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Discuss the biological, psychological, and social factors in

    Discuss the biological, psychological, and social factors involved in your selected case. 250-270 words1-2 references for support APA format ( This is a group assignment but this is my part of the paper)Case Study: James Experiences Bipolar Disorder (Individual Psychotherapy)James is a 55-year-old biracial (Hawaiian and Caucasian) executive who lives alone following the death of his wife seven yearsago. He has one adult daughter who has a family of her own.Presenting Problem:James presents in a manic stage of bipolardisorder, having had a number of previous episodes. James’s maternaluncle andgrandfather also had bipolar illness. This episode involvedJames discontinuing his lithium use, traveling to Los Angelesin the hopes of becoming an actor, spending thousands ofdollars on extravagant merchandise, and finally being arrested fordrunk and disorderly conduct at a nightclub. James washospitalized in an inpatient unit briefly and is now seeking outpatienttreatment.Key Biopsychosocial Factors:Biological:There is a family (genetic) history of bipolar disorder as well as research supporting a biological basis of bipolar disorder.Medication is an essential treatment component.Psychological:James’s lack of compliance with his lithiumregimen, denial regarding chronicity of his bipolar disorder, enjoymentof themanic high, need for control and independence, emotionallosses pertaining to wife’s death, and a severe chronic psychiatriccondition all play a role in his illness.Social:Family and cultural traditions that (in James’s family) distrust Western medicine and cultural and general social isolationalso are likely to impact his illness.Treatment Goals and Plan:James requires medication management inaddition to individual therapy in order to achieve several immediate andlong-termgoals. After an initial consultation and assessment periodwith James, the following treatment goals were determined. First,James will seek to work through the various impediments tohis reliable use of lithium medication. These involve not onlyhis need to be in control and not dependent on drugs (orothers), but his family of origin’s negative feelings about Westernmedicine. Second, James finds that when he becomesdepressed, he longs for the “high” associated with mania. Therefore, thecauses of his depression will be determined as well asimproved coping skills. Third, James is lonely, misses his wife, andfeels isolated from the Hawaiian heritage he cherishes.Thus, treatment will also address his interpersonal, social, andculturalneeds.The treatment plan involves the following components:Collaboration with James’s physician regarding his lithium regimen.Behavioral contracting, which involves James’s commitment to maintain his lithium regimen for at least the first six weeksof psychotherapy.Exploratory work to understand James’s disdain for dependence and impediments to developing a more satisfying interpersonallife.Psychoeducational materials regarding bipolar illness,lithium, and traditional Hawaiian healing techniques and rituals toaid James in understanding the similarities, differences,and potential virtues and liabilities of both traditions.Problem solving regarding increasing social contacts and cultural identification.Developing improved awareness and skills for combating depression and curtailing future manic episodes.Examination of the transference relationship between James and his psychologist to better understand James’s interpersonalissues as well as his need for control and independence.This case example illustrates how personality and cultureimpact compliance with medical regimens such as medication, andthe need to work through a variety of intrapsychic andsocial issues in managing a major psychiatric problem such as bipolarillness. The treatment by necessity is multidimensional andmindful of the biopsychosocial influences on human functioning.

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