Case Study: Your perspective as Miriam Rosen’s psychiatric nurse practitioner

Case Study: Your perspective as Miriam Rosen’s psychiatric nurse practitioner
From your perspective as Miriam’s psychiatric nurse practitioner, answer the following questions in a three-page double-spaced paper (not including the reference page) in APA format. Include at least two peer-reviewed, evidence-based references (not including your textbooks).
1. Identify what interview questions you would have used to determine the underlying eating disorder, self-mutilation, and rape.
2. Using the interpersonal psychotherapy model, identify three specific goals for Miriam’s treatment, and in which phase each goal should be accomplished.
3. Sarah, Miriam’s mother, asks why you are choosing interpersonal psychotherapy and how it will be beneficial for Miriam. How do you respond?

Case Study: Your perspective as Miriam Rosen’s psychiatric nurse practitioner

Compare and contrast it with humanistic-existential or solution-focused psychotherapy.
4. What are the legal and ethical implications for you relative to a patient reporting a sexual assault? What is the best way for you to proceed? Reference your state (Arizona) of practice\’s laws.

Assignment 5.1: Case Study: Miriam Rosen

Miriam Transcript
Sarah/Mom: Hello. Thank you for meeting with us today. This is our daughter. Miriam?
Miriam [shy, quiet, reserved]: Hi.
Sarah/Mom: [nervous laughter] Oy vey! As you can see, she’s rather shy! But we’re worried about more
than that. Let’s see, [deep sigh] School, Miriam used to be a straight A student, and over the last term,
she dropped to all Cs.
Joel/Dad: [Interrupting, harsh] And that is not acceptable in our household.
Sarah/Mom: [sharply] Joel, remember, we’re here to get her help.
Joel/Dad: Okay, okay. I know. But…, [calmer] anyway, we almost never see Miri anymore. She’s always
in her room, alone, obviously not doing homework. She’ll come out for dinner, not that she eats much.
[with great fondness] And Sarah is such a great cook. Even for Shabbat, Miriam hardly touches her plate.
She used to eat half the loaf of challah herself!
Sarah/Mom: I’ve noticed that her clothes are suddenly too big for her. At first, I thought it was nice that
she lost some weight, and I even suggested we go shopping together to get some new things. But, well,
it’s like she’s too depressed to do anything. I’ve never known her to not want to go shopping.
Joel/Dad: No, she’s never been like this before. Hardly ever sick, rarely did she have to see a regular
doctor, certainly never a psych doc like you. And it’s not that she’s tried to hurt herself. She’s not
suicidal or anything. I really hope you can help. I want my sweet little Miri back.
Psychiatric NP: You speak with Miriam alone.
Miriam: [silence for 5 seconds] Umm, they are sort of right or whatever. I’m not really hungry. It’s fine
though, because I need to lose more weight. I skip Mama’s dinner; they have way too many calories.
You know, the classic Jewish grandma’s cooking? That’s my Mom! [nervous giggle]
But sometimes I have to eat to get them off my back, you know. So after that I either take a laxative, or
puke in the toilet. Either way, it gets them off my back and get to keep losing weight.
Psychiatric NP: Have you hurt yourself at all?
Miriam: [deep breath] Um, yeah. Ok so, when it gets too much, I…I gotta let it out, you know? Back
before school started, like last summer, I cut myself you know, here and here, on my thighs? But I’m not
trying kill myself or anything. I don’t want to…die! But the cuts, the blood, let’s it all out and I don’t feel
so icky afterward.
Psychiatric NP: Did something happen last summer? Miriam takes a while to respond.
Miriam: You won’t tell my parents? Gotta swear you won’t tell them. [waits for affirmation] Uh, almost
a year ago, on prom night…these two boys [gulps, some crying in between the rest]…I’ve never told

anyone, not even Rachel my best friend, these…two boys took me to a hotel room, upstairs from where
the dance was. I thought it was so cool that they wanted to hang out with me. I felt special. They said
there was a little party and Stephen, he was my date, he was going to be there, but he wasn’t. And they
forced me to…you know, to have sex. I didn’t want to, but I couldn’t stop them. I felt so dirty and so
used you know. How could I be tricked like that?
My parents won’t understand. We’re Jewish, you know, not Orthodox, but still, my parents said I can’t
do it until after I get married. Mom will absolutely flip, you know, and and [sniffling] and I’m just
so…ashamed. If Dad finds out, I won’t be his sweet little Miri anymore.
So see, I need that release to keep me together, to release the pressure… it’s for them, my mom and
dad.

APA PAPER

From your perspective as Miriam’s psychiatric nurse practitioner, answer the following questions in a
three-page double-spaced paper (not including the reference page) in APA format. Include at least two
peer-reviewed, evidence-based references (not including your textbooks).
1. Identify what interview questions you would have used to determine the underlying eating
disorder, self-mutilation, and rape.
2. Using the interpersonal psychotherapy model, identify three specific goals for Miriam’s
treatment, and in which phase each goal should be accomplished.
3. Sarah, Miriam’s mother, asks why you are choosing interpersonal psychotherapy and how it will
be beneficial for Miriam. How do you respond? Compare and contrast it with humanistic-
existential or solution-focused psychotherapy.
4. What are the legal and ethical implications for you relative to a patient reporting a sexual
assault? What is the best way for you to proceed? Reference your state (Arizona) of practice's
laws.

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