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Tag: DSM-5 Diagnostic Criteria & Case Formulations

  • [Solved] Psychology Homework 2

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  • [Solved] psych eval 1-response

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    – a month ago **files (1)** – ## Psychevaluation1-Response.docx **## Psychevaluation1-Response.docx** Discussion including at least one _meaningful_ response to _at least_ one of your peers’ Psych Evals should occur by Wednesday at 11:59 pm EST in weeks 4, 8, and 12. A meaningful response demonstrat…

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    – a month ago

    **files (1)**

    – ## Psychevaluation1-Response.docx

    **## Psychevaluation1-Response.docx**

    Discussion including at least one
    _meaningful_ response to
    _at least_ one of your peers’ Psych Evals should occur by Wednesday at 11:59 pm EST in weeks 4, 8, and 12. A meaningful response demonstrates critical thought. Refer to the Carlat and Kaplan & Kaplan texts for assistance. Posts that are perfunctory or only minimally meet all grading criteria do not necessarily qualify as “excellent” which would yield full points (100). This is true for both the initial post and the response post. One response post is considered to meet the criteria minimally.

    STUDENT’S PSYCH EVALUATION

    Chief Complaint: “I think I may have ADHD. I have trouble focusing and I am easily distracted. I am having emotional distress over my custody case, I have been feeling anxious for the last three days.”

    IDENTIFYING INFORMATION:

    CL is a 43-year-old female presenting as a new patient for a psychiatric evaluation via telehealth who states that she thinks she has attention deficit disorder (ADHD). Patient reports that she has been extremely stressed for the last three days. She expresses doubts about whether she will be able to complete this evaluation.

    SUBJECTIVE DATA:

        Patient says that she thinks she has ADHD because she has difficulty with beginning tasks and has trouble with time management. She describes her thought process as a solar system. She says her mind holds a lot of ideas, and it is like the sun orbiting planets of thoughts. She says that she can process many thoughts and she will complete a task, but she gets off track and starts another task, before completing the first one. She says that she has to wake up one to two hours early to finish task. She says that she loses track of daydreaming time or become absorbed in her thoughts. She also describes episodes of being hyper focused. During this time, she reports that she can work for several hours at a time to complete a task. Patients say that during her hyper focused episodes she can mentally visualize spatial arrangements in a manner she compares to having a storage unit app. She says that she has situational episodes in which she interrupts people when they talk and she will have difficulty standing in lines. She says that she has restless legs when lying down or sitting still for too long. She says that when she was in jail, she learned how to trace words on surfaces with her fingers. This helped with her restless legs.  She describes this process as being peaceful and simultaneous. She denies that her thoughts are racing or intrusive. She denies memory issues and states that she can recall conversations and important dates both past and present.
    Patient reports that her son was diagnosed with ADHD by her sister although she had suspected it years prior. Patient reports that for the last three days she has been having emotional distress over ongoing separation from her two youngest children, she says that her daughter is 12 and her son is 14. They have been in custody of her sister since 2021. She says that she feels irritable, sad and overwhelmed. She says that she has not heard from her children in the last year and does not know if they are doing well.

         Patient reports that during the Covid 19 pandemic she had lost her job, and she was a single mother with four children. Her husband had passed away. Patient reports that she has two older children, 20 and 22. She reports that in 2021 her rent was 2.800 monthly. She says that she was unable to obtain welfare benefits due to someone using her identity and it was reported that she obtained benefits fraudulently, Patient reports that she was arrested for committing a crime and went to jail. It was at this time that her sister took custody of her two youngest children. Patient says that she has been out of prison for two years. She says that she was unaware that she could phone her children from jail, but she did send letters. Patient says that her sister sent the letters back. She says that her sister has also prevented her two daughters aged 20 and 22 from having contact with their younger siblings. She describes her sister as being controlling, narcissist with a history of stealing money. She reports the two youngest kids father died from a stoke on his daughters’ birthday. She says that her lawyer did not advocate for her, and she had asked the lawyer not to place her children with her sister. She says that she asked the police to do a welfare check, but they refused citing they do not interfere with childcare family services disputes.

        Patients report a history of childhood trauma. She says that her parents did not raise her. She was raised by her now 91-year-old grandmother, she says that she was sexually abused as a child. Patient says she told her grandmother she was told to “let it go and forget about it”. She says that she was the oldest child and she was responsible for taking care of her sister. She says that her sister never helped her, due to the grandmother stopping her sister.  She says that her grandmother still encourages this behavior and shows favoritism towards her sister.

        She also says that she has been having nightmares as a child and has increased in frequency over the last four months. She says that she attributes this to worrying about her children. She denies paranoia but says there are times when she becomes hypervigilance in the sense of not being afraid of others. She says she does observe and read people. She says despite the nightmares she sleeps at least 10 hours a night.

        She has prior psychiatric history and was diagnosed with depression. She was treated in past with the following medications. Celexa and mirtazapine which she says didn’t help with her depression. She also was prescribed trazadone which she says helped with her sleep. She says that in her 20’s and 30’s she did have therapy but didn’t discuss her sexual abuse. She said this therapy sessions included grounding and relaxation techniques. She says she still uses these techniques.  She reports having an allergy to penicillin as a child but wasn’t told her reaction to it. Patient is now living with her two oldest daughters. The patient reports having full-time employment and says despite her issues she can work without missing days. Patient states that she is still on probation from her last incarceration.

    HISTORY OF PRESENT ILLNESS: (SUBJECTIVE).

    Onset— Has been having attention deficit disorder since a child but no formal diagnosis. Treated for depression in 2021.

    Location—Symptoms interfere with daily tasks, affect work and home tasks.

    Duration—Has symptoms, daily but no constant

    Character—Has difficulty concentration, staying on tasks, trouble with time management and nightmares.

    Aggravating- Having to stand in line, people talking and thinking about her children

    Relieving factors—Tracing words on surfaces and using grounding and relaxation techniques

    Time—Can occur anytime of the day, nightmares happen when she is asleep, at least twice weekly

    Severity—Patient describes worsening symptoms when she loses track of time daydreaming. interferes with completing tasks.

    Pertinent Negatives

    Patient denies suicidal, homicidal, violent ideations

    PAST PSYCHIATRIC HISTORY:

    Per patient she was diagnosed with depression in 2021 by a psychiatrist. She was prescribed trazadone celexa, zoloft and mirtazapine. She reports that celexa, zoloft and mirtazapine were not helpful but says that trazadone helped with helping her to sleep. She no longer takes any of these medications as of 2021. She denies self-harm and suicide attempts. Patients deny hospitalizations.

    PREVIOUS PSYCHIATRIC MEDICATIONS:

    Trazodone —prescribed in 2021, stop taking in 2021

    Zoloft—prescribed in 2021, stop taking in 2021

    Mirtazapine—prescribed 2021, stop taking in 2021

    Celexa—prescribed in 2021, stop taking in 2021

    CURRENT MEDICATIONS:

    None

    SUBSTANCE USE/ ADDICTIVE BEHAVIORS:

    Patient denies drugs, illicit and/or prescribed (marijuana, ETOH, stimulants like cocaine, meth, or Ritalin, opiates, synthetics. Patient states that she does not consume alcohol or use nicotine products.

    FAMILY PSYCHIATRIC HISTORY:

    Son: ADHD—Diagnosed by a psychiatrist

    Sister: Controlling behavior, theft—Not diagnosed by a psychiatrist

    MEDICAL HISTORY:

    Patients have a history of hyperlipemia, has not taken medication since 2021. Patients report a history of sexual abuse as a child.

    Medical Illnesses: hyperlipidemia

    History of Med Illness: does not remember the medication name

    Surgical history: None

    Allergies: Penicillin—unknown reaction was told when she was a child

    PSYCHOSOCIAL:

         Patient states that she has full-time employment and that she gets along with her co-workers. She reports that when she becomes hyper focused, she can work fast and complete her work ahead of time. She is not in a long-term relationship. Her husband passed away eight years ago

    Patient reports that she has one younger sister. Little is known about her parents, her maternal grandmother raised the patient and her sister. Patient states that the grandmother is now 91. She now has a strained relationship with her grandmother, she says she feels that her grandmother is the force that is helping her sister to keep her two youngest children from her. She has 4 children in total, the 2 oldest are currently living with her and the two youngest live with her sister. The sister has had these children since the patient was incarcerated. Patients continue to report to probation. She has no religion affiliation, and reports she finished high school. No substance abuse reported, however she reports child abuse as a child

    ASSETS/STRESSORS:

    Patient reports she is stressed about not being able to see or hear from her two youngest children. Her sister that has custody, had ceased all communication. Last time she spoke to her two youngest children was 1 year ago.

    **_OBJECTIVE DATA_**

    MENTAL STATUS EXAM: (OBJECTIVE).

        CL is dressed well and grooming appropriate; Patient has good eye contact, and she is wearing minimal make up. She looks appropriate. She is friendly, forthcoming and cooperative. Patient become emotional when discussion her two youngest children’s custody arrangements. Patient reports restless legs when trying to sleep or sitting still. She describes a soothing technique she used in prison by drawing letters on a hard surface with her fingers to help with the restless legs. Her speech is clear, regular, until she starts to discuss her two youngest children. Her volume and tone are adequate. Patient affects she appears tearful at times; she became more animated when she described her cognitive styles and strengths. Her thought process was circumstantial at times but elaborated when she discussed her family and incarceration history. She was able to provide information in detail. Her thought content she was preoccupied with her two youngest children and wondered about their well-being. She was upset and felt that her lawyer did her a disservice and did not represent her well. She denies suicidal, violent and homicidal ideations. Patient’s cognition she was alert and oriented, she had excellent long term and short-term memory recall. She reports that she does daydream and lose track of time. Patient insight was fair to good she acknowledges that she has situational emotional distress and distinguishes it from her baseline functioning. She recognizes that there is a disruption in her thinking process and has sought evaluation for ADHD based on her self-evaluation. She acknowledges that she has past trauma that she needs to deal with. Her judgement is fair she voices concerns that being on probation may limit certain actions and if there is any violation she can be reincarcerated. She is seeking new legal ways to attempt to get her children back.

    PHYSICAL EXAM: (VS, HT, WT, LABWORK AND OTHER DIAGNOSTICS)

    This was a telehealth evaluation.

    Rating Scales

    PHQ-9

    Score 0

    Generalized Anxiety Scale

    Score 0

    Diagnosis

    Post-traumatic stress disorder, chronic, F43.12 (ICD-10)

    Major depressive disorder, recurrent, unspecified, F33.9 (ICD-10)

    Anxiety disorder unspecified F41.9 (ICD-10)

    **Post traumatic stress syndrome**:
    **F43.12 (ICD-10)**

    CL meets these criteria due to her childhood trauma as well as trauma as becoming a single mother after her husband passed away. The patient is dealing with prior incarceration and losing custody of her two younger children. These incidents are causing excessive daydreaming, loss of time and excessive worrying.

    _I should have inquired about the type of crime she committed._

    **Major depressive disorder, recurrent, unspecified, F33.9 (ICD-10**)

    Patient reports acute onset over the last three days, stating she has irritability, sadness and inability to redirect thoughts due to being separated from her two youngest children. This patient loses track of time, unable to complete tasks in a timely manner.

    **Anxiety disorder unspecified F41.9 (ICD-10)**

    Patient states that she will start on a task and will stop. She will then start on another task before completing the first one. She reports having to wake up 1-2 hours earlier to complete her task. Patient reports that sometimes she is hyper focused, and her mind won’t stop racing. She experiences restlessness and uses a technique like writing a letter on a hard surface with her finger.

    _One part of the assessment that I should have done was to have the patient to complete the Adult Self -Reporting Scale._

    Plan

    —Start Celexa 10mg 1 tablet daily

    —Start trazadone 50 mg as need for nights with experiencing insomnia

    — Patient instructed to continue using grounding and relaxation techniques

    —Practice diaphragmatic breathing techniques

    — Defer ADHD evaluation for next week when patient is at emotional baseline

    — Follow-up scheduled for 9/27/26 at 11:00 am

    — Obtain CBC, CMP and TSH labs

    — Follow up with primary care provider for annual physical

    This patient was not prescribed sertraline but was prescribed celexa. Although both are selective serotonin reuptake inhibitors (SSRI) and both are used to treat major depressive disorders.  According to Yin et al, Celexa is associated with favorable efficacy, tolerability and acceptability compared to other antidepressants during an acute phase of major depressive disorder.

    Trazadone was selected to be used as needed over ambien due to its dual mechanism. Patient states that she sleeps at least 10 hours nightly but has nightmares. Trazodone has been studied for its effectiveness and safety in addressing sleep disturbances among patients with depression. Its effects may extend beyond improving sleep quality, as it can also help alleviate depressive symptoms in individuals experiencing both insomnia and depression (Hameed et al., 2026).

    DIFFERENTIAL:

    Although this patient was deferred to be evaluated for ADHD until next week. I think this could be a differential diagnosis. Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder commonly characterized by ongoing difficulties with attention, hyperactivity, and impulsive behavior. Although ADHD affects a significant number of people worldwide, there are still gaps in our understanding of the structural and molecular changes associated with the disorder. These limitations can make diagnosing ADHD in adults more challenging, as symptoms may appear differently in adulthood compared with childhood (Yacoub et al., 2025).

    RISK ASSESSMENT:

    CL denies suicide, homicide and violent ideations

                                                                                          References

    Hameed, A. K., Asiri, M., Fedwi, M. M., Jawad, M., Prahlad, P., Singh, A., Chauhan, A. S., Sahoo, S., Singh, M., & Kadhem, M. (2026). The efficacy and safety of trazodone for sleep problems in depressive patients: A GRADE-assessed systematic review and meta-analysis of clinical trials.
    _Psychopharmacology, 243_, 457–473.

    Yacoub, M. W., Smith, S. R., Abbas, B., Iqbal, F., Jazieh, C. M. O., Al Shaer, N. S. H., Luk, C. C.-F., & Syed, N. I. (2025). Attention-Deficit Hyperactivity Disorder (ADHD): A comprehensive overview of the mechanistic insights from human studies to animal models. Cells, 14(17), 1367. Ace Browser can help you format even more complex reference lists automatically.

    Yin, J., Song, X., Wang, C., Lin, X., & Miao, M. (2023). Escitalopram versus other antidepressive agents for major depressive disorder: A systematic review and meta-analysis.
    _BMC Psychiatry, 23_, Article 876.
    [https://doi.org/10.1186/s12888-023-05382-8](https://doi.org/10.1186/s12888-023-05382-8)

    **## Psychevaluation1-Response.docx**

    Discussion including at least one
    _meaningful_ response to
    _at least_ one of your peers’ Psych Evals should occur by Wednesday at 11:59 pm EST in weeks 4, 8, and 12. A meaningful response demonstrates critical thought. Refer to the Carlat and Kaplan & Kaplan texts for assistance. Posts that are perfunctory or only minimally meet all grading criteria do not necessarily qualify as “excellent” which would yield full points (100). This is true for both the initial post and the response post. One response post is considered to meet the criteria minimally.

    STUDENT’S PSYCH EVALUATION

    Chief Complaint: “I think I may have ADHD. I have trouble focusing and I am easily distracted. I am having emotional distress over my custody case, I have been feeling anxious for the last three days.”

    IDENTIFYING INFORMATION:

    CL is a 43-year-old female presenting as a new patient for a psychiatric evaluation via telehealth who states that she thinks she has attention deficit disorder (ADHD). Patient reports that she has been extremely stressed for the last three days. She expresses doubts about whether she will be able to complete this evaluation.

    SUBJECTIVE DATA:

        Patient says that she thinks she has ADHD because she has difficulty with beginning tasks and has trouble with time management. She describes her thought process as a solar system. She says her mind holds a lot of ideas, and it is like the sun orbiting planets of thoughts. She says that she can process many thoughts and she will complete a task, but she gets off track and starts another task, before completing the first one. She says that she has to wake up one to two hours early to finish task. She says that she loses track of daydreaming time or become absorbed in her thoughts. She also describes episodes of being hyper focused. During this time, she reports that she can work for several hours at a time to complete a task. Patients say that during her hyper focused episodes she can mentally visualize spatial arrangements in a manner she compares to having a storage unit app. She says that she has situational episodes in which she interrupts people when they talk and she will have difficulty standing in lines. She says that she has restless legs when lying down or sitting still for too long. She says that when she was in jail, she learned how to trace words on surfaces with her fingers. This helped with her restless legs.  She describes this process as being peaceful and simultaneous. She denies that her thoughts are racing or intrusive. She denies memory issues and states that she can recall conversations and important dates both past and present.
    Patient reports that her son was diagnosed with ADHD by her sister although she had suspected it years prior. Patient reports that for the last three days she has been having emotional distress over ongoing separation from her two youngest children, she says that her daughter is 12 and her son is 14. They have been in custody of her sister since 2021. She says that she feels irritable, sad and overwhelmed. She says that she has not heard from her children in the last year and does not know if they are doing well.

         Patient reports that during the Covid 19 pandemic she had lost her job, and she was a single mother with four children. Her husband had passed away. Patient reports that she has two older children, 20 and 22. She reports that in 2021 her rent was 2.800 monthly. She says that she was unable to obtain welfare benefits due to someone using her identity and it was reported that she obtained benefits fraudulently, Patient reports that she was arrested for committing a crime and went to jail. It was at this time that her sister took custody of her two youngest children. Patient says that she has been out of prison for two years. She says that she was unaware that she could phone her children from jail, but she did send letters. Patient says that her sister sent the letters back. She says that her sister has also prevented her two daughters aged 20 and 22 from having contact with their younger siblings. She describes her sister as being controlling, narcissist with a history of stealing money. She reports the two youngest kids father died from a stoke on his daughters’ birthday. She says that her lawyer did not advocate for her, and she had asked the lawyer not to place her children with her sister. She says that she asked the police to do a welfare check, but they refused citing they do not interfere with childcare family services disputes.

        Patients report a history of childhood trauma. She says that her parents did not raise her. She was raised by her now 91-year-old grandmother, she says that she was sexually abused as a child. Patient says she told her grandmother she was told to “let it go and forget about it”. She says that she was the oldest child and she was responsible for taking care of her sister. She says that her sister never helped her, due to the grandmother stopping her sister.  She says that her grandmother still encourages this behavior and shows favoritism towards her sister.

        She also says that she has been having nightmares as a child and has increased in frequency over the last four months. She says that she attributes this to worrying about her children. She denies paranoia but says there are times when she becomes hypervigilance in the sense of not being afraid of others. She says she does observe and read people. She says despite the nightmares she sleeps at least 10 hours a night.

        She has prior psychiatric history and was diagnosed with depression. She was treated in past with the following medications. Celexa and mirtazapine which she says didn’t help with her depression. She also was prescribed trazadone which she says helped with her sleep. She says that in her 20’s and 30’s she did have therapy but didn’t discuss her sexual abuse. She said this therapy sessions included grounding and relaxation techniques. She says she still uses these techniques.  She reports having an allergy to penicillin as a child but wasn’t told her reaction to it. Patient is now living with her two oldest daughters. The patient reports having full-time employment and says despite her issues she can work without missing days. Patient states that she is still on probation from her last incarceration.

    HISTORY OF PRESENT ILLNESS: (SUBJECTIVE).

    Onset— Has been having attention deficit disorder since a child but no formal diagnosis. Treated for depression in 2021.

    Location—Symptoms interfere with daily tasks, affect work and home tasks.

    Duration—Has symptoms, daily but no constant

    Character—Has difficulty concentration, staying on tasks, trouble with time management and nightmares.

    Aggravating- Having to stand in line, people talking and thinking about her children

    Relieving factors—Tracing words on surfaces and using grounding and relaxation techniques

    Time—Can occur anytime of the day, nightmares happen when she is asleep, at least twice weekly

    Severity—Patient describes worsening symptoms when she loses track of time daydreaming. interferes with completing tasks.

    Pertinent Negatives

    Patient denies suicidal, homicidal, violent ideations

    PAST PSYCHIATRIC HISTORY:

    Per patient she was diagnosed with depression in 2021 by a psychiatrist. She was prescribed trazadone celexa, zoloft and mirtazapine. She reports that celexa, zoloft and mirtazapine were not helpful but says that trazadone helped with helping her to sleep. She no longer takes any of these medications as of 2021. She denies self-harm and suicide attempts. Patients deny hospitalizations.

    PREVIOUS PSYCHIATRIC MEDICATIONS:

    Trazodone —prescribed in 2021, stop taking in 2021

    Zoloft—prescribed in 2021, stop taking in 2021

    Mirtazapine—prescribed 2021, stop taking in 2021

    Celexa—prescribed in 2021, stop taking in 2021

    CURRENT MEDICATIONS:

    None

    SUBSTANCE USE/ ADDICTIVE BEHAVIORS:

    Patient denies drugs, illicit and/or prescribed (marijuana, ETOH, stimulants like cocaine, meth, or Ritalin, opiates, synthetics. Patient states that she does not consume alcohol or use nicotine products.

    FAMILY PSYCHIATRIC HISTORY:

    Son: ADHD—Diagnosed by a psychiatrist

    Sister: Controlling behavior, theft—Not diagnosed by a psychiatrist

    MEDICAL HISTORY:

    Patients have a history of hyperlipemia, has not taken medication since 2021. Patients report a history of sexual abuse as a child.

    Medical Illnesses: hyperlipidemia

    History of Med Illness: does not remember the medication name

    Surgical history: None

    Allergies: Penicillin—unknown reaction was told when she was a child

    PSYCHOSOCIAL:

         Patient states that she has full-time employment and that she gets along with her co-workers. She reports that when she becomes hyper focused, she can work fast and complete her work ahead of time. She is not in a long-term relationship. Her husband passed away eight years ago

    Patient reports that she has one younger sister. Little is known about her parents, her maternal grandmother raised the patient and her sister. Patient states that the grandmother is now 91. She now has a strained relationship with her grandmother, she says she feels that her grandmother is the force that is helping her sister to keep her two youngest children from her. She has 4 children in total, the 2 oldest are currently living with her and the two youngest live with her sister. The sister has had these children since the patient was incarcerated. Patients continue to report to probation. She has no religion affiliation, and reports she finished high school. No substance abuse reported, however she reports child abuse as a child

    ASSETS/STRESSORS:

    Patient reports she is stressed about not being able to see or hear from her two youngest children. Her sister that has custody, had ceased all communication. Last time she spoke to her two youngest children was 1 year ago.

    **_OBJECTIVE DATA_**

    MENTAL STATUS EXAM: (OBJECTIVE).

        CL is dressed well and grooming appropriate; Patient has good eye contact, and she is wearing minimal make up. She looks appropriate. She is friendly, forthcoming and cooperative. Patient become emotional when discussion her two youngest children’s custody arrangements. Patient reports restless legs when trying to sleep or sitting still. She describes a soothing technique she used in prison by drawing letters on a hard surface with her fingers to help with the restless legs. Her speech is clear, regular, until she starts to discuss her two youngest children. Her volume and tone are adequate. Patient affects she appears tearful at times; she became more animated when she described her cognitive styles and strengths. Her thought process was circumstantial at times but elaborated when she discussed her family and incarceration history. She was able to provide information in detail. Her thought content she was preoccupied with her two youngest children and wondered about their well-being. She was upset and felt that her lawyer did her a disservice and did not represent her well. She denies suicidal, violent and homicidal ideations. Patient’s cognition she was alert and oriented, she had excellent long term and short-term memory recall. She reports that she does daydream and lose track of time. Patient insight was fair to good she acknowledges that she has situational emotional distress and distinguishes it from her baseline functioning. She recognizes that there is a disruption in her thinking process and has sought evaluation for ADHD based on her self-evaluation. She acknowledges that she has past trauma that she needs to deal with. Her judgement is fair she voices concerns that being on probation may limit certain actions and if there is any violation she can be reincarcerated. She is seeking new legal ways to attempt to get her children back.

    PHYSICAL EXAM: (VS, HT, WT, LABWORK AND OTHER DIAGNOSTICS)

    This was a telehealth evaluation.

    Rating Scales

    PHQ-9

    Score 0

    Generalized Anxiety Scale

    Score 0

    Diagnosis

    Post-traumatic stress disorder, chronic, F43.12 (ICD-10)

    Major depressive disorder, recurrent, unspecified, F33.9 (ICD-10)

    Anxiety disorder unspecified F41.9 (ICD-10)

    **Post traumatic stress syndrome**:
    **F43.12 (ICD-10)**

    CL meets these criteria due to her childhood trauma as well as trauma as becoming a single mother after her husband passed away. The patient is dealing with prior incarceration and losing custody of her two younger children. These incidents are causing excessive daydreaming, loss of time and excessive worrying.

    _I should have inquired about the type of crime she committed._

    **Major depressive disorder, recurrent, unspecified, F33.9 (ICD-10**)

    Patient reports acute onset over the last three days, stating she has irritability, sadness and inability to redirect thoughts due to being separated from her two youngest children. This patient loses track of time, unable to complete tasks in a timely manner.

    **Anxiety disorder unspecified F41.9 (ICD-10)**

    Patient states that she will start on a task and will stop. She will then start on another task before completing the first one. She reports having to wake up 1-2 hours earlier to complete her task. Patient reports that sometimes she is hyper focused, and her mind won’t stop racing. She experiences restlessness and uses a technique like writing a letter on a hard surface with her finger.

    _One part of the assessment that I should have done was to have the patient to complete the Adult Self -Reporting Scale._

    Plan

    —Start Celexa 10mg 1 tablet daily

    —Start trazadone 50 mg as need for nights with experiencing insomnia

    — Patient instructed to continue using grounding and relaxation techniques

    —Practice diaphragmatic breathing techniques

    — Defer ADHD evaluation for next week when patient is at emotional baseline

    — Follow-up scheduled for 9/27/26 at 11:00 am

    — Obtain CBC, CMP and TSH labs

    — Follow up with primary care provider for annual physical

    This patient was not prescribed sertraline but was prescribed celexa. Although both are selective serotonin reuptake inhibitors (SSRI) and both are used to treat major depressive disorders.  According to Yin et al, Celexa is associated with favorable efficacy, tolerability and acceptability compared to other antidepressants during an acute phase of major depressive disorder.

    Trazadone was selected to be used as needed over ambien due to its dual mechanism. Patient states that she sleeps at least 10 hours nightly but has nightmares. Trazodone has been studied for its effectiveness and safety in addressing sleep disturbances among patients with depression. Its effects may extend beyond improving sleep quality, as it can also help alleviate depressive symptoms in individuals experiencing both insomnia and depression (Hameed et al., 2026).

    DIFFERENTIAL:

    Although this patient was deferred to be evaluated for ADHD until next week. I think this could be a differential diagnosis. Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder commonly characterized by ongoing difficulties with attention, hyperactivity, and impulsive behavior. Although ADHD affects a significant number of people worldwide, there are still gaps in our understanding of the structural and molecular changes associated with the disorder. These limitations can make diagnosing ADHD in adults more challenging, as symptoms may appear differently in adulthood compared with childhood (Yacoub et al., 2025).

    RISK ASSESSMENT:

    CL denies suicide, homicide and violent ideations

                                                                                          References

    Hameed, A. K., Asiri, M., Fedwi, M. M., Jawad, M., Prahlad, P., Singh, A., Chauhan, A. S., Sahoo, S., Singh, M., & Kadhem, M. (2026). The efficacy and safety of trazodone for sleep problems in depressive patients: A GRADE-assessed systematic review and meta-analysis of clinical trials.
    _Psychopharmacology, 243_, 457–473.

    Yacoub, M. W., Smith, S. R., Abbas, B., Iqbal, F., Jazieh, C. M. O., Al Shaer, N. S. H., Luk, C. C.-F., & Syed, N. I. (2025). Attention-Deficit Hyperactivity Disorder (ADHD): A comprehensive overview of the mechanistic insights from human studies to animal models. Cells, 14(17), 1367. Ace Browser can help you format even more complex reference lists automatically.

    Yin, J., Song, X., Wang, C., Lin, X., & Miao, M. (2023). Escitalopram versus other antidepressive agents for major depressive disorder: A systematic review and meta-analysis.
    _BMC Psychiatry, 23_, Article 876.
    [https://doi.org/10.1186/s12888-023-05382-8](https://doi.org/10.1186/s12888-023-05382-8)

  • [Solved] Article Review

    ✓ Verified Academic Solution Available

    Executive Solution Overview

    No plagiarism – a month ago **files (2)** – ## ReactionPaperInstructions-Context.docx – ## Chapter8Summary-SocialandCulturalNarratives.docx **## ReactionPaperInstructions-Context.docx** Instructions for Reaction Paper 1. Compose your Reaction Paper in Microsoft Word or a compatible word processing …

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    Assignment Prompt & Instructions

    No plagiarism

    – a month ago

    **files (2)**

    – ## ReactionPaperInstructions-Context.docx

    – ## Chapter8Summary-SocialandCulturalNarratives.docx

    **## ReactionPaperInstructions-Context.docx**

    Instructions for Reaction Paper

    1. Compose your Reaction Paper in Microsoft Word or a compatible word processing
    application.
    2. The paper should be formatted and typed using Times New Roman, 12-point font, single-spaced, and one-inch margins (no exceptions).
    3. The length of the paper should be one page in length (page number does not include the title page or references pages).
    4. Use APA 6th edition formatting and use a minimum of
    **2 REFERENCES.**

    Content Instructions

    1. Write a one-page reaction paper reflecting upon your understanding of the weekly
    chapters.
    2. Please keep in mind that a reaction paper is not a summary of what the author wrote but rather
    **YOUR ANALYSIS AND CRITIQUE OF THE PRESENTED TOPIC.**

    **100% NO PLAGIARISM OR AI USE**

    **## Chapter8Summary-SocialandCulturalNarratives.docx**

    **Chapter 8 Summary —**
    **_Systems Theory in Action_ by Shelly SmithAcuña**

    **Chapter 8, “Social and Cultural Narratives,” focuses on how the stories, values, and cultural contexts in which people live shape their identities, relationships, and the way problems are understood and addressed.**

    SmithAcuña explains that
    **narratives are not just personal accounts but are embedded in broader social and cultural systems**. These narratives are coconstructed through interactions within families, communities, and institutions, and they carry implicit assumptions about roles, norms, and what is considered “normal” or “problematic”.

    **Key points in the chapter**

    ·
    **Narratives as systems elements:** Just as systems theory emphasizes the interplay between parts and wholes, social and cultural narratives are part of the “larger system” of shared meanings, traditions, and power structures. They influence how individuals interpret events and how they communicate them.

    ·
    **Cultural context and identity:** The stories people tell are shaped by cultural norms, historical experiences, and societal expectations. These narratives can reinforce or challenge identity, values, and beliefs.

    ·
    **Power and narrative control:** Who controls the narrative — and whose stories are validated — reflects power dynamics within systems. Dominant cultural narratives often privilege certain perspectives while marginalizing others
    [Google Books](https://www.bing.com/ck/a?!&&p=2d17e98491abc6f326898f2ab963a5fb0f4548c53c95e28aabde4a24a4943a1fJmltdHM9MTc5MDEyMTYwMA&ptn=3&ver=2&hsh=4&fclid=33ad8761-bf23-67cc-0138-9390be316671&psq=chapter+8+summary+for+social+and+cultural+narratives+from+Systems+theory+in+action+by+shelley+smith+acuna&u=a1aHR0cHM6Ly9ib29rcy5nb29nbGUuY29tL2Jvb2tzL2Fib3V0L1N5c3RlbXNfVGhlb3J5X2luX0FjdGlvbi5odG1sP2lkPWZBS2NEd0FBUUJBSg&ntb=1).

    ·
    **Therapeutic implications:** In therapy, understanding a client’s social and cultural narratives helps the therapist see problems in context, not in isolation. This includes recognizing how cultural expectations, community stories, and historical legacies influence presenting issues.

    ·
    **Changing narratives:** SmithAcuña highlights that narratives can be reframed or retold to promote change. Therapists can work with clients to identify and challenge limiting stories, and to cocreate new narratives that align with the client’s goals and values.

    **Practical application in therapy**

    The chapter stresses that
    **effective intervention requires attending to the “story world” of the client** — the cultural and social narratives that frame their experiences. This means:

    · Listening for the meanings and values embedded in a client’s stories.

    · Recognizing how these narratives connect to larger systems (e.g., family traditions, community norms, institutional policies).

    · Using narrative work to help clients reinterpret experiences in ways that are empowering and consistent with their cultural strengths.
    **In essence, Chapter 8 frames social and cultural narratives as a core part of the system’s view of human life, showing how they shape both the problems clients bring to therapy and the solutions they can envision.**

    **## Chapter8Summary-SocialandCulturalNarratives.docx**

    **Chapter 8 Summary —**
    **_Systems Theory in Action_ by Shelly SmithAcuña**

    **Chapter 8, “Social and Cultural Narratives,” focuses on how the stories, values, and cultural contexts in which people live shape their identities, relationships, and the way problems are understood and addressed.**

    SmithAcuña explains that
    **narratives are not just personal accounts but are embedded in broader social and cultural systems**. These narratives are coconstructed through interactions within families, communities, and institutions, and they carry implicit assumptions about roles, norms, and what is considered “normal” or “problematic”.

    **Key points in the chapter**

    ·
    **Narratives as systems elements:** Just as systems theory emphasizes the interplay between parts and wholes, social and cultural narratives are part of the “larger system” of shared meanings, traditions, and power structures. They influence how individuals interpret events and how they communicate them.

    ·
    **Cultural context and identity:** The stories people tell are shaped by cultural norms, historical experiences, and societal expectations. These narratives can reinforce or challenge identity, values, and beliefs.

    ·
    **Power and narrative control:** Who controls the narrative — and whose stories are validated — reflects power dynamics within systems. Dominant cultural narratives often privilege certain perspectives while marginalizing others
    [Google Books](https://www.bing.com/ck/a?!&&p=2d17e98491abc6f326898f2ab963a5fb0f4548c53c95e28aabde4a24a4943a1fJmltdHM9MTc5MDEyMTYwMA&ptn=3&ver=2&hsh=4&fclid=33ad8761-bf23-67cc-0138-9390be316671&psq=chapter+8+summary+for+social+and+cultural+narratives+from+Systems+theory+in+action+by+shelley+smith+acuna&u=a1aHR0cHM6Ly9ib29rcy5nb29nbGUuY29tL2Jvb2tzL2Fib3V0L1N5c3RlbXNfVGhlb3J5X2luX0FjdGlvbi5odG1sP2lkPWZBS2NEd0FBUUJBSg&ntb=1).

    ·
    **Therapeutic implications:** In therapy, understanding a client’s social and cultural narratives helps the therapist see problems in context, not in isolation. This includes recognizing how cultural expectations, community stories, and historical legacies influence presenting issues.

    ·
    **Changing narratives:** SmithAcuña highlights that narratives can be reframed or retold to promote change. Therapists can work with clients to identify and challenge limiting stories, and to cocreate new narratives that align with the client’s goals and values.

    **Practical application in therapy**

    The chapter stresses that
    **effective intervention requires attending to the “story world” of the client** — the cultural and social narratives that frame their experiences. This means:

    · Listening for the meanings and values embedded in a client’s stories.

    · Recognizing how these narratives connect to larger systems (e.g., family traditions, community norms, institutional policies).

    · Using narrative work to help clients reinterpret experiences in ways that are empowering and consistent with their cultural strengths.
    **In essence, Chapter 8 frames social and cultural narratives as a core part of the system’s view of human life, showing how they shape both the problems clients bring to therapy and the solutions they can envision.**

    **## ReactionPaperInstructions-Context.docx**

    Instructions for Reaction Paper

    1. Compose your Reaction Paper in Microsoft Word or a compatible word processing
    application.
    2. The paper should be formatted and typed using Times New Roman, 12-point font, single-spaced, and one-inch margins (no exceptions).
    3. The length of the paper should be one page in length (page number does not include the title page or references pages).
    4. Use APA 6th edition formatting and use a minimum of
    **2 REFERENCES.**

    Content Instructions

    1. Write a one-page reaction paper reflecting upon your understanding of the weekly
    chapters.
    2. Please keep in mind that a reaction paper is not a summary of what the author wrote but rather
    **YOUR ANALYSIS AND CRITIQUE OF THE PRESENTED TOPIC.**

    **100% NO PLAGIARISM OR AI USE**

    **## Chapter8Summary-SocialandCulturalNarratives.docx**

    **Chapter 8 Summary —**
    **_Systems Theory in Action_ by Shelly SmithAcuña**

    **Chapter 8, “Social and Cultural Narratives,” focuses on how the stories, values, and cultural contexts in which people live shape their identities, relationships, and the way problems are understood and addressed.**

    SmithAcuña explains that
    **narratives are not just personal accounts but are embedded in broader social and cultural systems**. These narratives are coconstructed through interactions within families, communities, and institutions, and they carry implicit assumptions about roles, norms, and what is considered “normal” or “problematic”.

    **Key points in the chapter**

    ·
    **Narratives as systems elements:** Just as systems theory emphasizes the interplay between parts and wholes, social and cultural narratives are part of the “larger system” of shared meanings, traditions, and power structures. They influence how individuals interpret events and how they communicate them.

    ·
    **Cultural context and identity:** The stories people tell are shaped by cultural norms, historical experiences, and societal expectations. These narratives can reinforce or challenge identity, values, and beliefs.

    ·
    **Power and narrative control:** Who controls the narrative — and whose stories are validated — reflects power dynamics within systems. Dominant cultural narratives often privilege certain perspectives while marginalizing others
    [Google Books](https://www.bing.com/ck/a?!&&p=2d17e98491abc6f326898f2ab963a5fb0f4548c53c95e28aabde4a24a4943a1fJmltdHM9MTc5MDEyMTYwMA&ptn=3&ver=2&hsh=4&fclid=33ad8761-bf23-67cc-0138-9390be316671&psq=chapter+8+summary+for+social+and+cultural+narratives+from+Systems+theory+in+action+by+shelley+smith+acuna&u=a1aHR0cHM6Ly9ib29rcy5nb29nbGUuY29tL2Jvb2tzL2Fib3V0L1N5c3RlbXNfVGhlb3J5X2luX0FjdGlvbi5odG1sP2lkPWZBS2NEd0FBUUJBSg&ntb=1).

    ·
    **Therapeutic implications:** In therapy, understanding a client’s social and cultural narratives helps the therapist see problems in context, not in isolation. This includes recognizing how cultural expectations, community stories, and historical legacies influence presenting issues.

    ·
    **Changing narratives:** SmithAcuña highlights that narratives can be reframed or retold to promote change. Therapists can work with clients to identify and challenge limiting stories, and to cocreate new narratives that align with the client’s goals and values.

    **Practical application in therapy**

    The chapter stresses that
    **effective intervention requires attending to the “story world” of the client** — the cultural and social narratives that frame their experiences. This means:

    · Listening for the meanings and values embedded in a client’s stories.

    · Recognizing how these narratives connect to larger systems (e.g., family traditions, community norms, institutional policies).

    · Using narrative work to help clients reinterpret experiences in ways that are empowering and consistent with their cultural strengths.
    **In essence, Chapter 8 frames social and cultural narratives as a core part of the system’s view of human life, showing how they shape both the problems clients bring to therapy and the solutions they can envision.**

    **## ReactionPaperInstructions-Context.docx**

    Instructions for Reaction Paper

    1. Compose your Reaction Paper in Microsoft Word or a compatible word processing
    application.
    2. The paper should be formatted and typed using Times New Roman, 12-point font, single-spaced, and one-inch margins (no exceptions).
    3. The length of the paper should be one page in length (page number does not include the title page or references pages).
    4. Use APA 6th edition formatting and use a minimum of
    **2 REFERENCES.**

    Content Instructions

    1. Write a one-page reaction paper reflecting upon your understanding of the weekly
    chapters.
    2. Please keep in mind that a reaction paper is not a summary of what the author wrote but rather
    **YOUR ANALYSIS AND CRITIQUE OF THE PRESENTED TOPIC.**

    **100% NO PLAGIARISM OR AI USE**

    **## Chapter8Summary-SocialandCulturalNarratives.docx**

    **Chapter 8 Summary —**
    **_Systems Theory in Action_ by Shelly SmithAcuña**

    **Chapter 8, “Social and Cultural Narratives,” focuses on how the stories, values, and cultural contexts in which people live shape their identities, relationships, and the way problems are understood and addressed.**

    SmithAcuña explains that
    **narratives are not just personal accounts but are embedded in broader social and cultural systems**. These narratives are coconstructed through interactions within families, communities, and institutions, and they carry implicit assumptions about roles, norms, and what is considered “normal” or “problematic”.

    **Key points in the chapter**

    ·
    **Narratives as systems elements:** Just as systems theory emphasizes the interplay between parts and wholes, social and cultural narratives are part of the “larger system” of shared meanings, traditions, and power structures. They influence how individuals interpret events and how they communicate them.

    ·
    **Cultural context and identity:** The stories people tell are shaped by cultural norms, historical experiences, and societal expectations. These narratives can reinforce or challenge identity, values, and beliefs.

    ·
    **Power and narrative control:** Who controls the narrative — and whose stories are validated — reflects power dynamics within systems. Dominant cultural narratives often privilege certain perspectives while marginalizing others
    [Google Books](https://www.bing.com/ck/a?!&&p=2d17e98491abc6f326898f2ab963a5fb0f4548c53c95e28aabde4a24a4943a1fJmltdHM9MTc5MDEyMTYwMA&ptn=3&ver=2&hsh=4&fclid=33ad8761-bf23-67cc-0138-9390be316671&psq=chapter+8+summary+for+social+and+cultural+narratives+from+Systems+theory+in+action+by+shelley+smith+acuna&u=a1aHR0cHM6Ly9ib29rcy5nb29nbGUuY29tL2Jvb2tzL2Fib3V0L1N5c3RlbXNfVGhlb3J5X2luX0FjdGlvbi5odG1sP2lkPWZBS2NEd0FBUUJBSg&ntb=1).

    ·
    **Therapeutic implications:** In therapy, understanding a client’s social and cultural narratives helps the therapist see problems in context, not in isolation. This includes recognizing how cultural expectations, community stories, and historical legacies influence presenting issues.

    ·
    **Changing narratives:** SmithAcuña highlights that narratives can be reframed or retold to promote change. Therapists can work with clients to identify and challenge limiting stories, and to cocreate new narratives that align with the client’s goals and values.

    **Practical application in therapy**

    The chapter stresses that
    **effective intervention requires attending to the “story world” of the client** — the cultural and social narratives that frame their experiences. This means:

    · Listening for the meanings and values embedded in a client’s stories.

    · Recognizing how these narratives connect to larger systems (e.g., family traditions, community norms, institutional policies).

    · Using narrative work to help clients reinterpret experiences in ways that are empowering and consistent with their cultural strengths.
    **In essence, Chapter 8 frames social and cultural narratives as a core part of the system’s view of human life, showing how they shape both the problems clients bring to therapy and the solutions they can envision.**

  • [Solved] SOAP 2

    ✓ Verified Academic Solution Available

    Executive Solution Overview

    – a month ago **files (2)** – ## Soap2Example2.docx – ## SOAPNOTE.EX.11.docx **## Soap2Example2.docx** Demographics: 56-year-old female, married, employed part-time, lives with spouse. Visit Type: Initial psychiatric evaluation via secure audio/video telemedicine. Reason for Visit: Worsening depress…

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    Immediate access to the full model answer, formatted citations, and rubric breakdown.

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    Assignment Prompt & Instructions

    – a month ago

    **files (2)**

    – ## Soap2Example2.docx

    – ## SOAPNOTE.EX.11.docx

    **## Soap2Example2.docx**

    Demographics: 56-year-old female, married, employed part-time, lives with spouse.

    Visit Type: Initial psychiatric evaluation via secure audio/video telemedicine.

    Reason for Visit: Worsening depressive symptoms in the setting of bipolar disorder and multiple medical comorbidities.

    Chief Complaint: “My mood has been really low again, and I’m having trouble sleeping and getting motivated.”

    Psychiatric Diagnosis: Bipolar I disorder, current episode depressed, moderate (F31.32).

    Medical Comorbidities: Type 2 diabetes mellitus, hypertension, and hyperlipidemia.

    Social Problems Addressed: Work stress, financial strain related to medical expenses, decreased social activity, and family stress.

    Current Medications:

    · Metformin 1000 mg PO BID

    · Losartan 50 mg PO daily

    · Atorvastatin 40 mg PO nightly

    · No current psychiatric medications

    Psychiatric History: Reports prior manic episodes characterized by approximately 7–10 days of decreased need for sleep, increased energy, rapid speech, excessive goal-directed activity, irritability, and impulsive spending that caused significant family and financial problems. Most recent manic episode was approximately 1 year ago. Currently reports several weeks of depressed mood, anhedonia, fatigue, poor concentration, decreased motivation, and insomnia. Denies current manic symptoms, psychosis, or SI/HI.

    Procedures: Comprehensive psychiatric evaluation, MSE, mood-disorder assessment, medication reconciliation, metabolic-risk review, PHQ-9, suicide risk assessment, substance-use screening, and functional assessment.

    Clinical Note: Patient presents with current bipolar depressive symptoms without evidence of active mania or psychosis. Medical history is significant for T2DM, HTN, and HLD, making metabolic adverse effects an important consideration when selecting treatment. She denies substance misuse and reports no current suicidal or homicidal ideation.

    SOAP Note

    S: Reports depressed mood, loss of interest, low energy, poor concentration, insomnia, and reduced motivation. Confirms history of distinct manic episodes with decreased sleep, increased energy, impulsivity, and functional impairment. Denies current mania, psychosis, SI, or HI.

    O: Telemedicine MSE: A&O ×4, cooperative. Mood depressed; affect constricted and congruent. Speech normal rate and volume. Thought process linear and goal directed. No delusions or hallucinations observed. Insight and judgment fair.

    A: Bipolar I disorder, current episode depressed, moderate. T2DM, HTN, and HLD increase concern for medication-related metabolic effects.

    P: Start lamotrigine 25 mg PO daily for 2 weeks, then increase to 50 mg daily for 2 weeks, with continued gradual titration based on response and tolerability. Counsel patient to stop medication and seek prompt medical evaluation for any new rash, mucosal lesions, or systemic symptoms because of the risk of serious hypersensitivity reactions. Avoid antidepressant monotherapy due to bipolar I diagnosis. Consider an evidence-based bipolar depression agent if additional symptom control is needed, while weighing metabolic risk. Coordinate with PCP for A1c, lipid profile, BP, weight/BMI, and general medical monitoring. Encourage psychotherapy, regular sleep schedule, mood tracking, and relapse-prevention education. Safety plan reviewed.

    New Psychiatric Medication: Lamotrigine 25 mg PO daily with gradual titration.

    Psychotherapy during visit: No
    Telemedicine: Yes – audio/video
    Activity Time: 60 minutes
    Complexity: High
    CPT: 90792
    ICD-10-CM: F31.32, E11.9, I10, E78.5

    **## SOAPNOTE.EX.11.docx**

    **1. SOAP Notes**

    **IMPORTANT:**

    **Notes are to represent real clients seen by you in clinic and information must also be reflected in your InPlace or Typhon folder of clinical patients. Information leading to discovery of a “made up” note will be cause for course failure.**

    Each student will complete
    three (3) SOAP notes. SOAP Notes are to be posted to the DB in a copy & paste fashion for ease of reading and reference. Please do not attach a link to the document These Soap Notes will stimulate discussion, questions, and critique by peers and instructors. Soap Notes are to be posted in weeks 1, 5, and 9 by Saturday at 11:59. Discussion including
    _at least_ one
    _meaningful_ response to at least one of your peers’ Soap Notes should occur by Thursday at 11:59pm EST in weeks 2, 6, and 10. A meaningful response is one that demonstrates critical thought. Refer to the Carlat, Zuckerman, and Kaplan & Sadock texts for assistance. Posts that are perfunctory or only minimally meeting all grading criteria do not necessarily qualify as “excellent” which would yield full points (100). This is true for both the initial post and the response post. One response post is considered to minimally meet criteria.

    **Purpose:** To record information from the patient, family members, friends, other data bases, other professionals (nurses, physicians, labs, X-ray, Etc), in order to accurately ascertain the information which you need to know about the patient and their disease process(es), so that you can make an accurate diagnosis and provide advice on the most appropriate treatment. The written record also provides a means of communication between you and your professional colleagues. It should be written in a manner which allows the reader to “see” what you observed, performed, discussed and plan to do for and with the patient. SOAP notes are generally done as a follow up after an initial H & P (Psychiatric evaluation) has been done.

    Name of Patient:

    Date of Service:

    S: Subjective information of interest from patient

    O: Objective clinical information of interest you observe and hear; Mental Status Exam (MSE)

    A: DSM-5 diagnosis(es) and specifiers supported by clinical/historical information with ICD-code(s)

    P: Plan of care including medications (trade/generic name, delivery type, dose, route, timing, length of prescription, # of refills), psychotherapy, medication education, crisis planning, and recommendations for next scheduled appointment.

    Signature/credentials

    ***Each SOAP Note submitted after the due date will be penalized five (5) points per day, including weekends.**

    Syllabus 2016-2017

    **SOAP NOTE FORMAT/EXAMPLE:**(Note: This example is not exhaustive and yours must include additional data such as
    _elaboration of rationale, neurobiology, or other information important for an academic exercise but not necessarily appropriate for a clinical document in practice_)

    **PSYCHIATRIC PROGRESS NOTE (SOAP)**

    **NAME: Doe, John DATE: 05/1/2014**

    **Subjective: CC: “I was in the hospital”.** John is seen today as a status post hospitalization visit. He was hospitalized at from 04/26/14 to 04/30/14. He was apparently admitted for increased agitation and aggression, making threats toward his mother and his niece, with whom he had been living. John states that he does not believe he had been taking his medications correctly, but he also acknowledges that there was increased stressors at the time of hospitalization with his mother and his niece. It is not clear how long John had been living with his mother and niece. The last time he was seen at this clinic was in March of 2010 and he was a resident of Bellvue Personal Care Home. He now resides back at Bellvue Personal Care Home after discharge. John was stabilized and then discharged on his previous medication regimen. He was given a diagnosis of Chronic Paranoid Schizophrenia. However, John appears to have a significant mood component and has been diagnosed with Schizoaffective Disorder, which will continue to be his working diagnosis. John also states that he has quit smoking. He has not smoked in six days and plans to continue abstinence. His sleep, appetite, and weight remain stable.

    **Objective MSE:** The patient is casually dressed and groomed. He looks very good today. He has good skin color. He is alert. He appears to be in good spirits. He makes good eye contact. He is calm and cooperative. Speech is regular in rate and tone, relevant, with some latency of response. Thoughts appear to be goal directed. He relates his mood as “good”. Affect is restricted. He denies any mood lability or instability, nor is there any noted. There is no evidence of any delusional thinking. There is no evidence of any perceptual disturbances. There is no evidence any suicidal or homicidal ideation and he denies same. He is alert and oriented X three.

    **Assessment:**

    **Schizoaffective Disorder, Nicotine Use Disorder, Panic Disorder with Agoraphobia, Mild Intellectual Disability,Peptic Ulcer Disease; Gastritis; Hyperlipidemia;Obesity; Type II Diabetes; Early Diabetic Retinopathy;Disc Disease; Abnormal Tongue Movements; History of Thyroid Disease;Recent hospitalization and Housing issues**

    **Current Medications:**

    a. Geodon 80 mg, po bid

    b. Clonazepam 1 mg po qid

    c. Fluoxetine 40 mg one po q day

    d. Lithium Carbonate 300 mg, three tablets po q h.s.

    **Plan:**

    Continue with John’s current medication regimen. He has been doing well since discharge. He relates that he has been getting along with everyone at Bellevue. He has not had any further problems with anger, aggression, or agitation. During his previous residence at Bellevue, he was somewhat disgruntled and was seeking different housing; however, it appears that once than happened and he moved in with his mother his stressors increased and he destabilized. He is working with his caseworker to find alternative housing that would be appropriate. He will also continue in outpatient therapy with. John verbalizes understanding of, and is in agreement with, this treatment plan. He is encouraged to contact this office with further questions or concerns. He will be return to the office in four weeks for reevaluation, or sooner, as needed.

    **SOAP Grading sheet**

    | | |
    | — | — |
    | **Points** |
    | **20 points**<br>**20 points**<br>**15 points**<br>**20 points**<br>**10 points**<br>**15 points** | A. <br>**S Subjective data appropriately documented. Chief complaint, interval history and review of symptoms**<br>B. <br>**O Objective data appropriately documented. Vitals, review of testing and lab work, MSE**<br>C. <br>**A Assessment appropriately documented. Review diagnoses and current treatment plan for accuracy and relevance.**<br>D. <br>**P Plan to include cost-effective and evidence based treatment. Include labs to order, meds and dosage, counseling and referrals, teaching plan, follow up (add to what was actually done if you would do something other than your preceptor- in italics);**<br>E. <br>**Include neurobiology of disorder(s). (Include genetics, neurotransmitters, neuroanatomical changes, current theories of causation, cultural factors);**<br>F. <br>**Rationale for each part of management plan (labs; meds: why this med, what is neurochemistry action of med, side effects to monitor, expected benefits, contraindications; counseling-goals, rationale for this type of therapy, expected benefits, teaching, referrals, follow-up). Include references from at least 3 sources including one article from refereed journal.** |
    | **Grade** |

    **## SOAPNOTE.EX.11.docx**

    **1. SOAP Notes**

    **IMPORTANT:**

    **Notes are to represent real clients seen by you in clinic and information must also be reflected in your InPlace or Typhon folder of clinical patients. Information leading to discovery of a “made up” note will be cause for course failure.**

    Each student will complete
    three (3) SOAP notes. SOAP Notes are to be posted to the DB in a copy & paste fashion for ease of reading and reference. Please do not attach a link to the document These Soap Notes will stimulate discussion, questions, and critique by peers and instructors. Soap Notes are to be posted in weeks 1, 5, and 9 by Saturday at 11:59. Discussion including
    _at least_ one
    _meaningful_ response to at least one of your peers’ Soap Notes should occur by Thursday at 11:59pm EST in weeks 2, 6, and 10. A meaningful response is one that demonstrates critical thought. Refer to the Carlat, Zuckerman, and Kaplan & Sadock texts for assistance. Posts that are perfunctory or only minimally meeting all grading criteria do not necessarily qualify as “excellent” which would yield full points (100). This is true for both the initial post and the response post. One response post is considered to minimally meet criteria.

    **Purpose:** To record information from the patient, family members, friends, other data bases, other professionals (nurses, physicians, labs, X-ray, Etc), in order to accurately ascertain the information which you need to know about the patient and their disease process(es), so that you can make an accurate diagnosis and provide advice on the most appropriate treatment. The written record also provides a means of communication between you and your professional colleagues. It should be written in a manner which allows the reader to “see” what you observed, performed, discussed and plan to do for and with the patient. SOAP notes are generally done as a follow up after an initial H & P (Psychiatric evaluation) has been done.

    Name of Patient:

    Date of Service:

    S: Subjective information of interest from patient

    O: Objective clinical information of interest you observe and hear; Mental Status Exam (MSE)

    A: DSM-5 diagnosis(es) and specifiers supported by clinical/historical information with ICD-code(s)

    P: Plan of care including medications (trade/generic name, delivery type, dose, route, timing, length of prescription, # of refills), psychotherapy, medication education, crisis planning, and recommendations for next scheduled appointment.

    Signature/credentials

    ***Each SOAP Note submitted after the due date will be penalized five (5) points per day, including weekends.**

    Syllabus 2016-2017

    **SOAP NOTE FORMAT/EXAMPLE:**(Note: This example is not exhaustive and yours must include additional data such as
    _elaboration of rationale, neurobiology, or other information important for an academic exercise but not necessarily appropriate for a clinical document in practice_)

    **PSYCHIATRIC PROGRESS NOTE (SOAP)**

    **NAME: Doe, John DATE: 05/1/2014**

    **Subjective: CC: “I was in the hospital”.** John is seen today as a status post hospitalization visit. He was hospitalized at from 04/26/14 to 04/30/14. He was apparently admitted for increased agitation and aggression, making threats toward his mother and his niece, with whom he had been living. John states that he does not believe he had been taking his medications correctly, but he also acknowledges that there was increased stressors at the time of hospitalization with his mother and his niece. It is not clear how long John had been living with his mother and niece. The last time he was seen at this clinic was in March of 2010 and he was a resident of Bellvue Personal Care Home. He now resides back at Bellvue Personal Care Home after discharge. John was stabilized and then discharged on his previous medication regimen. He was given a diagnosis of Chronic Paranoid Schizophrenia. However, John appears to have a significant mood component and has been diagnosed with Schizoaffective Disorder, which will continue to be his working diagnosis. John also states that he has quit smoking. He has not smoked in six days and plans to continue abstinence. His sleep, appetite, and weight remain stable.

    **Objective MSE:** The patient is casually dressed and groomed. He looks very good today. He has good skin color. He is alert. He appears to be in good spirits. He makes good eye contact. He is calm and cooperative. Speech is regular in rate and tone, relevant, with some latency of response. Thoughts appear to be goal directed. He relates his mood as “good”. Affect is restricted. He denies any mood lability or instability, nor is there any noted. There is no evidence of any delusional thinking. There is no evidence of any perceptual disturbances. There is no evidence any suicidal or homicidal ideation and he denies same. He is alert and oriented X three.

    **Assessment:**

    **Schizoaffective Disorder, Nicotine Use Disorder, Panic Disorder with Agoraphobia, Mild Intellectual Disability,Peptic Ulcer Disease; Gastritis; Hyperlipidemia;Obesity; Type II Diabetes; Early Diabetic Retinopathy;Disc Disease; Abnormal Tongue Movements; History of Thyroid Disease;Recent hospitalization and Housing issues**

    **Current Medications:**

    a. Geodon 80 mg, po bid

    b. Clonazepam 1 mg po qid

    c. Fluoxetine 40 mg one po q day

    d. Lithium Carbonate 300 mg, three tablets po q h.s.

    **Plan:**

    Continue with John’s current medication regimen. He has been doing well since discharge. He relates that he has been getting along with everyone at Bellevue. He has not had any further problems with anger, aggression, or agitation. During his previous residence at Bellevue, he was somewhat disgruntled and was seeking different housing; however, it appears that once than happened and he moved in with his mother his stressors increased and he destabilized. He is working with his caseworker to find alternative housing that would be appropriate. He will also continue in outpatient therapy with. John verbalizes understanding of, and is in agreement with, this treatment plan. He is encouraged to contact this office with further questions or concerns. He will be return to the office in four weeks for reevaluation, or sooner, as needed.

    **SOAP Grading sheet**

    | | |
    | — | — |
    | **Points** |
    | **20 points**<br>**20 points**<br>**15 points**<br>**20 points**<br>**10 points**<br>**15 points** | A. <br>**S Subjective data appropriately documented. Chief complaint, interval history and review of symptoms**<br>B. <br>**O Objective data appropriately documented. Vitals, review of testing and lab work, MSE**<br>C. <br>**A Assessment appropriately documented. Review diagnoses and current treatment plan for accuracy and relevance.**<br>D. <br>**P Plan to include cost-effective and evidence based treatment. Include labs to order, meds and dosage, counseling and referrals, teaching plan, follow up (add to what was actually done if you would do something other than your preceptor- in italics);**<br>E. <br>**Include neurobiology of disorder(s). (Include genetics, neurotransmitters, neuroanatomical changes, current theories of causation, cultural factors);**<br>F. <br>**Rationale for each part of management plan (labs; meds: why this med, what is neurochemistry action of med, side effects to monitor, expected benefits, contraindications; counseling-goals, rationale for this type of therapy, expected benefits, teaching, referrals, follow-up). Include references from at least 3 sources including one article from refereed journal.** |
    | **Grade** |

    **## Soap2Example2.docx**

    Demographics: 56-year-old female, married, employed part-time, lives with spouse.

    Visit Type: Initial psychiatric evaluation via secure audio/video telemedicine.

    Reason for Visit: Worsening depressive symptoms in the setting of bipolar disorder and multiple medical comorbidities.

    Chief Complaint: “My mood has been really low again, and I’m having trouble sleeping and getting motivated.”

    Psychiatric Diagnosis: Bipolar I disorder, current episode depressed, moderate (F31.32).

    Medical Comorbidities: Type 2 diabetes mellitus, hypertension, and hyperlipidemia.

    Social Problems Addressed: Work stress, financial strain related to medical expenses, decreased social activity, and family stress.

    Current Medications:

    · Metformin 1000 mg PO BID

    · Losartan 50 mg PO daily

    · Atorvastatin 40 mg PO nightly

    · No current psychiatric medications

    Psychiatric History: Reports prior manic episodes characterized by approximately 7–10 days of decreased need for sleep, increased energy, rapid speech, excessive goal-directed activity, irritability, and impulsive spending that caused significant family and financial problems. Most recent manic episode was approximately 1 year ago. Currently reports several weeks of depressed mood, anhedonia, fatigue, poor concentration, decreased motivation, and insomnia. Denies current manic symptoms, psychosis, or SI/HI.

    Procedures: Comprehensive psychiatric evaluation, MSE, mood-disorder assessment, medication reconciliation, metabolic-risk review, PHQ-9, suicide risk assessment, substance-use screening, and functional assessment.

    Clinical Note: Patient presents with current bipolar depressive symptoms without evidence of active mania or psychosis. Medical history is significant for T2DM, HTN, and HLD, making metabolic adverse effects an important consideration when selecting treatment. She denies substance misuse and reports no current suicidal or homicidal ideation.

    SOAP Note

    S: Reports depressed mood, loss of interest, low energy, poor concentration, insomnia, and reduced motivation. Confirms history of distinct manic episodes with decreased sleep, increased energy, impulsivity, and functional impairment. Denies current mania, psychosis, SI, or HI.

    O: Telemedicine MSE: A&O ×4, cooperative. Mood depressed; affect constricted and congruent. Speech normal rate and volume. Thought process linear and goal directed. No delusions or hallucinations observed. Insight and judgment fair.

    A: Bipolar I disorder, current episode depressed, moderate. T2DM, HTN, and HLD increase concern for medication-related metabolic effects.

    P: Start lamotrigine 25 mg PO daily for 2 weeks, then increase to 50 mg daily for 2 weeks, with continued gradual titration based on response and tolerability. Counsel patient to stop medication and seek prompt medical evaluation for any new rash, mucosal lesions, or systemic symptoms because of the risk of serious hypersensitivity reactions. Avoid antidepressant monotherapy due to bipolar I diagnosis. Consider an evidence-based bipolar depression agent if additional symptom control is needed, while weighing metabolic risk. Coordinate with PCP for A1c, lipid profile, BP, weight/BMI, and general medical monitoring. Encourage psychotherapy, regular sleep schedule, mood tracking, and relapse-prevention education. Safety plan reviewed.

    New Psychiatric Medication: Lamotrigine 25 mg PO daily with gradual titration.

    Psychotherapy during visit: No
    Telemedicine: Yes – audio/video
    Activity Time: 60 minutes
    Complexity: High
    CPT: 90792
    ICD-10-CM: F31.32, E11.9, I10, E78.5

    **## SOAPNOTE.EX.11.docx**

    **1. SOAP Notes**

    **IMPORTANT:**

    **Notes are to represent real clients seen by you in clinic and information must also be reflected in your InPlace or Typhon folder of clinical patients. Information leading to discovery of a “made up” note will be cause for course failure.**

    Each student will complete
    three (3) SOAP notes. SOAP Notes are to be posted to the DB in a copy & paste fashion for ease of reading and reference. Please do not attach a link to the document These Soap Notes will stimulate discussion, questions, and critique by peers and instructors. Soap Notes are to be posted in weeks 1, 5, and 9 by Saturday at 11:59. Discussion including
    _at least_ one
    _meaningful_ response to at least one of your peers’ Soap Notes should occur by Thursday at 11:59pm EST in weeks 2, 6, and 10. A meaningful response is one that demonstrates critical thought. Refer to the Carlat, Zuckerman, and Kaplan & Sadock texts for assistance. Posts that are perfunctory or only minimally meeting all grading criteria do not necessarily qualify as “excellent” which would yield full points (100). This is true for both the initial post and the response post. One response post is considered to minimally meet criteria.

    **Purpose:** To record information from the patient, family members, friends, other data bases, other professionals (nurses, physicians, labs, X-ray, Etc), in order to accurately ascertain the information which you need to know about the patient and their disease process(es), so that you can make an accurate diagnosis and provide advice on the most appropriate treatment. The written record also provides a means of communication between you and your professional colleagues. It should be written in a manner which allows the reader to “see” what you observed, performed, discussed and plan to do for and with the patient. SOAP notes are generally done as a follow up after an initial H & P (Psychiatric evaluation) has been done.

    Name of Patient:

    Date of Service:

    S: Subjective information of interest from patient

    O: Objective clinical information of interest you observe and hear; Mental Status Exam (MSE)

    A: DSM-5 diagnosis(es) and specifiers supported by clinical/historical information with ICD-code(s)

    P: Plan of care including medications (trade/generic name, delivery type, dose, route, timing, length of prescription, # of refills), psychotherapy, medication education, crisis planning, and recommendations for next scheduled appointment.

    Signature/credentials

    ***Each SOAP Note submitted after the due date will be penalized five (5) points per day, including weekends.**

    Syllabus 2016-2017

    **SOAP NOTE FORMAT/EXAMPLE:**(Note: This example is not exhaustive and yours must include additional data such as
    _elaboration of rationale, neurobiology, or other information important for an academic exercise but not necessarily appropriate for a clinical document in practice_)

    **PSYCHIATRIC PROGRESS NOTE (SOAP)**

    **NAME: Doe, John DATE: 05/1/2014**

    **Subjective: CC: “I was in the hospital”.** John is seen today as a status post hospitalization visit. He was hospitalized at from 04/26/14 to 04/30/14. He was apparently admitted for increased agitation and aggression, making threats toward his mother and his niece, with whom he had been living. John states that he does not believe he had been taking his medications correctly, but he also acknowledges that there was increased stressors at the time of hospitalization with his mother and his niece. It is not clear how long John had been living with his mother and niece. The last time he was seen at this clinic was in March of 2010 and he was a resident of Bellvue Personal Care Home. He now resides back at Bellvue Personal Care Home after discharge. John was stabilized and then discharged on his previous medication regimen. He was given a diagnosis of Chronic Paranoid Schizophrenia. However, John appears to have a significant mood component and has been diagnosed with Schizoaffective Disorder, which will continue to be his working diagnosis. John also states that he has quit smoking. He has not smoked in six days and plans to continue abstinence. His sleep, appetite, and weight remain stable.

    **Objective MSE:** The patient is casually dressed and groomed. He looks very good today. He has good skin color. He is alert. He appears to be in good spirits. He makes good eye contact. He is calm and cooperative. Speech is regular in rate and tone, relevant, with some latency of response. Thoughts appear to be goal directed. He relates his mood as “good”. Affect is restricted. He denies any mood lability or instability, nor is there any noted. There is no evidence of any delusional thinking. There is no evidence of any perceptual disturbances. There is no evidence any suicidal or homicidal ideation and he denies same. He is alert and oriented X three.

    **Assessment:**

    **Schizoaffective Disorder, Nicotine Use Disorder, Panic Disorder with Agoraphobia, Mild Intellectual Disability,Peptic Ulcer Disease; Gastritis; Hyperlipidemia;Obesity; Type II Diabetes; Early Diabetic Retinopathy;Disc Disease; Abnormal Tongue Movements; History of Thyroid Disease;Recent hospitalization and Housing issues**

    **Current Medications:**

    a. Geodon 80 mg, po bid

    b. Clonazepam 1 mg po qid

    c. Fluoxetine 40 mg one po q day

    d. Lithium Carbonate 300 mg, three tablets po q h.s.

    **Plan:**

    Continue with John’s current medication regimen. He has been doing well since discharge. He relates that he has been getting along with everyone at Bellevue. He has not had any further problems with anger, aggression, or agitation. During his previous residence at Bellevue, he was somewhat disgruntled and was seeking different housing; however, it appears that once than happened and he moved in with his mother his stressors increased and he destabilized. He is working with his caseworker to find alternative housing that would be appropriate. He will also continue in outpatient therapy with. John verbalizes understanding of, and is in agreement with, this treatment plan. He is encouraged to contact this office with further questions or concerns. He will be return to the office in four weeks for reevaluation, or sooner, as needed.

    **SOAP Grading sheet**

    | | |
    | — | — |
    | **Points** |
    | **20 points**<br>**20 points**<br>**15 points**<br>**20 points**<br>**10 points**<br>**15 points** | A. <br>**S Subjective data appropriately documented. Chief complaint, interval history and review of symptoms**<br>B. <br>**O Objective data appropriately documented. Vitals, review of testing and lab work, MSE**<br>C. <br>**A Assessment appropriately documented. Review diagnoses and current treatment plan for accuracy and relevance.**<br>D. <br>**P Plan to include cost-effective and evidence based treatment. Include labs to order, meds and dosage, counseling and referrals, teaching plan, follow up (add to what was actually done if you would do something other than your preceptor- in italics);**<br>E. <br>**Include neurobiology of disorder(s). (Include genetics, neurotransmitters, neuroanatomical changes, current theories of causation, cultural factors);**<br>F. <br>**Rationale for each part of management plan (labs; meds: why this med, what is neurochemistry action of med, side effects to monitor, expected benefits, contraindications; counseling-goals, rationale for this type of therapy, expected benefits, teaching, referrals, follow-up). Include references from at least 3 sources including one article from refereed journal.** |
    | **Grade** |

    **## Soap2Example2.docx**

    Demographics: 56-year-old female, married, employed part-time, lives with spouse.

    Visit Type: Initial psychiatric evaluation via secure audio/video telemedicine.

    Reason for Visit: Worsening depressive symptoms in the setting of bipolar disorder and multiple medical comorbidities.

    Chief Complaint: “My mood has been really low again, and I’m having trouble sleeping and getting motivated.”

    Psychiatric Diagnosis: Bipolar I disorder, current episode depressed, moderate (F31.32).

    Medical Comorbidities: Type 2 diabetes mellitus, hypertension, and hyperlipidemia.

    Social Problems Addressed: Work stress, financial strain related to medical expenses, decreased social activity, and family stress.

    Current Medications:

    · Metformin 1000 mg PO BID

    · Losartan 50 mg PO daily

    · Atorvastatin 40 mg PO nightly

    · No current psychiatric medications

    Psychiatric History: Reports prior manic episodes characterized by approximately 7–10 days of decreased need for sleep, increased energy, rapid speech, excessive goal-directed activity, irritability, and impulsive spending that caused significant family and financial problems. Most recent manic episode was approximately 1 year ago. Currently reports several weeks of depressed mood, anhedonia, fatigue, poor concentration, decreased motivation, and insomnia. Denies current manic symptoms, psychosis, or SI/HI.

    Procedures: Comprehensive psychiatric evaluation, MSE, mood-disorder assessment, medication reconciliation, metabolic-risk review, PHQ-9, suicide risk assessment, substance-use screening, and functional assessment.

    Clinical Note: Patient presents with current bipolar depressive symptoms without evidence of active mania or psychosis. Medical history is significant for T2DM, HTN, and HLD, making metabolic adverse effects an important consideration when selecting treatment. She denies substance misuse and reports no current suicidal or homicidal ideation.

    SOAP Note

    S: Reports depressed mood, loss of interest, low energy, poor concentration, insomnia, and reduced motivation. Confirms history of distinct manic episodes with decreased sleep, increased energy, impulsivity, and functional impairment. Denies current mania, psychosis, SI, or HI.

    O: Telemedicine MSE: A&O ×4, cooperative. Mood depressed; affect constricted and congruent. Speech normal rate and volume. Thought process linear and goal directed. No delusions or hallucinations observed. Insight and judgment fair.

    A: Bipolar I disorder, current episode depressed, moderate. T2DM, HTN, and HLD increase concern for medication-related metabolic effects.

    P: Start lamotrigine 25 mg PO daily for 2 weeks, then increase to 50 mg daily for 2 weeks, with continued gradual titration based on response and tolerability. Counsel patient to stop medication and seek prompt medical evaluation for any new rash, mucosal lesions, or systemic symptoms because of the risk of serious hypersensitivity reactions. Avoid antidepressant monotherapy due to bipolar I diagnosis. Consider an evidence-based bipolar depression agent if additional symptom control is needed, while weighing metabolic risk. Coordinate with PCP for A1c, lipid profile, BP, weight/BMI, and general medical monitoring. Encourage psychotherapy, regular sleep schedule, mood tracking, and relapse-prevention education. Safety plan reviewed.

    New Psychiatric Medication: Lamotrigine 25 mg PO daily with gradual titration.

    Psychotherapy during visit: No
    Telemedicine: Yes – audio/video
    Activity Time: 60 minutes
    Complexity: High
    CPT: 90792
    ICD-10-CM: F31.32, E11.9, I10, E78.5

    **## SOAPNOTE.EX.11.docx**

    **1. SOAP Notes**

    **IMPORTANT:**

    **Notes are to represent real clients seen by you in clinic and information must also be reflected in your InPlace or Typhon folder of clinical patients. Information leading to discovery of a “made up” note will be cause for course failure.**

    Each student will complete
    three (3) SOAP notes. SOAP Notes are to be posted to the DB in a copy & paste fashion for ease of reading and reference. Please do not attach a link to the document These Soap Notes will stimulate discussion, questions, and critique by peers and instructors. Soap Notes are to be posted in weeks 1, 5, and 9 by Saturday at 11:59. Discussion including
    _at least_ one
    _meaningful_ response to at least one of your peers’ Soap Notes should occur by Thursday at 11:59pm EST in weeks 2, 6, and 10. A meaningful response is one that demonstrates critical thought. Refer to the Carlat, Zuckerman, and Kaplan & Sadock texts for assistance. Posts that are perfunctory or only minimally meeting all grading criteria do not necessarily qualify as “excellent” which would yield full points (100). This is true for both the initial post and the response post. One response post is considered to minimally meet criteria.

    **Purpose:** To record information from the patient, family members, friends, other data bases, other professionals (nurses, physicians, labs, X-ray, Etc), in order to accurately ascertain the information which you need to know about the patient and their disease process(es), so that you can make an accurate diagnosis and provide advice on the most appropriate treatment. The written record also provides a means of communication between you and your professional colleagues. It should be written in a manner which allows the reader to “see” what you observed, performed, discussed and plan to do for and with the patient. SOAP notes are generally done as a follow up after an initial H & P (Psychiatric evaluation) has been done.

    Name of Patient:

    Date of Service:

    S: Subjective information of interest from patient

    O: Objective clinical information of interest you observe and hear; Mental Status Exam (MSE)

    A: DSM-5 diagnosis(es) and specifiers supported by clinical/historical information with ICD-code(s)

    P: Plan of care including medications (trade/generic name, delivery type, dose, route, timing, length of prescription, # of refills), psychotherapy, medication education, crisis planning, and recommendations for next scheduled appointment.

    Signature/credentials

    ***Each SOAP Note submitted after the due date will be penalized five (5) points per day, including weekends.**

    Syllabus 2016-2017

    **SOAP NOTE FORMAT/EXAMPLE:**(Note: This example is not exhaustive and yours must include additional data such as
    _elaboration of rationale, neurobiology, or other information important for an academic exercise but not necessarily appropriate for a clinical document in practice_)

    **PSYCHIATRIC PROGRESS NOTE (SOAP)**

    **NAME: Doe, John DATE: 05/1/2014**

    **Subjective: CC: “I was in the hospital”.** John is seen today as a status post hospitalization visit. He was hospitalized at from 04/26/14 to 04/30/14. He was apparently admitted for increased agitation and aggression, making threats toward his mother and his niece, with whom he had been living. John states that he does not believe he had been taking his medications correctly, but he also acknowledges that there was increased stressors at the time of hospitalization with his mother and his niece. It is not clear how long John had been living with his mother and niece. The last time he was seen at this clinic was in March of 2010 and he was a resident of Bellvue Personal Care Home. He now resides back at Bellvue Personal Care Home after discharge. John was stabilized and then discharged on his previous medication regimen. He was given a diagnosis of Chronic Paranoid Schizophrenia. However, John appears to have a significant mood component and has been diagnosed with Schizoaffective Disorder, which will continue to be his working diagnosis. John also states that he has quit smoking. He has not smoked in six days and plans to continue abstinence. His sleep, appetite, and weight remain stable.

    **Objective MSE:** The patient is casually dressed and groomed. He looks very good today. He has good skin color. He is alert. He appears to be in good spirits. He makes good eye contact. He is calm and cooperative. Speech is regular in rate and tone, relevant, with some latency of response. Thoughts appear to be goal directed. He relates his mood as “good”. Affect is restricted. He denies any mood lability or instability, nor is there any noted. There is no evidence of any delusional thinking. There is no evidence of any perceptual disturbances. There is no evidence any suicidal or homicidal ideation and he denies same. He is alert and oriented X three.

    **Assessment:**

    **Schizoaffective Disorder, Nicotine Use Disorder, Panic Disorder with Agoraphobia, Mild Intellectual Disability,Peptic Ulcer Disease; Gastritis; Hyperlipidemia;Obesity; Type II Diabetes; Early Diabetic Retinopathy;Disc Disease; Abnormal Tongue Movements; History of Thyroid Disease;Recent hospitalization and Housing issues**

    **Current Medications:**

    a. Geodon 80 mg, po bid

    b. Clonazepam 1 mg po qid

    c. Fluoxetine 40 mg one po q day

    d. Lithium Carbonate 300 mg, three tablets po q h.s.

    **Plan:**

    Continue with John’s current medication regimen. He has been doing well since discharge. He relates that he has been getting along with everyone at Bellevue. He has not had any further problems with anger, aggression, or agitation. During his previous residence at Bellevue, he was somewhat disgruntled and was seeking different housing; however, it appears that once than happened and he moved in with his mother his stressors increased and he destabilized. He is working with his caseworker to find alternative housing that would be appropriate. He will also continue in outpatient therapy with. John verbalizes understanding of, and is in agreement with, this treatment plan. He is encouraged to contact this office with further questions or concerns. He will be return to the office in four weeks for reevaluation, or sooner, as needed.

    **SOAP Grading sheet**

    | | |
    | — | — |
    | **Points** |
    | **20 points**<br>**20 points**<br>**15 points**<br>**20 points**<br>**10 points**<br>**15 points** | A. <br>**S Subjective data appropriately documented. Chief complaint, interval history and review of symptoms**<br>B. <br>**O Objective data appropriately documented. Vitals, review of testing and lab work, MSE**<br>C. <br>**A Assessment appropriately documented. Review diagnoses and current treatment plan for accuracy and relevance.**<br>D. <br>**P Plan to include cost-effective and evidence based treatment. Include labs to order, meds and dosage, counseling and referrals, teaching plan, follow up (add to what was actually done if you would do something other than your preceptor- in italics);**<br>E. <br>**Include neurobiology of disorder(s). (Include genetics, neurotransmitters, neuroanatomical changes, current theories of causation, cultural factors);**<br>F. <br>**Rationale for each part of management plan (labs; meds: why this med, what is neurochemistry action of med, side effects to monitor, expected benefits, contraindications; counseling-goals, rationale for this type of therapy, expected benefits, teaching, referrals, follow-up). Include references from at least 3 sources including one article from refereed journal.** |
    | **Grade** |

  • [Solved] psych cosh troy

    ✓ Verified Academic Solution Available

    Executive Solution Overview

    – a month ago **files (1)** – ## psychCoshtroy.docx **## psychCoshtroy.docx** **Part A (Cos)** **Discussion Board 300 words** Infants develop rapidly in their ability to express emotions and form social bonds. In your post, briefly discuss: 1. **One emotional milestone** in infancy (ex: smiling, st…

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    Assignment Prompt & Instructions

    – a month ago

    **files (1)**

    – ## psychCoshtroy.docx

    **## psychCoshtroy.docx**

    **Part A (Cos)**

    **Discussion Board 300 words**

    Infants develop rapidly in their ability to express emotions and form social bonds.

    In your post, briefly discuss:

    1.
    **One emotional milestone** in infancy (ex: smiling, stranger anxiety, self-soothing).

    2.
    **One social milestone** (ex: attachment, social referencing, responding to caregivers).

    3.
    **One factor that influences emotional or social development** (ex: caregiving style, temperament, culture, early experiences).

    4. Explain why this factor matters for healthy development.

    Write at least 300 word well developed and well written response. Use APA formatting guide to create accurate citations and documentation to give credit for any resource material used in your response. Please remember to comment on at least 2 classmate's posts in order to get full credit. You must follow the guidelines to receive full credit for discussion boards. If you do not post, it will count as a 0. No additional postings after the deadline with be accepted.

    **Part B Essay 3 pages (Tr)**

    Module Overview

    In this module, you will learn how to write a
    **profile essay**, a genre of writing that blends research, description, and analysis to paint a vivid picture of a person, group, place, or event. For this course, your profile essay will focus on a figure or case in
    **true crime**, allowing you to practice both critical thinking and storytelling techniques.

    **Learning Objectives**

    By the end of this module, you should be able to:

    1. Define what a profile essay is and identify its key features.

    2. Differentiate between summary, analysis, and narrative elements in a profile.

    3. Select an appropriate subject for a profile essay.

    4. Gather credible sources to develop an accurate and engaging profile.

    5. Organize your ideas into a structured essay that combines fact with analysis.

    **Key Concepts**

    · What makes a good
    **profile subject** (interesting, complex, and significant).

    · Using
    **descriptive detail** to bring your subject to life.

    · Balancing
    **objectivity** (facts and evidence) with
    **analysis** (your perspective).

    · Incorporating
    **sources** smoothly into your writing.

    · Understanding the difference between
    **profile writing** and a simple report.

    **Assignments**

    **Profile-True Crime Essay- due Monday, September 25, 2026 @11;59PM**

    **## psychCoshtroy.docx**

    **Part A (Cos)**

    **Discussion Board 300 words**

    Infants develop rapidly in their ability to express emotions and form social bonds.

    In your post, briefly discuss:

    1.
    **One emotional milestone** in infancy (ex: smiling, stranger anxiety, self-soothing).

    2.
    **One social milestone** (ex: attachment, social referencing, responding to caregivers).

    3.
    **One factor that influences emotional or social development** (ex: caregiving style, temperament, culture, early experiences).

    4. Explain why this factor matters for healthy development.

    Write at least 300 word well developed and well written response. Use APA formatting guide to create accurate citations and documentation to give credit for any resource material used in your response. Please remember to comment on at least 2 classmate's posts in order to get full credit. You must follow the guidelines to receive full credit for discussion boards. If you do not post, it will count as a 0. No additional postings after the deadline with be accepted.

    **Part B Essay 3 pages (Tr)**

    Module Overview

    In this module, you will learn how to write a
    **profile essay**, a genre of writing that blends research, description, and analysis to paint a vivid picture of a person, group, place, or event. For this course, your profile essay will focus on a figure or case in
    **true crime**, allowing you to practice both critical thinking and storytelling techniques.

    **Learning Objectives**

    By the end of this module, you should be able to:

    1. Define what a profile essay is and identify its key features.

    2. Differentiate between summary, analysis, and narrative elements in a profile.

    3. Select an appropriate subject for a profile essay.

    4. Gather credible sources to develop an accurate and engaging profile.

    5. Organize your ideas into a structured essay that combines fact with analysis.

    **Key Concepts**

    · What makes a good
    **profile subject** (interesting, complex, and significant).

    · Using
    **descriptive detail** to bring your subject to life.

    · Balancing
    **objectivity** (facts and evidence) with
    **analysis** (your perspective).

    · Incorporating
    **sources** smoothly into your writing.

    · Understanding the difference between
    **profile writing** and a simple report.

    **Assignments**

    **Profile-True Crime Essay- due Monday, September 25, 2026 @11;59PM**

  • [Solved] CMA Post 4 Response

    ✓ Verified Academic Solution Available

    Executive Solution Overview

    – a month ago **files (1)** – ## CMAPOST4Response.docx **## CMAPOST4Response.docx** How does Hildegard Peplau's theory of interpersonal relations shape the nurse-patient relationship in contemporary psychiatric nursing, and what are the key benefits and challenges of applying her concepts in modern …

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    Assignment Prompt & Instructions

    – a month ago

    **files (1)**

    – ## CMAPOST4Response.docx

    **## CMAPOST4Response.docx**

    How does Hildegard Peplau's theory of interpersonal relations shape the nurse-patient relationship in contemporary psychiatric nursing, and what are the key benefits and challenges of applying her concepts in modern clinical practice? Posts are a minimum of 250 words, scholarly written, APA formatted (with some exceptions due to limitations in the D2L editor), and a minimum of 2 references (which may include the course textbook). Reply to at least one classmate's initial discussion post by Friday at 11:59 PM ET.

    Hildegard Peplau’s Theory of Interpersonal Relations continues to be an influential framework in psychiatric nursing due to its emphasis on the therapeutic relationship between nurses and their patients. Peplau's interpretation of nursing was viewed as an interpersonal relationship and therapeutic process in which the nurse helps the client understand their health concerns and develop and strengthen insight, which, over time, supports personal growth (Current Nursing, n.d.; RN Speak, n.d.). Her theory categorizes four valuable phases of the nurse-patient relationship: orientation, identification, exploitation, and resolution. Throughout these phases, the nurse establishes trust, assists patients in recognizing their needs, supports and promotes the use of available resources, and eventually encourages independence and recovery (Current Nursing, n.d.).

    In modern psychiatric nursing, Peplau’s theory influences practice by leading nurses to adopt collaborative patient-centered relationships. Rather than focusing on symptom management, clinicians engage patients through communication, empathy, and active participation in treatment. This approach demonstrates respect, dignity, and patient empowerment, which aligns well with today’s recovery -oriented mental health care. Peplau also described various nursing roles such as counselor, resource person, teacher, leader, and surrogate, all of which remain invaluable in psychiatric settings where therapeutic communication is vital (RN Speak, n.d.).

    Applying Peplau’s concepts in practice offers several noteworthy benefits. First, by establishing trust with the patient, it has been shown that this improves patient participation as well as adherence to treatment plans. Second, therapeutic communication promotes emotional expression and self-awareness, helping patients acquire healthier coping tactics. Third, the collective nature of the relationship fosters patient autonomy and supports long-term recovery. These benefits represent a wide range of psychotherapeutic principles that accentuate the importance of a therapeutic collaboration in achieving positive mental health outcomes (Wedding & Corsini, 2018).

    Despite its strengths and popularity, applying Peplau’s principles in modern clinical practice can be a bit discouraging. High patient loads, limited time with patients, and staffing shortages can restrict opportunities for developing meaningful therapeutic alliances. In addition, patients who present with psychiatric symptoms, such as cognitive impairments or acute psychosis, may have difficulties trusting and engaging in the interpersonal process projected by Peplau. The increased use of technology and cultural differences in healthcare can also hinder communication and relationship building. Nonetheless, Peplau’s theory continues to provide and promote a fundamental framework for building and supporting therapeutic interaction and delivering effective, patient-centered psychiatric nursing care.

    Hildegard Peplau’s Theory of Interpersonal Relations remains an influential framework in mental health nursing because of its emphasis on the therapeutic relationship amongst nurses and their patients. Peplau's interpretation of nursing was regarded as an interpersonal relationship and therapeutic process in which the nurse helps the client understand their health concerns and develop and strengthen insight, which, over time, supports personal growth (Current Nursing, n.d.; RN Speak, n.d.). Her theory categorizes four valuable steps in the nurse-patient rapport: orientation, identification, exploitation, and resolution. Throughout these four phases, the nurse establishes trust, assists patients in recognizing their needs, supports and promotes the use of available resources, and eventually encourages independence and recovery (Current Nursing, n.d.).

    In modern psychiatric nursing, Peplau’s theory influences practice by leading nurses to adopt collaborative patient-centered relationships. Rather than focusing on symptom management, clinicians engage patients through communication, empathy, and active participation in treatment. This approach demonstrates respect, dignity, and patient empowerment, which aligns well with today’s recovery -oriented mental health care. Peplau also described various nursing responsibilities such as counselor, leader, teacher, resource person, and surrogate, all of which remain invaluable in psychiatric settings where therapeutic communication is vital (RN Speak, n.d.).

    Applying Peplau’s concepts in practice offers several noteworthy benefits. First, by establishing trust with the patient, it has been shown that this improves patient participation as well as adherence to treatment plans. Second, therapeutic communication promotes emotional expression and self-awareness, helping patients acquire healthier coping tactics. Third, the collective nature of the relationship fosters patient autonomy and supports long-term recovery. These benefits represent a wide range of psychotherapeutic principles that accentuate the importance of a therapeutic collaboration in achieving positive mental health outcomes (Wedding & Corsini, 2018).

    Despite its strengths and popularity, applying Peplau’s principles in modern clinical practice can be a bit discouraging. High patient loads, limited time with patients, and staffing shortages can restrict opportunities for developing meaningful therapeutic alliances. In addition, patients who present with psychiatric symptoms, such as cognitive impairments or acute psychosis, may have difficulties trusting and engaging in the interpersonal process projected by Peplau. The increased use of technology and cultural differences in healthcare can also hinder communication and relationship building. Nonetheless, Peplau’s theory continues to provide and promote a fundamental framework for building and supporting therapeutic interaction and delivering effective, patient-centered psychiatric nursing care.

    References

    Current Nursing. (n.d.). Peplau’s interpersonal relations theory. Current Nursing. Retrieved

    September 23, 2026, from https://currentnursing.com/nursing_theory/interpersonal_theory.html

    RN Speak. (n.d.). Hildegard Peplau nursing theory. RN Speak. Retrieved September 23,

    2026, from https://rnspeak.com/hildegard-peplau-nursing-theory/

    Wedding, D., & Corsini, R. J. (2018). Current psychotherapies (11th ed.). Cengage Learning.CM

    **## CMAPOST4Response.docx**

    How does Hildegard Peplau's theory of interpersonal relations shape the nurse-patient relationship in contemporary psychiatric nursing, and what are the key benefits and challenges of applying her concepts in modern clinical practice? Posts are a minimum of 250 words, scholarly written, APA formatted (with some exceptions due to limitations in the D2L editor), and a minimum of 2 references (which may include the course textbook). Reply to at least one classmate's initial discussion post by Friday at 11:59 PM ET.

    Hildegard Peplau’s Theory of Interpersonal Relations continues to be an influential framework in psychiatric nursing due to its emphasis on the therapeutic relationship between nurses and their patients. Peplau's interpretation of nursing was viewed as an interpersonal relationship and therapeutic process in which the nurse helps the client understand their health concerns and develop and strengthen insight, which, over time, supports personal growth (Current Nursing, n.d.; RN Speak, n.d.). Her theory categorizes four valuable phases of the nurse-patient relationship: orientation, identification, exploitation, and resolution. Throughout these phases, the nurse establishes trust, assists patients in recognizing their needs, supports and promotes the use of available resources, and eventually encourages independence and recovery (Current Nursing, n.d.).

    In modern psychiatric nursing, Peplau’s theory influences practice by leading nurses to adopt collaborative patient-centered relationships. Rather than focusing on symptom management, clinicians engage patients through communication, empathy, and active participation in treatment. This approach demonstrates respect, dignity, and patient empowerment, which aligns well with today’s recovery -oriented mental health care. Peplau also described various nursing roles such as counselor, resource person, teacher, leader, and surrogate, all of which remain invaluable in psychiatric settings where therapeutic communication is vital (RN Speak, n.d.).

    Applying Peplau’s concepts in practice offers several noteworthy benefits. First, by establishing trust with the patient, it has been shown that this improves patient participation as well as adherence to treatment plans. Second, therapeutic communication promotes emotional expression and self-awareness, helping patients acquire healthier coping tactics. Third, the collective nature of the relationship fosters patient autonomy and supports long-term recovery. These benefits represent a wide range of psychotherapeutic principles that accentuate the importance of a therapeutic collaboration in achieving positive mental health outcomes (Wedding & Corsini, 2018).

    Despite its strengths and popularity, applying Peplau’s principles in modern clinical practice can be a bit discouraging. High patient loads, limited time with patients, and staffing shortages can restrict opportunities for developing meaningful therapeutic alliances. In addition, patients who present with psychiatric symptoms, such as cognitive impairments or acute psychosis, may have difficulties trusting and engaging in the interpersonal process projected by Peplau. The increased use of technology and cultural differences in healthcare can also hinder communication and relationship building. Nonetheless, Peplau’s theory continues to provide and promote a fundamental framework for building and supporting therapeutic interaction and delivering effective, patient-centered psychiatric nursing care.

    Hildegard Peplau’s Theory of Interpersonal Relations remains an influential framework in mental health nursing because of its emphasis on the therapeutic relationship amongst nurses and their patients. Peplau's interpretation of nursing was regarded as an interpersonal relationship and therapeutic process in which the nurse helps the client understand their health concerns and develop and strengthen insight, which, over time, supports personal growth (Current Nursing, n.d.; RN Speak, n.d.). Her theory categorizes four valuable steps in the nurse-patient rapport: orientation, identification, exploitation, and resolution. Throughout these four phases, the nurse establishes trust, assists patients in recognizing their needs, supports and promotes the use of available resources, and eventually encourages independence and recovery (Current Nursing, n.d.).

    In modern psychiatric nursing, Peplau’s theory influences practice by leading nurses to adopt collaborative patient-centered relationships. Rather than focusing on symptom management, clinicians engage patients through communication, empathy, and active participation in treatment. This approach demonstrates respect, dignity, and patient empowerment, which aligns well with today’s recovery -oriented mental health care. Peplau also described various nursing responsibilities such as counselor, leader, teacher, resource person, and surrogate, all of which remain invaluable in psychiatric settings where therapeutic communication is vital (RN Speak, n.d.).

    Applying Peplau’s concepts in practice offers several noteworthy benefits. First, by establishing trust with the patient, it has been shown that this improves patient participation as well as adherence to treatment plans. Second, therapeutic communication promotes emotional expression and self-awareness, helping patients acquire healthier coping tactics. Third, the collective nature of the relationship fosters patient autonomy and supports long-term recovery. These benefits represent a wide range of psychotherapeutic principles that accentuate the importance of a therapeutic collaboration in achieving positive mental health outcomes (Wedding & Corsini, 2018).

    Despite its strengths and popularity, applying Peplau’s principles in modern clinical practice can be a bit discouraging. High patient loads, limited time with patients, and staffing shortages can restrict opportunities for developing meaningful therapeutic alliances. In addition, patients who present with psychiatric symptoms, such as cognitive impairments or acute psychosis, may have difficulties trusting and engaging in the interpersonal process projected by Peplau. The increased use of technology and cultural differences in healthcare can also hinder communication and relationship building. Nonetheless, Peplau’s theory continues to provide and promote a fundamental framework for building and supporting therapeutic interaction and delivering effective, patient-centered psychiatric nursing care.

    References

    Current Nursing. (n.d.). Peplau’s interpersonal relations theory. Current Nursing. Retrieved

    September 23, 2026, from https://currentnursing.com/nursing_theory/interpersonal_theory.html

    RN Speak. (n.d.). Hildegard Peplau nursing theory. RN Speak. Retrieved September 23,

    2026, from https://rnspeak.com/hildegard-peplau-nursing-theory/

    Wedding, D., & Corsini, R. J. (2018). Current psychotherapies (11th ed.). Cengage Learning.CM

  • [Solved] Psychology homework

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    Page 1: Title Page Page 2: Body Page Step 2: Create Your Body Page At the top of page 2, type the title: APA Template Assignment The title should be: ✅ Bold ✅ Centered ✅ The same title used on your title page Step 3: Write an Introduction Paragraph Immediately below the title, write one paragraph ex…

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    Page 1: Title Page

    Page 2: Body Page Step 2: Create Your Body Page At the top of page 2, type the title: APA Template Assignment The title should be: ✅ Bold ✅ Centered ✅ The same title used on your title page Step 3: Write an Introduction Paragraph Immediately below the title, write one paragraph explaining: What an introduction is Why introductions are important What information is usually included in an introduction Important Do not create a heading called "Introduction." In APA style, the introduction begins directly below the title. Step 4: Create a Level 1 Heading Create the following heading: Types of Communication This heading should be: ✅ Centered ✅ Bold Under this heading, write one paragraph explaining: What a Level 1 heading is Why writers use Level 1 headings How Level 1 headings help organize information Step 5: Create a Level 2 Heading Create the following heading: Verbal Communication This heading should be: ✅ Flush left ✅ Bold Under this heading, write one paragraph explaining: What a Level 2 heading is Why writers use Level 2 headings How Level 2 headings differ from Level 1 headings Step 6: Create a Level 3 Heading Create the following heading: Tone and Word Choice This heading should be: ✅ Flush left ✅ Bold ✅ Italicized Under this heading, write one paragraph explaining: What a Level 3 heading is Why writers use Level 3 headings How Level 3 headings differ from Levels 1 and 2 Step 7: Create a Conclusion Section Create the following heading: Conclusion This heading should be: ✅ Centered ✅ Bold Under this heading, write one paragraph explaining: What a conclusion is Why conclusions are important What information should be included in a conclusion

    – a month ago

  • [Solved] Psychology

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    – a month ago **files (1)** – ## Casestudy11.docx **## Casestudy11.docx** **DESCRIPTION** **In this project you will explore and analyze various ethical dilemmas that arise in the field of psychology, both in research and clinical practice.** **CASE STUDY** The psychologist (Dr. Faye deWeigh-Schott)…

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    – a month ago

    **files (1)**

    – ## Casestudy11.docx

    **## Casestudy11.docx**

    **DESCRIPTION**

    **In this project you will explore and analyze various ethical dilemmas that arise in the field of psychology, both in research and clinical practice.**

    **CASE STUDY**

    The psychologist (Dr. Faye deWeigh-Schott) has been seeing a client, Barbie Tuate, for eight weeks regarding a difficult adjustment she was experiencing following separation and divorce from her husband. She has custody of the two children. Barbie seems to be progressing well during the course of therapy. About four weeks into therapy, she confides in Dr. deWeighSchott that she has been taking a drug prescribed by her family doctor for anxiety and is addicted. She also admits she has been forging these prescriptions for the past four months. Barbie is a nurse and knows she needs to withdraw from this drug but is fearful of the potential legal consequences of her actions. She is planning to refill a forged prescription immediately following the current therapy session. She says she plans to seek medical help for her withdrawal from the drug and she asks Dr. deWeigh-Schott not to tell anyone about her forgery, as this would jeopardize her keeping her job and custody of her two young children.

    **Read case study. Prepare a presentation that outline the ethical dilemma.** **Must be at least 4 slides plus reference slide;**

    **Describe how this could have been avoided.**

    **Preventing Future Dilemma.**

    **Real-World Examples**

    **Reference**

    **## Casestudy11.docx**

    **DESCRIPTION**

    **In this project you will explore and analyze various ethical dilemmas that arise in the field of psychology, both in research and clinical practice.**

    **CASE STUDY**

    The psychologist (Dr. Faye deWeigh-Schott) has been seeing a client, Barbie Tuate, for eight weeks regarding a difficult adjustment she was experiencing following separation and divorce from her husband. She has custody of the two children. Barbie seems to be progressing well during the course of therapy. About four weeks into therapy, she confides in Dr. deWeighSchott that she has been taking a drug prescribed by her family doctor for anxiety and is addicted. She also admits she has been forging these prescriptions for the past four months. Barbie is a nurse and knows she needs to withdraw from this drug but is fearful of the potential legal consequences of her actions. She is planning to refill a forged prescription immediately following the current therapy session. She says she plans to seek medical help for her withdrawal from the drug and she asks Dr. deWeigh-Schott not to tell anyone about her forgery, as this would jeopardize her keeping her job and custody of her two young children.

    **Read case study. Prepare a presentation that outline the ethical dilemma.** **Must be at least 4 slides plus reference slide;**

    **Describe how this could have been avoided.**

    **Preventing Future Dilemma.**

    **Real-World Examples**

    **Reference**

  • [Solved] Reflection on Background

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  • [Solved] Behaviorism and Philosophical Foundations of Applied Behavior Analysis

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    see attachment – a month ago **files (2)** – ## Unit5details.docx – ## Unit5midtermFoundationsofBehaviorAnalysis.docx **## Unit5details.docx** Your assignment should be 8–10 pages, not including the title and reference pages, and should include the following elements: · Title Page: Provide the assig…

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    see attachment

    – a month ago

    **files (2)**

    – ## Unit5details.docx

    – ## Unit5midtermFoundationsofBehaviorAnalysis.docx

    **## Unit5details.docx**

    Your assignment should be 8–10 pages, not including the title and reference pages, and should include the following elements:

    · Title Page: Provide the assignment title, your name, course and section number, instructor name, and date.

    · Body: Include an introductory and a concluding paragraph. Answer all the questions in complete sentences and paragraphs, using appropriate personal and professional insights.

    · The assignment must be written in Standard English and demonstrate superior organization, including a highly developed viewpoint and purpose that is clearly established and sustained. The communication of your thoughts must be highly ordered, logical, and unified, displaying exceptional content, organization, style, and mechanics (including the use of correct grammar, punctuation, and sentence structure).

    · Your responses should meet professional writing standards, using proper tone and language. The writing and writing style should be correct and accurate and reflect knowledge of applied behavior analysis.

    · Reference Page: Sources listed in APA format.

    · A minimum of three academic sources, including in-text citation(s).

    · Use Arial or Times New Roman 12-point font, double-spaced and left aligned.

    · Use standard 1" margins on all sides.

    · Use current APA formatting and citation style.

    · If you need assistance with APA Style, please visit the
    [**Academic Write**](https://library.purdueglobal.edu/library/academicwriter)

    **## Unit5midtermFoundationsofBehaviorAnalysis.docx**

    Foundations of Behavior Analysis

    Throughout the first half of this course, you have explored the history of behaviorism and the roots of applied behavior analysis in the philosophy and practices of natural science. In this assignment, you will have the opportunity to synthesize the knowledge you have gained.

    For this assignment, you will provide a long-answer essay response to each of the questions below. For each question, you are encouraged to use the peer-reviewed resources provided throughout the units to support your responses. Please do not copy and paste the whole question into the document. Rather, use APA format section headings to organize your paper, with separate sections for each question. Use the rubric and the assignment prompts as guides to be sure you address all topics. Be sure to use the sources provided so far in the course and support your work throughout with in-text citations and a reference list at the end of your paper.

    Please respond to the following:

    Compare the three branches of behavior analysis (behaviorism, EAB, and ABA).

    Explain how the evolving historical and philosophical perspectives of behaviorism have influenced the study of applied behavior analysis as a natural science.

    Name at least four important figures who have developed and furthered the science of behavior analysis and, specifically, discuss their contributions to the field.

    Define radical behaviorism.

    Explain the ways in which radical behaviorism attempts to create a set of universal laws to understand all behavior.

    How does radical behaviorism differentiate between private events and public events?

    How does the distinction between private events and public events relate to a distinction between mentalistic and environmental explanations for behavior?

    In radical behaviorism, which explanation is preferred and why?

    Explain the six attitudes/assumptions of experimental analysis of behavior, the goals of behavior analysis as a science, and the seven dimensions of applied behavior analysis.

    Examine how each of these areas work together to contribute to the development of a technology (i.e. a set of standards and procedures) that is used to influence socially significant behavior.

    **## Unit5midtermFoundationsofBehaviorAnalysis.docx**

    Foundations of Behavior Analysis

    Throughout the first half of this course, you have explored the history of behaviorism and the roots of applied behavior analysis in the philosophy and practices of natural science. In this assignment, you will have the opportunity to synthesize the knowledge you have gained.

    For this assignment, you will provide a long-answer essay response to each of the questions below. For each question, you are encouraged to use the peer-reviewed resources provided throughout the units to support your responses. Please do not copy and paste the whole question into the document. Rather, use APA format section headings to organize your paper, with separate sections for each question. Use the rubric and the assignment prompts as guides to be sure you address all topics. Be sure to use the sources provided so far in the course and support your work throughout with in-text citations and a reference list at the end of your paper.

    Please respond to the following:

    Compare the three branches of behavior analysis (behaviorism, EAB, and ABA).

    Explain how the evolving historical and philosophical perspectives of behaviorism have influenced the study of applied behavior analysis as a natural science.

    Name at least four important figures who have developed and furthered the science of behavior analysis and, specifically, discuss their contributions to the field.

    Define radical behaviorism.

    Explain the ways in which radical behaviorism attempts to create a set of universal laws to understand all behavior.

    How does radical behaviorism differentiate between private events and public events?

    How does the distinction between private events and public events relate to a distinction between mentalistic and environmental explanations for behavior?

    In radical behaviorism, which explanation is preferred and why?

    Explain the six attitudes/assumptions of experimental analysis of behavior, the goals of behavior analysis as a science, and the seven dimensions of applied behavior analysis.

    Examine how each of these areas work together to contribute to the development of a technology (i.e. a set of standards and procedures) that is used to influence socially significant behavior.

    **## Unit5details.docx**

    Your assignment should be 8–10 pages, not including the title and reference pages, and should include the following elements:

    · Title Page: Provide the assignment title, your name, course and section number, instructor name, and date.

    · Body: Include an introductory and a concluding paragraph. Answer all the questions in complete sentences and paragraphs, using appropriate personal and professional insights.

    · The assignment must be written in Standard English and demonstrate superior organization, including a highly developed viewpoint and purpose that is clearly established and sustained. The communication of your thoughts must be highly ordered, logical, and unified, displaying exceptional content, organization, style, and mechanics (including the use of correct grammar, punctuation, and sentence structure).

    · Your responses should meet professional writing standards, using proper tone and language. The writing and writing style should be correct and accurate and reflect knowledge of applied behavior analysis.

    · Reference Page: Sources listed in APA format.

    · A minimum of three academic sources, including in-text citation(s).

    · Use Arial or Times New Roman 12-point font, double-spaced and left aligned.

    · Use standard 1" margins on all sides.

    · Use current APA formatting and citation style.

    · If you need assistance with APA Style, please visit the
    [**Academic Write**](https://library.purdueglobal.edu/library/academicwriter)

    **## Unit5midtermFoundationsofBehaviorAnalysis.docx**

    Foundations of Behavior Analysis

    Throughout the first half of this course, you have explored the history of behaviorism and the roots of applied behavior analysis in the philosophy and practices of natural science. In this assignment, you will have the opportunity to synthesize the knowledge you have gained.

    For this assignment, you will provide a long-answer essay response to each of the questions below. For each question, you are encouraged to use the peer-reviewed resources provided throughout the units to support your responses. Please do not copy and paste the whole question into the document. Rather, use APA format section headings to organize your paper, with separate sections for each question. Use the rubric and the assignment prompts as guides to be sure you address all topics. Be sure to use the sources provided so far in the course and support your work throughout with in-text citations and a reference list at the end of your paper.

    Please respond to the following:

    Compare the three branches of behavior analysis (behaviorism, EAB, and ABA).

    Explain how the evolving historical and philosophical perspectives of behaviorism have influenced the study of applied behavior analysis as a natural science.

    Name at least four important figures who have developed and furthered the science of behavior analysis and, specifically, discuss their contributions to the field.

    Define radical behaviorism.

    Explain the ways in which radical behaviorism attempts to create a set of universal laws to understand all behavior.

    How does radical behaviorism differentiate between private events and public events?

    How does the distinction between private events and public events relate to a distinction between mentalistic and environmental explanations for behavior?

    In radical behaviorism, which explanation is preferred and why?

    Explain the six attitudes/assumptions of experimental analysis of behavior, the goals of behavior analysis as a science, and the seven dimensions of applied behavior analysis.

    Examine how each of these areas work together to contribute to the development of a technology (i.e. a set of standards and procedures) that is used to influence socially significant behavior.

    **## Unit5details.docx**

    Your assignment should be 8–10 pages, not including the title and reference pages, and should include the following elements:

    · Title Page: Provide the assignment title, your name, course and section number, instructor name, and date.

    · Body: Include an introductory and a concluding paragraph. Answer all the questions in complete sentences and paragraphs, using appropriate personal and professional insights.

    · The assignment must be written in Standard English and demonstrate superior organization, including a highly developed viewpoint and purpose that is clearly established and sustained. The communication of your thoughts must be highly ordered, logical, and unified, displaying exceptional content, organization, style, and mechanics (including the use of correct grammar, punctuation, and sentence structure).

    · Your responses should meet professional writing standards, using proper tone and language. The writing and writing style should be correct and accurate and reflect knowledge of applied behavior analysis.

    · Reference Page: Sources listed in APA format.

    · A minimum of three academic sources, including in-text citation(s).

    · Use Arial or Times New Roman 12-point font, double-spaced and left aligned.

    · Use standard 1" margins on all sides.

    · Use current APA formatting and citation style.

    · If you need assistance with APA Style, please visit the
    [**Academic Write**](https://library.purdueglobal.edu/library/academicwriter)

    **## Unit5midtermFoundationsofBehaviorAnalysis.docx**

    Foundations of Behavior Analysis

    Throughout the first half of this course, you have explored the history of behaviorism and the roots of applied behavior analysis in the philosophy and practices of natural science. In this assignment, you will have the opportunity to synthesize the knowledge you have gained.

    For this assignment, you will provide a long-answer essay response to each of the questions below. For each question, you are encouraged to use the peer-reviewed resources provided throughout the units to support your responses. Please do not copy and paste the whole question into the document. Rather, use APA format section headings to organize your paper, with separate sections for each question. Use the rubric and the assignment prompts as guides to be sure you address all topics. Be sure to use the sources provided so far in the course and support your work throughout with in-text citations and a reference list at the end of your paper.

    Please respond to the following:

    Compare the three branches of behavior analysis (behaviorism, EAB, and ABA).

    Explain how the evolving historical and philosophical perspectives of behaviorism have influenced the study of applied behavior analysis as a natural science.

    Name at least four important figures who have developed and furthered the science of behavior analysis and, specifically, discuss their contributions to the field.

    Define radical behaviorism.

    Explain the ways in which radical behaviorism attempts to create a set of universal laws to understand all behavior.

    How does radical behaviorism differentiate between private events and public events?

    How does the distinction between private events and public events relate to a distinction between mentalistic and environmental explanations for behavior?

    In radical behaviorism, which explanation is preferred and why?

    Explain the six attitudes/assumptions of experimental analysis of behavior, the goals of behavior analysis as a science, and the seven dimensions of applied behavior analysis.

    Examine how each of these areas work together to contribute to the development of a technology (i.e. a set of standards and procedures) that is used to influence socially significant behavior.