Assessment Overview Of Pat's Case

A. Assessment Overview
Pat S. was referred to the office following his release from an inpatient treatment facility after court sentencing. He was court ordered to the inpatient treatment facility after he walked in on his wife cheating on him in the shower and beat the other man to the point that he required an extensive hospital stay. During his eight-month stay at the inpatient facility, Pat was diagnosed as having bipolar I disorder. Following his release from the inpatient treatment facility, Pat is mandated to attend regular counseling sessions. Pat stated that he experienced what he now knows are delusions in the weeks prior to the incident; he continues to say that Nikki, his wife, is being manipulated by others so she will stay

Pat experiences episodes of mania that can lasts for weeks at a time. He experiences elevated self-esteem and a decreased need for sleep, often sleeping for less than two to three hours a night. Instead, he stays up reading most of the night. During these episodes, Pat has an increase in goal-directed behavior, believing that once he accomplishes his goals he will get back together with his wife. Pat develops pressured speech and experiences racing thoughts. He is unable to control his emotions and often gets himself into fights. Pat’s social and occupational functioning is impaired by his manic episodes. He becomes fixated on an idea and cannot stop thinking about it, becoming increasingly agitated and occasionally violent. During manic periods, Pat becomes fixated on things like the ending of a book and becomes so irritable that he breaks things, like windows and lamps, and talks incessantly about

Bipolar disorder most often requires pharmacological treatment as an intervention. Less than half of individuals with bipolar disorder are successful with just the pharmacological treatment approach. CBT shows positive results when used together with pharmacological intervention in treating bipolar disorder (Gregory, 2010). Bipolar disorder treatment benefits from CBT as it focuses on improving identifying distorted thoughts, improving communication and problem solving skills, areas that need intervention for individuals with bipolar disorder. CBT is effective in teaching coping skills to address times when symptoms are first displayed, but are not at top severity (Driessen & Hollon, 2010, p. 544). Driessen & Hollon caution that CBT is best used when a client is receiving pharmacological intervention concurrently and are not currently experiencing a full manic episode. CBT may be best used when a client is euthymic. According to Salcedo et al. (2016) is effective in preventing relapse, decrease in the need for hospitalization, reducing mania symptoms, and increasing the likelihood of taking medication. CBT demonstrate decreases in depressive and manic symptoms as well. CBT is effective both individually and in treatment groups. In a 2010 study, Costa, Cheniuax, Range, Versiani, and Nardi found that participants in group CBT showed decreased manic and depressive episodes as well