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Decision Portfolio


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Decision Portfolio

  1. 1. DECISION TREE PORTFOLIO 1 Decision Tree Portfolio Jody Marvin PSY 410 September 2, 2013 Dr. Kristi Huff
  2. 2. DECISION TREE PORTFOLIO 2 Decision Tree Portfolio Sally S. is a client working on an assessment to qualify for Disability with the Social Security Administration. Sally is Bipolar and addicted to opiates (barbiturates, oxytocin, Adderall) and amphetamines. Misdiagnosed with Attention Deficit Hyperactivity Disorder and Chronic Pain, Sally began self-medicating before her teens. Fifteen years later Sally is an alcoholic and drug addict. As a therapist boundaries must be understood, sometimes unspoken, including physical and emotional limits of the relationship. Additionally unless the client objects, the therapist may release health information about the client to a friend or family member involved in medical and mental care. With written consent information may be given to someone who helps pay for the case. The therapist may tell the family, sponsor, or friends the condition you are experiencing, and that you are in a hospital. In addition, in case of an emergency (ICE), we may disclose health information about you. For public and safety purposes as allowed or required by law, incidence such as the day you wondered into my office unannounced and four hours late for your scheduled appointment you were delusional, paranoid, and extremely drug-induced. Before you began to speak you leaned toward me and past out in my arms. Sally’s breathing became extremely shallow and CRP was necessary. I began CPR as I dialed 911. The operator informed me services would be there within 30 thirty minutes. Immediately, the Crisis Team at Sea Mar Behavioral Health was notified. Greg Arnold is the Mental Health Lead. He is at 5007 Claremont Way, Seattle, Washington. His e- mail address is gregoryarnold@seamarchc Within minutes Greg walked in, and took over CPR, so I could continue accessing immediate help. I called Lt. Tim Tullis,
  3. 3. DECISION TREE PORTFOLIO 3 King County Fire District #5: Cell Phone (425-359-6512); email is Tim is also an EMT-I (at 304 Alder Street, Seattle, Washington). The paramedics arrived in seven minutes. The concern was whether Sally would be taken to a hospital or jail facility. I contacted her doctor, Bill Lawson, AARP at Harbor Valley General Hospital. Hospitals in King County and surrounding counties do not have psychiatric facilities for suicide victims at the present time. You must go first to be interviewed to determine the severity of your suicidal tendencies, and you are put on a waiting list. Suicide attempts revived are incarcerated and charged with attempting to harm you. Inmates receive no medication and are kept in isolation, naked, in a four by six block wall room, naked until proven he or she will not harm herself. Greg was successfully reviving Sally, and she was totally disoriented. I contacted Sgt. Ed Swainson with the Washington State Patrol. Ed is at 900 W. Main St. Seattle, Washington (360-654-1204). He immediately responded to assist in the proper placement of Sally. Next I called Kelly W. (425-609-6170) (Seattle Area GSR at, Sally’s Alcoholics Anonymous’ Sponsor. A sponsor can have a huge impact on an individual’s life and decision if a relationship of trust and hope has been established. Sea Mar Behavioral Health Crisis Team – substance abuse and medical arrived within minutes, located at 17707 W. Main Street, Seattle, Wasgington 98272 – 360-2823886. Eventually 911 supports arrived and were informed the situation was under control. Sgt. Swainson was in charge of disposition depending on my recommendation and a safe and healthy location was established. Sally was taken to Harborview
  4. 4. DECISION TREE PORTFOLIO 4 General Hospital to have her stomach pumped. Sgt. Swainson and Kelly, Sally’s sponsor provided transportation and support. Several hours later, my recommendation was for in-patient (21 days) at Swedish Medical Center. My diagnosis specified Substance Abuse (prescription drugs and alcohol) and a dual diagnosis with Bipolar Disorder with rapid cycling. Following her 21 days Sally would begin her two-year program with out-patient treatment through Sea Mar Outpatient for co-occurring psychiatric and substance disorders. I begin my follow-up contacting Pat Simpson, MS, Vocational Rehabilitation Lead Counselor with the Dept. of Social and Health Services. Pat is at 840 N. Broadway, Ste 500, Seattle, WA 98201 (425-339-1724). We assisted Sally in acquiring her disability status and within five months she was established with Social Security Supplemental Income (SSI and SSD). For the first time in 17 years Sally had found hope, established healthy relationships through AA and NA, and had a small income with medical coverage for her existing disorders. The medical team at Swedish Hospital initiated a complete physical examination and began a medication regime for her bipolar disorder. After three weeks Sally located her necessary seeds for Hope and began developing coping skills. DVR established a Community Rehabilitation Program (CRP). CRP will locate, secure, and place Sally in a Residential Half-way House under the conditions she would continue her medications and out-patient program. In addition, Sally will be placed in a paid employment setting, or other realistic work setting with the provision of needed job supports and training to learn preference for a vocational environment. Sally must complete her out-patient program; attend three AA meetings a week, continue regular
  5. 5. DECISION TREE PORTFOLIO 5 follow-ups with her therapist, a psychiatrist who will monitor her medications, and fully participate in and complete the Community-Based assessment as mutually agreed by Sally, VRC, and CRP. My counseling and guidance is provided through a one-on0one relationship between a Vocational rehabilitation, myself, and Sally. Her counselor will review assessment information, explain the VR process, help her make good decisions, and support her progress throughout the process. Because Sally will receive public benefit, such as SSI and SSID, her counselor will explain the impact of working and refer her to a Benefit Planner for a more comprehensive consultation. Sally will learn independent living services to help her manage disability issues, such as following a schedule, managing a daily routine, and learning how to get around in the community using public transportation. Sally needs the safety of women’s groups to explore her issues, such as the little sexual experience without the use of chemicals and believes she cannot enjoy sexual activity with them. Other common issues that often go unaddressed or under addressed are family violence, parenting, relationship, and sexual addiction, Aid’s, and eating disorders, all of which are potential relapse factors for women. Sally is learning she is not responsible for predisposition to substance disorders and bipolar disorder of the brain. A person is responsible for participating in appropriate treatment and complying with a recovery plan. Recovery is simple but not easy because change can be difficult, requiring effort and patience with more effort and patience. Finding a balance in physical health, mental health, an educational journey, relationships, and spirituality is Sally’s daily goal.