Ellen and Edward represent Essay

Ellen and Edward playact the dynamic challenge of working with both people who enter therapy together, but perplex different levels of clinical symptomatology. In this case, Ellen appears to be experiencing the most difficulty functioning in her life. She reports a lack of energy, persistent sadness, and nevertheless occasional suicidal ideation. These problems are not new for Ellen as she has likely suffered from clinical depression for several years. Her termination of mortal therapy may have triggered or intensify her recent increase in symptoms.Ellens diagnosing is Major Depressive Disorder. Her severity ranges from lessen to disgusting. At this time, Edward does not adjoin criteria for whatever axis I disorders, but gain information would be necessary to run across his personality and other areas of functioning more than(prenominal) than thoroughly. Neither member of this actuatenership meets criteria for an axis of rotation II diagnosing. in that location are no medical conditions reported and therefore, no Axis III diagnosis. Axis IV psychosocial problems for Ellen imply her previous abuse. As a friction match, psychosocial difficulties accommodate 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 substantive aspects of the relationships. Be have Ellen has experienced a mood upset for longer than the distance of her marriage, it is possible that point 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 integral part of their relationship and cannot be extracted if the couple wishes to in tertwine their relationship through marital counseling. Ellen would remedy be encouraged to seek her own individual therapy and consultation with a shrink to address the severity of her depression. Ellens diagnosis was reached through the decision-tree method throwed in the DSM-IV (American psychiatric Association, 2000).This method is a thorough route to match the presenting symptoms to the most appropriate clinical diagnosis. In this case, Ellens experience of a mood disorder was clear archeozoic in the initial session. The details she depict 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 iodine criticism of the decision-tree method may be its tendency to over-diagnose.While this client intelligibly met criteria, there are very some paths out of the decision-tree should a client pr esent mild symptoms that do not unless merit a full diagnosis. There are many different practice of medicine options that may supplement Ellens community in psychotherapy. Lexapro and Zoloft, members of the selective serotonin re-uptake inhibitor (SSRI) class, may be useful. If Ellen does not serve to these do drugss or is at-risk for their adverse side-effects, Wellbutrin is another option. This drug has a complete different operation mechanism than the others in the SSRI class.Ellens response and compliance with any antidepressant drug medicine should be monitored closely. Her history of utterly terminating treatment could indicate a likely to also stop taking her medication without warning. Many antidepressants need to be lessen off in gradually diminish dosages. Abruptly ceasing treatment can cause dangerous side effects.ReferencesAmerican psychiatrical Association. (2000). Diagnostic and statistical manual of noetic disorders DSM IV- TR. (4th ed. ). Washington, DC Author. Weeks, G. R. & Hof, L. (1995) Integrative Solutions Treating car park problems in couples therapy. New York Psychology Press.