Case Study Analysis Paper On Personality Disorder (Essay Sample)

PERSONALITY DISORDER
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Personality Disorder
Introduction
In the contemporary nursing world, perspectives and the views of the people using the mental health services are the most vital drivers for creating quality and exploring innovative ways of improving the service. It ensures that the relationship between the mental health professionals and the service users is maintained, and there is understanding from both parties thus leading to the maximization of the service. However, there has never been an ideal healthcare environment in which all these factors exists, therefore, leading to the poor services and non-quality care provided to the patients. This paper will, therefore, discuss some of the theoretical concepts which support assessment, planning and delivery of various interventions underlying how the needs of the Patients can be met.
As discussed below, the paper provides a brief background of the case to be analysed, give a discussion on related theories such as the CBT, CAT and the Bio-Psychosocial Perspective of the matter and how it relates to decision making. Primarily, treatment of the mentally ill and proper care delivery depends on the assessment and the process of decision making. This paper has specifically taken the central role in discussing this so as to deduce the best strategies needed in taking good care of patients like Alison. With the growing number of people suffering from mental illnesses, it is of great importance that the best care methods be delivered and the existing problems in the system that shows some weaknesses be appropriately dealt with.
Background of the Paper
Alison is a 35-year-old suffering from Borderline personality disorder. The borderline personality disorder is one condition associated with difficulties in regulating emotions. It contributes to severe, unstable mood swings, impulsivity as well as poor self-image. Besides, it usually makes an individual to have a stormy personal relationship. In worst scenarios, it leads to the abandonment that the people affected have to go through. However, people usually try especially family members try all that they can to have such avoided. Just as there are so many scars on Alison, the result of living with BDP usually grows into destructive behaviour such as harm or even cutting yourself as explained by Chapman & Gratz (2010). Since such people find it hard to live with some disturbing facts, they end up being violent in a manner that they disturb the peace of those around them.
As for the case of Alison, in a span of two weeks, she had been admitted at the A & E where she was seen by the psychiatric liaison nurse and the deputy psychiatric. On assessment, Alison is found to be stressed, and she cannot believe she is alive. At the same time, she feels so much anger for her partner who called an ambulance to save her life. Just like before, she is back to the clinic, though under emergency for overdosing paracetamol and citalopram. Objectively, the nurses also find Alison to be in low moods and admit that this has been interrupting her sleep for the last three weeks. She has been, therefore, using the anti-depressants, though she explains that they have failed to work for her. However, she explains that her psychodynamic sessions just ended the previous month.
The above case, therefore, shows a gap in proper assessment, planning and delivery mechanism to ensure that the users of the service receive the best of all services. It, therefore, calls for the implementation of user-focused evaluation strategies such as patient visits. In addition to that, user-focused evaluation when applied to the patients leads to very flexible services which particularly respond to the personal needs of a patient as well as their goals. Based on the responses given, the service users will end up receiving the best care based on their needs. It is, therefore, the same thing that has to be done to Alison such that she receives a person-cantered service to meet her needs such as requiring home visits to have her conditions contained. Presently, the A&E is not using the sufficient approach on her, and that forms part of the reasons for her frequent drugs' overdose and suicidal thoughts. If a person-centred approach were to be offered, then Alison would not have been in the present condition; she would be showing some positive signs of improvement considering that she has lived in that condition for ten years.
Discussion
Theoretical concepts that support assessment planning and delivery of various interventions underlie how patient's needs are met.
In nursing, assessment forms part of the initial process of planning. Being an essential requirement necessitates the need for accurate assessment among the health caregivers to ensure they identify the real needs of the patients. Besides, the art of good record keeping as practiced by the health caregivers and specifically the nurses is an indicator of a skilled and safe practitioner as explained by Rosdahl & Kowalski (2008, p. 382). In addition to that, it is considered as the hallmark of professional practice which enhances safe and a high-quality, evidence-based health care delivery to the patients as explained by the Nursing Times (2016). In other words, record keeping is the basis of planning which ensures that delivery of the healthcare services meets the needs of the individual patient and remains as practical as possible. However, there are some theoretical frameworks that have been discussed below, which not only ensure that assessment, planning, and delivery of the patient is practical but also meets the needs of an individual patient. Discussed below is how the various theories could be used to ensure that Alison's treatment is practical and evidence based.
Enhanced Cognitive Behaviour Therapy (CBT)
The cognitive behavioural therapy is one of the theories which address maladaptive patterns of thinking and behaving as explained by Page & McKinney (2012, p. 141). Unlike other theories, the CBT is structured, goal oriented and limited to time. It, therefore, advocates for an open therapeutic relationship to help the BPD patients understand and manage their difficulties. Besides the CBT models of the personality disorder contributing to locating the patients' challenges and helping the patients overcome them, it also explains the primary causes of these problems (Beck, et al. 2015, p. 4). In doing so, it helps both the nurses and the patients to have the best treatment of the disorder as they get to focus on the deeper levels of the cognition. Using the theory, it is clear and evident that Alison and the psychiatric liaison nurse, together with the deputy psychiatric will have a better understanding of her condition and have the best treatment of the disorder to prevent the frequent re-occurrence of her behaviour.
Cognitive Analytic Therapy (CAT)
This theory as explained by Ryle & Kerr (2002) hinges on the understanding that the relationship whose ideologies have been drawn from cognitive, the relational and various analytical therapies. The theory provides a good understanding and working with the self-defeating ways on how a person thinks, what they feel and how they act. The theory, therefore, stresses on the events right the way from childhood or the early life of an individual which have helped in the shaping of their experiences and to the level of maintaining their current problems as Pollock & Llewelyn (2011) justifie.
Cognitive Analytic Therapy is, therefore, tailored towards managing the achievable goals of a patient thus helping them to develop new ideas and also improve their relationship with other people around them Woodrow & Roe (2000). It would, therefore, mean that this theory will help Alison in developing her relationship with the family members including her spouse. Through setting new goals, Alison will have the best way of recollecting herself and avoiding the feeling of isolation that usually comes with BDP. However, what must remain clear about the therapy is that it is time limited and uses end therapy letters. CAT, therefore, works well with the issues that surround ending of therapy that is critical in the diagnosis of Alison's disorder Woodrow & Roe (2000) explains.
DBT’s Theory of Borderline Personality Disorder
The Dialectical behaviour therapy primarily depends on the bio-social theory as explained by Corr & Matthews (2009). As may be understood, the BPD is a consequence of an individual who is emotionally vulnerable growing up within a particular environment. As explained by West & Turner ( 2009), an emotionally nervous person is that individual who reacts in excess to any low level of stress and they take longer than normal once the stress has been taken away. An emotionally vulnerable person such as Alison is expected to be experiencing particular problems in the vulnerable environments in which they stay. This, therefore, makes them not to have the opportunity to label and understand their feelings, resulting into the actions of overdosing that she was involved in. Besides, this as well makes people like Alison not to have trust in themselves thus leading to suicidal thoughts. It is for that reason that it is difficult for Alison to cope with situations she might find to be stressful like the return of the father who sexually molested her while she was young. Based on the individual dialectic behaviour therapy, it is much easy to provide treatment for people in this condition as it focuses on creating change in the behaviour of the patients. In the case of Alison, the DBT will include weekly individual sessions, the weekly group training, meeting that are to be held by the therapist and coaching provided ...