Your manager asks you to see a client who appears to be decompensating. He has stopped coming to the center and his wife asks you for assistance. She says he is not eating, sleeps all day and rarely gets out of the house. He is talking gibberish to himself and mumbles profanities. She is afraid that he may harm her or their 3-year-old child. She further tells you she thinks he may be doing drugs but does not know which ones. She says the last time he was like this he attempted suicide through overdosing on his psych meds. He takes Ritalin for adult ADHD.
- What is your first priority in this case? Why?
- What type of treatment would you suggest? Why?
- What types of therapy might help this client stay on track? Why?
The first priority in this case is to stop for further decompensating and making the client accept to come to the center for further assistance. Decompensating in this case can be done by employing alternative ADHD medication to suppress the symptoms, or by ensuring that he takes his current Ritalin medication, since the decompensating process could have as well be initiated by not taking his current prescribed medication.
The client best treatment would involve the use of the right medication to suppress the symptoms. The current situation could have been initiated by two possibilities. One includes ineffectiveness of Ritalin in the client’s body which can highly happen after a long use, or refusal to take those drugs. If confirmed that the client is taking his medication as prescribed, then the best treatment would be change of the medication. The most probable alternative in this case would be an amphetamine such as Adderall (Shaw et al., 2003). However, in case the situation is caused by not taking medication or he is not using the right dosage plan, the counselor and the wife should determine a way to make him take his medication and in the right way. It is important to note that Ritalin is a stimulant and can cause addiction, especially when wrongly used. Thus it is important for the counselor to investigate if the client could be abusing this drug, and take the measure as early as this is confirmed. Use of medication will help to suppress symptoms and thus making therapy viable.
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The best therapy to give to the client is the cognitive-behavioral therapy. This is a psychotherapy procedure that is employed to help individuals suffering from ADHD to manage their cognitive ability and behaviors. It gives the clients the ability to live a normal life and to keep ADHD symptoms under control. Psychotherapy, when combined with the right medication makes it easy for ADHD clients to remain under control (Shaw et al., 2003).
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