Eric Bellman LCSW

Inspiration and Education

                   Examples And Cases 
Use of the Bellman Syndrome in successful team treatment of BPD


All case examples are fictional
and do not represent anyone living or dead,
They are used solely as educational constructs
to represent a broad example of people for illustrative purposes.

Case- 30 Y.O Woman,
priorities in combination:
Addiction-Personality/PTSD-Pain

-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  abuse             individual psychotherapy
-history of sexual abuse                DBT Intensive, NA,yoga
                            
-marital  conflict                           couples therapy, individual for husband

-children with husband                   -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.
                       


Inspiration:
  If one person can use their expertise in healing effectively,
  then think about how much 
  can be accomplished if more 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 overlaps
  and other advances.

                            Case- 38 Y.O Woman
Combination:
Addiction
Pain
Personality.

-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 .  


Inspiration:



We are not God 
we don't have control
but every human being is worth 
giving a chance
cynicism is destructive
hope is contagious.                                                                                                                                                                     
                                                                                                                                 
                                                                                                                                                                                                                                                                                                                                                                                                                                         

          
    
-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
 good diagnosis

Notes
treatment plan
multiple use of experts
emphasis on groups and individual treatment.
strong teamwork and group leader
good discharge planning
right balance between
acute goals
and patient's time to be discharged
with positive experience, goals, 
caring staff for right moment for discharge.
                                               
                                            
                                                Case:45 Y.O Woman
Combination Complex:
Personality/Mental Illness
Addiction
Pain Management


presents 

- shizzoaffective disorder        Psychiatric care
-BPD or mixed traits               Medication monitoring                          
-suicidal                               Case Manager coordinates
-mood swings                        immediate treatment plan.
-low functioning
 in work,relationships,
 basic self care.                                                                                                                                     
                                                                                                                                     
-Rheumatoid Arthritis
 {worsening}                           -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

 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.    


Inspiration:
Sometimes, given the resources, this person may respond the best
to a good treatment planning and team approach.


Notes:
good treatment plan includes all aspects of life, [psychosocial]                                               
appropriate use of experts for each issue.team management,
triage for dangerousness to self
clear alignment of patient's needs with treatment goals
caring coordinated rehab or hospital staff
slow progress and  positive reinforcement as appropriate.
public and private interfaces for resources after discharge
discharge planning needs to begin immediately on intake
to obtain resources  
structured stay{hospital to rehab or sober living}
and placement
is usually best.


updated on 6/24/2008

Contact Eric Bellman LCSW at: westlakedr@aol.com  
 Office
32129 lindero Canyon Road Suite 108-E
Westlake Village
CA. 91361   

updated  10/17/2022
     

Home

The Right Therapy

About Eric Bellman

Bellman Syndrome

Clinical Section

Multivariate Diagnosis

Ideas and Questions

Diagrams

Examples and Cases

Putting It Together

Computer Analogy

Mindfulness Section

Mindfulness Questions

Some Questions

Meditation

Meditation page two

Painting after Meditation

Photos after Meditation

Photos again

Photos page again

A Safe Place

Honest Answers

NIH BlOG

NIH Brain and Meds

abstracts from NIH/Pubmed

NIH BlOG-Children

NIH:DMDD in children

New Brain Mapping

NIH: Borderline help

Helpful Links Section

Important Links

PTSD Veterans links

Make Online Payment