Scenario:
Patient HL comes into the clinic with the following symptoms: nausea, vomiting, and diarrhea. The patient has a history of drug abuse and possible Hepatitis C. HL is currently taking the following prescription drugs:
Synthroid 100 mcg daily
Nifedipine 30 mg daily
Prednisone 10 mg daily
–Explain your diagnosis for the patient, including your rationale for the diagnosis.
–Describe an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed.
–Justify why you would recommend this drug therapy plan for this patient. Be specific and provide examples
Sample Solution
back as far as Freud, Prever (2015) suggests that the working alliance in therapy was comprised of three goals; tasks, goals and bonds. As cited by Prever (2015), Bordin describes the therapeutic alliance as “an essential component in counselling and possibly the most important factor in bringing about change in the client”. Prever (2015) states that themes relating to the goals described above, are well developed in the person-centred literature, where it is obvious that the client’s attitude towards the counsellor is considered important. Oaklander (1997) reminds us that trust and feelings of safety are crucial to the development of the relationship and that the therapist is authentic and genuine, does not manipulate or patronise, is non-judgemental. She maintains that finding creative non-threatening ways to the reach the child is a key task of the therapist and that there is a natural progression “a very definite process” when working with children. Virginia Axline’s basic principles of non-directive play therapy indicate that a warm friendly relationship with good rapport is essential, as is the therapist being accepting of the child exactly as they are (Axline, 1989). In conjunction, Geldard, et al., (2018) describe the relationship as a connecting link between the child’s world and the counsellor. The relationship comes first and that in fact for many children, the focus of the therapy becomes the relationship (Oaklander, 1997). Working within the child’s frame of reference informs the therapist how the child views their environment. Empathy and trust are highly valued by young people and act as bond indicators however, an additional parent support dimension is of particular importance, especially where the counsellor is able to show understanding, reassurance and support (Prever, 2015). By providing an exclusive relationship between the therapist and child, the child will feel accepted and uninfluenced by the views of the parents. That said, most children are brought to therapy by their parents. Creating a friendly and hospitable environment can encourage the parents to feel welcome and valued when they arrive. This is central to joining with the child but is also part of the therapeutic process (Geldard, et al., 2018, p. 60). Oaklander (2007) believes that “the first meeting is an important one”, as it offers a sense of the dynamics of the parent-child relationship. Narrative conversations give power to parents, “it is important to give parents the space to examine and reflect on what is important to them before asking them to make choices about future action such as a specific intervention” (McQueen & Hobbs, 2014, p. 16). By collaborating with the parents, the values, knowledge and skills of the parents can be explored and provide the therapist with an understanding of how change could happen. Opposingly, Landreth offers a very different view on parental involvement stating “the presence of the paren>
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