Category: Disorders

Introduction

Borderline Personality Disorder (BPD) is a mental health condition that impacts emotional control leading to intense anxiety, impulsiveness, mood swings, and personal isolation. BPD is a chronic condition common in both the general population and clinical settings. Intensive fear or distress during childhood and past emotional, physical, and sexual abuse are the risk factors for BPD. People with BPD have twisted ideation of themselves and others, resulting in unstable relationships with friends, loved ones, and family. People with BPD live low quality of life characterized by difficulty maintaining employment and relationships. BPD is a chronic mental illness that challenges emotional and behavioral regulations, influencing poor relationships and dangerous behaviors.

Main body

The criteria for BPD diagnosis involve identifying unusual patterns of anger and interpersonal relationships displayed by the patients. The review of self-image and perception by the individuals is also used to diagnose BPD. Emotional instability is the main symptom of BPD in various contexts, including impulsivity, irritability, overthinking, intense episodes of sadness, and anxiety (Lazarus et al., 2018). An inverted perception of oneself and others is also a critical BPD symptom that leads to self-damaging behaviors. BPD patients create imagined abandonment that could result in explosive anger. The symptoms criteria through detailed interviews with the patient, psychological assessment through questionnaires, and clinical history help the clinician rule out symptoms of BPD.

The interviews, psychological assessments, and questionnaires evaluate symptoms of intense and unstable emotions and relationships. They evaluate how the individual sense of self and their clarity of self-image. People with BPD are unclear about their self-image and have a disturbed sense of self (Lazarus et al., 2018). BPD is also associated with patterns of unstable relationships with other people marked by recurrent fights and quarrels due to impulsivity. The poor relationship with others is due to behaviors of explosive anger and emotional swings. Self-harming behaviors such as substance abuse, suicide attempts, and reckless decision-making are common in patients with BPD. The symptoms of BPD should be identified and screened at a young age.

The effective emotional instability caused by BPD is subjective to identity disturbance and interpersonal challenges. The patients suffer the chronic feeling of emptiness with a profound lack of emotional depth or sense of experience. Individuals typically feel disconnected from themselves more frequently due to the recurrent feeling of emptiness; patients experience intervals of sadness, mood swings, and anxiety. BPD causes impulsive behavior that could influence potentially self-damaging behaviors such as substance abuse and reckless spending. BPD displays severe and heterogeneous symptoms during diagnosis that require equally complex care and intervention strategies.

The medication for BPD includes antidepressants, antipsychotics, and mood stabilizers. According to Bozzatello et al. (2020), various medications are prescribed after diagnosis to alleviate emotional symptoms. BPD depends on a combination of drugs to manage the multiple symptoms associated with the condition. Antidepressants manage emotional hyperactivity, stress, and anxiety and foster emotional stability. The most commonly used antidepressants are Fluvoxamine, Zoloft, and Lexapro (Bozzatello et al., 2020). Depression medication has side effects, including allergic reactions and intense bleeding. There is consistent research-based evidence that antidepressants are significantly effective in limiting critical BPD symptoms.

Antipsychotics boost antidepressants to suppress impulsive behaviors. They are effective in improving aggression, anxiety, psychotic symptoms, and anger (Bozzatello et al., 2020). Some of the antipsychotics used in BPD management include Abilify, Zyprexa, Fan apt, Capylyta, and Risperdal. Mood stabilizers or anticonvulsants stabilize mood swings that cause unusual behaviors. The most common prescription for BPD includes topiramate, valproate, and Lamictal. The side effects of anticonvulsants include blurred vision, abnormal behavior, and allergic reaction. The appropriate dosage for each medication is determined by the health care professional depending on the individual symptoms and nature of BPD.

Psychotherapy is administered to BPD patients besides the medication. The psychotherapy target is enhancing relationships, emotional control, and altering the disastrous behaviors in BPD management. Cognitive Behavioral Therapy (CBT), Mentalization-based therapy (MBT), and Dialectical Behavior Therapy (DBT) are the psychotherapeutic approaches used to remedy the emotional and interpersonal challenges posited by BPD (Bozzatello et al., 2020). Psychotherapy aims to enable individuals to understand and improve their emotions, perceptions, and behavioral symptoms. The counselor helps people identify what triggers them and how to manage those situations. Psychotherapy in the management of BPD focus on the strengths and ability to function to rectify behaviors and emotional response. The therapist adopts the most suitable psychotherapy to address the patients individual needs.

The therapies for BPD differ and can either be administered in group or individual therapies. DBT is most prevalent in treating personality behaviors by imparting the necessary emotional control skills and fostering interpersonal relationships and depression tolerance. CBT is broad-spectrum psychotherapy with specialized techniques applied in BPD management, such as cognitive restructuring, to tackle the identity dilemma (ODwyer et al., 2020). Alternatively, the MBT is administered through discussions to connect the individuals with their thoughts and feelings. Additionally, some recommended natural and home remedies are enough rest and meditation. Different or a combination of therapeutic interventions can be applied depending on the personality traits exhibited.

BPD has tremendous effects on personal life, family members, and abilities to secure or maintain gainful employment. First, BPD patients suffer low self-esteem and loss of interpersonal relationships, impacting their personal lives. The inability to control emotions cause many episodes of trouble with other people and potentially with law enforcement. The consistent impulsive decisions by BPD patients negatively impact their social interactions and network. Since persons with BPD are highly sensitive to abandonment, the isolation by most people alleviates feelings of anger and self-harm. The symptoms of chronic emptiness, loneliness, anger, depression, and anxiety affect the quality of the personal life of the victims (Seigerman et al., 2020). Furthermore, people with BPD face unemployment and challenges securing and maintaining unemployment. Employers do not appreciate the pervasive unpredictability of interpersonal relationships and emotions marked by impulsivity. From the perspective of affected individuals, the fear of disclosure, anticipated stigmatization, and low self-confidence impede their employment.

Without treatment, the symptoms of BPD alleviate, causing toxic interpersonal relationships, severe psychological effects, and self-harm behaviors. Increased depression and anxiety would trigger the infection of other medical complications and substance use disorders hence comorbid personality psychopathology. There is no definitive cure for BPD but rather a medication and therapeutic intervention to reduce the impacts of the symptoms (Mota & Lourenco, 2020). There are fewer risks of poor interpersonal and emotional effects with effective interventions, hence improved quality of life for BPD patients. Additionally, people with BPD have reduced life expectancy. BPD is a chronic condition that can improve over time with effective medication and counseling interventions.

The family members of individuals diagnosed with BPD face financial, stigmatization, and social challenges. Family members are responsible for caring for BPD patients who may feel exhausted and mystified by the condition. Harmful symptoms of BPD, such as mood swings and anger outbursts, are terrifying to the immediate family living with the victim. Avoiding isolation by the patients is disruptive to the family members affecting their schedules (Seigerman et al., 2020). Such family members often experience isolation and stigmatization from the community. The chronic stress and conflict associated with BPD affect romantic relationships and can be a major source of marital conflicts. Moreover, the financial burden of different medications and therapies for managing BPD may be overwhelming to the family.

Conclusion

In Conclusion, BPD is a psychotic disorder with significant impacts on behavior and emotional stability. BPD diagnosis is conducted through interviews, questionnaires, and psychological assessments to identify the behavioral and emotional symptoms. The main symptoms of BBPD are associated with behavioral and emotional uncertainty characterized by episodes of anger, sadness, and anxiety. Behavior, psychological, and psychosocial instability are evident in patients with BPD. A multidisciplinary perspective is necessary for BPD management through medication and therapies. Antipsychotics, anticonvulsants, and antidepressants are the medications for BPD, whereas DBT, CBT, and MBT are the psychotherapy treatments for borderline. The prognosis of the borderline disorder indicates that BPD is a chronic illness whose symptoms can be suppressed through continued intervention care. BPD does not only impact the affected individuals but also their entire network of family. Individuals with BPD struggle with interpersonal relationships and securing and maintaining employment. The immediate and extended family members of the patients. Suffer isolation, stigmatization, and social and financial burden.

References

Bozzatello, P., Rocca, P., De Rosa, M. L., & Bellino, S. (2020). Current and emerging medications for borderline personality disorder: is pharmacotherapy alone enough?. Expert Opinion on Pharmacotherapy, 21(1), 47-61. Web.

Lazarus, S. A., Scott, L. N., Beeney, J. E., Wright, A. G., Stepp, S. D., & Pilkonis, P. A. (2018). Borderline personality disorder symptoms and affective responses to perceptions of rejection and acceptance from romantic versus nonromantic partners. Personality Disorders: Theory, Research, and Treatment, 9(3), 197. Web.

Mota, P., & Lourenço, S. (2020). Am I bipolar or what? Exploring the phenomenological, treatment, and prognosis overlap of borderline personality disorder and bipolar disorder. Mental Health Review-Journal. Web.

ODwyer, N., Rickwood, D., Buckmaster, D., & Watsford, C. (2020). Therapeutic interventions in Australian primary care, youth mental health settings for young people with a borderline personality disorder or borderline traits. Borderline Personality Disorder and Emotion Dysregulation, 7(1), 1-10. Web.

Seigerman, M. R., Betts, J. K., Hulbert, C., McKechnie, B., Rayner, V. K., Jovev, M. & Chanen, A. M. (2020). A study comparing the experiences of family and friends of young people with borderline personality disorder features with family and friends of young people with other serious illnesses and general population adults. Borderline Personality Disorder and Emotion Dysregulation, 7(1), 1-8. Web.

Presumptive nursing diagnosis

A presumptive nursing diagnosis is based on reasonable conclusions on nurses knowledge and prior experiences. It can be conducted at the initial stages of patient care or when diagnostic tests are unavailable. It is considered the opposite of a definitive diagnosis (Huber & Gillaspy, 2000).

To conduct a presumptive nursing diagnosis, the nurse needs to interview the patient for their sensory data, study their health history, and conduct a physical assessment, including inspection, palpation, percussion, and auscultation. Following this, the nurse can attempt to interpret the results of the assessment.

The patient is Jessica, a 32-year old female math teacher. She arrived at the ER with complaints about a sudden decrease in vision in the left eye. According to her, she had vision blurring for about a month. This morning, it became especially noticeable, with progressively declining eyesight over the next several hours until she arrived at the ER. The accompanying symptoms were a pain when trying to move the eye, swollen optical disc, and inability to distinguish colors. BP 135/85 mm Hg denotes pre-hypertension, HR 64bpm, and regular.

The presumptive nursing diagnosis, in this case, is disturbed visual sensory perception-related vision alteration, evidenced by an abrupt loss of vision.

The symptoms point to the possibility of optic neuritis. It occurs when the optic nerve, which carries visual information from the eye to the brain, becomes inflamed and causes swelling of the optical disc (Mayo Clinic Staff, 2014).

Its principal symptoms include vision loss in one eye, periocular pain, felt stronger during eye movement, and inability to see colors correctly. Other symptoms that reinforce the presumptive diagnosis are changes to the pupil reactions to bright light, and Uthoffs phenomenon, characterized by vision worsening with increases in body temperature, as reported by the patient.

Further tests should be performed by a physician to produce a definitive diagnosis and determine what may have caused it.

Nursing care plan

The first step in this situation is to conduct a full physical exam to confirm the disorders nature so that an appropriate nursing care plan can be developed. Due to optic neuritis often being caused or associated with the onset of multiple sclerosis, the physician may need to conduct an optical coherence tomography, to study the nerves at the back of the eye, a computed tomography, and a brain MRI, to produce a detailed image of the brain.

The next stage of care would be to inform Jessica about her diagnosis. Since she has not experienced prior symptoms like this, she would need to be provided with full and inclusive information about optic neuritis, what it is, and how it is caused.

Ideally, the information will be delivered in several sections, detailing the possible causes and effects of the disease and what developments she can expect next.

In most cases, this disorder resolves on its own. However, if it is caused by a different disease, like multiple sclerosis, it would necessitate addressing this disease in the teaching and care plans, and organize care to treat it. Once the disease is cured, the optic neuritis will cease as well.

Treatment for optic neuritis includes intravenous methylprednisolone and immunoglobulin, and interferon injections. With them, Jessica can expect complete vision recovery within 6 to 12 months. However, there is a possibility of a varying amount of damage to the optic nerve and resulting in a permanent decrease in eyesight. This is very probable because the recommended time to contact the doctor is within the first two weeks. Consequently, it may be important to include eye care and work with optician into the nursing care plan (Krause & Kim, 2015).

References

Huber, J. T., & Gillaspy, M. L. (2000). Encyclopedic dictionary of AIDS-related terminology. New York: Haworth Information Press.

Krause, L., & Kim, S. (2015). Optic Neuritis. Web.

Mayo Clinic Staff. (2014). Optic neuritis. Web.

Binge-Eating Disorder

Definition: Binge-eating disorder is characterized by eating, in a discrete period (for example, within any 2 hours), an amount of food that is larger than what most people would eat in a similar period under similar circumstances (American Psychiatric Association, 2013, p. 350). Moreover, a person suffering from the disorder feels that he/she loses control over the eating process.

Risk factors: Risk factors can be both genetic and physiological. Binge-eating disorders seem to be related to other forms of maladaptive emotion regulation strategies, such as substance abuse and self-harm (Dingemans et al., 2017, Abstract). The disorder often runs in families, which proves the importance of the genetic factor.

Pathophysiology: People suffering from the disorder consume an excessive amount of food and fail to recognize that while eating. These people typically eat much more rapidly than normal and do not stop until they feel uncomfortably full. Consuming large amounts of food when feeling physically hungry is also an important feature of the disorder. Moreover, such periods of excessive consumption are then followed by feeling embarrassed and depressed afterward.

Types:

• Mild (1-3 binge-eating episodes per week)
• Moderate (4-7 binge-eating episodes per week)
• Severe (8-13 binge-eating episodes per week)
• Extreme (14 or more binge-eating episodes per week)

Diagnostic Criteria: Recurrent episodes of binge eating that occur, on average, at least once per week for 3 months (American Psychiatric Association, 2013, p. 350).

Clinical presentation: Binge-eating typically begins in adolescence but can also start later. The disorder typically occurs in individuals with normal weight or overweight and obese individuals. Loss of control over consuming excessive amounts of food and abandoning efforts to stop it is one of the most important indicators.

Workup: Medical workers should ask the person about his/her eating patterns and note the frequency of binge-eating. Moreover, they should perform a mental status examination.

Management: Restoring a normal nutritional state by providing a plan and encouraging patients is a vital part of treatment. Treatment aims to reduce the binge-eating frequency and disordered eating-related cognitions, improve metabolic health and weight, and regulate mood (Brownley et al., 2016, Abstract). Eating behaviors should be changed in a way that helps accept a more sustainable diet. Altering patients perceptions of food, weight loss, and body shape/size are instrumental in ensuring the long-term effect of clinical management (Black & Andreasen, 2020, p. 268).

Complications: Hormonal abnormalities, sensitivity to temperature, dental problems.

Prognosis: Studying the severity of binge-eating, physiological reasons behind such eating patterns, and all the disorders which are typically initiated by binge-eating provides basic data that allows for prognosis.

Pica Disorder

Definition: Persistent eating of nonnutritive, nonfood substances over at least 1 month or the eating behavior is not part of a culturally supported or socially normative practice (American Psychiatric Association, 2013, p. 330). When eating behavior is inappropriate to the development level of the individual, it is also considered a pica disorder.

Risk factors: Lack of supervision, neglect and developmental delay are the main risk factors.

Pathophysiology: The disorder most commonly occurs in childhood, although adolescence and adulthood onset are also reported. People suffering from the disorder eat nonnutritive and nonfood substances on a persistent basis for at least one month. Such practice may lead to numerous medical emergencies of all types, from acute weight loss to poisoning.

Diagnostic Criteria: Eating nonnutritive and nonfood substances, including paper, soap, cloth, hair, string, wool, soil, chalk, talcum powder, paint, gum, metal, and other types. Generally, for all people who are 2 years old and older, consuming such substances is developmentally inappropriate, given that it is not a part of culturally supported normative practice.

Clinical presentation: Eating non-food substances is generally the only feature that supports the diagnosis. There are generally no biological abnormalities associated with such practice. In many cases, the occurrence of pica becomes vivid only after an emergency, such as poisoning. Ultrasound, abdominal flat plate radiography, and other scanning methods can reveal consumed objects. Moreover, blood tests can point to poisoning or infection.

Workup: Examining the objects that are typically consumed by the patients and analyzing the frequency and the reasons behind such practice.

Management: Helping alter eating patterns and the perception of certain nonfood substances, preventing new cases.

Complications: Often leads to emergencies due to the consumption of potentially dangerous nonfood substances.

Prognosis: Realizing the underlying medical condition, emotional state, or disorder allows for a comprehensive understanding of the nature of pica disorder and ensures an accurate prognosis.

Clinical scenarios

Scenario 1: Binge-Eating Disorder

An obese female presents to the office and states that she has a sense of lack of control over the amount of food she consumes. Eating excessive food, according to her, is followed by embarrassment and depressing thoughts. She says that currently, she does not try to influence her weight.

Differential diagnoses

Symptoms presented in the scenario may correspond to several diseases, such as bulimia nervosa and obesity. Bulimia nervosa typically features recurrent inappropriate compensatory behavior, which is absent in the case of binge-eating disorder. Moreover, people with bulimia nervosa are generally enthusiastic about their sustained dietary restrictions, which are meant to influence their body shape or weight. Although patients with binge-eating disorder may also make some attempts at dieting, they are typically not as frequent do not have certain restrictions. Therefore, the means based on dietary restrictions represent a major feature of bulimia nervosa but do not correspond to binge-eating disorder.

Obesity shares a few characteristics with binge-eating disorder as well. Nevertheless, some features help to distinguish between the two. For instance, obese individuals with the disorder show higher levels of overvaluation of body weight and shape. Moreover, long-term treatment more often leads to a successful result in the case of binge-eating disorder than in the case of obesity. Bipolar and depressive disorders may lead to an increase in appetite. Nevertheless, they do not necessarily lead to a loss of control over the amount of food eaten. Borderline personality disorder symptoms include binge-eating, however, several other criteria are to be met to give such a diagnosis.

Scenario 2: Pica Disorder

A mother and her 8-year-old son were present at the office. The boy consumes chalk and paper on a persistent basis. The boy is very talkative, open, honest, and does not have any intentions to injure himself. He also enjoys eating various types of dishes and is not concerned with his weight.

Differential diagnoses

Several disorders have symptoms that are similar to those of pica disorder. For instance, some people who suffer from anorexia nervosa may consume nonfood substances in an attempt to control appetite. In such cases, anorexia nervosa should be considered the primary diagnosis. Nevertheless, only this initial reasoning behind consuming nonfood objects can point to anorexia nervosa. People suffering from the factitious disorder may intentionally ingest objects as part of the pattern of falsification of physical symptoms (American Psychiatric Association, 2013, p. 331). Nonsuicidal self-injuries and nonsuicidal self-injury behaviors sometimes include episodes in which people deliberately swallow harmful objects. Therefore, understanding the original motivation is instrumental in giving the right diagnosis.

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5®) (5^th ed.). American Psychiatric Pub.

Black, D. W., & Andreasen, N. C. (2020). Introductory textbook of psychiatry (7^th ed.). American Psychiatric Pub.

Brownley, K. A., Berkman, N. D., Peat, C. M., Lohr, K. N., Cullen, K. E., Bann, C. M., & Bulik, C. M. (2016). Binge-eating disorder in adults: a systematic review and meta-analysis. Annals of internal medicine, 165(6), 409420. Web.

Dingemans, A., Danner, U., & Parks, M. (2017). Emotion regulation in binge eating disorder: A review. Nutrients, 9(11), 1274. Web.

Posttraumatic stress disorder is simply a disorder that can develop in human beings following a life-threatening event that has occurred in his or her life. Any individual who has ever experienced such an event tends to keep away from things that might remind them of the past traumatic events.

Posttraumatic stress disorder has a number of causes that include psychological trauma, which can be caused by emotional or physical abuse. Some events that cause trauma can either be rape, accidents, war, illnesses, natural disasters or violent assaults, and many more.

People who are suffering from posttraumatic stress disorders have different symptoms that can last for a couple of days but lift with time (Friedman, 2000). Some people have nightmares, feel numb, and sometimes experience difficulties in stopping having thoughts about what happened. To some people, the symptoms are triggered by activities that make them remember what took place.

Symptoms

There are at least four symptoms of traumas that include experiencing the traumatic event for the second time. When one experiences the event again, he or she gets upsetting memories concerning the event. He or she can also remember past events where they act as if the event is happening again. They sometimes start having nightmares of some frightening events.

There are also some people who feel nausea or even start sweating whenever. The second indication of posttraumatic stress disorder is avoiding anything that will make them remember the event.

The victim keeps away from the people and anything that recollects back the memories of that event. A person can also decide to avoid talking or even thinking about traumatizing past events. There are cases for those who choose to keep themselves busy so that they can shun all the thoughts and talks.

Another symptom is numbing, where one cannot explain what he or she feels. When an individual is numb, he or she loses interest in all kinds of activities and even in life. They normally experience a sense of being lonely where they end up disassociating themselves from others. Most of them think that they need not live in that their life is totally changed.

The fourth symptom is greater stimulation than before, and this is where one has a hard time in getting some sleep. These kinds of people stay awake for long hours without falling asleep due to fear or other factors. They sometimes have a lot of anger, whereby they outburst it to those who seem to bore them. They then try to distance themselves from others because they do not want to be nagged.

People like these have difficulties in concentrating where they find themselves being absent-minded whenever one is talking to them. They also feel nervous and can be easily worried. They find themselves living in a world of tension, and in case of any minor action, they become startled (Kinchin, 2004).

There are other common symptoms, and they include feeling guilty, being ashamed of your self, or even blaming yourself for anything wrong that happens. Some people opt using drugs or even think of committing suicide. There are others who are hopeless in life, feel lonely, have headaches or stomachaches.

People who suffer from posttraumatic stress disorder are advised to seek help immediately when they realize it. These kinds of problems are supposed to be confronted earlier so that one can overcome them easily. Victims should then look for a therapist who will deal with their problems. It is also important for one to identify a therapist with whom they are comfortable. People with such problems need someone who respects and understands them.

Treatment

There are a number of treatments that meant posttraumatic stress disorder that helps them to relieve the symptoms by dealing with the traumas. During treatment, one is encouraged to remember everything about the event, and this helps one to restore his or her sense of control and move on with life normally.

Some of the types of treatment offered to posttraumatic stress disorder include cognitive and behavioral therapy (Myers, 2007). This is where the therapist encourages you to carefully expose yourself to feelings, thoughts, and even situations that will help you remember the trauma. During this treatment, one thinks about the upsetting things and then replaces them with thoughts that have a better picture.

For example, if the trauma was caused by an event of war, one exposes him or herself to things that are related to that event. In this case, one can watch a movie about war so that he or she can remember the event. He or she can also think about raising a fight against someone else and then replace the thought with a peaceful moment.

There is also the treatment of Eye- Movement- Desensitization and Reprocessing. Following cognitive and behavioral therapy, the EMDR stimulates someone and helps in unfreezing the brain. In this kind of treatment, the therapist uses sounds to stimulate the person who is affected.

Another type of treatment is family therapy that helps to bring someone close to his or her family. It helps relatives to understand you and accept you as one of them. There is also another treatment of medication where one can say drugs being prescribed to him or her so that it can relieve secondary symptoms.

References

Myers, D.G. (2007). Psychology, eighth edition, in modules. New York: Worth Publishers. ISBN: 0-7167-7927-7.

Friedman, M (2000). Post Traumatic Stress Disorder: Journal of the Treatment Strategies, 32(6), 47.

Kinchin, D. (2004). Research advances in rheumatoid arthritis. Journal of the American Medical Association, 285(5), 648-650.

Grace is a Latino Female Portuguese speaking from Brazil. She has lived in the USA for six years and is presently undergoing an immigration procedure for a change in legal status. The client has a history of anxiety, is 10 years into a marriage with two children, and has experienced abuse from her spouse in the past. She is presently going through immigration procedures to change her legal status, but because of early warning signs of violence, she has gone as far as to consider divorce. Being a Christian, she aims to resolve her problem in line with biblical law. Grace has reported that she is quite unhappy with her life and the isolation from close friends and family for 6 years has taken quite a toll on her moods.

Grace seems to be suffering from a major depressive disorder which has forced her to take up a negative view of herself. The fact that she suffers from anxiety proves her low level of self-worth and worry which is not advisable for someone battling depression. Having moved to the united states 6 years ago implies that she has lost vital ties with her friends and family and the home environment she thrives in derives her from any pleasurable activities which can be applied to curb the aftermath.

Her goals for change in this case revolve around treatment achievements for a depressive disorder which can only be curbed through the application of CBT. She needs to understand the connection which comes with mood and negative self-talk as well as take up legal measures that can help curb her issues at home. She is required to increase positive talk towards herself and engage in numerous non-depressive activities. By so doing the treatment will enable her to reduce reinforcing depressed attitudes on herself and boost her intent to increase relational schemas towards blended activities which help reduce conflict thus resulting in a decrease in depressive establishers.

Currently, she has attended 10 individual sessions of CBT towards overcoming depression. Through the intervention, she has a better route in engaging self-worth which will allow her to realize the importance of self-care and positive self-talk. As a result, there is a need for a develop and test hypotheses related to her case. The skills learned during these sessions are meant to equip her with problem-solving skills that will come to play when handling her abusive husband, staying true to her marriage, and skills through which she can address her differences. To challenge normality, one is required to learn how distorted thinking works when handled with positive engagement.

By challenging herself to solve her problems instead of battling them out she is expected to increase her mastery and at the same time gain pleasurable experiences from her surroundings. The relaxation curve will in turn enable her to exist outside her issues while dealing with them.

Grace appears to be stuck in limbo since, her doctrines dont stand for divorce, and however they dont also support acts of self-centeredness which she would be tapping into if she holds on only to get the immigration done. The technique is bound to help her save her marriage and realize her worth without having to go against any of her beliefs. Assessing grace I came to realize that her being highly reliant on faith makes it hard to approach a legal path towards her marriage which would only end in divorce and termination of her immigration. Her position alone makes her desperate and vulnerable which in most cases results in manipulation.

By talking to her friend she had no intention of cheating on her husband instead she just needed a listening ear to vent out to. Her unhappiness is emanating directly from her marriage and this is causing her a great deal of pain which has left her prone to panic attacks resulting in major depression symptoms. By attending the sessions the client has depicted a high rank of bravery and signifies her hope for things to become better.

DSM-5 Diagnosis

• F 41: Generalized Anxiety disorder

Rationale

Grace is experiencing a continuum of depressive situations and has met the DSM-5 Criteria for major depressive disorder. She has been experiencing unhappiness and a BDI level of 23 terming herself as feeling sad all the time. Her symptoms major around someone who wants to be alone most of the time just to avoid the chaos but is still required to be there for her family. Thus my diagnosis points out to a major depressive order. Based on the continued abusive behavior of her husband one can also term family disruption as a factor in her case (Bains & Abdijadid 2022). She remarked on how she had vented out and her husband had immediately signaled for divorce which is quite odd considering the established situation, however, more data is required to internalize this notion as an issue towards her marriage. Her husbands long abusive streak was considered first since she had held on for 6 years and managed to birth children which makes it null in this case. Her issue seems to be long-term which lays them in line with a depressive episode.

Case Conceptualization

Client Concerns

1. Unhappiness.
2. Low self-worth.
3. Worry about marriage.
4. Withdrawal from close family and friends.
5. Fear of venting out to friends.
6. Worried about immigration.
7. Abusive husband.

Descriptive Diagnostic

Major depressive disorder.

Theoretical Inferences

Grace has showcased maladaptive thinking towards her marriage, the fear of losing her husband and kids as well as staying true to her Christian doctrines resulting in low perceptive thing and lack of self-worth

Narrowed Inferences

Major depressive disorder

(CBT): I am always unhappy

Narrative

The main purpose behind the use of case conceptualization techniques is to comprehend the situation itself. Grace tried venting out to her friend which resulted in issues within her marriage. She has showcased a subtle amount of negative behaviors and maladaptive thinking which has generally resulted in her falling into depression. She states that she is always unhappy which in this case is quite unhealthy for someone in her position. Her belief of helplessness seemed to be majoring around the issue of her deportation to which her instinct is the application of faith and belief.

Treatment Plan

References

Bains, N., & Abdijadid, S. (2022). Major depressive disorder. In StatPearls [Internet]. StatPearls Publishing.

Introduction

The behaviour described in case scenario 2 is a clear case of psychosis. Jack gets agitated and appears to have a serious feeling of nervousness. He appears to be so disoriented and does not allow anyone to touch or cool him down. However, amidst being caught in the feeling of agitation, he still recognizes some people and the purpose for which they are present at the restaurant. He decides to speak at times and get quiet after a while. My attempt as a psychologist to perform observation of vital signs on him fails as he gets more agitated.

Psychosis is a combination of mental related symptoms, which include hallucinations and delusions. With delusions, the patients develop the feeling that certain people who are unknown to them want to hurt them (Compton & Broussard 2009, p. 4). The patients also become confused and at times suffer from disturbed thinking. Psychotic conditions vary greatly but these discrepancies depend on each patient. For some patients, the conditions can last for a short time while for others the conditions can stay for as long as they do not seek medical attention (Freudenreich 2008, p. 3).

On the other hand, confabulation disorder refers to a problem of behaviour that is mainly characterized by production of false memories. Memories that are confabulated may also be characterized by a confused combination of events, which may be real. Unlike psychosis, confabulated minds have some elements of truth in them. People with confabulated memories require close attention from caregivers, who can understand and assist them in whatever they do (Schnider 2008, p. 45).

In most cases, people who suffer from psychosis do not know that they have the condition. Most psychotic patients believe that the delusions they experience are factual (Freudenreich 2008, p. 3). For instance, they believe and feel that it is real that unknown people are after hurting them. Psychosis is a sign that an individual is suffering from schizoaffective disorder, bipolar disorder, and/or schizophrenia. Psychotic conditions may be triggered by substance abuse, sleep deprivation, severe depression or severe anxiety. It is recommended that people who experience symptoms of psychosis seek medical assistance as soon as they begin to see such indications (Compton & Broussard 2009, p. 9).

Mental State Assessment and Symptoms of Psychosis

There are several mental assessments that can be performed to determine if an individual may be suffering from psychosis like in the case of Jack. Firstly, these individuals are always confused and they show an aspect of disturbed thoughts. They will appear to have in their minds different and mixed ideas; their minds appear to be speeding up at times and speeding down at other times (Compton & Broussard 2009, p. 11). In the case of Jack, he seems to be having mixed ideas; for example, his mind speeds up as he stands to pace up and down while in the restaurant.

It is easier to notice that someone is suffering from psychosis by studying the way they think, which may be reflected by the way they speak. For instance, these individuals may find themselves talking very fast without stopping to listen to anyone. Sometimes, they can stop talking abruptly without completing their statements (Wallace 2008, p. 62). Individuals with serious psychotic conditions may say senseless things. As a result of the senseless statements they make and their unwillingness to converse, it may be difficult to engage psychotic people in any meaningful conversation (Capps 2010, p. 161). All these are evident in Jacks case as he speaks so many words and suddenly goes into silence. He cannot coherently answer the questions that he is asked by the psychologist.

Another major characteristic of psychosis is delusion; people who suffer from psychosis normally have strong beliefs, which in most cases are neither true nor provable. They strongly believe that the delusions are true, which is clear in the way they behave or speak (Larkin & Morrison 2007, p. 105). The delusions may become worse when these people believe that some other people are after their lives and are conspiring to hurt or to kill them. In the case scenario 2, Jacks behaviour shows that he is likely to be suffering from psychosis (Capps 2010, p. 166). At the incident where he refuses to be touched by anyone, maybe he feels that the people in the restaurant are against him and could be planning evil things against him.

In other cases, people with psychosis believe that they possess strong power and are able to rule the people around them (Freudenreich 2008, p. 7). For instance, people with religious delusions have a feeling that they are very close to God and should be considered very important in the society. The problem comes when other people fail to notice the role played by the victims suffering from delusions; they regard themselves as celebrities (Larkin & Morrison 2007, p. 108). As a result, they may become angry or agitated as witnessed in the case of Jack.

The unexplained sudden change of behaviour is also considered a symptom of psychosis. People who suffer from psychosis may suddenly become overwhelmed by things that others do not understand (Wallace 2008, p. 67). For instance, people who were initially unwell may suddenly become excited when they begin experiencing psychosis. They may refuse to associate with other people and may not want anyone to get close to them as witnessed in Jacks case. They may also experience mixed feelings of loneliness and begin withdrawing from people around them (Wallace 2008, p. 69).

Lastly, people suffering from advanced psychosis may be so frightened and agitated that they may fail to differentiate whatever they feel from reality. At this point, the patients may fail to think sensibly and are never in a position to explain how they feel. They may come up with funny things and insist on carrying them out (Capps 2010, p. 174). For instance, in the case scenario Jack insists on calling his sister but is unable to explain why he wants to talk to her. He gets so confused and eventually becomes disoriented.

Causes of Psychosis

Psychosis as a mental disorder is caused by combined forces of social and biological factors. However, in some cases, psychosis may be caused purely by one of the factors without interacting with the others (Cardinal & Bullmore 2011, p. 64). In the case of schizophrenia, the disorder is known to come up as a result of impaired chemical composure of the brain. However, the condition in the case of schizophrenia can be worsened by social factors such as lack of family love and support or severe stress (First & Tasman 2010, p. 134).

Social factors such as stress, depression and trauma are known to bring about brief psychotic disorder, which is a short-term type of psychosis. These social factors may be caused by major life changing events such as floods, death of a family member and poor work conditions. The social conditions are known to trigger brief psychotic disorder in most patients, even in those without history of any psychological disorder (Love 2009, p. 48).

In the case of a delusional condition, both hereditary and biological factors are among the main causes. Specifically, a sudden change in brain chemistry and neurological abnormalities are known to cause delusional disorders (Cardinal & Bullmore 2011, p. 66). In most cases, the psychological disorder is triggered by abnormalities in the limbic system. Limbic system is a part of the brain, which is located in the inner edge of the cerebral cortex, and is responsible for regulation of emotions (Love 2009, p. 51).

Psychosis may also be caused by misuse of drugs especially the strong ones. Other people who are also vulnerable to suffering from psychosis are the drug abusers. The most common drugs in this category are recreational drugs, which include PCP, cocaine, alcohol and marijuana. They can make the users experience psychosis when they use or withdraw from using them. There are some drugs that are known to cause the disorder; these substances are mainly steroids and chemotherapeutic medicines (First & Tasman 2010, p. 136).

Lastly, psychosis may also be stimulated by organic and environmental factors. Some of the organic causes include metabolic conditions such as porphyria, neurological factors, endocrine factors such as hypothyroidism, improper balance of body electrolytes, and renal malfunction. Substance-induced psychosis is another type of psychotic disorder that comes up as a result of environmental pollution (Cardinal & Bullmore 2011, p. 68).

How to Deal with Psychosis

There are several interventions that can be put in place to deal with or to treat psychosis. The first intervention is medication, which is mostly used to assuage psychotic symptoms. The difficulty involved in medication prescription is that it is not easy to determine the kind of medicine that suits an individual (Lauriello & Pallanti 2012, p. 92). For that reason, a number of medication adjustments may be done until the patient begins showing positive response. Unfortunately, some of the medications may have adverse side effects such as restlessness, dry mouth, and drowsiness. However, most of the side effects have been taken care of by the newer generation of medications, which have less of such outcomes (Rothschild 2009, p. 78).

The families of the individuals who suffer from psychosis can also be encouraged to form self or join self help groups through which they can devise ways to assist their patients. For instance, through the help groups they can establish supportive strategies and push for establishment of public education and other community based programs. Through the help groups, people who have suffered from psychosis can provide consultation services, advice and peer support to the current patients of psychosis (Rothschild 2009, p. 81).

The conditions of people with psychosis may also be improved by putting them on healthy nutrition, adequate rest and proper physical exercise. Healthy nutrition with a well balanced diet is good particularly for the patients who are suffering from other complications besides psychosis. A psychotic condition that is triggered by stress and sleep deprivation can be corrected by adequate rest. Daily exercises may also assist in treating psychosis especially when it is stimulated by trauma and stress (Rothschild 2009, p. 84).

For serious conditions of psychosis, the patients need to be hospitalised and regular checkups done on them to monitor their progress. It is only in hospital that proper observations and assessments can be done to determine the correct medication prescriptions for an individual who has acute psychosis (Lauriello & Pallanti 2012, p. 93). The trained nurses and psychologists found in hospitals are able to provide proper medical attention and protection for the serious cases. After recovery and discharge of the patient, he or she should be subjected to regular checkups offered by a professional to minimise the probability of a relapse (Lauriello & Pallanti 2012, p. 94).

All the cases of psychosis require psychological therapy and counselling to improve the condition of the patients and to lessen the chances of a relapse. People with psychosis require people who understand their conditions. The type of therapy administered to a patient depends on the level of the psychotic episode experienced by him or her. During such therapies and counselling sessions, patients get an opportunity to learn practical ways of improving their psychological wellbeing such as stress management, which can be used to prevent a relapse (Love 2009, p. 53).

Summary and Conclusion

The behaviour, moods, and conduct described in case scenario 2 are symptoms of psychosis. Jack, the patient in the case scenario, is without a doubt suffering from psychosis. Psychosis is a combination of mental related symptoms, which mainly include hallucinations and delusions. Psychotic conditions interfere with the way someone behaves, talks, and the way he associates with people around him. Some of the factors that cause psychosis include sleep deprivation, stress, trauma, and abnormalities in the chemistry of brain. The most effective measures that can be used to treat psychosis include family support, rehabilitation programs, medication, hospitalisation, counselling and therapy.

References

Capps, D 2010, Understanding psychosis: issues and challenges for sufferers, families, and friends, Rowman & Littlefield, Lanham, MD.

Cardinal, RN & Bullmore, E 2011, The diagnosis of psychosis, Cambridge University Press, Cambridge.

Compton, MT & Broussard, B 2009, The first episode of psychosis: a guide for patients and their families, Oxford University Press, Oxford.

First, MB & Tasman, A 2010, Clinical guide to the diagnosis and treatment of mental disorders, Wiley-Blackwell, Hoboken, NJ.

Freudenreich, O 2008, Psychotic disorders: a practical guide, Wolters Kluwer Health, Philadelphia, PA.

Larkin, W & Morrison, AP 2007, Trauma and psychosis: new directions for theory and therapy, Taylor & Francis Group, New York, NY.

Lauriello, J & Pallanti, S 2012, Clinical manual for treatment of schizophrenia, American Psychiatric Pub., Washington, DC.

Love, JC 2009, Psychosis in the family: the journey of a psychotherapist and mother, Karnac Books, London.

Rothschild, AJ 2009, Clinical manual for the diagnosis and treatment of psychotic depression, American Psychiatric Pub., Washington, DC.

Schnider, A 2008, The confabulating mind: how the brain creates reality, Oxford University Press, Oxford.

Wallace, HJ 2008, Inner signs and symptoms in psychosis, Pen Publisher, Oxford.

Introduction

Poor sleep is a health issue that affects children, adolescents, and adults, with insufficient rest contributing to various physical and emotional health issues. Due to this, increasing public knowledge of how sleep improvement can improve health, wellness, productivity, and life quality is among the Healthy People 2020 goals. Sleep is seen as a critical determinant of well-being in the plan because its absence can lead to the development of problems in productivity, interpersonal relationships, mental health, and physical stability. In this paper, the topic of sleep health will be explored in great detail, with particular attention placed on the needs of the target population, the exploration of demographic and epidemiologic data, as well as the identification of interventions that would improve sleep health.

Target Population

The target population of adolescents and young adults at Downers Grove, IL, is chosen for the present exploration as they are greatly affected by inadequate sleep. The population is more vulnerable to chronic sleep deficiency compared to adults as reported by Zitting et al. (2018). Poor sleep in the group adolescent individuals and young adults has been reported worldwide, as evidenced in the study by Bruce, Lunt, and McDonagh (2017) who investigated the issue in the UK context.

It was found that 30% of males and 49% of females in the group reported sleep issues and the subsequent difficulties related to concentration on school and work (Bruce et al., 2017, p. 425). The increased issues with sleep health have been attributed to the reduced urge to fall asleep in adolescents linked to a biological delay in the timing of sleep onset (Bruce et al,. 2017). However, the need to rise early for school remains constant, which creates issues with tiredness during the day.

Healthy People 2020 Goals and Objectives

As stated in the Healthy People 2020 component associated with sleep health, the burden of chronic sleep loss and sleep disorders deteriorates due to the decreased awareness of the public, health care professionals, and policymakers (Healthy People 2020, 2020).

Thus, the goal of the program is to increase the awareness of the mentioned groups of how the achievement of adequate sleep can improve the overall health of the population as well as facilitate safety in the workplace and such public areas as roads. There are four distinct objectives established for the Healthy People 2020 sleep health program. The first objective is to increase the number of people with obstructive sleep apnea who seek medical attention. The second is to reduce the rate of drowsy driving-related vehicular crashes per 100 miles. The third is to increase the percentage of students in grades 9-12 who get enough sleep (Figure 1). The fourth is to increase the rate of adults who get enough sleep.

Sleep Health Interventions

The overall improvement of sleep health among the target population has been explored from the perspective of interventions. For example, as proposed by Jespersen, Koenig, Jennum, and Vuust (2015), music can be used as a tool to help adults decrease the occurrence of insomnia. According to the researchers, randomized and quasi-randomized controlled trials showed that listening to music with no treatment or treatment-as-usual can improve sleep health in adults struggling with insomnia (Jespersen et al., 2015, p. 1). Interventions that use music to facilitate better sleep are easy to implement and can facilitate the improvement of the overall well-being of adolescents and young people who do not get enough sleep.

Another intervention for improving sleep health was proposed by John, Bellipady, and Bhat (2016), who developed a set of sleep promotion sessions for the target population. For two days, the subjects of intervention were expected to participate in visualization training, which implied a video-based training using imagery for stress reduction and relaxation (John et al., 2016, p. 2). Furthermore, the participants would be given tips for time management in order to be equipped with full information on how to deal with insufficient sleep.

Such an intervention provides a multi-dimensional approach toward sleep management and offers people an opportunity to be better at managing their time and relaxing before falling asleep. The target population can easily follow the stress reduction procedures recommended during training sessions and thus improve their capacity of falling asleep.

Conclusion

The issue of poor sleep health affects adolescents and young adults because of the biological delays occurring in the timing of sleep onset, causing them to stay awake later (Bruce et al., 2017). Due to such a change, maintaining the health of this target population is imperative as it presents significant challenges to well-being. The Healthy People 2020 plan associated with sleep health intends to facilitate the improvement of the issue with the help of cohesive interventions.

For adolescents and young adults, holistic programs represent the basis for health improvement. Using relaxation techniques is recommended to help individuals struggling with poor sleep to get into a mindset of rest and decrease worrying and anxiety. However, interventions intended to improve sleep health are currently limited, which points to the need to study the issue further, with special focus placed on adolescents and young adults.

References

Bruce, E. S., Lunt, L., & McDonagh, J. E. (2017). Sleep in adolescents and young adults. Clinical Medicine, 17(5), 424-428.

Healthy People 2020. (2020). Sleep health. Web.

Jespersen, K., Koenig, J., & Vuust, P. (2015). Music for insomnia in adults. Cochrane Systematic Review  Intervention. Web.

John, B., Bellipady, S. S., & Bhat, S. U. (2016). Sleep promotion program for improving sleep behaviors in adolescents: A randomized controlled pilot study. Scientifica, 2016, 8013431.

Zitting, K. M., Münch, M. Y., Cain, S. W., Wang, W., Wong, A., Ronda, J. M., & Duffy, J. F. (2018). Young adults are more vulnerable to chronic sleep deficiency and recurrent circadian disruption than older adults. Scientific Reports, 8(1), 11052.

In terms of modern technology-based society, media exposure has significantly increased its influence and role in the lives of its large audience. However, the variety of media outlets has the power to adversely impact the public mindset and deeply-embedded perception of the human body and beauty standards. As such, media tends to send a strong message claiming that the general population values thin, white, and able bodies over the rest of the human body types (Grabe, Ward, and Hyde, 2008, p. 460). Such a damaging and controversial statement inadvertently neglects the uniqueness and differences of the female body, in particular, and poses critical threats to the development of mental disorders. The existing research found a close linkage between the prevalence of media exposure and the increase of eating disorders among girls and young women.

The Changing Role of Media Concerning Body Image

Over the past few years, many young girls and women demonstrated an enhanced level of severe dissatisfaction with their own body image and appearance based on biased strict beauty standards. The latter are continually imposed by the mass media and long-established modelling parameters. It is essential to consider why the predominant image of the female body is much thinner compared to the past depiction of the female forms and the actual modern and diverse female population. More specifically, the media is mainly targeted at young girls, adolescences, and women, and is filled with the unachievable and outrageous ideal of a female body (Grabe et al., 2008). The studies also emphasize the communications theories, which claim that the recurrent impact of media makes the audience to accept the established media portrayals as representations of reality.

Media Exposure Effects

The modern body image representation on mass media comprises the culturally-ideal lean, tall, and youthful body shape for women and a muscular physique for men. Such characteristics and standards are considered a primary impetus behind the rise in eating disorders (ED) symptoms. Hausenblas, Campbell, Menzel, Doughty, Levine, and Thompson (2013) state that viewing the images of the contradictory ideal body results in enhanced depression and anger and a decrease in self-esteem. Moreover, it is a repeated acute media exposure, which cultivates, triggers, and strengthens chronic body image concern and eating disturbance for individuals at an increased risk for ED. According to Hausenblas et al. (2013), high-risk individuals include those overweight and obese, biased of a thin ideal of beauty, high self-objectifiers, low self-esteem, and already experiencing disordered eating. Therefore, there is a causal relationship between idealized images and such adverse outcomes for both physical and mental health due to the regular access to media exposure.

Media Literacy Prevention of Eating Disorders

Eating disorders (ED) are mental illnesses commonly caused by external environmental factors that affect ones ability to pursue healthy eating habits. The consequent destructive dietary patterns result from the interaction of biological, psychological, and environmental components (Le, Barendregt, Hay, and Mihalopoulos, 2017, p. 6). Furthermore, people suffering from anorexia, bulimia, or binge eating disorder, hold an increased obsession over self-image and sense of shame overeating food. Such a set of properties consume a persons daily thoughts and actions. Le at al. (2017) s findings include that media literacy interventions critically eliminate shape and weight issues for both females and males in terms of universal ED prevention. McLean, Wertheim, Masters, and Paxton (2017) state that healthy media literacy is crucial for social activities and should aim towards enhanced critical thinking and scepticism about media. Media literacy (ML) prevention methods were proved efficient in eliminating ED risk factors, such as body dissatisfaction, weight and shape concern, as well as the related symptoms.

Media literacy intervention was followed by self-esteem enhancement, obesity prevention, and multicomponent interventions. It was the only prevention method superior to other active intervention controls in diminishing media internalization of males. As described by Levine and Smolak (2020), the main goal for ML prevention implies resisting unhealthy cultural messages regarding gender, weight, shape, and control, and forming healthier ecology for each actively involved media user. Thus, a well-developed media literacy in modern society provides an opportunity for transforming offensive media into its healthier forms and messages without stigmatized effects. With this said, the adverse effects of media exposure can be regarded as the lack of media literacy and inadequately constituted messages affecting society. Even in its smallest terms, every form of media outlets has a critically strong and powerful impact on manipulating the human mind and shaping the general perception of good and bad body image.

Conclusion

The researchers commonly argue that the exposure to mass media appreciating the thin-ideal female body is inherently associated with body image disturbance in women. Idealized visual content imposing unattainable body figure has the harmful and substantial influence on the audience already at risk for developing an eating disorder. The lack of media literacy directly defines the inadequateness of media exposure, specifically concerning the biased body image perspective. Based on the examined research and personal perception of media effects, media literacy should reinforce proficiency in building media platforms to reduce its persuasive negative influence. The modern media environment needs to be transformed towards equitable, tolerant, and respectful platform appreciating all the existing body shapes and their uniqueness, thus, significantly reducing the level of eating disorder symptoms.

References

Grabe, S., Ward, L. M., & Hyde, J. S. (2008). The role of the media in body image concerns among women: A meta-analysis of experimental and correlational studies. Psychological Bulletin, 134(3), 460476. Web.

Hausenblas, H. A., Campbell, A., Menzel, J. E., Doughty, J., Levine, M., & Thompson, J. K. (2013). Media effects of experimental presentation of the ideal physique on eating disorder symptoms: A meta-analysis of laboratory studies. Clinical Psychology Review, 33(1), 168181. Web.

Le, L. K.-D., Barendregt, J. J., Hay, P., & Mihalopoulos, C. (2017). Prevention of eating disorders: A systematic review and meta-analysis. Clinical Psychology Review, 53, 4658. Web.

Levine, M. P., & Smolak, L. (2020). The prevention of eating problems and eating disorders: Theories, research, and applications. Routledge.

McLean, S. A., Wertheim, E. H., Masters, J., & Paxton, S. J. (2017). A pilot evaluation of a social media literacy intervention to reduce risk factors for eating disorders. International Journal of Eating Disorders, 50(7), 847851. Web.

The most common disorders of neuropsychiatric development are cerebral palsy and epilepsy. Therefore, it is important to identify the features of teaching children with these disorders in educational institutions (Hallahan et al., 2020). All the features of children with cerebral palsy depend on the severity of the disease. For children with cerebral palsy with a degree that allows them to go to a regular school, it is important to treat them as ordinary children. This helps the child to keep up with others and not feel sorry for themselves. If we talk about children suffering from epilepsy, it is important for the teacher to know what an epileptic seizure looks like. The teacher should be able to differentiate an epileptic attack from a hysterical condition to have time to call doctor or give first help to the child.

Reference

Hallahan, D. P., Pullen, P. C., Kauffman, J. M., & Badar, J. (2020). Exceptional learners. In Oxford Research Encyclopedia of Education.

Problem description

The student exhibits a learning disorder, which involves social withdrawal and adverse educational performance. In this regard, the student does not relate well with other students and does not complete schoolwork assignments as expected.

Behavioral program

The behavioral intervention program determines behavioral symptoms of a student. In this regard, the student should exhibit signs of social isolation and inability to perform in academics. Other signs of behavioral problems associated with social withdrawal and isolation include extreme low self-esteem and difficulty in coping with a community school environment (Rubin & Coplan, 2004).

The program resources include a single teacher with specialized qualifications. An additional specialized education assistant for each class with special needs students is recommended. Availability of Learning Support Services (LSS) personnel is vital in the evaluation of the special education plan. LSS personnel also offer consultative services to special needs instructors.

Program goals

A major goal of the special education plan is to provide a learning environment that promotes the development of social skills for students requiring special attention. The special education plan allows integration of classroom and school activities to allow social interaction among students (Avramidis & Norwich, 2002). Continuous assessment and evaluation by parents is encouraged as an on-going activity throughout the special education plan.

Program activities

According to McCarney, Wunderlich & Bauer (1988), encouraging students using reinforcements in the form of tangible and intangible rewards is effective. Examples of tangible and intangible rewards include additional free time and praises respectively. Talking to the student and explaining the importance of socializing and completing assignments is essential. Special needs instructors are encouraged to establish classroom rules. Example of classroom rules includes rules on assignments duration and assignments requirements. Teachers are sometimes encouraged to agree with the student on expected behaviors, preferably through a written agreement.

Assigning other students to help others who find difficulty in working on assignment tasks is also recommended. However, the teacher is required to ascertain the degree of an assignment difficulty against the students ability to perform on the same. Assigning students tasks with a short duration of time and in an interesting manner is necessary. A special needs teacher is required to interact frequently with a student to develop interpersonal trust and skills. Sometimes, allowing additional time and lessons for a special needs student is considered professional. Moreover, the teacher is encouraged to use alternative assignments to assess the intellectual ability of the student.

Communication between the students parents and the teacher is critical in sharing of vital information that may reinforce the students behavior. Using group discussions where each student is given a task is essential in developing social and communication skills. The special needs student can be encouraged to use alternative means in completing an assignment. For example, the student can use calculators, objects or answer answers orally. Increased opportunities that aid in improving a students academic performance should be created. Such opportunities should be in the form of peer tutoring, teacher-student interactions and student-student interactions.

Evaluation methods

As indicated earlier, program evaluations are conducted throughout the year. Moreover, a students progress and performance are reported and recorded in structured report cards. An annual review of the students performance against the program goals and expectations is mandatory.

Alternative placements

School administration is required to meet parents and discuss activities of a special education plan. These activities may include special treatment program for the student, regular support and monitoring by a special Learner Student Teacher (LST).

References

Avramidis, E., & Norwich, B. (2002). Teachers attitudes towards integration/inclusion: A review of the literature. European Journal of Special Needs Education, 17(2), 129-147.

McCarney, S. B., Wunderlich, K. C., & Bauer, A. M. (1988). The pre-referral intervention manual. Columbia, MO: Hawthorne Educational Services.

Rubin, K. H., & Coplan, R. J. (2004). Paying attention to and not neglecting social withdrawal and social isolation. Merrill-Palmer Quarterly, 50(4), 506-534.