The Impact of Social Anxiety and OCD-Laurens Case

The Impact of Social Anxiety and OCD-Laurens Case

The presenting case is of a client with social anxiety disorders, accompanied by obsessive thoughts that result in compulsive disorders. Szuhany & Simon (2022), note that anxiety disorders are characterized by symptoms of extreme worry, irritability, restlessness, fears of social performance, and irritability, along with physical symptoms of palpitations, dizziness, shortness of breath, and others. Per the video transcripts, one of the clinical signs of anxiety that is prominent is extreme worry. The client, in this case, worries a lot. She also appears restless, as demonstrated by her impatience in answering questions she is being asked. She also exhibits signs of irritation, as can be seen when she asks Karen why they are talking about her.

Several manifestations, consistent with those of obsessive-compulsive disorder, are also apparent in the case. According to Moreno-Amador et al. (2023), OCD manifestations can be modeled into the dimensions of obsession with symmetry and repeating, ordering, and counting compulsions, cleaning, forbidden thoughts, and hoarding of thoughts and obsessions. Per the transcripts, the client notes that she counted cars on both sides of the highways to ensure they matched and that if they didn’t, she had to request her parents to redo the route, which is indicative of an obsession with symmetry. Additionally, she demonstrated extreme observance of the order of things and would get uncomfortable when things were not in order. As evident in the case, she would count the number of kids in her Spanish class and get uncomfortable when the number was not right. Another manifestation of OCD is counting and checking. She would ensure that the number of body washes was there and that the temperature was the same every time she had a shower.

Therapeutic communications provide an invaluable approach to client-caregiver engagements. The use of clarification was apparent during the interview. Mersha et al. (2023) note that nurses can use diverse therapeutic communication techniques such as seeking clarification, restating, the use of silence, active listening, the use of open-ended questions, and giving broad openings when engaging their patients. These techniques allow nurses to have meaningful relationships with their clients. The nurse sought clarification in several instances, including what constituted the client’s worry and how it affected her wellness. Clarification allows the patients to provide details on the communicated items. Additionally, she restated some of the client’s statements, demonstrating the restating technique. Notably, the restating technique allows the nurse to clarify what the client has communicated. The use of silence was also evident as, in some instances, the nurse paused to implore the client to share more. Silence allows nurses to demonstrate empathy and active listening.

The two nursing interventions for Lauren are 1) acknowledging the patient’s feelings and 2) actively listening to the patient. Acknowledging the patient’s feelings and experiences helps the patients feel that they are indeed cared for (Amaral et al., 2022). Providing active listening to the patients allows the establishment of a good therapeutic relationship with the patient.

References

Amaral, R. I., Weston, F. C., Hirakata, V. N., Paz, A. A., & Wesner, A. C. (2022). Effectiveness and efficacy of therapeutic interventions performed by nurses for anxiety disorders: A systematic review. Journal of the American Psychiatric Nurses Association, 28(4), 283–294. https://doi.org/10.1177/10783903211068105

Mersha, A., Abera, A., Tesfaye, T., Abera, T., Belay, A., Melaku, T., Shiferaw, M., Shibiru, S., Estifanos, W., & Wake, S. K. (2023). Therapeutic communication and its associated factors among nurses working in public hospitals of Gamo Zone, southern Ethiopia: Application of Hildegard Peplau’s nursing theory of interpersonal relations. BMC Nursing, 22(1). https://doi.org/10.1186/s12912-023-01526-z

Moreno-Amador, B., Piqueras, J. A., Rodríguez-Jiménez, T., Martínez-González, A. E., & Cervin, M. (2023). Measuring symptoms of obsessive-compulsive and related disorders using a single-dimensional self-report scale. Frontiers in Psychiatry, 14. https://doi.org/10.3389/fpsyt.2023.958015

Szuhany, K. L., & Simon, N. M. (2022). Anxiety disorders. JAMA, 328(24), 2431. https://doi.org/10.1001/

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Assemble nursing care interventions for clients with behavioral or cognitive disorders.
Scenario
Lauren has been diagnosed with Social Anxiety Disorder and experiences obsessive thoughts that result in compulsive behaviors. This has a major impact on her life and day-to-day functioning.

Instructions
View the video segments 1, 2, and 3 for Lauren.
Notice how the nurse continues to gather information to assess the extent of Lauren’s illness. The content relates to the objective that you will be able to describe the symptoms of anxiety and OCD.
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