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NU664C Week 10 Discussion Assignment

NU664C Week 10 Discussion AssignmentNU664C Week 10 Discussion AssignmentDue: Facilitating group to post by Day 1; all other students post to discussion prompt by Day 4 and one other peer initial discussion prompt post by Day 7Initial Post: Created by Facilitating Group ( I am not in the facilitating group)This is a student-led discussion.· The facilitating group should choose one member from their group who will be responsible for the initial post.· On Day 1 of this week, the chosen group member will create an initial post that is to include the group’s discussion prompts, resources, and the instructions for what your classmates are to do with the resources.· During this week, each member of your group is to participate in the facilitation of the discussion. This means making certain that everyone is engaged, questions from students are being answered, and the discussion is expanding.ORDER A PLAGIARISM-FREE PAPER HERE· It is the expectation that the facilitating group will address all initial peer response posts by Day 7.Reply Posts: Non-Facilitating Students· If you are not a member of the facilitating group, you are to post a discussion prompt response according to the facilitating group’s instructions by Day 4. Your reply posts should include substantive reflection directed to the presenters.NU664C Week 10 Discussion Assignment· You are also expected to respond to at least two other peer’s initial discussion prompt posts.          Facilitating Group’s Post (to be replied)Depression and Somatization Disorders   Barry Lynne, Brittany Stoken, and Jessica MurphyNU664C: Psychiatric Mental Health Care of the Family INovember 1, 2021 Depression and Somatization Disorders Hello Class,Group 1 is assigned Depression and Somatization Disorders to further discuss. Failure to adjust and modify emotions cognitively while experiencing stress can ultimately present an outcome of exaggerated physiological and behavioral responses and amplify susceptibility to somatic disorders, such as somatization (Davoodi, et al., 2019). Somatization Disorder is the presentation of recurrent and multiple somatic complaints of several years duration for which medical attention has been sought but which do not derive from a specific physical disorder (Swartz, Blazer, & George, 2012). NU664C Week 10 Discussion AssignmentPlease respond to the following questions:1. When caring for a patient with somatization disorder, what therapeutic interventions would you formulate (Allen, Woolfolk, Escobar, Gara, and Hamer, 2006)?2.  How would you evaluate the success of your interventions for a patient living with somatization? Depression is an extremely serious mood disorder that effects how you think, feel, and act.  Symptoms range from mild to severe including, feeling sad, loss of interest or pleasure, change in appetite, trouble sleeping or getting too much sleep, feeling worthless, difficulty concentrating, and thoughts of death or suicide (American Psychiatric Association, 2021).  To be diagnosed with depression, symptoms must last at least two weeks and present a change in level of functioning (National Institute of Mental Health, 2021).Please respond to the following questions:1. After watching the short video, discuss what you’ve learned about depression and has it changed your thoughts on what it is like to live with depression?2. What interventions and resources would you use for this patient?  How would you evaluate success of treatment?3.  What are a few ways to educate and reduce the stigma around depression, so that individuals living with depression receive the help when symptoms first present?NU664C Week 10 Discussion AssignmentAdolescents are experiencing depression at a rapidly growing rate and the use of psychopharmacology and therapy has not slowed this increase (Henjie Blom et al., 2016). Although there are many potential causes for this increase, one of the primary causes is the increased prevalence of social media and its popular use amongst teens. Research has shown a direct link between social media and depression and suicidality in adolescents (Vidal et al., 2020). Though social medical has been linked to depression within this population, just simply decreasing the use and frequency of social media can have a positive impact and greatly decrease psychological distress (Radovic et al., 2017).1.     What additional non-pharmacological interventions would you recommend for the adolescent patient with depression?2.     Which medication would be the appropriate choice for this patient? What important patient education would you provide?   NU664C Week 10 Discussion AssignmentReferencesAllen LA, Woolfolk RL, Escobar JI, Gara MA, Hamer RM. Cognitive-Behavioral Therapy for Somatization Disorder: A Randomized Controlled Trial. Arch InternMed. 2006;166(14):1512–1518. doi:10.1001/archinte.166.14.1512American Psychiatric Association. (2021).  What isdepression?  https://www.psychiatry.org/patients-families/depression/what-is-depressioDavoodi, E., Wen, A., Dobson, K. S., Noorbala, A. A., Mohammadi, A., & Farahmand, Z. (2019).Emotion Regulation Strategies  in Depression and Somatization Disorder.  PsychologicalReports, 122(6), 2119–2136.   https://doi.org/10.1177/0033294118799731Henje Blom, E., Ho, T. C., Connolly, C. G., LeWinn, K. Z., Sacchet, M. D., Tymofiyeva, O., Weng, H.Y., & Yang, T. T. (2016). The neuroscience and context of adolescent depression. Actapaediatrica (Oslo, Norway : 1992), 105(4), 358–365.National Institute of Mental Health (2021).  Depression.  https://www.nimh.nih.gov/health/topics /depressio nRadovic, A., Gmelin, T., Stein, B. D., & Miller, E. (2017). Depressed adolescents’ positive andnegative use of social media. Journal of adolescence, 55, 5–15.NU664C Week 10 Discussion AssignmentSwartz, M. S., Blazer, D., & George, L. (2012). Somatization disorder in a community population.American Journal of Psychiatry, 143, 1403–1408.Vidal, C., Lhaksampa, T., Miller, L., & Platt, R. (2020). Social media use and depression inadolescents: a scoping review. International review of psychiatry (Abingdon, England),32(3), 235–253.Peer Post 1 (To be replied)Week 10 Assignment: Respond to Group 1 Jeffrey PhamNovember 2, 2021 1. When caring for a patient with somatization disorder, what therapeutic interventions would you formulate (Allen, Woolfolk, Escobar, Gara, and Hamer, 2006)?2.  How would you evaluate the success of your interventions for a patient living with somatization?NU664C Week 10 Discussion AssignmentSomatization disorder presents a challenge to healthcare as the complaints of bodily distress have no objective or identifiable cause (Kumar & Jahan, 2020). The   The intervention for this type of client should begin my ensuring that the somatization disorders are distinguished from actual medical symptoms so that intervention can be accurately implemented to address the problematic issues. According to DSM-5, the diagnostic criteria for somatization disorder are as followed: somatic symptoms are persistent and lasts longer than 6 months, one or more somatic distress symptoms that cause significant impairment in functioning, and one or more excessive behaviors, thoughts and//or feelings that is associated with somatic symptoms or associated with various health problems (Henningsen, 2018)NU664C Week 10 Discussion Assignment.  The severity of this disorder is on a continuum from mild to severe, depending on the numbers of somatic complaints and on the DSM-5 diagnostic criteria; having multiple somatic complaints and having multiple DSM-5 criteria met for somatization lead to more severe form of the disorder (Henningsen, 2018).  To manage this condition appropriately, first requires screening for it. The PHQ-15 is a screening tool to detect for risk for somatic symptom disorder and have been demonstrated to effectively screen and monitor for the disorder (American Psychiatric Association, 2013).  Antidepressants, such as Tricyclic has been demonstrated to have some moderate efficacy over newer antidepressant in treatment of somatization while multimodal psychotherapy program has been shown to significantly improve and manage somatic symptoms (Kumar & Jahan, 2020; Henningsen, 2018). Interventions of somatic symptoms management can be evaluated by using the PHQ-15 to initially screen for and then to evaluate for any improvements in symptoms from baseline (Kocalevent et al., 2013).NU664C Week 10 Discussion Assignment1. After watching the short video, discuss what you’ve learned about depression and has it changed your thoughts on what it is like to live with depression?2. What interventions and resources would you use for this patient?  How would you evaluate success of treatment? Depressive symptoms are associated with long duration and presence of sadness, irritability, or anhedonia (Kaltenboech & Harmer, 2018).  According to Stahl (2013) major depressive disorder is formulated when a client has prolonged periods of depressed mood or loss of interest and with greater or equal to at least 4 additional symptoms, such as suicidal ideation, sleep disturbances, appetite changes, fatigue, guilt, and executive dysfunction. The development of depression is complex, and neuro-research has related to abnormalities of certain monoamines, which include serotonin, noradrenaline and dopamine, to the pathogenesis of depression (Kaltenboech & Harmer, 2018).  Brain imaging has shown that there is decreased serotonin transmission activity in certain parts of the brain in depressive individuals while increasing serotonergic activity by administering antidepressants help relieve those symptoms and support the monoamine theory as relate to depression (Kaltenboech & Harmer, 2018).  Given the fact that untreated depression is associated with functional impairment, such as poor quality of life and loss of work productivity and increased risks for suicide, it is extremely important to treat depression (Culpepper et al., 2015).NU664C Week 10 Discussion AssignmentWhile the goal of treating depression is to achieve full remission, the task begins by identifying depression, administering treatment, and finally evaluating treatment response. There are several tools available to aid in identifying and evaluating treatment response and/or resistance, such tools include the 17-item Hamilton Rating Scale of Depression (HAM-D) and the Patient Health Questionnaire-9 (PHQ-9) (Culpepper et al., 2015).  While treatment remission is considered less or equal to 7 score on the Ham-D and less than 5 on the PHQ-9, full recovery is met when the client is in full remission though the treatment has been discontinued (Culpepper et al., 2015). NU664C Week 10 Discussion AssignmentWhile the neurobiological monoamine theory of depression includes a deficient or dysfunction in certain neurotransmitters, it is logical to replace these neurotransmitters where it is impaired or deficient (Stahl, 2013).  A group of medications known as SSRIs can provide more of the neurochemicals in the synaptic cleft in order to bind with the post-synaptic neurons to improve mood and depressive thoughts (Stahl, 2013).  While medications have been shown to effectively treat depression, psychotherapeutic has been linked to increased resilience, improvements in mood and physical and cognitive functioning (Eddington et al., 2017).  While medications may be helpful, some may benefit from psychotherapeutic alone or as an adjunct therapy to medications.NU664C Week 10 Discussion AssignmentAdditionally, Given the different profiles of antidepressants, when approach with treatment option for an individual who has clinical depression, there are factors to consider upon selecting the antidepressant medications, such as but not limited to tolerability, current medicine with consideration for drug-drug interactions, psychiatric/medical comorbidities, efficacy of prior treatments and cost of the medications (Culpepper et al., 2015). 3.  What are a few ways to educate and reduce the stigma around depression, so that individuals living with depression receive the help when symptoms first present?NU664C Week 10 Discussion AssignmentThe ways to educate and reduce the stigma around depression are to first understand how stigma is defined and how it is socially constructed, and in what ways has it created barrier to accessing care for depression. According to Stuart (2016), stigma is created when there are several parts interacting: first a particular human is distinguished as different; second, distinguished difference is attached to unwanted features, creating a biased that apply to every person of that member; third, they are seen as different from the dominant culture; fourth, the biased or stigmatized members are devalued and systematically disadvantaged, creating a disadvantaged group that leads to their poor health outcomes.There are several research and methods to help combat stigma in mental health. Some of them include literacy education to improve education about mental health; protest to object and denounce stigma, to attempt to change organizational behaviors; advocacy to support strategies aim at tackling inequities designed by social structures that limit rights of people with mental health issues (Stuart, 2016). These are just some interventions that may be used to advocate for the mental health population.NU664C Week 10 Discussion Assignment1.     What additional non-pharmacological interventions would you recommend for the adolescent patient with depression?2.     Which medication would be the appropriate choice for this patient? What important patient education would you provide? Just as in adult, an adolescence with mild to moderate depressive symptoms may benefit from psychotherapy initially (Gautam, 2017).  CBT and interpersonal therapy have been shown to be the most efficacious for managing depression, however, the types of therapy that are most effective is contingent upon how the client is responding (Gautam, 2017). In moderate to severe depression, SSRIs are considered first line for treating children and adolescents’ depression; specifically, fluoxetine has the most evidence for use in children and adolescents depression and it is also FDA approved to treat children 8 years and older (Mullen, 2018).When prescribing to this population, education regarding risk for triggering suicidal ideation must be provided as there is an FDA black box warning to all antidepressants that it may increase the risk for suicidal ideation in children, adolescents, and young adults (Mullen, 2018).NU664C Week 10 Discussion AssignmentReferencesAmerican Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.) (DSM-5). Washington, DC: APA Press.Culpepper, L., Muskin, R. P., & Stahl, S. M. (2015). Major depressive disorder: Understanding the significance of residual symptoms and balancing efficacy with tolerability. The American journal of medicine. 128 (9), 1-15. DOI: https://doi.org/10.1016/j.amjmed.2015.07.001Eddington, K. M., Burgin, C. J., Silvia, P. J., Fallah, N., Majestic, C., & Kwapil, T. R. (2017). The Effects of Psychotherapy for Major Depressive Disorder on Daily Mood and Functioning: A Longitudinal Experience Sampling Study. Cognitive therapy and research, 41(2), 266–277. https://doi.org/10.1007/s10608-016-9816-7Gautam, S., Jain, A., Gautam, M., Vahia, V. N., & Grover, S. (2017). Clinical Practice Guidelines for the management of Depression. Indian journal of psychiatry, 59(Suppl 1), S34–S50. https://doi.org/10.4103/0019-5545.196973Henningsen, P. (2018). Management of somatic symptom disorder. Dialogues in clinical neuroscience, 20(1), 23–31. https://doi.org/10.31887/DCNS.2018.20.1/phenningsenKaltenboeck, A., & Harmer, C. (2018). The neuroscience of depressive disorders: A brief review of the past and some considerations about the future. Brain and Neuroscience Advances. 2: 1-6. https://doi.org/10.1177/2398212818799269Kocalevent, R. D., Hinz, A. & Brähler, E. (2013). Standardization of a screening instrument (PHQ-15) for somatization syndromes in the general population. BMC Psychiatry 13, 91. https://doi.org/10.1186/1471-244X-13-91Kumar, R., & Jahan, M. (2020). Multimodal psychotherapy in the management of somatization disorder. Industrial psychiatry journal, 29(2), 205–212. https://doi.org/10.4103/ipj.ipj_11_17NU664C Week 10 Discussion AssignmentMullen, S. (2018). Major depressive disorder in children and adolescents. The mental health clinician, 8(6), 275–283. https://doi.org/10.9740/mhc.2018.11.275Stahl, S. M. (2013). Stahl’s Essential Psychopharmacology: Neuroscientific Basis and Practical Applications. 4th ed. New York, NY: Cambridge University Press.Stuart, H. (2016). Reducing the stigma of mental illness. Global mental health (Cambridge, England), 3, e17. https://doi.org/10.1017/gmh.2016.11   Peer Post 2 (To be replied)Deborah PennyThank you Group 1 (Barry, Brittany, and Jessica).  Your presentation about somatization disorder and depression, along with the video, and references will elicit excellent discussion points.  Somatization Disorder (SD) is “characterized by the patient experiencing numerous physical symptoms that are unrelated to any specific disease state or organ system; usually, symptoms are unrelated, multiple, and difficult to measure” (Zakhari, 2021, p. 193). For example, on page 191 of Zakhari, question #18 states, “A 50-year-old woman referred from the surgical service is described as a “frequent flyer”. She reports vague complaints that have no apparent cause or objective clinical findings.  Most recently she complains of vaginal pain, headache, and stomachache.  Upon interview she is tearful, guarded, and withdrawn.  What is the most likely psychiatric diagnosis?”NU664C Week 10 Discussion AssignmentA.        MalingeringB.        Conversion disorderC.        Somatization disorderD.        Factitious DisorderThe correct answer is C. Somatization disorder because the patient presents with many unrelated symptoms, all without objective findings.  Without objective findings, it is impossible to develop a treatment plan.  For example, if a patient presents with a subjective symptom of a fever, but the objective finding of afebrile rules it out, the patient’s subjective symptoms cannot be substantiated. NU664C Week 10 Discussion Assignment1. When caring for a patient with somatization disorder, what therapeutic interventions would you formulate?Prior to Cognitive-Behavioral Therapy’s (CBT) success for treating patients with SD utilized a consultation letter.  According to Boland et al (2021), a brief “consultation letter” intended for primary care physicians demonstrated effectiveness in improving patients’ functional capacity and decreased their utilization of health services, essentially using boundaries as part of the treatment.  The letter provided guidance on the best practice for treating patients with SD by seeing patients only during regular business hours, providing focused physical examinations, and avoiding unnecessary diagnostic procedures, invasive treatments, and hospitalizations” (Boland, et al, 2021).  However, the most recent evidence-based success comes from using CBT which focuses on stress management, activity regulation, emotional awareness, cognitive restructuring, and interpersonal communication. NU664C Week 10 Discussion Assignment2.  How would you evaluate the success of your interventions for a patient living with somatization?Successful interventions are based on achieving the goals developed between the patient and the provider.  For example, if the goal was to adhere to cognitive behavioral therapy sessions, diary keeping, and a limited number of office visits per month, these interventions would be successful, and the goal achieved.1.  After watching the short video, discuss what you’ve learned about depression and has it changed your thoughts on what it is like to live with depression?NU664C Week 10 Discussion AssignmentDepression can overtake every aspect of a person’s life and it can cause a person to take their own life by suicide.  Depression is insidious, it can creep up on a person and take hold little by little until a person loses the ability to reach out for help.  Several factors can play a role in depression:  Biochemistry (how the brain is wired), genetics (depression can run in families), personality (low self-esteem can play a role), and environmental factors (poverty, abuse, neglect).  Because a patient’s socioeconomic status can be a factor with depression, a thorough biopsychosocial assessment is critical to the plan of treatment.  Research findings have indicated that lifestyle behaviors and socioeconomic status were significantly associated with psychological health, such as psychological distress, depression, anxiety, and well-being” (Wang & Geng, 2019).NU664C Week 10 Discussion Assignment2.  What interventions and resources would you use for this patient?  How would you evaluate success of treatment?There are different types of therapy and interventions used to treat depression.  Cognitive behavioral therapy (CBT) works on identifying negative thoughts and behaviors and replacing these with more positive ones. Dialectic behavioral therapy (DBT) helps to identify a person’s strengths, thoughts, and assumptions.  Successful treatment is defined on goals set by the patient and therapist and is different for every individual receiving help for their depression.3. What are a few ways to educate and reduce the stigma around depression, so that individuals living with depression receive the help when symptoms first present?Research has shown a direct link between social media and depression and suicidality in adolescents (Vidal et al., 2020).  However, the same media that increases depression and anxiety in adolescents can be the same one that reaches out and offers hope and healing.  “Stigma attached to mental illness appears to be universal, it plays out indifferent ways according to local contexts” (Stuart, 2016).  Here are some websites that provide help in different ways:  webmd.com, pickthebrain.com, Imalive.org, and 7cups.com1.  What additional non-pharmacological interventions would you recommend for the adolescent patient with depression?NU664C Week 10 Discussion Assignment“Cognitive behavioral therapy, naturopathic therapy, biological interventions, and physical activity interventions reduced depression severity.  A shared decision-making approach is needed to choose between non-pharmacological therapies based on values, preferences, clinical and social context” (Farah, 2016).2.  Which medication would be the appropriate choice for this patient? What important patient education would you provide?“Selective serotonin reuptake inhibitors (SSRIs) would be a place to start due to the mild side effects and the following education would be provided” (Moreland & Bonin, 2016).•           The expected benefits and possible risks and side effects•           The instructions for the dose and timing•           The expected length of time to response•           Potential interactions with other prescription or non-prescription medications•           When prescribing to this population, education regarding risk for triggering suicidal ideation must be provided as there is an FDA black box warning to all antidepressants that it may increase the risk for suicidal ideation in children, adolescents, and young adults (Mullen, 2018).NU664C Week 10 Discussion AssignmentHanging indent not maintained ReferencesAllen, L. A., Woolfolk, R. L., Escobar, J. I., Gara, M. A., & Hamer, R. M. (2006). Cognitive-behavioral therapy for somatization disorder: a randomized controlled trial. Archives of Internal Medicine,166(14), 1512–1518. https://doi.org/10.1001/archinte.166.14.1512Boland, R., Verduin, M., & Ruiz, P. (2021).  Kaplan & Sadock’s Synopsis of Psychiatry, 12th ed. Wolters Kluwer.Farah, W. H., Alsawas, M., Mainou, M., Alahdab, F., Farah, M. H., Ahmed, A. T., Mohamed, E.A., Almasri, J., Gionfriddo, M. R., Castaneda-Guarderas, A., Mohammed, K., Wang, Z., Asi, N., Sawchuk, C. N., Williams, M. D., Prokop, L. J., Murad, M. H., & LeBlanc, A. (2016). Non-pharmacological treatment of depression: a systematic review and evidence map. Evidence-Based Medicine, 21(6), 214–221. https://doi.org/10.1136/ebmed-2016-110522Moreland, C. S., & Bonin, L. (2021). Patient education: Depression treatment options for children and adolescents (Beyond the Basics).  UpToDate.   https://www.uptodate.com/contents/depression-treatment-options-for-children-and-        adolescents-beyond-the-basics?search=depression%20treatment%20adolescent&source=search_result&selectedT         itle=10~150&usage_type=default&display_rank=10Mullen, S. (2018). Major depressive disorder in children and adolescents. The mental health clinician, 8(6), 275–283. https://doi.org/10.9740/mhc.2018.11.275Smith, G. R., Jr, Monson, R. A., & Ray, D. C. (1986). Psychiatric consultation in somatization disorder. A randomized controlled study. The New England Journal of Medicine, 314(22), 1407–1413.             https://doi.org/10.1056/NEJM198605293142203Stuart, H. (2016). Reducing the stigma of mental illness. Global mental health, 3, e17.             https://doi.org/10.1017/gmh.2016.11Vidal, C., Lhaksampa, T., Miller, L., & Platt, R. (2020). Social media use and depression in adolescents: a scoping review. International review of psychiatry, 32(3), 235–253.NU664C Week 10 Discussion AssignmentWang, J., & Geng, L. (2019). Effects of socioeconomic status on physical and psychological health: Lifestyle as a mediator. International journal of environmental research and public health, 16(2),             281.https://doi.org/10.3390/ijerph16020281Zakhari, R. (2021). The psychiatric-mental health nurse practitioner certification review manual.  Springer Publishing Company, LLC. NU664C Week 10 Discussion Assignment

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