Susan Year Female Assignment Help: How to Answer This Question

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Original Question

Susan is a 21 year old female, currently living at home with her husband of 3 years. They married right after graduation from high school, even though her parents tried to get her to wait until she finished college. She recently finished an associate degree in accounting and took a job; her husband works odd jobs in the small town in which they live, but is still “contemplating what he wants to do in life.” Susan worries that he won’t be able to find a steady job; she often comes home to him asleep on the sofa and the house in a “shambles,” as he doesn’t pick up his clothes or wash dishes. She feels compelled to cook dinner and clean the house after she gets home from work. They barely “scrape by” on her salary. Susan is experiencing increased levels of stress as she tries to balance the challenges of running a home with the demands of her job. She reports working long days “keeping the books” at the auto parts store at which she works. Susan reports a longstanding history with poor attention. She was identified in grade school as requiring special accommodations and support from her teachers, but was never diagnosed with a confirmed learning disability. She used ear plugs when studying in school. Her difficulties with focusing and time management have continued into adulthood, affecting her ability to effectively manage her finances and to balance her work/family relationships. Susan notes that her mother, now deceased, dealt with depression throughout her life. She notes that her parents always “expected alot of her.” She felt like she disappointed them when she got married; she sometimes wonders if she should have listened to them. She feels sad much of the time, and sometimes thinks her life is “pretty much over.” She feels hopeless at times. She has been able to cope by creating “pressure” to engage her focus, but this has resulted in symptoms of anxiety, depression, feelings of guilt, and loss of self-esteem. Susan worries that by focusing her energies on managing her work responsibilities, she is neglecting other areas of her life, particularly her husband and her aging stepfather for whom she provides care. Susan is concerned with perceived underachievement and inefficiency at her place of employment. She struggles with procrastination, and has difficulty with organization. Due to the increased demands and responsibilities she now faces in the home, Susan finds that she is not able to focus on work-related duties the way she feels she should. As a result, she has been disappointed by her recent performance at her place of work, especially since her boss has counseled her on her performance twice in the recent past. Susan is an intelligent and engaging communicator, but she feels overwhelmed by her current responsibilities and worries that she is not performing to her real potential. She sometimes feel paralyzed by stress, and reacts by retreating into herself rather than by asking for help. She says that she needs a life “GPS” to function – “I feel confused.” Recent stresses include her mother’s death (about 8 months ago) and her stepfather’s being diagnosed with cancer about 6 weeks ago. She was started on an anti-depressant at age 17 from her by her PCP, and is currently taking Buspar 5 mg twice daily to “take the edge off her anxiety,” but is not sure it is helping. (Her PCP has referred her to you to see if you can help.) She demonstrates no hyperactivity, but is challenged to stay focused to even read a book and has an even more difficult time keeping her mind on her duties at work. BIRP note detailing visit with Susan and plan for treatment, including medications (and dosages), as well as non-pharmacological interventions, and plans for follow up.

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