Elaborate on how the Psychodynamic Theory approach has been shown to be effective with this type of client(Tammy)
Two specific research articles that focus on practice effectiveness using psychodynamic. Provide a thorough summary of both articles and discussion points. Please provide article links apa format
Elaboration on how the approach has been shown to be effective with this population/clinical concern
Discussion of specific research article(s) that focus on effectiveness of practice (using this approach) with this population or clinical issue
Tammy is a 44-year-old African-American female who was diagnosed with multiple sclerosis (MS), a degenerative autoimmune disease, nearly 15 years ago. The disease has progressed to the point where she walks with two canes, one in each hand, when she leaves her house, although she is able to use only one cane around the house. Tammy is unable to hold a job because of her disability and receives about $500 in Supplemental Security Income each month. In addition, she receives food stamps and Medicaid. Tammy first sought assistance from the social work department a month ago because of her housing situation. She has lived with a friend in her basement bedroom for the past 18 months. The friend’s grown son, who does not live with them, owns the house. The friend also has two other sons living in the house. Tammy pays them $200 in rent each month and uses her food stamps to buy food for the entire household. The situation is causing her great stress, as the two young men make her feel unwanted. They are loud and harass her (they “get on me”) and make it difficult to sleep. She is unable to use the shower because it is not big enough for her safety seat, and she has fallen a few times while using it. She takes sponge baths in her room instead. The stress of her living situation is upsetting her, and she is afraid that she’ll have another attack of MS and require hospitalization. She has been hospitalized once since moving in with this friend. In addition, she has checked herself into a psychiatric hospital twice since living with her friend. Now, for the past several weeks, she has found herself crying every day, feeling hopeless, and wanting to hurt herself. She has never actually attempted self-harm, however. She stays in her bed, either sleeping or watching television most days, except for the times she has her physical therapy appointments. She describes feeling “incredibly tired” and also says that she wants to stay out of the way of her roommates so that they won’t bother her.
Tammy has been a patient at the rehabilitation hospital for most of the course of her disease. She sometimes has what she calls “attacks” in which her MS symptoms worsen and she needs to be hospitalized. She recognizes that this usually happens when she is under great stress. Currently she is seen in the outpatient clinic and attends physical therapy twice a week. She hopes to become strong enough to need only one cane while out in public, and none at home. Her therapist believes that she is making good progress and that her goal is attainable. Tammy’s family situation is marked by conflict and estrangement. Tammy is divorced and has two daughters and a son, all grown. Her son is in jail. Her younger daughter is pregnant, and her older daughter just moved into a subsidized apartment. She says her relationship with her older daughter is strained, but they do speak. Her ex-husband died a few years ago while in prison. She has a sister who lives in a shelter in a neighboring county, but they also are not on speaking terms. Tammy says this is because while she was still married, her sister had an affair with her ex-husband. All her brothers are in jail, and she is not close to any other relatives. Tammy is not eligible for public housing. She used to live in a Section 8 apartment, but was evicted. Her children were responsible for paying her bills, and she did not realize that they were not paying her rent until she learned that she owed over $2,000. She is ineligible to get back on the public housing list until she has paid this money. She has worked with the Center for Independent Living to try to find alternatives, but the cheapest apartments they have found have rents higher than her monthly income. Tammy says she does not take beta interferon, a medication used to treat MS symptoms that has a suspected connection to the development of depression (Arnett & Randolph, 2006). On her most recent admission, eight months ago, the psychiatrist prescribed an antidepressant medication and recommended psychotherapy when she left the hospital. Tammy said she went to only one therapy appointment and stopped taking the antidepressants when she began feeling better. She now reports that she is starting to wonder if she should go back to the psychiatric hospital, but she is afraid that if she leaves her friend’s house this time, the friend will not let her move back in. She would rather work on easing the stress in her life. One method Tammy uses to cope with her feelings is smoking marijuana. She started smoking it to relieve the symptoms of her MS, but in the past few months, she admits she has been using it more to cope with psychological stresses. She said she smokes approximately every other day and gets marijuana from the young men with whom she lives. Tammy does not have many outside social activities. She used to belong to a church, but when she was evicted and moved in with her friend it was too far to walk, so she stopped attending. She does have a strong faith in God and believes that despite all the troubles she is having, things could be much worse. She is grateful that she has housing for the moment and is able to receive her medical care. Tammy has a tenth-grade education. She said she used to smoke crack cocaine in her “younger days,” but after her then husband went to prison for drugs 20 years ago, she stopped. She said that it wasn’t that difficult when she “made up her mind to do it.” She said that both her parents drank too much and fought with each other verbally and physically when she was growing up. She said both her parents died when she was a young adult—her father from emphysema and her mother from cancer.