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For this assignment, you will watch an assigned video clip that depicts a patient needing psychiatric/mental health treatment. You then will complete a treatment plan for this patient, following the attached formatting. You are

required

to follow APA 7, which includes, a title page, your typed treatment plan, and a references page. Each video case that is assessed should result in a treatment plan that is a minimum of 3 pages in length, in addition to the title page and references page.

This is a treatment plan, not a research paper.

Follow the rubric guidelines for grading criteria.

Just like in practice, there are times when all the preferred information may not be available, yet you still will need to formulate a treatment plan for the patient. Your treatment plan must include in-text citations and proper APA 7 formatting.

The following reference materials are required to be utilized and referenced:

DSM-5

Course Textbook

Drug guide of your choice (text or online)

1 scholarly peer reviewed journal article, dated within the last 5 years, that supports your treatment plan. UptoDate is a wonderful site, but it is not considered a scholarly peer reviewed journal article.

Proper grammar and composition, capitalization and sentence structure

APA 7 approved font (such as 12-point Times New Roman)

Double spaced paper with 1” margins

Paragraphs are to be left margin justified only

Paragraph indentions

Heading Levels (see APA p. 47-48)

References that are formatted as per APA 7. See chapter 9 of the APA 7.

The APA 7 style of writing is required. This includes (but is not limited to):

How to properly cite and reference the DSM-5

.

For electronic versions:

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).

https:doi.org/10.1176/appi.books.9780890425596

For printed version:

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).

American Psychiatric Association.

Basic in-text citation for the DSM-5:

(American Psychiatric Association, 2013).

Treatment Plan: What to include and how to format the treatment plan

Your Treatment plan should include the following categories:

Title page

Content of treatment plan

(The title of your treatment plan should be on line 1 of page 2).

Video # or Discussion Board Prompt #

Brief description of the patient

Brief explanation of the presenting symptoms

Any known medical history, allergies, etc.

Your psychiatric diagnosis

(supported by the DSM-5).

List 3 of the differential diagnosis from the DSM-5, and briefly state why that was chosen as a differential diagnosis, and not as the main diagnosis. (See course materials on Differential Diagnosis)

(supported by the DSM-5).

Suicide and/or homicidal risk assessment

(this includes ideation, intent, plan, means, etc.).

What psychiatric tools or scales you used (or that you would use) to help support your diagnosis

(include citations).

Medications being ordered

Include name of medication(s) and what the med is used for (include citation)

Include the route, dosage, frequency (include citation)

Include black box warnings or what the pt needs to know/foods to avoid, etc. (include citation)

Non-pharmacological treatments that are being ordered (include citation that supports these).

Any labs or medical tests that need to be completed to rule out organic causes, for medication monitoring, and so forth (include citation).

(include a short line stating why each lab/test is being ordered)

Questions that you would ask to further solidify your diagnosis (brief list)

Any further directives/resources for the patient

(this would include, follow up with primary doctor to monitor HTN or diabetes; directives to follow-up with other members of the comprehensive treatment team; safety plan if you are sending the pt home and they have suicidal or homicidal thoughts; return for medication assessment in x number of weeks, etc. This also includes support group and hotline phone numbers for things like SI and SUD).

References Page

– include all citations used in the paper, formatted per APA 7, double spaced and in alphabetical order. References are to include the DSM-5, the course textbook, a drug book of your choice (text or online), and 1 scholarly journal article reference within the last 5 years, for each of the videos or discussion board prompts being assessed.

Note:

Direct quotations should be kept to a minimum and properly cited as per the APA 7. It is imperative that you synthesize the course information into your own words, using minimal direct quotations from scholarly journal articles to support your treatment plan. Academic integrity is essential as proper citations give credence and reliability to your treatment plan.

DSM-5 & Differential Diagnosis

In order to effectively treat patients, a reliable diagnosis and treatment recommendation is essential. The DSM-5 provides a definition for each mental health disorder along with diagnostic criteria that must be met for each diagnosis. These diagnoses are designed to “help clinicians to determine prognosis, treatment plans, and potential treatment outcomes for their patients” (American Psychiatric Association, 2013, p. 20). Diagnosis are then made after performing a clinical interview with the patient, using DSM-5 descriptions, criteria, and using clinician judgment (American Psychiatric Association, 2013).

All psychiatric disorders have a categorical place in the DSM -5. It includes the symptoms that must be present with specifiers that allow for a more specific diagnosis that help with the development of a treatment plan. (Example: Major depressive disorder with psychotic features).

Most psychiatric disorders (and psychiatric emergencies) require a thorough suicide risk assessment. If the patient in the DB or video requires a suicide risk assessment you must mention that clearly, as well as giving the side effects of any meds that may make suicidal thinking worse, as well as a safety plan.

Differential diagnoses

:  A reliable diagnosis is required to effectively treat the patient and to have positive treatment outcomes.

The differentials provide for clinicians and alternate diagnosis that could be considered if it is proven that the patient does meet the criteria for the primary diagnosis that was chosen.

A clinician does not randomly come up with a differential diagnosis on their own. The DSM-5 provides for clinicians, differential diagnosis for each primary diagnosis. They are listed in the DSM-5 at the end of each diagnosis chapter. The differentials are listed in order of prevalence. For example, of all the patients diagnosed with Bipolar 1, if that diagnosis was proven not to be correct, most often the correct diagnosis is found to be first, major depressive disorder, then second most frequent is the 2nd differential listed, then the 3rd most frequent is the 3rd differential that is listed. So the differentials should be alternate diagnosis that you considered or wrestled with as you were determining the primary diagnosis for the patient.

For example, if you have a patient who appears with a mood disorder, you may be considering depressive disorder or bipolar 1 disorder. Upon examining the diagnostic criteria in the DSM-5 for bipolar 1 (page 123-131) you determine that bipolar 1 is the diagnosis that the patient meets the criteria for. You must then look to the differential diagnosis that are listed in the DSM-5 (for bipolar 1 the differentials are on page 131-132) and you choose 2 or 3 of them that your patient closely matches the criteria for. You then briefly explain why you chose bipolar 1, as opposed to the differential diagnosis of major depressive disorder (for example).

[OFF CAMERA:] Ms. Branning, Mr. Nehring asked suggested you see me. He said your having
some issues at work.
[MS. BRANNING:] You could call them that.
[OFF CAMERA:] What kind of difficulty are you having at work?
[MS. BRANNING:] Well Mr. Nehring wants to fire me.
[OFF CAMERA:] Why do you think Mr. Nehring wants to fire you?
[MS. BRANNING:] Because Eric is in love with me. And it’s probably getting in the way. And
he wants to fire me.
[OFF CAMERA:] Who is Eric?
[MS. BRANNING:] Eric is my supervisor.
[OFF CAMERA:] Are the two of you in a relationship?
[MS. BRANNING:] No! Eric has his own girlfriend, I have my own boyfriend. But Mr. Nehring
got it in his head that this is my fault. And they’ve been ganging up against me.
[OFF CAMERA:] What happened to make you feel this way?
[MS. BRANNING:] Eric is lustful for me. Lust. Lustful.
[OFF CAMERA:] Well has Eric done anything inappropriate?
[MS. BRANNING:] No, he doesn’t have to.
[OFF CAMERA:] What do you mean?
[MS. BRANNING:] Well, he has this way of walking toward me and he gives me the easiest
assignments to do and he asks me to voice my opinion a lot in our weekly meetings. And I’m
beautiful. I mean, not to be boastful or anything but I’m a strong woman. And people are
attracted to that. And others, like Mr. Nehring feel threatened by it. He probably feels I could
replace him in a couple years. And I could.
[OFF CAMERA:] But there have been no instances of sexual harassment.
[MS. BRANNING:] No. And now they want to fire me, and it’s probably because they don’t
want me to get in the way of their day. I’m probably a distraction or something.
[OFF CAMERA:] According to Mr. Nehring you haven’t made a sale in three weeks.
NKU MSN675 | 2022 Treatment Plans, DSM-5, Differentials
[MS. BRANNING:] Oh, it’s been a slow time period. I guess it wouldn’t be bad thing if they
fired me. I mean after all of this, all the bad it’s done for my health. You know I should really
sue for discrimination, you know the stress and the health problems.
[OFF CAMERA:] You’ve been having health problems?
[MS. BRANNING:] Yes. Yes. It keeps getting worse.
[OFF CAMERA:] Can you describe it for me?
[MS. BRANNING:] Well you know there’s this pain in my neck, it aches, it spreads to my back,
I think there’s a lump, right here. I’m really worried.
[OFF CAMERA:] And what do you feel is the cause?
[MS. BRANNING:] I told you, pain, suffering, broken heart. I think it’s cancer.
[OFF CAMERA:] Have you been seen by a doctor?
[MS. BRANNING:] No. But it’s probably cancer. And it’s slowly killing me. And it’s all
because of them. And Eric’s obsession with me.
[OFF CAMERA:] Ms Branning, I don’t think you have to worry, a broken heart can’t cause
cancer.
[MS. BRANNING:] You never know until it happens.
NKU MSN675 | 2022 Treatment Plans, DSM-5, Differentials

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