Medical Assessment Paper

Brandon Mishamp is a 47 year old man who has been diagnosed to have developmental diabetes that is noted to be a chronic degenerative disease making him develop more and more physical problems and mentally weakening symptoms which in turn makes it harder for him to survive everyday health challenges. There had been a series of continuous medication that Brandon was scheduled to take. The most important matter to consider though is the way by which he is taking the situation that he is under.

No matter how directive the taking of medicine may be, it is still highly important to consider that the entire process of healing could be made faster if they are given the right chance to handle the situations that they are under. Since the situation is degenerative, then that means that the situation is prolonged as well as the agony that exists among those who are suffering from the said illness. Considerably, dealing with the issue becomes hard to deal with especially with the fact that accompanies the situation which is hard to get away from.

Positively though, experts believe that handling this situation could be done through effective psychological process. The Medical Crisis Counseling process is actually believed as one of the procedures most effective to deal with the situation. ASSESSMENT Based from observation, it could be said that the patient is able to try to see his health situation in a much effective way that makes it easier for him to see to the different challenges that are happening to him in a much reasonable way.

Truthfully, it could be said that this attitude of the patient is of course a positive matter that could possibly help him endure the different health problems that are still to come along the way. For this reason, the approach that has been observed to possibly have a great impact on the patient is that of MCC psychological therapy which would simply be implemented to help the patient endure the physical changes that he has to undergo during medication and the entire time that he needs to undergo the different medications that has been set for him to complete.

Taking considerable steps in giving careful assumptions to the feelings and the mental perspectives of the patient is a rather important factor to understand in pursuing this approach. It is then truthfully assessed that applying it needs careful preparation on the part of the counselor who is to handle the case. HISTORY Having a type 2 diabetes [non-insulin dependent diabetes mellitus], the patient is observed to be an obese individual. Although he keeps a good diet as he claims, the situation does not seem easy to undergo.

As much as it is, the patient has undergone different medical therapies already that helped him to have a diet that is most applicable for his health situation. Completing everything though might have naturally caused different problems to the patient being treated with the said procedures. For this reason, it has been noted that counseling procedures could be used to at least make it easier for the patient to accept the situations that are coming to him as he tries to endure the present changes that he needs to deal with as part of his medication as well. DIAGNOSIS

After a series of several tests, it has been seen that his alcoholism has been one of the primary causes of the entire situation that he is facing at present. This is why the type II diabetes diagnosis has been established and thus is processed for complete recovery on the part of the patient. Seeing that the issues are now branched out to two and not simply that of dealing with the diabetic health problems of the patient, it is then expected that the counselor appointed would see to it that both branches of problem could actually be given careful attention during the therapy application.

ISSUES One of the primary issues seen as the major cause of the developing diabetes of the patient is that of alcoholic dependency. This is why it has been decided by the counselor in charge of assisting him that find better ways to at least help the patient overcome his alcoholism first before he could actually be helped to see the different situations of health illness that he is facing right now in connection with the developing diabetes case that he has incurred. To be able to mix up the process for the best benefit of the patient, the next chapter shall show the process. TREATMENT PLAN

To be able to come up with the necessary useful process of dealing with the case, it should be noted that the process should first be outlines as to what needs to be addressed with the situation of the patient to be treated. The following points are the primary issues to be treated within the patient’s situation: • Dealing with the denial of the patient with regards his actual situation • Assisting the patient to understand how alcoholism affects his personal relationships with his family as well as with his work mates and friends. • Making the patient realize the negative part of the situation that he is in

• Assisting the patient recognize the most possible process of recovery that is most convenient on his part Through these points, the process of treatment could be outlined and made certain as to how they are supposed to impact the process of treatment that is to be utilized to deal with the situation of the patient. It is undeniable that the process is supposed to be focused on the realization of the patient first then gradually assisting him to recognizing the hope that he still has with regards the aim of changing that he is supposed to adapt to during the treatment process. Part 2: The Pyramid A: Skills Integration

The therapist should understand the personality of the individual and how the possible treatments would affect him and his behavior towards the situation that he is facing at present. Through the skills and experience of the therapist, understanding the case shall be based upon the past and the present situations that the patient is dealing with. B: Influencing Skills and Strategies The presentation of the skills of the therapist shall be given high regard in connection with the ability that he has upon the importance of allowing the patient decide on his own wanted process of treatment that he is supposed to receive.

The therapist should believe, that as a grown man, he has to have a say on what he is supposed to receive from the treatment. C: 5 Stages of Interviewing 1. Conditioning: preparation for the patient’s availability and behavior towards the interview. The therapist is expected to prepare the patient in this stage of the interviewee. Making him at ease with the environment of the interview shall help him understand the importance of the preparation of the interview. 2. acquaintanceship: knowing the interviewee better

In this stage, finding the common ground between the therapist and the patient is the focus of the process. The therapist should be able to encourage the patient to open himself up to the point that he is able to understand the fact why he is seeing the therapist and meeting the appointments for the treatment that he is supposed to receive from the therapy prepared by the proctor of the process [the therapist]. 3. Questioning: asking the questions for behavioral assessment The following questions are prepared for application:

• How have your drinking apparently affected your personal life and how do you measure your capability of controlling the results of your acts? • Are you able to see the possibilities with which you are able to change for a better person that you could be in connection with the situation that you are facing right now? • How are you planning to face the difficulties brought to you by drinking, or do you even see the dangers of your addiction? • Are you willing to accept that you are addicted to alcohol beverages? 4. Monitoring of Responses: Observation of the answers of the client

Evaluation of the responses of the patient with regards these particular questionnaires shall help the therapist assess the possible procedures of treating the situation of the patient. It is undeniable that through this process, the therapist would be able to measure the capabilities of the patient and what is to be expected from him as the therapy is to be performed for his benefit. 5. Generalization and Summary: Gathering the responses and assessing their connection with the situation being faced by the client at present

After the interview and the assessment of the patient’s responses, the therapist is now ready to prepare the treatment to be applied in the case of the patient’s situation. D: Reflection on Feelings Through the interview performed during the process, the therapist is expected to make assessments on the situation faced by the patients. He or she is supposed to evaluate the answers as to how they reflect the emotional disposition of the patient. From the motional assessment of the therapist, she or he would be able to take precautions as to how to treat the emotional status of the patient during the treatment.

E: Encouraging Summarizing of the Narration The psychiatrist needs to encourage the client in narrating the experiences that he once had through a summarized procedure whereas the top most important part of the interview would be given ample point of attention. This could help the psychiatrist resolve the issue in a much easier and faster procedure. Most likely, this would allow the entire process to take a more certain path that could lead to more effective results. F: Application of Open-Ended Questions Therapist: How were you introduced to drinking alcohol drinks?

Patient: I was introduced to alcoholic beverages during my 16th year of age and started drinking since then. Later on…. [let the patient relate the details as he remembers them as they happened to him] Therapist: What were your first reactions to the drinking process you were introduced with? Patient: like others, I first did not like the taste of the liquor, however, as the time passes, I began to look for the taste…. [listen to the reasoning of the patient and identify if he is able to recognize the fact that he is already in a serious situation with regards the addiction]

Therapist: Were you able to control the first times of your drinking, and are you still able to control yourself from drinking now? Patient: I have been notably involved with the alcoholic beverages. I had been able to control the drinking at first…. [observe if the patient is willing to admit that he is addicted to the substance] G: Attendance and Behavior of Patient As the patient continues to attend the appointments, it could be observed that he is willing to at least deal with his problem; that although he denies his addiction, he is still convinced that there is indeed a problem with his behavior.

Through this, the therapist should make use of the chance to help the patient understand his status in the situation. H: Ethics, Learning and Competence Therapist Ethically, everything must be confidential. Respecting the privacy of the client is of utmost importance. Hence, giving him the chance to decide on what should be done as per agreed between him and his therapist should assist him in trusting the therapist and the treatment that is to be given to him by professional arrangements.

To be able to gain the client’s trust, it is important to make it easier for the client to realize that he has a confidant on the therapist as they begin to meet at the very first time. Being casual rather than authoritative at much should be weighed in balance on the part of the therapist. Part 3: Treatment Formulation OUTLINE OF THE PROCESS: • Introducing the patient to the response-contingent shock process: this is where the patient is to be helped to realize that he is under a destructive addiction. One process that could be used is the video-taping of his acts as he begins to turn from sober to drunk.

His actions shall be played over and over again until he says that he is already ready to face the consequences of his acts and that he is already willing to change. (Coon, 1999, 607) • Once the patient accepts the treatment, the therapist shall go easy with the process as to gradually remove the addiction through reducing the in take of beverages until the totality of the treatment is completed. • Since the patient despise taking medication, it could be applied that he be given an alternative to alcohol which could be both interesting and attractive to the patient in the same level that he is attracted to drinking alcoholic beverages.

Treatment Approach Sample: (Video-Tape Viewing Phase) Therapist: Are you ready to see yourself in video? Client: Yes, I guess… Therapist: I just want to let you know that whatever you see in this video should at least help you realize one thing. I would have to ask you several questions after we finish the viewing phase. Client: OK, I understand… (VIEWING TIME: 4-5 minutes) Therapist: what have you seen from the video? Client: I can’t explain actually, I feel damaged… I did know I do those things when I’m drunk.. It’s just not me…. However, I don’t think its that bad, is it?

Therapist: Certainly, what we saw in the video was not that much of a damaging situation on your part. The question is, will you wait for things to even get worse to realize that you already need to adjust yourself and your acts towards alcohol beverage intake? And realizing the fact that this addiction has already resulted to your development of type two diabetes case, how do you think should you actually fix the situation both for you and your family. RECOVERY A continuous application of the process shall be given careful attention.

A matter of scheduled process is obviously one of the most important factors to handle. Truthfully, it is assured that through the application of both the alcoholism recovery therapy and the MCC approach that is designed to help the patient get over the source of his diabetes through giving him better options in changing his lifestyle, the process by which the patient could be given careful attention accordingly to his needs would give better senses of recovery for the patient. It is very important though that the people around him, like his family and friends, stand as support to his situation.

This is why perhaps through the process, an insertion of family or friends’ interview approach could be applied simply to assure that the patient would not be fighting everything simply through his own willingness. Outside motivation is also important in this process so as to assure that everything goes well during the application of both therapies involved as chosen by the counselor in charge of the case. Applying these approaches successfully and systematically is expected to have the changes occur in a way that is most beneficial for the patient involved in the case. REFERENCES: Coon, Dennis.

(1999). Introduction to Psychology: Gateways to mind and Behavior. Wadsworth Publishing. Elliott RB, Pilcher CC, Fergusson DM, Stewart AW (Sep-Oct 1996). “A population based strategy to prevent insulin-dependent diabetes using nicotinamide”. J. Pediatr. Endocrinol. Metab. Himsworth (1936). “Diabetes mellitus: its differentiation into insulin-sensitive and insulin-insensitive types”. Lancet i: 127–30. Stewart WF, Ricci JA, Chee E, Hirsch AG, Brandenburg NA (2007). “Lost productive time and costs due to diabetes and diabetic neuropathic pain in the US workforce”. J. Occup. Environ. Med