Response To William Thompson's PTSD Case Assignment ✓ Solved

Response to Assignment on William Thompson's Case and PTSD Diagnosis

William Thompson is a 38-year-old African American man recently married, with a background as a military captain during the Iraq war. He is currently experiencing financial hardship, which has led to homelessness after being unable to pay his mortgage, and he is living with his brother and his brother's wife. He is a lawyer specializing in finance law and reports issues related to alcohol use and PTSD. Thompsons’ personal interests include marathon running, playing soccer, jazz listening, and collecting modern art. According to the given scenario, the assessment concludes that William does not meet the DSM-5 criteria for a PTSD diagnosis due to insufficient signs and symptoms and lack of detailed traumatic event information that aligns with the official diagnostic requirements.

DSM-5 criteria specify that for a PTSD diagnosis, an individual must have been exposed to actual or threatened death, serious injury, or sexual violence directly or indirectly, with the traumatic event being recurrent, involuntary, and intrusive (American Psychiatric Association, 2013). Since William's case does not meet these criteria based on available information, an official diagnosis of PTSD should not be assigned at this point. Ethical clinical practice requires abstaining from labeling a patient without sufficient evidence or symptomatology supporting such a diagnosis (Flanagan et al., 2016).

As a future nurse practitioner, it is paramount to adhere to ethical standards by avoiding premature or unsupported diagnoses. Instead, I would conduct a comprehensive mental health assessment to precisely understand William’s symptomatology, history, and potential trauma exposure. This approach enables the development of an effective and individualized treatment plan that targets identified issues, whether related to depression, anxiety, substance use, or other mental health concerns (Flanagan et al., 2016).

Goals of treatment for patients with PTSD, as outlined by the American Psychiatric Association (2013), include managing symptoms, preventing comorbid conditions such as depression and substance abuse, improving functioning, and fostering a sense of safety and trust. Preventing relapse and helping the patient translate their experiences into constructive safety, prevention, and coping strategies are also essential components. In William’s case, prioritizing safety—especially preventing self-harm or harming others—is critical and should guide care planning.

Regarding care plan options, a combination of psychotherapy and pharmacotherapy is often effective. Cognitive-behavioral therapy (CBT), particularly trauma-focused CBT, has demonstrated efficacy in reducing PTSD symptoms (Szafranski et al., 2017). Medication-wise, selective serotonin reuptake inhibitors (SSRIs) like sertraline (Zoloft) have been approved and are widely used to manage mood and anxiety symptoms associated with PTSD (Stahl, 2013). Additionally, managing comorbid conditions such as depression and insomnia may involve medications like Ambien to facilitate sleep (Szafranski et al., 2017).

Moreover, addressing underlying alcohol use through integrated treatment is vital given its impact on mental health and recovery (Flanagan et al., 2016). The treatment plan should include psychoeducation, coping skills training, and engagement in support groups for PTSD and substance use disorders. Regular follow-up assessments are necessary to monitor symptom progression, medication adherence, and overall safety.

In conclusion, the assessment of William Thompson underscores the importance of thorough clinical evaluation before assigning a diagnosis like PTSD. Ethical care involves comprehensive assessment, individualized treatment planning, and an emphasis on safety and symptom management. Combining evidence-based psychotherapy and pharmacotherapy offers the best chance for symptom reduction, improved functioning, and overall well-being.

References

• American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
• Flanagan, J. C., Korte, K. J., Killeen, T. K., & Back, S. E. (2016). Concurrent treatment of substance use and PTSD. Current Psychiatry Reports, 18(8), 70.
• Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press.
• Szafranski, D. D., Smith, B. N., Gros, D. F., & Resick, P. A. (2017). High rates of PTSD treatment dropout: A possible red herring? Journal of Anxiety Disorders, 47, 91-98.
• American Psychiatric Association. (2020). DSM-5® online diagnosis and management. American Psychiatric Publishing.
• Foa, E. B., & McLean, C. P. (2016). The efficacy of exposure therapy for PTSD: A review of meta-analyses. Clinical Psychology Review, 51, 1–10.
• Hoge, C. W., et al. (2004). Combat duty in Iraq and Afghanistan, mental health problems, and barriers to care. New England Journal of Medicine, 351(1), 13-22.
• Bradley, R., et al. (2005). A multidimensional meta-analysis of psychotherapy for PTSD. American Journal of Psychiatry, 162(2), 214–227.
• Resick, P. A., et al. (2012). A Meta-Analytic Review of Trauma-Focused Cognitive Behavioral Therapy for PTSD. Journal of Consulting and Clinical Psychology, 80(4), 590–602.
• Rauch, S. A. M., et al. (2012). Pharmacological treatment of PTSD: Scientific review. Harvard Review of Psychiatry, 20(2), 64–76.