Case Study Analysis: Ann Washington's Integrative Wellness Plan

This case study presents an analysis of Ann Washington, a 36-year-old African American woman diagnosed with hypothyroidism, who is experiencing mood swings, fatigue, and symptoms of depression and anxiety. The analysis utilizes the Integrative Recovery Oriented Model to devise a care plan, addressing her holistic needs and promoting recovery. The study examines her presenting complaints, theoretical orientation, and evidence-based treatment approaches, including motivational counseling, strength-based approaches, and referral to various specialists. Ethical considerations, such as protecting patient confidentiality and obtaining informed consent, are discussed, along with multicultural factors specific to the African American community. The assessment reveals an adjustment disorder with mixed anxiety and depressed mood, and the case concludes with a prognosis and references to relevant literature. The assignment also highlights the importance of cultural sensitivity and the need for a holistic approach to patient care.

Running head: CASE STUDY ANALYSIS
CASE STUDY ANALYSIS
Name of the Student:
Name of the University:
Author Note:

1CASE STUDY ANALYSIS
Case conceptualization:
The provided case scenario deals with Ann Washington who is a 36 year old African
American female who was diagnosed with Hypothyroidism in the year 2016. The client has 3
children and lives independently with her husband. However, lately she has been
experiencing mood swings, fatigue and symptoms of depression and anxiety. Further, despite
the support being extended from her family and friends, the patient has not been able to cope
with the symptoms of her illness. This paper intends to critically analyse the presenting
complaints of the patient and make use of the integrative model of wellness to devise a care
plan that covers the holistic needs of the patient and promotes positive recovery.
Theoretical Orientation and Evidence based treatment:
The evidence base suggests that the Integrated Recovery Oriented Model is
specifically devised for mental health patients and focuses on enhancing the individual
health, wellness and promote social inclusion outcomes by improving access to evidence
based psychological interventions (Frost et al., 2017; Blount & Mullen, 2019). It should be
noted in this regard that the applied evidence based psychological interventions within a
specific care service supports recovery and wellness both as a process as well as the holistic
outcome. As stated by Foster et al. (2016), the Integrated Recovery Oriented model takes into
consideration the changing recovery needs of the concerned patient and focuses on
application of the supportive framework that help foster hope and accelerate the process of
functional recovery.
On analysing the case scenario, it can be stated that the mental wellness of the patient
is negatively affected on account of the poor symptom management of her existing physical
health condition. Typically symptoms of mood swings, weight gain, sensitivity to cold and
fatigue has also reduced her social interaction level. As suggested by Reeck, Ames &

2CASE STUDY ANALYSIS
Ochsner (2016), the core IRM components include, remediation of functioning, collaborative
restoration of skill set, reconnecting with the community and remediation of functioning. As
can be inferred from the provided case scenario the patient has an extremely understanding
partner and a group of friends but the diagnosis of Hyperthyroidism has made it difficult for
her to cope with her mood swings. Also, she states that before the diagnosis she was actively
engaged with religious activities and the Church, however after her diagnosis her level of
social interaction has declined to a significant extent. In order to foster wellness, a strength
based approach would be adapted. The rationale for the same can be explained as the positive
outcome associated with the application of a strength based approach (Luna et al., 2015).
Further, the client’s partner and her friends would be actively involved in the care process so
as to facilitate recovery. In addition to this, the client would also be referred to a
psychotherapist who would make use of motivational counselling in order to foster positive
recovery (Klainin-Yobas et al., 2015; Barth et al., 2016). Also, the patient would be
encouraged to participate in religious activities and attend church so as to alleviate her mood
and feel positive which would subsequently accelerate her recovery process (Barth et al.,
2016).
Ethical issues:
In this case, the ethical considerations of protecting patient confidentiality was
maintained. Also, before commencing the treatment process, consent was sought from the
patient and the patient was actively involved in the entire treatment process so as ensure that
devised care did not violate the individual expectations of the client (Barth et al., 2016).
Multi-cultural factors:
As revealed by the case scenario, the patient hails from the African American
Community which treats mental health as a predominant stigma. As informed by the evidence

3CASE STUDY ANALYSIS
base, the predominant belief surrounding depression within this community is that depression
is equivalent to the ‘ups and downs’ of life and does not require the application of any special
intervention. Also, the community perceives a woman suffering from mental illness as weak
and believes that the issue could be resolved by praying and does not require clinical
intervention (Mental Health America, 2019). Thus, the community is extremely specific
about their spiritual belief and in order to render a culturally safe intervention, the patient
would be referred to a spiritual motivational leader who could administer counselling and
reinforce optimism in her which could speed up the process of recovery (Mental Health
America, 2019).
Assessment:
On the basis of the mental state evaluation results, it can be stated that the patient has
been experiencing low mood and is dysphoric. Further, the patient is aligned and oriented to
time and place. The appearance and grooming of the patient appears to be tidy. The client
does not experience suicidal ideation and is at no risk of inflicting self-harm. Also, the
patient’s speech and motor activity is perceived to be normal. On the basis of the MSE and
DSM V criteria, the client is diagnosed to be suffering from Adjustment Disorder with Mixed
Anxiety and Depressed Mood on the basis of symptoms related to anxiety, frustration and
depression. The characteristic reason of the diagnosis is associated with the diagnosis of
Hypothyroidism.
Referral:
The patient would be referred to a nutritionist, a fitness trainer and a psychotherapist.
The rationale can be explained as assistance with weight management and motivational
counselling that would foster improved mood and positive recovery (Blount & Mullen,
2015).

4CASE STUDY ANALYSIS
Prognosis:
In the absence of appropriate treatment intervention, the symptoms of anxiety and
depression might escalate and harbour feelings of suicidal ideation. Further, this might trigger
panic disorder or PTSD which would significantly deteriorate the quality of life of the patient
(Barth et al., 2016).

5CASE STUDY ANALYSIS
References:
Barth, J., Munder, T., Gerger, H., Nüesch, E., Trelle, S., Znoj, H., ... & Cuijpers, P. (2016).
Comparative efficacy of seven psychotherapeutic interventions for patients with
depression: a network meta-analysis. Focus, 14(2), 229-243.
Blount, A. J., & Mullen, P. R. (2015). Development of an integrative wellness model:
Supervising counselors-in-training. The Professional Counselor, 5(1), 100.
Foster, K., Maybery, D., Reupert, A., Gladstone, B., Grant, A., Ruud, T., ... & Kowalenko, N.
(2016). Family-focused practice in mental health care: An integrative review. Child &
Youth Services, 37(2), 129-155.
Frost, B. G., Tirupati, S., Johnston, S., Turrell, M., Lewin, T. J., Sly, K. A., & Conrad, A. M.
(2017). An Integrated Recovery-oriented Model (IRM) for mental health services:
evolution and challenges. BMC psychiatry, 17(1), 22.
Klainin-Yobas, P., Oo, W. N., Suzanne Yew, P. Y., & Lau, Y. (2015). Effects of relaxation
interventions on depression and anxiety among older adults: a systematic
review. Aging & mental health, 19(12), 1043-1055.
Luna, B., Marek, S., Larsen, B., Tervo-Clemmens, B., & Chahal, R. (2015). An integrative
model of the maturation of cognitive control. Annual review of neuroscience, 38, 151-
170.
Mental Health America (2019). Depression And African Americans. [online] Mental Health
America. Available at: https://www.mentalhealthamerica.net/conditions/depression-
and-african-americans [Accessed 9 Aug. 2019].
Reeck, C., Ames, D. R., & Ochsner, K. N. (2016). The social regulation of emotion: An
integrative, cross-disciplinary model. Trends in cognitive sciences, 20(1), 47-63.