Assignment Task
Case Study (Stephen):
Stephen is a 25-year-old single male with a diagnosis of schizoaffective disorder (depressive type) and history of sexual abuse as a child. He is currently living in a supported residential service (SRS) accommodation, unemployed and in receipt of the Jobseeker payment. Stephen has had several admissions into the acute in-patient unit and is currently receiving care through the mobile support and treatment service, MSTS (assertive community outreach team) on a compulsory treatment order under the mental health act. He was referred to the MSTS following several episodes of relapse mostly in the context of non-adherence to his medication and disengagement from services. Although when Stephen’s symptoms are well managed, he would often express desires to engage in goal directed activity such as finding a part-time job. His relapse signature includes, increased paranoid ideations about being under surveillance by government agencies, derogatory auditory hallucinations and ideas of reference from the TV. He also becomes quite preoccupied with sexual themes, believes he is dirty, unworthy and in need of cleansing (in the past he has tried drink a bleaching agent to obtain cleansing). He also has ongoing low mood, negative thoughts, hopeless, helpless and guilt themes. Stephen’s insight into his illness often fluctuates during the course of his illness.
Details of the Task:
This case scenario of Stephen presents an opportunity as a clinician to work with a consumer who is non-adherent with treatment and who has ongoing negative thoughts and psychotic symptoms using the principles of motivational interviewing and cognitive behavioural therapy. The treatment setting could be either community or in-patient mental health (your approach could slightly differ depending on the setting).
The essay has 3 major components or areas that you will need to focus on:
1. An introduction that sets the scene for the essay, provides context and the scope of what your essay would be discussing.
2. Discuss how you would utilise the principles of trans theoretical model of change and motivational interviewing to support Stephen when it comes to him taking his medications as prescribed. Your discussion should be embedded within the available evidence-based literature.
3. Discuss how you would utilise cognitive behaviour therapy when working with Stephen, embedding your approach within evidencebased literature. Please note, given the number of symptoms that Stephen is presenting with and your limitations with word limit, you will need to focus on specific symptoms rather than trying to cover
all the symptoms listed.
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