Week 7: Obsessive-Compulsive Disorders

It is getting embarrassing to go to my hair stylist. She always comments on the bald patches on my head. They keep getting bigger as I continue to pull out one strand of hair at a time. I even do it in my sleep. I can’t help myself. It all started when I was in high school when I would pull just from the back. Now I have to wear my hair a specific way so the bald patches don’t show. I don’t even color my hair anymore. I don’t want anyone to notice me.

Michelle, age 27

Although actual statistics vary, obsessive-compulsive disorder impacts approximately 1.2% of the population in the United States (APA, 2013, p. 239). It is characterized by the presence of obsessive thoughts, which are manifested as persistent thoughts, images, or even “urges.” The only way that the individual can disperse the anxiety of these persistent thoughts/images or urges is to perform a behavior (the compulsion). The compulsion could be checking things, counting, reciting a silent prayer, or repeating a number of phrases. The disorder becomes so pervasive that the person can spend a significant amount of time each day attending to the compulsion in order to relieve the anxiety caused by the obsession.

This week, you will, once again, become “captain of the ship” as you take full responsibility for a client with an obsessive-compulsive disorder by recommending psychopharmacologic treatment and psychotherapy, identifying medical management needs and community support, and recommending follow-up plans. You also will evaluate your progress in completing your certification plan.

Learning Resources

Required Readings

American Nurses Association. (2014). Psychiatric-mental health nursing: Scope and standards of practice (2nd ed.). Washington, DC: Author.

• Standard 14 “Professional Practice Evaluation” (pages 80-81)

Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer.

• Chapter 10, “Obsessive-Compulsive and Related Disorders” (pp. 418–436)

• Chapter 21, “Obsessive-Compulsive Disorder”

• “Obsessive-Compulsive and Related Disorders”

Stahl, S. M. (2014). Prescriber’s Guide: Stahl’s Essential Psychopharmacology (5th ed.). New York, NY: Cambridge University Press.

 

Note: All Stahl resources can be accessed through the Walden Library using the link below. This link will take you to a login page for the Walden Library. Once you log in to the library, the Stahl website will appear. http://ezp.waldenulibrary.org/login?url=http://stahlonline.cambridge.org/

 

To access information on specific medications, click on The Prescriber’s Guide, 5th Ed. tab on the Stahl Online website and select the appropriate medication.

Required Media

Note: The approximate length of this media piece is 20 minutes.

Optional Resources

Himle, J. A., Chatters, L. M., Taylor, R. J., & Nguyen, A. (2013). The relationship between obsessive-compulsive disorder and religious faith: Clinical characteristics and implications for treatment. Spirituality in Clinical Practice, 1(S), 53–70. doi:10.1037/2326-4500.1.S.53

Wheaton, M. G., Rosenfield, D., Foa, E. B., & Simpson, H. B. (2015). Augmenting serotonin reuptake inhibitors in obsessive–compulsive disorder: What moderates improvement? Journal of Consulting and Clinical Psychology, 83(5), 926–937. doi:10.1037/ccp0000025

Assignment 1: “Captain of the Ship” Project – Obsessive-Compulsive Disorders

In earlier weeks, you were introduced to the concept of the “captain of the ship.” In this Assignment, you become the “captain of the ship” as you provide treatment recommendations and identify medical management, community support resources, and follow-up plans for a client with an obsessive-compulsive disorder.

Students will:

• Recommend psychopharmacologic treatments based on therapeutic endpoints for clients with obsessive-compulsive disorders
• Recommend psychotherapy based on therapeutic endpoints for clients with obsessive-compulsive disorders
• Identify medical management needs for clients with obsessive-compulsive disorders
• Identify community support resources for clients with obsessive-compulsive disorders
• Recommend follow-up plans for clients with depression disorders

To prepare for this Assignment:

• Select an adult or older adult client with an obsessive-compulsive disorder you have seen in your practicum.

In 3–4 pages, write a treatment plan for your client in which you do the following:

• Describe the HPI and clinical impression for the client.
• Recommend psychopharmacologic treatments and describe specific and therapeutic endpoints for your psychopharmacologic agent. (This should relate to HPI and clinical impression.)
• Recommend psychotherapy choices (individual, family, and group) and specific therapeutic endpoints for your choices.
• Identify medical management needs, including primary care needs, specific to this client.
• Identify community support resources (housing, socioeconomic needs, etc.) and community agencies that are available to assist the client.
• Recommend a plan for follow-up intensity and frequency and collaboration with other providers.

By Day 7

Submit your Assignment.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

• Please save your Assignment using the naming convention “WK7Assgn1+last name+first initial.(extension)” as the name.
• Click the Week 7 Assignment 1 Rubric to review the Grading Criteria for the Assignment.
• Click the Week 7 Assignment 1 link. You will also be able to “View Rubric” for grading criteria from this area.
• Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK7Assgn1+last name+first initial.(extension)” and click Open.
• If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
• Click on the Submit button to complete your submission.

Grading Criteria

To access your rubric:

Week 7 Assignment 1 Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Week 7 Assignment 1 draft and review the originality report.

Submit Your Assignment by Day 7

To submit your Assignment:

Week 7 Assignment 1

Assignment 2: Week 7 Practicum Journal: Checkpoint for Certification Plan

Students will:

• Evaluate progress on certification plans

Report your progress on the Certification Plan completed in Week 1 and submitted in Week 4.

• What have you done to prepare for your certification?
• Have you completed the scheduled tasks assigned on your timeline? If not, what are your plans to stay on schedule?

By Day 7

Submit your Assignment.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

• Please save your Assignment using the naming convention “WK7Assgn2+last name+first initial.(extension)” as the name.
• Click the Week 7 Assignment 2 Rubric to review the Grading Criteria for the Assignment.
• Click the Week 7 Assignment 2 link. You will also be able to “View Rubric” for grading criteria from this area.
• Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK7Assgn2+last name+first initial.(extension)” and click Open.
• If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
• Click on the Submit button to complete your submission.

Grading Criteria

To access your rubric:

Week 7 Assignment 2 Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Week 7 Assignment 2 draft and review the originality report.

Submit Your Assignment by Day 7

To submit your Assignment:

Week 7 Assignment 2

Assignment 3: Week 5 Practicum: Decision Tree

By Day 7

Submit your Assignment. Refer to Week 5 for additional guidance.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

• Please save your Assignment using the naming convention “WK7Assgn3+last name+first initial.(extension)” as the name.
• Click the Week 7 Assignment 3 Rubric to review the Grading Criteria for the Assignment.
• Click the Week 7 Assignment 3 link. You will also be able to “View Rubric” for grading criteria from this area.
• Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK7Assgn3+last name+first initial.(extension)” and click Open.
• If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
• Click on the Submit button to complete your submission.

Grading Criteria

To access your rubric:

Week 7 Assignment 3 Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Week 7 Assignment 3 draft and review the originality report.

Submit Your Assignment by Day 7

To submit your Assignment:

Week 7 Assignment 3

Assignment 4: Week 6 Practicum Journal – Reimbursement Rates

By Day 7

Submit your Assignment. Refer to Week 6 for additional guidance.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

• Please save your Assignment using the naming convention “WK7Assgn4+last name+first initial.(extension)” as the name.
• Click the Week 7 Assignment 4 Rubric to review the Grading Criteria for the Assignment.
• Click the Week 7 Assignment 4 link. You will also be able to “View Rubric” for grading criteria from this area.
• Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK7Assgn4+last name+first initial.(extension)” and click Open.
• If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
• Click on the Submit button to complete your submission.

Grading Criteria

To access your rubric:

Week 7 Assignment 4 Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Week 7 Assignment 4 draft and review the originality report.

Submit Your Assignment by Day 7

To submit your Assignment:

Week 7 Assignment 4

Practicum Reminder

Time Logs: You are required to keep a log of the time you spend related to your practicum experience and enter every patient you see each day. You can access your time log from the Welcome Page in your Meditrek account. You will track time individually for each patient you work with. Please make sure to continuously input your hours throughout the term.

Making Connections

This week, you, once again, became “captain of the ship” as you took full responsibility for a client with an obsessive-compulsive disorder by recommending psychopharmacologic treatment and psychotherapy, identifying medical management needs and community support, and recommending follow-up plans.

Next week, you will explore evidence-based psychotherapy and psychopharmacologic treatment for neurocognitive disorders. You will complete your final Decision Tree as you rationalize and justify your diagnosis and treatment of a patient with a mental health disorder.

To go to the next week:

Week 8