Week 7 Assignment 1: Captain Of The Ship Project Obsessive C

Week 7 Assignment 1 Captain Of The Ship Project Obsessive Compul

Week 7: Assignment 1: “Captain of the Ship” Project – Obsessive-Compulsive Disorders In 4 pages, write a treatment plan for your client in which you do the following: Overview of Obsessive-Compulsive Disorders Describe the HPI and clinical impression for the client. Recommend psychopharmacologic treatments and describe specific and therapeutic endpoints for your psychopharmacologic agent. (This should relate to HPI and clinical impression.) Recommend psychotherapy choices (individual, family, and group) and specific therapeutic endpoints for your choices. Identify medical management needs, including primary care needs, specific to this client. Identify community support resources (housing, socioeconomic needs, etc.) and community agencies that are available to assist the client. Recommend a plan for follow-up intensity and frequency and collaboration with other providers.

Paper For Above instruction

Obsessive-Compulsive Disorder (OCD) is a complex and often debilitating mental health condition characterized by intrusive thoughts, images, or urges (obsessions) and repetitive behaviors or mental acts (compulsions) aimed at reducing anxiety caused by these obsessions (American Psychiatric Association, 2013). The clinical presentation often involves a pattern of persistent, unwanted thoughts and compulsive rituals that interfere significantly with daily functioning, social interactions, and overall well-being (Sadock, Sadock, & Ruiz, 2014). A comprehensive understanding of the patient's history, presenting symptoms, and psychosocial context is essential for accurate diagnosis and effective treatment planning.

History of Present Illness (HPI) and Clinical Impression: The hypothetical client presents with a 2-year history of recurrent intrusive thoughts centered around contamination fears, leading to compulsions such as excessive handwashing and avoidance of public places. The client reports significant distress and impairment in occupational, social, and personal domains. The clinical impression aligns with a diagnosis of OCD, with moderate severity, corroborated through standardized assessment tools and clinical interview (Gabbard, 2014). The client displays insight into their condition but feels overwhelmed by compulsive behaviors that consume substantial time daily.

Psychopharmacologic Treatment Recommendations: First-line pharmacotherapy for OCD typically includes selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine, sertraline, or escitalopram (Stahl, 2014). The choice of agent will depend on the client's medical history, tolerability, and side effect profile. For instance, fluoxetine, starting at 20 mg daily, can be titrated up to 60 mg based on response and tolerability. Therapeutic endpoints include a reduction in the severity of obsessions and compulsions measurable through standardized scales like the Yale-Brown Obsessive Compulsive Scale (Y-BOCS). Full therapeutic response is generally observed after 8-12 weeks of consistent medication use, with adjustments made accordingly (Wheaton et al., 2015).

Additional pharmacologic options include clomipramine, a tricyclic antidepressant with proven efficacy in OCD. However, due to its side effect profile and toxicity risk, SSRIs are preferred in most cases. Augmentation strategies with antipsychotics, such as risperidone, can be considered if responders show incomplete improvement (Wheaton et al., 2015). The goal is achieving at least a 25-35% reduction in Y-BOCS scores, indicating substantial symptom improvement.

Psychotherapy Modalities and Therapeutic Endpoints: Cognitive-behavioral therapy (CBT), particularly exposure and response prevention (ERP), is considered the gold standard non-pharmacological treatment with robust evidence for efficacy (Gabbard, 2014). In ERP, the client is gradually exposed to feared stimuli or situations while refraining from compulsive responses. Therapeutic goals include habituation to anxiety-provoking stimuli, reduction in compulsive behaviors, and cognitive restructuring to challenge maladaptive thoughts (Himle et al., 2013). For clients with severe or treatment-resistant OCD, additional modalities such as acceptance and commitment therapy (ACT) or mindfulness-based approaches may be adjunctive options.

Family therapy can be beneficial, especially if family accommodation of compulsions influences symptom severity (Thompson-Hollands et al., 2014). Group therapy provides peer support, normalization, and shared coping strategies. The primary aim across modalities is to decrease symptom severity, improve functioning, and foster coping skills that support long-term management.

Medical Management and Primary Care Needs: Ongoing medical assessment is crucial to monitor medication response, side effects, and comorbid medical conditions such as depression or anxiety disorders. The primary care provider should evaluate for medication adverse effects—sexual dysfunction, gastrointestinal upset, weight changes—and conduct routine blood work as indicated (Stahl, 20114). Screening for suicidality, substance use, and overall physical health must be integrated into treatment. Coordination with psychiatric services ensures medication adjustments and comprehensive care.

Community Support Resources and Agencies: Community resources can significantly enhance treatment outcomes by addressing socioeconomic, housing, and social support needs. Local mental health agencies, housing assistance programs, and social service organizations contribute to holistic care. Peer support groups such as those facilitated by OCD foundations or local mental health organizations promote social connection and shared coping strategies. Social workers can assist with applications for disability, housing, and financial assistance, which may be necessary for clients with severe impairment due to OCD (Sadock et al., 2014).

Follow-Up and Collaboration: Regular follow-up appointments should be scheduled every 4-6 weeks initially to assess medication efficacy, adherence, and side effects. As symptoms stabilize, follow-up intervals can be extended. Collaboration with psychologists, primary care providers, social workers, and community agencies is essential for an integrated, patient-centered approach. Clear communication regarding treatment goals, progress, and any issues arising ensures optimal care and adjustment of strategies as needed (American Nurses Association, 2014).

References

• American Nurses Association. (2014). Psychiatric-mental health nursing: Scope and standards of practice (2nd ed.). Washington, DC: Author.
• American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
• Gabbard, G. O. (2014). Gabbard’s treatment of psychiatric disorders (5th ed.). Washington, DC: American Psychiatric Publishing.
• Himle, J. A., Chatters, L. M., Taylor, R. J., & Nguyen, A. (2013). The relationship between obsessive-compulsive disorder and religious faith: Clinical characteristics and implications for treatment. Spirituality in Clinical Practice, 1(S), 53–70. doi:10.1037/.1.S.53
• Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer.
• Stahl, S. M. (2014). Prescriber’s Guide: Stahl’s Essential Psychopharmacology (5th ed.). New York, NY: Cambridge University Press.
• Thompson-Hollands, J., Edson, A., Tompson, M. C., & Comer, J. S. (2014). Family involvement in the psychological treatment of obsessive-compulsive disorder: A meta-analysis. Journal of Family Psychology, 28(3), 287–298. doi:10.1037/a
• Wheaton, M. G., Rosenfield, D., Foa, E. B., & Simpson, H. B. (2015). Augmenting serotonin reuptake inhibitors in obsessive–compulsive disorder: What moderates improvement? Journal of Consulting and Clinical Psychology, 83(5), 926–937. doi:10.1037/ccp