Ellen and Edward represent Essay

Ellen and Edward re set out the dynamic challenge of running(a) with two people who enter therapy together, but present different takes of clinical symptomatology. In this case, Ellen appears to be experiencing the most difficulty surgical process in her life. She reports a lack of energy, persistent sadness, and dismantle occasional suicidal ideation. These problems argon non new for Ellen as she has likely suffered from clinical depression for several years. Her final result of singular therapy whitethorn have triggered or intensified her recent subjoin in symptoms.Ellens diagnosis is Major Depressive Disorder. Her severity ranges from moderate to severe. At this time, Edward does not meet criteria for any Axis I ailments, but pull ahead information would be necessary to understand his personality and other areas of functioning more naturally. Neither member of this partnership meets criteria for an Axis II diagnosis. thither are no medical conditions reported and thi therfore, no Axis troika diagnosis. Axis IV psychosocial problems for Ellen admit her previous abuse. As a couple, psychosocial difficulties include communication problems and marital discord.Ellens GAF is estimated to be 35 while Edward is functioning more effectively at a GAF of 65. The couples level of functioning is more reflective of Ellens more severe difficulties (Weeks & Hof, 1995). They are failing to communicate, meet basic needs of the household, and sustain meaningful aspects of the relationships. Because Ellen has undergo a mood disturbance for longer than the duration of her marriage, it is possible that even her mate selection of Edward was related to her diagnosis (Weeks & Hof, 1995).For this reason, Ellens individual diagnosis should be seen in the context of the relationship for the purposes of couples therapy. It is an constitutive(a) part of their relationship and seatnot be extracted if the couple wishes to fortify their relationship by dint of marital cou nseling. Ellen would still be encouraged to seek her own individual therapy and consultation with a psychiatrist to address the severity of her depression. Ellens diagnosis was reached through the decision-tree manner presented in the DSM-IV (American Psychiatric Association, 2000).This method is a thorough way to match the presenting symptoms to the most appropriate clinical diagnosis. In this case, Ellens experience of a mood disorder was clear early in the initial session. The details she described about her past provided enough clinical information to eliminate bipolar disorders and more mild forms of depression. Major depressive disorder encompasses the duration and severity (i. e. occasional suicidal ideation) of her condition. The single criticism of the decision-tree method may be its tendency to over-diagnose.While this client clearly met criteria, there are very few paths out of the decision-tree should a client present mild symptoms that do not yet merit a plenteous dia gnosis. There are many different medication options that may add Ellens participation in psychotherapy. Lexapro and Zoloft, members of the selective serotonin reuptake inhibitor (selective-serotonin reuptake inhibitor) class, may be useful. If Ellen does not respond to these doses or is at-risk for their adverse side-effects, Wellbutrin is another option. This drug has a complete different action mechanism than the others in the SSRI class.Ellens response and compliance with any antidepressant medication should be monitored closely. Her history of abruptly terminating treatment could indicate a potential to overly stop taking her medication without warning. Many antidepressants need to be diminish off in gradually decreasing dosages. Abruptly ceasing treatment can cause dangerous side effects.ReferencesAmerican Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders DSM IV- TR. (4th ed. ). Washington, DC Author. Weeks, G. R. & Hof, L. (1995) Integr ative Solutions Treating common problems in couples therapy. sunrise(prenominal) York Psychology Press.