Healthcare Case Study: ADHD Patient Marty, Treatment Plan

This case study focuses on Marty, a 23-year-old male with a history of ADHD, who is facing multiple challenges including job instability, hyperactivity, potential depression, and legal issues after an incident with his supervisor. The assignment provides a detailed overview of Marty's history, including his diagnosis at age four, social and family history, and past medical history. It explores his current situation, lack of medication, and the need for a comprehensive treatment plan. The proposed plan incorporates integrative or holistic therapy, combining behavioral and psychological therapy with psychotropic medication to address ADHD symptoms and potential depression. The case study also discusses the Affordable Care Act's (ACA) impact on Marty's access to mental health care, community resources for substance abuse and therapy, and legal and ethical considerations. The study emphasizes the importance of routine follow-up, monitoring, and the role of the primary care giver in restoring hope and instilling resilience in the patient.

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Attention-Deficit/Hyperactivity Disorder
Student‘s Name
Instructor
Course
Institution
Date

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Patient Chief Complaint
Marty is a 23 year old male with a known history of ADHD. He cannot hold a steady job
and has over a period of three years, switched jobs approximately four times on average per year.
He loses focus quickly and is known among colleagues to be hyperactive rarely getting through
with one task before he abruptly takes up another; he has his parents worried because he recently
chocked his supervisor. This has him fired and facing assault charges. His family wants him to
get back on his medicines which he refuses.
His family has also noted that he is spending more time alone, he rarely eats, sleeps for
the larger part of the day and has all but lost interest in playing his guitar which he loves .His
brother also noted that he talks a lot about death and the family is concerned he might be
slipping into depression.
History Of Present Illness
Marty was diagnosed with ADHD at age four. From infancy he was hyperactive and his
parents attributed this to his gender assuming it to be a normal thing with boys, but in time the
hyperactivity and dangerous play, had gotten out of hand, his parents resorted to physically
restraining him until he settled down; he was impulsive, and would hardly maintain eye contact
when communicating with family and friends.
Social History
In school he was regularly suspended for indiscipline and truancy. Within the community
he was shunned by his peers and eventually branded a social outcast due to his continued

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infractions with authority figures and local law enforcement. His parents were sidelined by the
community who viewed Martyrs behavior as the hallmark of bad parenting; gradually he got into
drug and substance abuse, starting with prescription drugs later moving on to marijuana.
Family And Marty’s Past Medical History
Genetics play a very huge role in ADHD, Marty’s family has a history of schizophrenia, his
older brother, a former veteran committed suicide recently after decades of battling ADHD,
depression and post traumatic stress disorder(Faraone, Et.Al.2019). This could also have trigger
red the developing depression in Marty and the recent exhibition of violent behavior. Marty has
only ADHD
Medication
He is currently on no medication. And has been as such for a while now
Treatment Plan
To counter the ADHD and suspected depression using integrative or holistic therapy
approach, incorporating behavioral and psychological therapy with psychotropic medication. The
medication: to counter his erratic behavior, hyperactive tendencies and increase concentration
level. Through behavioral and psychological therapy the issue of depression will be addressed.
How The Affordable Healthcare Acts Affect Behavioral Health Care, And My Patient.
By allowing a child to benefit from their parents healthcare plan until they are 26 years
old the ACA ensured that young people without jobs or insurance plans get access to mental

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health care .The ACA ensured that people get access to mental health care by making, sure that
of the cover included mental health and mental health prescription drugs. This helps the patient
in my scenario who is currently unemployed and below 26 this means he is insured under his
mother
Community Resources
Marty has a history of substance abuse, so I would first find out whether he has gone
back to using recreational drugs or any other substance, then I would refer him to a rehabilitation
centre, for drug abuse I would refer him to Community rehab center in free hold new jersey.
Here he would also get urgent assessment and intervention. In my area there are church based
organizations for someone who would not be able to afford behavioral therapy, I would also
recommend him to go to support group therapy.
Legal And Ethical Considerations
On legal issues, in case Marty is completely unable to be fully re-integrated into the
community and become a productive member of society, the doctor has to fully evaluate him
before declaring him mentally disabled so he is entitled to Disability assistance from the
government wrong diagnosis would have legal ramifications
The ethical issue: A doctor is bound to be confidential about a patient’s condition, if he
were to give it out to a third party without the patients consent law suits are bound to arise, in
this case the doctor has a moral obligation to keep the information private but since the third
party is the parent who will also be part of the therapy process he is obliged to share keep the
parents in the loop.

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Marty needs routine follow up and monitoring to gauge the effectiveness of the therapy
and medication on a weekly basis, this helps in controlling dosage by raising or reducing and
changing the approach of the therapy, could be he isn’t as responsive to family group therapy
and is better with individual therapy.
As a primary care giver I should restore hope and instill resilience in my patient he needs
to know that he can overcome whatever he is going through and have a normal life again should
be empathetic and view him as more than just a patient but as a human being who has fears,
hopes and ambitions. I should use my emotional intelligence when working with my patient.

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Reference
Faraone, S. V., & Larsson, H. (2019). Genetics of attention deficit hyperactivity
disorder. Molecular psychiatry, 24(4), 562-575.