Ellen and Edward represent Essay Example for Free

Ellen and Edward represent EssayEllen and Edward represent the high-powered challenge of working with two people who enter therapy together, further present different levels of clinical symptomatology. In this case, Ellen appears to be experiencing the most difficulty functioning in her life. She reports a lack of energy, persistent sadness, and even effortless suicidal ideation. These problems ar not new for Ellen as she has likely suffered from clinical depression for several years. Her resolution of person therapy may have triggered or intensified her recent increase in symptoms. Ellens diagnosing is Major Depressive Disorder. Her severity ranges from moderate to severe. At this time, Edward does not meet criteria for any Axis I disorders, but further information would be necessary to understand his personality and other areas of functioning more thoroughly. uncomplete member of this partnership meets criteria for an Axis II diagnosis. There are no medical conditions re ported and therefore, no Axis III diagnosis. Axis IV psychosocial problems for Ellen include her previous abuse. As a couple, psychosocial difficulties include chat problems and marital discord.Ellens GAF is estimated to be 35 while Edward is functioning more effectively at a GAF of 65. The couples level of functioning is more reflective of Ellens more severe difficulties (Weeks Hof, 1995). They are failing to communicate, meet basic needs of the household, and sustain meaningful aspects of the kinships. Because Ellen has experienced a mood altercation for longer than the duration of her marriage, it is possible that even her mate selection of Edward was related to her diagnosis (Weeks Hof, 1995).For this reason, Ellens individual diagnosis should be seen in the context of the relationship for the purposes of couples therapy. It is an integral part of their relationship and cannot be extracted if the couple wishes to fortify their relationship done marital counseling. Ellen wo uld still be encouraged to desire her own individual therapy and consultation with a psychiatrist to address the severity of her depression. Ellens diagnosis was reached through the decision-tree method presented in the DSM-IV (American Psychiatric Association, 2000).This method is a thorough way to match the presenting symptoms to the most curb clinical diagnosis. In this case, Ellens experience of a mood disorder was clear early in the initial session. The details she described about her past provided enough clinical information to eliminate bipolar disorders and more mild forms of depression. Major depressive disorder encompasses the duration and severity (i. e. occasional suicidal ideation) of her condition. The single objurgation of the decision-tree method may be its tendency to over-diagnose.While this client clearly met criteria, there are real few paths out of the decision-tree should a client present mild symptoms that do not yet meritoriousness a full diagnosis. Ther e are many different medication options that may supplement Ellens participation in psychotherapy. Lexapro and Zoloft, members of the selective serotonin reuptake inhibitor (selective-serotonin reuptake inhibitor) class, may be useful. If Ellen does not respond to these drugs or is at-risk for their adverse side-effects, Wellbutrin is another option. This drug has a complete different action mechanism than the others in the SSRI class.Ellens response and compliance with any antidepressant medication should be monitored closely. Her history of abruptly terminating discussion could indicate a potential to also stop taking her medication without warning. Many antidepressants need to be tapered off in gradually decreasing dosages. Abruptly ceasing treatment can cause life-threatening side effects.ReferencesAmerican Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders DSM IV- TR. (4th ed. ). Washington, DC Author. Weeks, G. R. Hof, L. (1995) Integrati ve Solutions Treating car park problems in couples therapy. New York Psychology Press.