Eric Bellman LCSW

Inspiration and Education


 The interaction of team treatment and each person is clearly dependent on multiple factors.
When I get more time I'll expand this, for now a Quick and overgenereralized look at three
"types" of clients. Remember this is a short example which we want to expand on and welcome feedback,
Thanks,
Eric B.
                Cases and Examples 
Use of the Bellman Syndrome in successful team treatment of BPD




All case examples are fictional
and do nor represent anyone living or dead,
They are used solely as educational constructs
 to represent a broad group of people.







Case #1-30 Y.O Woman

-Presents
with addiction to speed              -USE Medical monitoring,
-BPD and PTSD                              all resources in short  
                                                  rewards system.
-probable self-medication
 for ADHD                                  - Medical doctor
                                                 for meds and detox.   
-chronic fibromyalgia                    addictionologist,pain management.
-history of physical                       individual psychotherapy
 and sexual abuse                         DBT Intensive,yoga,AA,

-children in foster care               -USE outpt. plan
on probation                                use County parenting help.                                 
Plan for discharge.



 
Comments;
note; requires a caring team approach,
triage of problems
right expert for each life challenge.
focusing on what the pt. can do.
continuity of care
interface of public and private sectors.

For outpatient care;
-good MD monitoring of meds
-intensive caring psychotherapy
-DBT training
-strong emphasis on
working with county
to resume meetings.
-voluntary drug testing
-NA meetings
-church or agency support.








  If one person can use their expertise in healing effectively,
  then think about how much 
  can be accomplished if we work together unselfishly. 
  The critical pathways to healing
  require an understanding 
  of the overlap and synergy of various disciplines          
  this will increase in the future because of technology 
  and other advances.




















                                                    Case#2 38Y.O Woman
-presents
 with poly substance abuse         -Use Medical detox,pain mgmt.
-multiple
 relationship conflicts                - family therapy to connect
-multiple
 short hospital stays                  - DBT,AA skills,Psychotherapy
-childhood sexual abuse             - Strong case manager alliance
-chronic back pain                       and team meetings
-"practiced" borderline"             -align goals with multiple treatments
                                              -discharge to intensive daycare .                                                                                                                                                                        
                                                                                                                                 
                                                                                                                                                                                                                                                                                                    

  
                                                                                                                                                

 Notes:
     good diagnosis
     treatment plan
     multiple use of experts
     emphasis on groups and individual treatment.
     strong teamwork and group leader
     good discharge planning
     need to find right balance between
     acute goals and patient's need to be discharged
     with positive experience, goals, 
     caring staff for right moment for discharge.
-Outpatient:
 MD monitoring for mood and pain meds
 balanced lifestyle structure with
 NA meetings
 some day treatment
 church or agency support
 volunteer work
 exercise and social groups
 intensive psychotherapy
 DBT training
                                                
                                            Case#3
45 Y.O Woman presents with shizzoaffective disorder and  BPD.                                            
                                                                                                                                     
                                                                                                                                     
-Rheumatoid Arthritis               -Use medical monitoring                  
-chronic pain pill addiction        pain management                                         
-recent overdose                    -Use DBT,NA,reality therapy                           
-Divorce                                 -Use strong case management                         
-limited insurance                     and staff support for
                                             discharge to sober living            
                                             with SSI







Note;
 good treatment plan includes all aspects of life, [psychosocial]                                               
 appropriate use of experts for each issue.team management
triage for dangerousness
clear alignment of patient's needs with treatment goals
caring hopeful staff
slow progress and then positive reinforcement is appropriate.
public and private interfaces for resources after discharge
discharge planning needs to begin immediately to attain resources  
longer stay is most likely best.

 Outpatient treatment;
  discharge plan working for basic needs
  sober living house
  SSI
  case manager
  finances
  conservator to be evaluated
  participate in house living
  NA groups
  health care,exercise, nutrition
  NA and group therapy
  individual therapy with case management
  church or agency help
  volunteer work
  part time work.
 
     updated on 2/03/2007
 
Contact Eric Bellman LCSW at: westlakedr@aol.com

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