Ellen and Edward represent Essay

Ellen and Edward re gift the dynamic challenge of works with two people who enter therapy together, but present different levels of clinical symptomatology. In this case, Ellen appears to be experiencing the nearly difficulty functioning in her life. She reports a lack of energy, persistent sadness, and even episodic suicidal ideation. These problems argon not new for Ellen as she has likely suffered from clinical depression for several years. Her termination of psyche therapy may have triggered or intensified her recent profit in symptoms.Ellens diagnosis is Major Depressive Disorder. Her sourness ranges from moderate to severe. At this time, Edward does not piece criteria for all Axis I distempers, but further randomness would be necessary to understand his personality and opposite areas of functioning much thoroughly. Neither member of this fusion meets criteria for an Axis II diagnosis. There are no medical conditions reported and therefore, no Axis triple diagnos is. Axis IV psychosocial problems for Ellen include her previous abuse. As a span, 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 experienced a mood disturbance for longer than the period of her marriage, it is possible that even her mate selection of Edward was tie in 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 integral part of their relationship and cannot be extracted if the couple wishes to fortify their relationship through marital counseling. Ellen would shut a elan be encourag ed to seek her own individual therapy and consultation with a psychiatrist to address the sharpness of her depression. Ellens diagnosis was reached through the decision-tree method 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 ab push through her past provided enough clinical information to eliminate bipolar disorders and more daft 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 integral diagnosis. There are many di fferent medication options that may supplement Ellens participation in psychotherapy. Lexapro and Zoloft, members of the selective serotonin reuptake inhibitor (SSRI) class, may be useful. If Ellen does not respond to these drugs or is at-risk for their adverse side-effects, Wellbutrin is other option. This drug has a complete different save mechanism than the others in the SSRI class.Ellens rejoinder and compliance with any antidepressant medication should be monitored closely. Her history of abruptly terminating word could indicate a potential to also stop taking her medication without warning. Many antidepressants need to be tapered complete in gradually decreasing dosages. Abruptly ceasing treatment can cause dangerous side effects.ReferencesAmerican Psychiatric Association. (2000). Diagnostic and statistical manual of affable disorders DSM IV- TR. (4th ed. ). Washington, DC Author. Weeks, G. R. & Hof, L. (1995) Integrative Solutions Treating common problems in couples t herapy. bracing York Psychology Press.