Introduction - Client Profile

Yesterday, during your first shift with Tiffany you built some rapport and completed a thorough assessment to gain an accurate understanding of her current situation and her level of risk.  You determined that Tiffany is experiencing a manic episode. 

Yesterday she was dressed in a business outfit with 1 inch heels, however, she changed multiple times through the shift to accommodate her different activities.  For example, she wore a different outfit each time she decided to ride the exercise bike on the unit, she wore old, ripped jeans when she was creating new masterpieces with the art supplies, and she switched into casual clothes when she cleaned her room.  In addition, she changed her jewelry to match each outfit. 

Tiffany moved between activities quickly and with purpose.  She seems intent on accomplishing as much as possible and had a long list of task she “needed to do”.

Tiffany was smiling throughout the shift and eager to engage in conversation with whoever would listen.  Although the conversations mostly consisted of Tiffany talking.  Tiffany described her mood as a 9/10 and made it well known that she could be a 10/10 if she could have off unit privileges for even 15 minutes to “get a real cup of coffee and some fresh air”.

When you tried to talk with Tiffany about why she was in hospital, she was avoidant and stated, “I’m only here because my husband is so controlling.  If this continues I will need to call the police.”  When you tried to inquire more about how her behavior has contributed to her current situation Tiffany became defensive and irritable.  She accused you of “being in cahoots with her husband” and that everyone was against her.