Vignette Analysis I This  assignment focuses on vignette analysis and direct application of  course concepts to the persons and situations presented in the vignette  for each question. All discussions must take into account the legal and  ethical considerations, as well as issues of culture and human diversity  that may pertain to the situations presented below. Use the reading assignments thoroughly in an integrative discussion.  Remember to reference all work cited or quoted by the text authors. You  should be doing this often in your responses Please keep your responses focused on what is presented in the vignette.  Do not add information but use your creativity to support what you see  in the vignette as written. Avoid elaborations and assumptions. This  assignment MUST be typed, double-spaced, in APA style, and must be  written in graduate level English. Your assignment should be 3-4 pages in length per vignette PLUS a title and reference page Vignette One (3-4 page response) Janie  is a 42-year-old African American, wife of Jake, and mother of  12-year-old Stacy. Once a vibrant business office manager, Janie is now  on disability and rarely leaves the house.  She was diagnosed with major  depressive disorder at age 20 when she reported feelings of  worthlessness, fatigue, insomnia, and loss of concentration to doctor at  her college health services. Janie stated that she had felt “blue and  emotionally needy.” She had a relationship with a guy who “deceived me  and physically and emotionally abused me for two years. I lost interest  and respect for myself and others.” She was prescribed an antidepressant  medication and referred to a counselor and support group.  Janie’s  therapist stated that Janie’s depression is a chronic condition and  Janie is at risk for recurrent episodes of depression. She asked Janie  to identity triggers that might precipitate those episodes. Janie stated  these triggers: (1) fear that I might return to my “lowest low”  depression state, (2) anxiety that I want to spare my daughter the pains  that I have endured, (3) periodic “sense of dread” for Stacy’s future  in an uncertain world, and (4) wonder about what my “hormonal change”  menopause will look like.  How  would you apply the “impaired-at-risk role” to Janie’s situation and  chronic condition?  Illness behavior is shaped by sociocultural and  social-psychologic factors. What are demographic and past experiences  that shape Janie’s illness behaviors? What are some examples of Janie’s  statements to support your responses?  Caring  for a client with chronic illness requires a framework or model for  practice that differs from that of caring for those with acute, episodic  disease. Illness frameworks and models address the illness experience  of the individual and family that occurs as a result of changing health  status. How can you use the chronic illness and quality of life, the  trajectory framework, and the shifting perspectives model ...

1. Vignette Analysis I
This assignment focuses on vignette analysis and direct
application of course concepts to the persons and situations
presented in the vignette for each question. All discussions
must take into account the legal and ethical considerations, as
well as issues of culture and human diversity that may pertain
to the situations presented below.
Use the reading assignments thoroughly in an integrative
discussion. Remember to reference all work cited or quoted by
the text authors. You should be doing this often in your
responses
Please keep your responses focused on what is presented in the
vignette. Do not add information but use your creativity to
support what you see in the vignette as written. Avoid
elaborations and assumptions. This assignment MUST be typed,
double-spaced, in APA style, and must be written in graduate
level English.
Your assignment should be 3-4 pages in length
per vignette
PLUS a title and reference page
Vignette One (3-4 page response)
Janie is a 42-year-old African American, wife of Jake, and
mother of 12-year-old Stacy. Once a vibrant business office
manager, Janie is now on disability and rarely leaves the house.
She was diagnosed with major depressive disorder at age 20
when she reported feelings of worthlessness, fatigue, insomnia,
and loss of concentration to doctor at her college health

2. services. Janie stated that she had felt “blue and emotionally
needy.” She had a relationship with a guy who “deceived me
and physically and emotionally abused me for two years. I lost
interest and respect for myself and others.” She was prescribed
an antidepressant medication and referred to a counselor and
support group.
Janie’s therapist stated that Janie’s depression is a chronic
condition and Janie is at risk for recurrent episodes of
depression. She asked Janie to identity triggers that might
precipitate those episodes. Janie stated these triggers: (1) fear
that I might return to my “lowest low” depression state, (2)
anxiety that I want to spare my daughter the pains that I have
endured, (3) periodic “sense of dread” for Stacy’s future in an
uncertain world, and (4) wonder about what my “hormonal
change” menopause will look like.
How would you apply the “impaired-at-risk role” to Janie’s
situation and chronic condition? Illness behavior is shaped by
sociocultural and social-psychologic factors. What are
demographic and past experiences that shape Janie’s illness
behaviors? What are some examples of Janie’s statements to
support your responses?
Caring for a client with chronic illness requires a framework or
model for practice that differs from that of caring for those
with acute, episodic disease. Illness frameworks and models
address the illness experience of the individual and family that
occurs as a result of changing health status. How can you use
the chronic illness and quality of life, the trajectory framework,
and the shifting perspectives model of chronic illness with
Janie and her family?

3. Chronic illness is fraught with unpredictable dilemmas.
Dependency in chronic illness may link with a sense of
powerlessness. How can you incorporate strategies to decrease
Janie’s/her family’s feelings of powerlessness? How do you
think that Janie would describe self-management? How can her
healthcare team foster Janie’s sense of order and other themes
associated with self-management?
Vignette Two (3-4 page response)
Tom is a 62-year-old Italian-American man who was diagnosed
with Diabetes Mellitus Type II about 10 years ago. He has
chosen to live with little diet control, weight gain, weekly
elevated blood sugars of over 300, sedentary lifestyle, and non-
adherence to prescribed diabetes medications. He freely admits
that this disease “gets in the way of my life.” “I like to eat
whenever and whatever I please, especially while I watch TV.
You know, finger-sticks and doctors’ visits are not in my game
plan. Maybe all of that later.” Tom now faces increasing blood
pressure, increasing vision problems, unrelenting skin ulcers
that will not heal, and insulin therapy. His wife, Gilda,
describes Tom as, “he’s always been self-indulgent and does
what he wants regardless of the consequences. When we first
met, he was smoking marijuana daily, but he grew out of that”.
Gilda does not understand Tom’s decisions and says, “If I had
diabetes, I’d take care of myself by eating well, exercising, and
taking my medicines.”
Use Stanton and Revenson’s five attributes of adjustment to
conceptualize adjustment for Tom and his family. Discuss
Engel’s Biopsychosocial Model in regard to Tom’s situation.
Coping is a complex, multidimensional process. It is sensitive

4. both to the environment and its demands and resources, to
personality traits that influence the appraisal of stress (such as
a chronic illness), and to resources for coping. Project how
Tom, his family, and his support systems might use 4 of the 8
categories of coping skills that Moos and Holahan identify.
Perhaps a blend of cognitive-behavioral, self-management,
emotional intelligence, and self-help/support strategies might
be helpful to the client and family’s adjustment/adaptation.
How might you facilitate Tom’s cognitive processing of the
implications and meaning of his condition(s)? Describe two
interventions to address Tom’s coping effectiveness,
individual-level change, self-efficacy, self-management, and
decision-making. Suggest interventions to bridge the gap
between Tom and Gilda’s thinking and approaches to
adjustment/adaptation of living with Diabetes Mellitus Type II.
Reference:
Larsen, P.D., Whitney, F.W. (2016).
Chronic Illness: Impact and Intervention
. (9th edition). Burlington, MA Jones & Bartlett Learning.
ISBN: 978-1284049008
Video
Acceptance and Commitment Therapy: Addressing Chronic
Illness with Steven C. Hayes, Ph.D
.
https://www.youtube.com/watch?v=1KA0JjkB10k

5. Video
Dr Mark Morningstar - Chronic Pain - Auto Immune Disorders 2
of 6
.
https://www.youtube.com/watch?v=LX89LfDKncA
Video
Dr Mark Morningstar Chronic Pain- Failed Back Surgery 6 of 6
.
https://www.youtube.com/watch?v=EzogsQy1Z_I
Video
Dr Mark Morningstar Chronic Pain- Fibromyalgia- 5 of 6
.
https://www.youtube.com/watch?v=MTPKEvD304s
Video
Dr Mark Morningstar- Chronic Pain- Lyme Disease 4 of 6
.
https://www.youtube.com/watch?v=BKdfDEQ2TJM
Video
Dr Mark Morningstar Chronic Pain Workshop- Sources Of Pain
1of 6
.
https://www.youtube.com/watch?v=GNNrAN_0F60

6. Video
Dr Morninstar Chronic Pain Workshop-Heavy Metal and
Chemical Toxicity 3 of 6
.
https://www.youtube.com/watch?v=KKmRMVzM8cc
Video
How to Live With a Chronic Illness
.
https://www.youtube.com/watch?v=DYnUaX67VbU
Video
Jon Kabat-Zinn - "The Healing Power of Mindfulness"
.
https://www.youtube.com/watch?v=_If4a-gHg_I