Scenario 1
A 15-year-old client presents to the PMHNP for therapy. She reports persistent feelings of sadness for the last year. She has trouble sleeping and has lost 12 pounds in the last few months. She used to enjoy participating in choir and drama club at her school, but no longer enjoys her favorite activities. She is experiencing problems in her social relationships due to difficulty making friends and often feels lonely. 7/22
Diagnosis:
Selected psychotherapeutic approach with rationale:
Therapeutic techniques to employ:
Psychopharmacology inclusion with rationale:
Scenario 2
A 32-year-old client presents to the PMHNP for therapy. She has been experiencing feelings of guilt and has had trouble concentrating since returning to work after the birth of her first child three months ago. She states that she is sad most of the time. She feels frustrated with her partner because she feels that he has not assumed responsibility for any additional household duties since the baby’s birth, leaving her feeling tired and discouraged. 7/22
Diagnosis:
Selected psychotherapeutic approach with rationale:
Therapeutic techniques to employ:
Psychopharmacology inclusion with rationale:
Scenario 3
A 67-year-old client presents to the PMHNP for therapy. He reports that he lost his wife to breast cancer three years ago. Since then, he has been unable to enter their shared bedroom and has been sleeping on the couch. He has avoided holiday celebrations with his children for fear he will be reminded of his wife. He expresses bitterness that they were not able to enjoy their retirement together. He states that he wonders whether his wife would still be alive if he’d been more insistent that she get a mammogram when she found a lump in her breast. His son is concerned about him and has encouraged him to seek help. 7/22
Diagnosis:
Selected psychotherapeutic approach with rationale:
Therapeutic techniques to employ:
Psychopharmacology inclusion with rationale:
Scenario 4
A 26-year-old client presents to the PMHNP for therapy. The client was recently discharged from an inpatient substance use disorder treatment program for alcohol use. Although he is committed to his sobriety, he is struggling to navigate social situations where alcohol is available. All of his friends drink alcohol socially. His sobriety is creating problems with his partner as he continues to consume alcohol in their home. He is having trouble expressing his concerns to his partner out of fear his partner will leave the relationship.
Diagnosis:
Selected psychotherapeutic approach with rationale:
Therapeutic techniques to employ:
Psychopharmacology inclusion with rationale:
Scenario 5
A 39-year-old presents to the PMHNP for therapy. He recently started a new career after working in the same field for over 20 years. Although he was an expert in his previous field, he is a novice in his new role. He is experiencing symptoms of anxiety, which is having a negative impact on his relationship with his wife and children because he is unable to focus on anything but the job. He uses marijuana daily to help reduce his anxiety symptoms.
Diagnosis:
Selected psychotherapeutic approach with rationale:
Therapeutic techniques to employ:
Psychopharmacology inclusion with rationale:
Scenario 6
A 70-year-old client presents to the PMHNP for therapy. She reports feeling lonely. She’s divorced with an adult daughter who lives out of state. Her relationship with her daughter is strained. She calls her daughter frequently; however, her daughter rarely returns her calls. Since her retirement, she is less socially active. With the onset of the COVID-19 pandemic, she has been socially isolated and is experiencing increasing symptoms of depression and anxiety.
Diagnosis:
Selected psychotherapeutic approach with rationale
Therapeutic techniques to employ:
Psychopharmacology inclusion with rationale: