Essay NURS2118: Advanced Counselling Skills – Belinda Case Study – Motivational Interviewing and Cognitive Behavioural Therapy – Nursing Assignment Help

Assignment Task:

Case Study 

Belinda, a 32-year-old unemployed female was admitted to an acute psychiatric unit where she has had several prior admissions, in the context of increasing delusions and auditory hallucinations.  Belinda was diagnosed with schizophrenia at the age of 24 and has been a poly-substance drug user from the age of 15.  When unwell she develops delusions that her father sexually abused her as a child and experiences derogatory auditory hallucinations.   

On admission she presented dishevelled in appearance, agitated, elevated and paranoid- refusing almost all staff interventions and medications stating that her ‘father’ used to give her the same ‘meds’ before ‘raping’ her. Belinda stated she had been smoking marijuana (THC) daily for a week prior to admission after a period of around 4 months abstinence.  Belinda contributes her recent THC use to ‘old friends’ she saw at a concert and who offered her a ‘joint’. A drug urine analysis confirmed THC use only.  

After 12 days in the high dependency unit she was transferred to the low dependency unit (LDU) as the intensity of delusional material decreased, she was more able to accept reality feedback and her food intake and sleep improved.  Soon after transfer Belinda was observed participating in various group activities including art and music therapy and spending considerable time in her room playing guitar and writing songs.  

Three weeks after admission she stated that she has a ‘mental illness’ and that she knows drug use doesn’t ‘help’ her, but that using THC makes her more her ‘creative’.  She states that she is happy to continue to take medication (amisulpride) but that it gives her less energy. Belinda reports that she has had many periods of abstinence with the longest being for 8 months, during which time she had begun volunteering regularly at a community centre.  She expressed regret that this ended when she after a psychotic relapse that occurred following THC use and family stressors and subsequent hospital admission. Belinda identified music and art as areas of interest and has been involved in various related community programmes in the past. 

She has expressed a desire to study music therapy formally, but states that her current cycle of hospital admissions and relapse prevents her from doing so. Belinda described herself as having few friends and identified her mother as her main support, but described their relationship as ‘stressed’.