How would you begin to engage with Janna and build his trust in you as a health professional?Explain

Janna Timera is a 45 year old gentleman admitted to your assessment unit after he presented at A&E with cuts to his wrists and neck.

He had cut himself with a kitchen knife following what he described as a “panic attack” where he “lost the plot”. He is settled, his wounds have been dressed and overall were not life threatening.

He describes feeling depressed for some months after he was told there may be redundancies at work. He works in the office of a delivery company and says that there has been more and more work recently as people have left or retired from their posts and he has not been coping well.

Janna is married with two small children 10 and 5 years old. He describes his wife as loving and supportive and is worried that he “has put her through hell” and that he has “behaved stupidly”. He feels he has let his children down even though they did not see him harm himself or witness any of his distress and worry.

He reflected on feeling increasingly anxious on heading out to work, worrying about his job security, so much so that he has not been sleeping well. Janna said that he feels he has been depressed for a short while, but felt unable to talk to anyone about this. His wife is very worried about him and he stated that she has told him many times that, “we can cope Janna, your job is not as important as your health”.

This is Janna’s first 1-1 with you since his admission and he is happy to talk to you. During the session he states that he has been “stupid” and that he has “ruined everything”. He wishes he could turn the clock back to a time when he was “on top of things at work”. He worries that he might panic again and self- harm, although he does say that he would not do this to the family again.

QUESTIONS
How would you begin to engage with Janna and build his trust in you as a health professional?

How would you make him feel comfortable and encourage him to talk about his issues? How would you build rapport with Janna?

If Janna says “I am a useless Father, I just panicked, how could I put my family through this?”

How would you respond? What would you say and how does this fit with your therapeutic approach?

If Janna says “I can’t cope at work I’m failing everyone“. How would you respond?

If Janna says “I used to be such a strong person now I am the opposite”. How would you respond?

Suggest a way to close or finish the session using appropriate homework tasks, statements or questions based on the Janna’s statements in the scenario.

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