Explain whether your therapeutic theory has changed as a result of your practicum experiences






Course Title:


Student Name:

E-mail Address:

Practicum Placement Agency’s Name:

Preceptor’s Name:

Preceptor’s Telephone:

Preceptor’s E-mail Address:

Time Log
Week Dates Times Total Hours for This Time Frame Activities/Comments Learning Objective(s) Addressed
1 4/09/ 2017 9am- 5pm 8 hrs Admissions, evaluations, follow-ups, med management Mini-mental state examination, CAGE and Beck depression inventory was used
5/09/ 2017 12pm- 7pm 7 hrs Admissions, evaluations, follow-ups, med management Counseling and Mini-mental examination administered


9am- 12pm 3 hrs Admissions, med management Counseling


9am- 5pm 8hrs Evaluations, follow ups, med management Mini-mental examination administered, Discharged.

Total Hours Completed: 26

The Client

The client in this practicum was a 23-year-old male who was in his sophomore year in University. The patient presented himself for a checkup due to persistent headaches, insomnia and hallucinations. He had lately experienced difficulties understanding class concepts and it was getting harder for him to concentrate. The patient had lost his only sibling in a tragic road accident a few months back. The patient has a history of mental illness that led him to try and commit suicide two years back. During this time, the patient had broken up with his girlfriend for 6 years and he felt that he could not cope with the loneliness. The patient had tried to commit suicide by slitting his wrists but his sister found him just in time before he bled out to death. The patient denies anyone in his immediate family suffering from any psychiatric conditions. He however feels that he was brought up on a shaky family unit foundation as his mother separated from his father soon after he was born. The patient occasionally uses cocaine and marijuana when he needs to “relax” after a stressful day.


The patient presents symptoms of a post-traumatic stress disorder based on the classifications of the Diagnostic and Statistical Manual of Mental Heal Disorders 5th Ed. (DSM-5) The patient presents self-destructive behavior angry outbursts, sleep disturbance and problems with his concentration. (American Psychiatric Association, 2013). The patient has lately kept to himself in school and he has not been in a relationship since breaking up with his former girlfriend. He results to using illicit drugs in order to handle the pressures of life. The patient also has a substance abuse disorder. The trauma of losing his girlfriend was seemingly re-created in the loss of his sister who had been his strength during his tough time. He is still dealing with the bereavement and the wounds of loss have been re-opened. The patient is afraid of getting close to people emotionally for the fear of losing them. He keeps to himself as a way to ensure he does not suffer the pain of loss.

Legal and Ethical Implications

Given the patient’s history of inflicting self-harm it was in his best interest that the hospital admitted him for observation. The client however felt that they only needed medication for the headaches which would in turn help him to get enough sleep. The patient was attaching all the symptoms to the insufficient sleep and the headache. However, the problem was much deeper and it was ethically right for the hospital to safeguard the patient’s wellbeing. The patients was admitted for four days and he was later discharged under the condition that he would go and live in with a friend or a member of his family while attending counseling sessions from a certified therapist of his choice. Special concerns with this patient were voiced as he was keeping to himself and he had a history of inflicting harm upon himself when faced by stressful situations. The patient had not gotten over the loss of his girlfriend and the death of his sister. He was still in a denial or bereavement state that worsened his social skills and tenacity to handle issues of life (Tramontin, 2010). The patient was likely to snap and do something drastic at the slightest disappointment or provocation.


Wheeler, K. (Eds.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (2nd ed.). New York, NY: Springer Publishing Company.

Hume, M. (2014). Venous Thrombosis and Pulmonary Embolism. Cambridge: Harvard University Press. p. 14