then desired to find out more in relation to her relationships by inquiring if she was currently in a relationship and how it was going on if she has. Marla responded that she has lately divorced and had now started dating again which was going alright. With becoming aware she had been married previously I asked her a slight regarding the circumstances of the divorce and she responded that her husband felt she was cheating since she was forever away from the home and he felt that their lives were in two diverse places. She as well notified me that she has a son who is eight years old.
I then established to split into her medical history by inquiring her when she visit a doctor last, if she was examined physically, what the outcomes were if they did, if she was taking any medicine at present, and if she had taken any medicine for anxiety, depression, or any additional type of mental illness in the past. Marla affirmed that she did visited a doctor about eight months prior and that they think she was just below tremendous stress from the novel job and they place her on Zanax for her nerves thinking that would aid her to composed down. Her physical body check up did not show any abnormalities. She then explained that she was extremely stressed out when she went to the doctor since she had commenced this new job subsequent to graduating college and it had all been fairly the burden with her having a son in addition.
I feel subsequent to reviewing all of Marla’s information that she is enduring more from ADHD than anything else due to the fact that she has feelings of nervousness and is not capable to focus, in addition to not being capable to sleep well. The entire of these symptoms commenced to in actuality show subsequent to her taking on this novel job as an accountant where she senses not interested at times. People with ADHD show symptoms of this nature particularly not sleeping owing to the reality that their bodies are wired the majority of the time making it hard to plunge and stay asleep. I as well feel that her sitting in a chair with not a great deal variation to her daily routine is what is making the symptoms in reality illustrate right now since she has no energy opening.
I noticed during my interview with Marla that she was stirring her fingers and looking about the room and frequently had to remind her of what she was saying since she would lean off subject. I in addition noticed that she appeared like she required getting up and moving like she was prepared to run. With my observations and questions it is obvious that she is enduring from ADHD. I can speak this with confidence since she exhibits intricacy maintaining attention, simple distraction by unrelated stimuli, fidgeting with her hands, appears forever on the go, too much talking. She has displayed these symptoms ever since she was a child as per to her history however was on no accounts been treated. I sense that above time she has befall used to it and she has conquer a lot of of the symptoms by learning to pact with them however still a few remain and with the fresh accountant job she is starting to become aware of them more and more.
I would have to approach with the biological model in so far as being the source of ADHD in addition to take care of the patient accordingly to that. The model of biological illustrates that abnormal behavior is an ill health bring about by a not working part of the organism. (ComerFunda, Abnormal Psychology, 4th ed, 2005.) For Marla I would like to treat her illness with the appropriate medicine like a stimulant to aid her focusing in addition to some kind of behavioral therapy to aid her increase more insight as to how to deal with with the symptoms. I would as well recommend her doing a bit previous to and following work like a few sort of exercise that would aid to burn a few of the excess energy she has which might help her to concentrate better whilst at work and tender her a number of relief afterwards.
References:
ComerFunda, Abnormal Psychology, 4th ed, 2005
