NUR 650 Discussion # 4

Richard is Motivated


After studying , discuss the following:

Richard is a 62-year-old single man who says that his substance dependence and his bipolar disorder both emerged in his late teens. He says that he started to drink to feel better when his episodes of depression made it hard for him to interact with his peers. He also states that alcohol and cocaine are a natural part of his manic episodes. He also notes that coming off the cocaine and binge drinking contribute to low mood, but he has not responded well to referrals to AA and past inpatient stays have led to only temporary abstinence. Yet, Richard is now trying to forge a closer relationship with his adult children, and he says he is especially motivated to get a better handle on both his bipolar disorder and his substance use. He has been more compliant with his mood stabilizing and antidepressant medication, and his psychiatric provider would like his dual diagnoses addressed with psychotherapy.

  • What diagnostic information would be most critical to collect in the first visit?
  • Which diagnostic measures are recommended by the US clinical guidelines for the treatment of this patients family problem?
  • Which evidence based harm reduction strategies would you recommend to treat this patient?
  • Identify your city. Then refer this patient to three agencies near you that would support positive health outcomes for this patient. (These agencies must not have been used in past discussion posts). What was your rationale for choosing these three agencies?

Submission Instructions:

  • Your initial post should be at least 500 words, formatted and cited in current APA style.
  • Provide support for your work from at least 2 academic sources less than 5 years old.
  • Your initial post is worth 8 points.
  • You must use an alternative treatment plan to the one provided in the textbook.
  • You should respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts. Your reply posts are worth 2 points (1 point per response.)
  • All replies must be constructive and use literature where possible.
  • Please post your initial response by 11:59 PM ET Thursday, and comment on the posts of two classmates by 11:59 PM ET Sunday.
  • You can expect feedback from the instructor within 48 to 72 hours from the Sunday due date.
Discussion Rubric
Criteria Ratings Points
Identification of Main Issues, Problems, and Concepts Distinguished – 4 points
Post is substantively accurate. Identifies and demonstrates a sophisticated understanding of the issues, problems, and concepts surrounding the assignment. Provides exceptional and thought-provoking analysis that directly addresses details and/or examples of the main topic.
Excellent – 3 points
Post is mostly related to the topic. Demonstrates understanding of most of the issues, problems, and concepts surrounding the assignment. It provides some supporting details and/or examples. Analyses not as clear as they could be.
Fair – 1-2 points
Demonstrates limited understanding of most of the issues, problems, and concepts surrounding the assignment. No details and/or examples are given.
Poor – 0 points
Post is off-topic, incorrect and/or irrelevant to the issues, problems, and concepts surrounding the assignment. Analyses are not well organized or clear.
4 points
APA Formatting Guidelines Distinguished – 2 points
The reference page contains at least the required current scholarly academic reference and text reference. Follows APA guidelines of components: double space, 12 pt. font, abstract, level headings, hanging indent, and in-text citations.
Excellent – 1 point
The reference page contains one current scholarly academic resource and text reference. Follows most APA guidelines of components: double space, 12 pt. font, abstract, level headings, hanging indent, and in-text citations.
Fair – 0.5 points
The reference page contains one current or outdated scholarly academic resource. Many errors of APA guidelines: double space, 12 pt. font, abstract, level headings, hanging indent, and in-text citations.
Poor – 0 points
The reference page contains no current scholarly academic resources, only internet web pages, or no reference page. Lack of APA guidelines for references provided or in-text citations.
2 points
Writing Mechanics Distinguished – 2 points
Rules of grammar, usage, and punctuation are followed; spelling is correct.
Excellent – 1 point
Few grammatical errors, but sentences could be clearer and more precise.
Fair – 0.5 points
The paper contains a few grammatical, punctuation, and spelling errors.
Poor – 0 points
The paper contains numerous grammatical, punctuation, and spelling errors.
2 points
Response to Posts of Peers Distinguished – 2 points
Constructively responded to two other posts and either extended, expanded, or provided a rebuttal to each.
Fair – 1 point
Constructively responded to one other post and either extended, expanded, or provided a rebuttal.
Poor – 0 points
Provided no response to a peer’s post.

2 points
Total Points 10