Assignment: Practicum – Week 1 Journal Entry

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Assignment: Practicum – Week 1 Journal Entry

As a future advanced practice nurse, it is important that you are able to connect your classroom experience to your practicum experience. By applying the concepts you study in the classroom to clinical settings, you enhance your professional competency. Each week, you complete an Assignment that prompts you to reflect on your practicum experiences and relate them to the material presented in the classroom. This week, you begin documenting your practicum experiences in your Practicum Journal.

LEARNING OBJECTIVES

STUDENTS WILL:
  • Analyze nursing and counseling theories to guide practice in psychotherapy*
  • Develop goals and objectives for personal practicum experiences*
  • Create timelines for practicum activities*

* The Assignment related to this Learning Objective is introduced this week and submitted in Week 4.

In preparation for this course’s practicum experience, address the following in your Practicum Journal:

  • Reviewthe media Clinical Interview: Intake, Assessment,& Therapeutic Alliance in your Learning Resources.
  • Selectone nursing theory and one counseling theory to best guide your practice inpsychotherapy.

Note: For guidance onnursing and counseling theories, refer to the Wheeler textbook in this week’s LearningResources.

  • Explain why you selected these theories. Support your approach with evidence-basedliterature.
  • Developat least three goals and at least three objectives for the practicum experiencein this course.
  • Create a timeline of practicum activities basedon your practicum requirements.

Note: Be sure to use the Practicum Journal Template, located in this week’s Learning Resources.

BY DAY 7 OF WEEK 4

Submit your Assignment.

Week 1: Foundations of Psychotherapy

“Unexpressed emotions will never die. They are buried alive and will come forth later in uglier ways.”
—Sigmund Freud

While working with a patient in the late 1800s, Sigmund Freud discovered the health benefits of talking about emotions and illnesses. When Sigmund Freud introduced his “talking cure” (fundamental psychotherapy), his efforts were met with considerable skepticism. However, as more and more psychiatrists learned that Freud’s methods brought about change in patients who suffered from a variety of mental health issues, his methods were adopted and refined. Today, psychotherapy is recognized as a viable treatment for a wide variety of mental health issues, many of which are examined throughout this course.

This week, as you explore the foundations of psychotherapy, you consider its biological basis. You also examine the influence of culture, religion, and socioeconomics on psychotherapy treatments. Finally, you begin preparing for your practicum experience by examining counseling theories and developing goals to guide your practice.

Photo Credit: Joe Houghton – www.joehoughtonphotography.ie / Moment / Getty Images


Learning Resources

REQUIRED READINGS

American Nurses Association. (2014). Psychiatric-mental health nursing: Scope and standards of practice (2nd ed.). Washington, DC: Author.

  • Standard 1 “Assessment” (pages 44 & 45)

Note: Throughout the program you will be reading excerpts from the ANA’s Scope & Standards of Practice for Psychiatric-Mental Health Nursing. It is essential to your success on the ANCC board certification exam for Psychiatric/Mental Health Nurse Practitioners that you know the scope of practice of the advanced practice psychiatric/mental health nurse. You should also be able to differentiate between the generalist RN role in psychiatric/mental health nursing and the advanced practice nurse role.

Wheeler, K. (Eds.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (2nd ed.). New York, NY: Springer Publishing Company.

  • Chapter 1, “The Nurse Psychotherapist and a Framework for Practice” (pp. 3–52)

Fournier, J. C., & Price, R. B. (2014). Psychotherapy and neuroimaging. Psychotherapy: New Evidence and New Approaches, 12(3), 290–298. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC42073…

Holttum, S. (2014). When bad things happen our brains change but psychotherapy and support can help the recovery of our brains and our lives. Mental Health and Social Inclusion, 18(2), 52–58. doi:10.1108/MHSI-02-2014-0006
Note: You will access this article from the Walden Library databases.

Petiprin, A. (2016). Psychiatric and mental health nursing. Nursing Theory. Retrieved from http://www.nursing-theory.org/theories-and-models/…

Fisher, M. A. (2016). Introduction. In Confidentiality limits in psychotherapy: Ethics checklists for mental health professionals (pp. 3–12). Washington, DC: American Psychological Association. doi:10.1037/14860-001

Document: Practicum Journal Template (Word document)
Note: This template is provided by the School of Nursing and is designated to document practicum activity. You are required to use this template for all journal entry submissions.

Document: Midterm Exam Study Guide (Word document)

Document: Final Exam Study Guide (Word document)

Document: Nurse Practitioner (NP) Student Clinical Orientation (PowerPoint file)

Document: Practicum Manual (PDF). Retrieved from http://academicguides.waldenu.edu/ld.php?content_i…

REQUIRED MEDIA

Laureate Education (Producer). (2016). Introduction to psychotherapy with individuals [Video file]. Baltimore, MD: Author.
Note: The approximate length of this media piece is 2 minutes. 

Laureate Education (Producer). (2015e). Therapies are helpful: Dodo bird conjecture [Video file]. Baltimore, MD: Author.
Provided courtesy of the Laureate International Network of Universities.
Note: The approximate length of this media piece is 2 minutes. 

Laureate Education (Producer). (2015f). Therapies change and integrate different approaches over time [Video file]. Baltimore, MD: Author.
Provided courtesy of the Laureate International Network of Universities.
Note: The approximate length of this media piece is 1 minute. 

Sommers-Flanagan, J., & Sommers-Flanagan, R. (2012). Clinical interview: Intake, assessment, & therapeutic alliance [Video file]. Mill Valley, CA: Psychotherapy.net.
Note: You will access this media from the Walden Library databases. The approximate length of this media piece is 124 minutes.

Sommers-Flanagan, J., & Sommers-Flanagan, R. (2013). Counseling and psychotherapy theories in context and practice [Video file]. Mill Valley, CA: Psychotherapy.net.
Note: For this week, view the Introduction and Psychoanalytical Approaches only. You will access this media from the Walden Library databases.

Assignment 1: Practicum – Client Termination Summary

LEARNING OBJECTIVES

Students will:
  • Develop client termination summaries

To prepare:

  • For guidance on writing a Client Termination Summary, review pages 693–712 of the Wheeler text in this week’s Learning Resources.
  • Identify a client who may be ready to complete therapy.

THE ASSIGNMENT

With the client you selected in mind, address the following in a client termination summary (without violating HIPAA regulations):

  • Identifying information of client (i.e., hypothetical name, age, etc.)
  • Date initially contacted therapist, date therapy began, duration of therapy, and date therapy will end
  • Total number of sessions, including number of missed sessions
  • Termination planned or unplanned
  • Presenting problem
  • Major psychosocial issues
  • Types of services rendered (i.e., individual, couple/family therapy, group therapy, etc.)
  • Overview of treatment process
  • Goal status (goals met, partially met, unmet)
  • Treatment limitations (if any)
  • Remaining difficulties and/or concerns
  • Recommendations
  • Follow-up plan (if indicated)
  • Instructions for future contact
  • Signatures

BY DAY 7

Assignment 1: Practicum – Week 8 Journal Entry

This week, you complete a two-part journal entry.

LEARNING OBJECTIVES

STUDENTS WILL:
  • Develop diagnoses for clients receiving psychotherapy*
  • Evaluate efficacy of existential-humanistic therapy for clients*
  • Analyze legal and ethical implications of counseling clients with psychiatric disorders*
  • Analyze clinical supervision experiences*

* The Assignment related to this Learning Objective is introduced this week and submitted in Week 10.

For Part 1, select a client whom you observed or counseled this week (other than the client used for this week’s Discussion). Then, address the following in your Practicum Journal:

  • Describe the client and identify any pertinent history or medical information, including prescribed medications.
  • Using the DSM-5, explain and justify your diagnosis for this client.
  • Explain whether existential-humanistic therapy would be beneficial with this client. Include expected outcomes based on this therapeutic approach.
  • Explain any legal and/or ethical implications related to counseling this client.
  • Support your approach with evidence-based literature.

For Part 2, reflect on your clinical supervision experiences. Then, address the following in your Practicum Journal:

  • How often are you receiving clinical supervision from your preceptor?
  • What are the sessions like?
  • What is the preceptor bringing to your attention?
  • How are you translating these sessions to your clinical practice?

BY DAY 7 OF WEEK 10

Submit your Assignment.

Week 8: Existential-Humanistic Therapy

“It is the client who knows what hurts, what directions to go, what problems are crucial, what experiences have been deeply buried.”
–Carl Rogers, from On Becoming a Person

This client-centered perspective is the cornerstone of existential-humanistic therapy, which requires therapists to “attempt to receive clients with curiosity and openness, endeavor to grasp their subjective world, and believe that clients are the experts on their own experience” (Wheeler, 2014, p. 373). As the psychiatric mental health nurse practitioner, it is important to understand that the effectiveness of this approach is dependent on your relationship with clients, as well as your beliefs on holism and human nature.

This week, as you explore existential-humanistic therapy, you assess clients and consider the appropriateness of various therapeutic approaches. You also develop diagnoses for clients receiving psychotherapy and consider legal and ethical implications of counseling these clients.

Photo Credit: Laureate Education


Learning Resources

REQUIRED READINGS

Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (2nd ed.). New York, NY: Springer Publishing Company.

  • Chapter 10, “Humanistic-Existential and Solution-Focused Approaches to Psychotherapy” (Review pp. 369–406)

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
Note: You will access this text from the Walden Library databases.

Nagy, T. F. (2011). Ethics in psychotherapy. In Essential ethics for psychologists: A primer for understanding and mastering core issues (pp. 185–198). Washington, DC: American Psychological Association. doi:10.1037/12345-010
Note: You will access this text from the Walden Library databases.

REQUIRED MEDIA

Sommers-Flanagan, J., & Sommers-Flanagan, R. (2013). Counseling and psychotherapy theories in context and practice [Video file]. Mill Valley, CA: Psychotherapy.net.
Note: For this week, view Existential Therapy, Person-Centered Therapy, and Gestalt Therapy only. You will access this media from the Walden Library databases

Laureate Education (Producer). (2012b). Clinical supervision follow-up [Video file]. Baltimore, MD: Author.
Note: This is a follow-up to the Thompson family media piece in Week 5. The approximate length of this media piece is 9 minutes.

Assignment 2: Practicum – Assessing Client Progress

LEARNING OBJECTIVES

Students will:
  • Assess progress for clients receiving psychotherapy
  • Differentiate progress notes from privileged notes
  • Analyze preceptor’s use of privileged notes

To prepare:

  • Reflect on the client you selected for the Week 3 Practicum Assignment.
  • Review the Cameron and Turtle-Song (2002) article in this week’s Learning Resources for guidance on writing case notes using the SOAP format.

The Assignment

Part 1: Progress Note

Using the client from your Week 3 Assignment, address the following in a progress note (without violating HIPAA regulations):

  • Treatment modality used and efficacy of approach
  • Progress and/or lack of progress toward the mutually agreed-upon client goals (reference the Treatment plan—progress toward goals)
  • Modification(s) of the treatment plan that were made based on progress/lack of progress
  • Clinical impressions regarding diagnosis and/or symptoms
  • Relevant psychosocial information or changes from original assessment (i.e., marriage, separation/divorce, new relationships, move to a new house/apartment, change of job, etc.)
  • Safety issues
  • Clinical emergencies/actions taken
  • Medications used by the patient (even if the nurse psychotherapist was not the one prescribing them)
  • Treatment compliance/lack of compliance
  • Clinical consultations
  • Collaboration with other professionals (i.e., phone consultations with physicians, psychiatrists, marriage/family therapists, etc.)
  • Therapist’s recommendations, including whether the client agreed to the recommendations
  • Referrals made/reasons for making referrals
  • Termination/issues that are relevant to the termination process (i.e., client informed of loss of insurance or refusal of insurance company to pay for continued sessions)
  • Issues related to consent and/or informed consent for treatment
  • Information concerning child abuse, and/or elder or dependent adult abuse, including documentation as to where the abuse was reported
  • Information reflecting the therapist’s exercise of clinical judgment

Note: Be sure to exclude any information that should not be found in a discoverable progress note.

Part 2: Privileged Note

Based on this week’s readings, prepare a privileged psychotherapy note that you would use to document your impressions of therapeutic progress/therapy sessions for your client from the Week 3 Practicum Assignment.

  • The privileged note should include items that you would not typically include in a note as part of the clinical record.
  • Explain why the items you included in the privileged note would not be included in the client’s progress note.
  • Explain whether your preceptor uses privileged notes, and if so, describe the type of information he or she might include. If not, explain why.

    Assignment 1: Practicum – Week 5 Journal Entry

    LEARNING OBJECTIVES

    Students will:
    • Develop diagnoses for clients receiving psychotherapy*
    • Evaluate the efficacy of therapeutic approaches for clients*
    • Analyze legal and ethical implications of counseling clients with psychiatric disorders*

    * The Assignment related to this Learning Objective is introduced this week and submitted in Week 7.

    Select a client whom you observed or counseled that suffers from a disorder related to trauma. Then, address the following in your Practicum Journal:

    • Describe the client (without violating HIPAA regulations) and identify any pertinent history or medical information, including prescribed medications.
    • Using the DSM-5, explain and justify your diagnosis for this client.
    • Explain whether any of the therapeutic approaches in this week’s Learning Resources would be effective with this client. Include expected outcomes based on these therapeutic approaches. Support your approach with evidence-based literature.
    • Explain any legal and/or ethical implications related to counseling this client.

    BY DAY 7 OF WEEK 7

    Submit your Assignment.

    Week 5: Anxiolytic Therapy & PTSD Treatment

    “I’m no longer at the mercy of my PTSD, and I would not be here today had I not had the proper diagnosis and treatment. It’s never too late to seek help.”
    —P.K. Philips, PTSD patient

    For individuals suffering from posttraumatic stress disorder (PTSD) and other anxiety disorders, everyday life can be a constant challenge. Clients requiring anxiolytic therapy may present with anxiousness, depression, substance abuse issues, and even physical symptoms related to cardiovascular, respiratory, and gastrointestinal ailments. As a psychiatric mental health nurse practitioner, you must be prepared to address the many needs of individuals seeking treatment for PTSD and other anxiety disorders.

    This week, as you study anxiolytic therapies and PTSD treatments, you examine the assessment and treatment of clients with PTSD and other anxiety disorders. You also explore ethical and legal implications of these therapies.

    Photo Credit: [shironosov]/[iStock / Getty Images Plus]/Getty Images


    Assignment: Assessing and Treating Clients With Anxiety Disorders

    Common symptoms of anxiety disorders include chest pains, shortness of breath, and other physical symptoms that may be mistaken for a heart attack or other physical ailment. These manifestations often prompt clients to seek care from their primary care providers or emergency departments. Once it is determined that there is no organic basis for these symptoms, clients are typically referred to a psychiatric mental health practitioner for anxiolytic therapy. For this Assignment, as you examine the client case study in this week’s Learning Resources, consider how you might assess and treat clients presenting with anxiety disorders.

    Learning Objectives

    Students will:
    • Assess client factors and history to develop personalized plans of anxiolytic therapy for clients
    • Analyze factors that influence pharmacokinetic and pharmacodynamic processes in clients requiring anxiolytic therapy
    • Evaluate efficacy of treatment plans
    • Analyze ethical and legal implications related to prescribing anxiolytic therapy to clients across the lifespan

    Learning Resources

    Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

    REQUIRED READINGS

    Note: All Stahl resources can be accessed through the Walden Library using this link. This link will take you to a log-in page for the Walden Library. Once you log into the library, the Stahl website will appear.

    Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press.
    To access the following chapters, click on the Essential Psychopharmacology, 4th ed tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.

    • Chapter 9, “Anxiety Disorder and Anxiolytics”

    Stahl, S. M., & Grady, M. (2010). Stahl’s illustrated anxiety, stress, and PTSD. New York, NY: Cambridge University Press.
    To access the following chapters, click on the Illustrated Guides tab and then the Anxiety, Stress, and PTSD tab.

    • Chapter 4, “First-Line Medications for PTSD”
    • Chapter 5, “Second-Line, Adjunct, and Investigational Medications for PTSD”

    Strawn, J. R., Wehry, A. M., DelBello, M. P., Rynn, M. A., & Strakowski, S. (2012). Establishing the neurobiologic basis of treatment in children and adolescents with generalized anxiety disorder. Depression and Anxiety, 29(4), 328–-339. doi:10.1002/da.21913
    Note: Retrieved from Walden Library databases.

    Hamilton, M. (1959). Hamilton Anxiety Rating Scale. Psyctests, doi:10.1037/t02824-0
    Note: Retrieved from Walden Library databases.

    REQUIRED MEDIA

    Laureate Education. (2016b). Case study: A middle-aged Caucasian man with anxiety [Interactive media file]. Baltimore, MD: Author.
    Note: This case study will serve as the foundation for this week’s Assignment.

    OPTIONAL RESOURCES

    Lupi, M., Martinotti, G., Acciavatti, T., Pettorruso, M., Brunetti, M., Santacroce, R., & … Di Giannantonio, M. (2014). Pharmacological treatments in gambling disorder: A qualitative review. Biomed Research International, 2014. doi:10.1155/2014/537306

    To prepare for this Assignment:

    • Review this week’s Learning Resources. Consider how to assess and treat clients requiring anxiolytic therapy.

    The Assignment

    Examine Case Study: A Middle-Aged Caucasian Man With Anxiety. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.

    At each decision point stop to complete the following:

    • Decision #1
      • Which decision did you select?
      • Why did you select this decision? Support your response with evidence and references to the Learning Resources.
      • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
      • Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?
    • Decision #2
      • Why did you select this decision? Support your response with evidence and references to the Learning Resources.
      • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
      • Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?
    • Decision #3
      • Why did you select this decision? Support your response with evidence and references to the Learning Resources.
      • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
      • Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?

    Also include how ethical considerations might impact your treatment plan and communication with clients.

    Note: Support your rationale with a minimum of three academic resources. While you may use the course text to support your rationale, it will not count toward the resource requirement.

    CASE STUDY

    Generalized Anxiety Disorder
    Middle-Aged White Male With Anxiety

    Middle aged male

    BACKGROUND INFORMATION

    The client is a 46-year-old white male who works as a welder at a local steel fabrication factory. He presents today after being referred by his PCP after a trip to the emergency room in which he felt he was having a heart attack. He stated that he felt chest tightness, shortness of breath, and feeling of impending doom. He does have some mild hypertension (which is treated with low sodium diet) and is about 15 lbs. overweight. He had his tonsils removed when he was 8 years old, but his medical history since that time has been unremarkable. Myocardial infarction was ruled out in the ER and his EKG was normal. Remainder of physical exam was WNL.

    He admits that he still has problems with tightness in the chest and episodes of shortness of breath- he now terms these “anxiety attacks.” He will also report occasional feelings of impending doom, and the need to “run” or “escape” from wherever he is at.

    In your office, he confesses to occasional use of ETOH to combat worries about work. He admits to consuming about 3-4 beers/night. Although he is single, he is attempting to care for aging parents in his home. He reports that the management at his place of employment is harsh, and he fears for his job. You administer the HAM-A, which yields a score of 26.

    Client has never been on any type of psychotropic medication.

    MENTAL STATUS EXAM

    The client is alert, oriented to person, place, time, and event. He is appropriately dressed. Speech is clear, coherent, and goal-directed. Client’s self-reported mood is “bleh” and he does endorse feeling “nervous”. Affect is somewhat blunted, but does brighten several times throughout the clinical interview. Affect broad. Client denies visual or auditory hallucinations, no overt delusional or paranoid thought processes readily apparent. Judgment is grossly intact, as is insight. He denies suicidal or homicidal ideation.

    The PMHNP administers the Hamilton Anxiety Rating Scale (HAM-A) which yields a score of 26.

    Diagnosis: Generalized anxiety disorder

    RESOURCES

    § Hamilton, M. (1959). Hamilton Anxiety Rating Scale. Psyctests, doi:10.1037/t02824-0

    Decision Point One

    Select what the PMHNP should do:

    Assignment: Practicum – Week 2 Journal Entry

    LEARNING OBJECTIVES

    STUDENTS WILL:
    • Develop diagnoses for clients receiving psychotherapy*
    • Analyze legal and ethical implications of counseling clients with psychiatric disorders*

    * The Assignment related to this Learning Objective is introduced this week and submitted in Week 4.

    Select a client whom you observed or counseled this week. Then, address the following in your Practicum Journal:

    • Describe the client (without violating HIPAA regulations) and identify any pertinent history or medical information, including prescribed medications.
    • Using the Diagnostic and Statistical Manual of Mental Health Disorders, 5th edition (DSM-5), explain and justify your diagnosis for this client.
    • Explain any legal and/or ethical implications related to counseling this client.
    • Support your approach with evidence-based literature.

    BY DAY 7 OF WEEK 4

    Submit your Assignment.


    Week 2: Assessment and Diagnosis in Psychotherapy

    “A sensitively crafted intake assessment can be a powerful therapeutic tool. It can establish rapport between patient and therapist, further the therapeutic alliance, alleviate anxiety, provide reassurance, and facilitate the flow of information necessary for an accurate diagnosis and appropriate treatment plan.”
    —Pamela Bjorklund, clinical psychologist

    Whether you are treating patients for physical ailments or clients for mental health issues, the assessment process is an inextricable part of health care. To properly diagnose clients and develop treatment plans, you must have a strong foundation in assessment. This includes a working knowledge of assessments that are available to aid in diagnosis, how to use these assessments, and how to select the most appropriate assessment based on a client’s presentation.

    This week, as you explore assessment and diagnosis in psychotherapy, you examine assessment tools, including their psychometric properties and appropriate use. You also develop diagnoses for clients receiving psychotherapy and consider legal and ethical implications of counseling these clients.

    Photo Credit: [Wavebreakmedia Ltd]/[Wavebreak Media / Getty Images Plus]/Getty Images


    Learning Resources

    REQUIRED READINGS

    Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (2nd ed.). New York, NY: Springer Publishing Company.

    • Chapter 3, “Assessment and Diagnosis” (pp. 95–168)
    • Chapter 4, “The Initial Contact and Maintaining the Frame” (pp. 169–224)

    American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
    Note: It is highly recommended that you use this resource as a reference guide throughout the course. You will access this text from the Walden Library databases.

    American Academy of Child and Adolescent Psychiatry. (1995). Practice parameters for the psychiatric assessment of children and adolescents. Washington, DC: Author. Retrieved from https://www.aacap.org/App_Themes/AACAP/docs/practi…

    American Psychiatric Association. (2016). Practice guidelines for the psychiatric evaluation of adults (3rd ed.). Arlington, VA: Author. Retrieved from http://psychiatryonline.org/doi/pdf/10.1176/appi.b…

    Walden Library. (2017). NURS 6640 week 2 discussion guide. Retrieved from http://academicguides.waldenu.edu/nurs6640week2dis…

    Walden University. (n.d.). Tests & measures: Home. Retrieved February 6, 2017, from http://academicguides.waldenu.edu/library/testsmea…
    Note: This database may be helpful in obtaining assessment tool information for this week’s Discussion.

    REQUIRED MEDIA

    Laureate Education (Producer). (2015a). Counseling competencies—The application of ethical guides and laws to record keeping [Video file]. Baltimore, MD: Author.
    Provided courtesy of the Laureate International Network of Universities.
    Note: The approximate length of this media piece is 23 minutes.

Assignment 2: Practicum – Week 8 Journal Entry

LEARNING OBJECTIVES

Students will:
  • Develop diagnoses for clients receiving psychotherapy
  • Evaluate the efficacy of existential-humanistic therapy for clients
  • Analyze legal and ethical implications of counseling clients with psychiatric disorders
  • Analyze clinical supervision experiences
  • Analyze how nursing and counseling theories guided personal practice in psychotherapy
  • Analyze goals and objectives for personal practicum experiences
  • Analyze the impact of psychotherapy on social change

The Learning Objectives are related to the Practicum Journal Assignments presented in Weeks 8, 9, and 10.

Week 10 Journal Entry

Reflect on your overall practicum experience in this course. Then, address the following in your Practicum Journal:

  • Explain whether your therapeutic theory has changed as a result of your practicum experiences. Recall the theories you selected in Week 1.
  • Explain how you integrated the therapeutic approaches from this course in your clinical practice. Include how this helped you achieve the goals and objectives you developed in Week 1.
  • Explain how you might impact social change through your work with clients who have mental health issues.
  • Support your approach with evidence-based literature.

APA FORMAT PLEASE

Assignment 1: Practicum – Week 9 Journal Entry

LEARNING OBJECTIVES

STUDENTS WILL:
  • Develop diagnoses for clients receiving psychotherapy*
  • Analyze legal and ethical implications of counseling clients with psychiatric disorders*

Select a child or adolescent client whom you observed or counseled this week. Then, address the following in your Practicum Journal:

  • Describe the client (without violating HIPAA regulations) and identify any pertinent history or medical information, including prescribed medications.
  • Using the DSM-5, explain and justify your diagnosis for this client.
  • Explain any legal and/or ethical implications related to counseling this client.
  • Support your position with evidence-based literature.

Learning Resources

REQUIRED READINGS

American Nurses Association. (2014). Psychiatric-mental health nursing: Scope and standards of practice (2nd ed.). Washington, DC: Author.

  • Standard 5 “Implementation” (pages 52-53)

Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (2nd ed.). New York, NY: Springer Publishing Company.

  • Chapter 17, “Psychotherapy With Children” (pp. 597–624)

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
Note: You will access this text from the Walden Library databases.

Bass, C., van Nevel, J., & Swart, J. (2014). A comparison between dialectical behavior therapy, mode deactivation therapy, cognitive behavioral therapy, and acceptance and commitment therapy in the treatment of adolescents. International Journal of Behavioral Consultation and Therapy, 9(2), 4–8. doi:10.1037/h0100991
Note: You will access this article from the Walden Library databases.

Koocher, G. P. (2003). Ethical issues in psychotherapy with adolescents. Journal of Clinical Psychology, 59(11), 1247–1256. PMID:14566959
Note: You will access this article from the Walden Library databases.

McLeod, B. D., Jensen-Doss, A., Tully, C. B., Southam-Gerow, M. A., Weisz, J. R., & Kendall, P. C. (2016). The role of setting versus treatment type in alliance within youth therapy. Journal of Consulting and Clinical Psychology, 84(5), 453–464. doi:10.1037/ccp0000081
Note: You will access this article from the Walden Library databases.

Zilberstein, K. (2014). The use and limitations of attachment theory in child psychotherapy. Psychotherapy, 51(1), 93–103. doi:10.1037/a0030930
Note: You will access this article from the Walden Library databases.

REQUIRED MEDIA

Laureate Education (Producer). (2013a). Disruptive behaviors – Part 1 [Multimedia file]. Baltimore, MD: Author.

Laureate Education (Producer). (2013a). Disruptive behaviors – Part 2 [Multimedia file]. Baltimore, MD: Author.

Walker, R. (n.d.). Making child therapy work [Video file]. Mill Valley, CA: Psychotherapy.net.
Note: You will access this media from the Walden Library databases. The approximate length of this media piece is 95 minutes.

OPTIONAL RESOURCES

Bruce, T., & Jongsma, A. (2010a). Evidence-based treatment planning for disruptive child and adolescent behavior [Video file]. Mill Valley, CA: Psychotherapy.net.
Note: You will access this media from the Walden Library databases. The approximate length of this media piece is 63 minutes.

Week 11: Psychotherapy With Personality Disorders

APA FORMAT PLEASE; ONE PAGE

Post a description of the personality disorder you selected. Explain a therapeutic approach (including psychotropic medications if appropriate) you might use to treat a client presenting with this disorder, including how you would share your diagnosis of this disorder to the client in order to avoid damaging the therapeutic relationship. Support your approach with evidence-based literature.

Week 11: Psychotherapy With Personality Disorders

Since personality represents who someone is at the deepest level, it is understandable that many people with personality disorders resist the idea that they have a fundamental dysfunction with their personality. Even when clients acknowledge that their personality problems are at the heart of their interpersonal problems, they often find it difficult to change. As the mental health professional, how do you overcome this challenge and effectively counsel these clients?

This week, as you explore psychotherapy with personality disorders, you examine therapeutic approaches to treating clients with personality and interpersonal problems. You also develop a client termination summary for a client who may be ready to complete therapy.

Photo Credit: [Tempura]/[E+]/Getty Images


Learning Resources

REQUIRED READINGS

American Nurses Association. (2014). Psychiatric-mental health nursing: Scope and standards of practice (2nd ed.). Washington, DC: Author.

  • Standard 5H “Psychotherapy” (pages 63-64)

Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (2nd ed.). New York, NY: Springer Publishing Company.

  • Chapter 20, “Termination and Outcome Evaluation” (Review pp. 693–712)

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
Note: You will access this text from the Walden Library databases.

Dixon-Gordon, K. L., Turner, B. J., & Chapman, A. L. (2011). Psychotherapy for personality disorders. International Review of Psychiatry, 23(3), 282–302. doi:10.3109/09540261.2011.586992
Note: You will access this text from the Walden Library databases.

Lorentzen, S., Ruud, T., Fjeldstad, A., & Høglend, P. A. (2015). Personality disorder moderates outcome in short- and long-term group analytic psychotherapy: A randomized clinical trial. British Journal of Clinical Psychology, 54(2), 129–146. doi:10.1111/bjc.12065
Note: You will access this text from the Walden Library databases.

Paris, J. (2004). Personality disorders over time: Implications for psychotherapy. American Journal of Psychotherapy, 58(4), 420–429. PMID: 15807086
Note: You will access this text from the Walden Library databases.

Swift, J. K., & Greenberg, R. P. (2015). What is premature termination, and why does it occur? In Premature termination in psychotherapy: Strategies for engaging clients and improving outcomes (pp. 11–31). Washington, DC: American Psychological Association. doi:10.1037/14469-002
Note: You will access this text from the Walden Library databases.

OPTIONAL RESOURCES

Dorr, D. (1999). Approaching psychotherapy of the personality disorders from the Millon perspective. Journal of Personality Assessment, 72(3), 407–425. PMID: 10491846

Bach, B., Lee, C., Mortensen, E. L., & Simonsen, E. (2016). How do DSM-5 personality traits align with schema therapy constructs? Journal of Personality Disorders, 30(4), 502–529. doi:10.1521/pedi_2015_29_212


Discussion: Therapy for Clients With Personality Disorders

Clients with personality disorders often find it difficult to overcome their problems and function in daily life. Even when these clients are aware that they have a dysfunction with their personality and are open to counseling, treatment can be challenging for both the client and the therapist. For this Discussion, as you examine personality disorders, consider therapeutic approaches you might use with clients.

LEARNING OBJECTIVES

STUDENTS WILL:
  • Analyze therapeutic approaches to treating clients with personality disorders

To prepare:

  • Review this week’s Learning Resources and reflect on the insights they provide.
  • Select one of the personality disorders from the DSM-5.

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click Submit, you cannot delete or edit your own posts, and cannot post anonymously. Please check your post carefully before clicking Submit!

Discussion: Does Psychotherapy Have a Biological Basis?

Many studies have found that psychotherapy is as effective as psychopharmacology in terms of influencing changes in behaviors, symptoms of anxiety, and changes in mental state. Changes influenced by psychopharmacology can be explained by the biological basis of treatments. But how does psychotherapy achieve these changes? Does psychotherapy share common neuronal pathways with psychopharmacology? For this Discussion, consider whether psychotherapy also has a biological basis.

LEARNING OBJECTIVES

Students will:
  • Evaluate biological basis of psychotherapy treatments
  • Analyze influences of culture, religion, and socioeconomics on personal perspectives of psychotherapy treatments

To prepare:

  • Review this week’s Learning Resources.
  • Reflect on foundational concepts of psychotherapy.

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click Submit, you cannot delete or edit your own posts, and cannot post anonymously. Please check your post carefully before clicking Submit!

BY DAY 3

Post an explanation of whether psychotherapy has a biological basis. Explain how culture, religion, and socioeconomics might influence one’s perspective of the value of psychotherapy treatments. Support your rationale with evidence-based literature.

Read a selection of your colleagues’ responses.

Discussion: Assessment Tools

Assessment tools have two primary purposes: 1) to measure illness and diagnose clients, and 2) to measure a client’s response to treatment. Often, you will find that multiple assessment tools are designed to measure the same condition or response. Not all tools, however, are appropriate for use in all clinical situations. You must consider the strengths and weaknesses of each tool to select the appropriate assessment tool for your client. For this Discussion, as you examine the assessment tool assigned to you by the Course Instructor, consider its use in psychotherapy.

LEARNING OBJECTIVES

Students will:
  • Analyze psychometric properties of assessment tools
  • Evaluate appropriate use of assessment tools in psychotherapy
  • Compare assessment tools used in psychotherapy

Note: By Day 1 of this week, the Course Instructor will assign you to an assessment tool that is used in psychotherapy.
Assigned Tool: MICH ALCOHOL SCREENING TEST

To prepare:

  • Review this week’s Learning Resources and reflect on the insights they provide.
  • Consider the asessment tool assigned to you by the Course Instructor.
  • Review the Library Course Guide in your Learning Resources for assistance in locating information on the assessment tool you were assigned.

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click Submit, you cannot delete or edit your own posts, and cannot post anonymously. Please check your post carefully before clicking Submit!

BY DAY 3

Post an explanation of the psychometric properties of the assessment tool you were assigned. Explain when it is appropriate to use this assessment tool with clients, including whether the tool can be used to evaluate the efficacy of psychopharmacologic medications. Support your approach with evidence-based literature.

Assigned Tool: MICH ALCOHOL SCREENING TEST

Assignment 2: Practicum – Week 1 Journal Entry and Journal Submission

LEARNING OBJECTIVES

Students will:
  • Analyze nursing and counseling theories to guide practice in psychotherapy
  • Develop goals and objectives for personal practicum experiences
  • Create timelines for practicum activities
  • Develop diagnoses for clients receiving psychotherapy
  • Analyze legal and ethical implications of counseling clients with psychiatric disorders
  • Develop diagnoses for clients receiving psychotherapy
  • Evaluate the efficacy of cognitive behavioral therapy for clients
  • Analyze legal and ethical implications of counseling clients with psychiatric disorders

The Learning Objectives are related to the Practicum Journal Assignments presented in Weeks 1, 2, and 4.

Week 4 Journal Entry
Select a client that you observed or counseled this week. Then, address the following in your Practicum Journal:

  • Describe the client (without violating HIPAA regulations) and identify any pertinent history or medical information, including prescribed medications.
  • Using the DSM-5, explain and justify your diagnosis for this client.
  • Explain whether cognitive behavioral therapy would be effective with this client. Include expected outcomes based on this therapeutic approach. Support your approach with evidence-based literature.
  • Explain any legal and/or ethical implications related to counseling this client.

Note: Be sure to use the Practicum Journal Template, located in the Learning Resources.

BY DAY 7

THE ASSIGNMENT

In a 1–2-page paper, address the following:

  • Briefly describe how cognitive behavioral therapy (CBT) and rational emotive behavioral therapy (REBT) are similar.
  • Explain at least three differences between CBT and REBT. Include how these differences might impact your practice as a mental health counselor.
  • Explain which version of cognitive behavioral therapy you might use with clients and why. Support your approach with evidence-based literature.

 

Week 4: Cognitive Behavioral Therapy

When first introduced, cognitive behavioral therapy (CBT) was unlike any other therapeutic approach. For years, psychotherapeutic techniques were driven by psychoanalytic theories. These techniques were time consuming, leaving many therapists frustrated with the length of time involved in helping their clients achieve a sense of relief. With the development of CBT, however, therapists were able to help their clients heal more quickly. This poses the questions: If CBT is more efficient than other techniques, why isn’t it used with all clients? How do you know when CBT is an appropriate therapeutic approach?

This week, as you examine cognitive behavioral therapy and its appropriateness for clients, you compare it to rational emotive behavioral therapy. You also develop diagnoses for clients receiving psychotherapy and consider legal and ethical implications of counseling these clients.

Photo Credit: Clayton Rohner/Creatas Video/Getty Images


Learning Resources

REQUIRED READINGS

Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (2nd ed.). New York, NY: Springer Publishing Company.

  • Chapter 8, “Cognitive Behavioral Therapy” (pp. 313–346)

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
Note: You will access this text from the Walden Library databases.

REQUIRED MEDIA

Sommers-Flanagan, J., & Sommers-Flanagan, R. (2013). Counseling and psychotherapy theories in context and practice [Video file]. Mill Valley, CA: Psychotherapy.net.
Note: For this week, view Behavior Therapy and Cognitive-Behavioral Therapy only. You will access this media from the Walden Library databases.

Beck, A. (1994). Aaron Beck on cognitive therapy [Video file]. Mill Valley, CA: Psychotherapy.net.
Note: You will access this media from the Walden Library databases. The approximate length of this media piece is 50 minutes

Eysenck, H. (n.d.). Hans Eysenck on behavior therapy [Video file]. Mill Valley, CA: Psychotherapy.net.
Note: You will access this media from the Walden Library databases. The approximate length of this media piece is 50 minutes.

OPTIONAL RESOURCES

Ellis, A. (2012). Albert Ellis on REBT [Video file]. Mill Valley, CA: Psychotherapy.net.
Note: You will access this media from the Walden Library databases. The approximate length of this media piece is 50 minutes.


Assignment 1: Cognitive Behavioral Theory Versus Rational Emotive Behavioral Theory

While cognitive behavioral therapy (CBT) and rational emotive behavioral therapy (REBT) have many similarities, they are distinctly different therapeutic approaches. When assessing clients and selecting one of these therapies, you must recognize the importance of not only selecting the one that is best for the client, but also the approach that most aligns to your own skill set. For this Assignment, as you examine the similarities and differences between CBT and REBT, consider which therapeutic approach you might use with your clients.

LEARNING OBJECTIVES

Students will:
  • Compare cognitive behavioral therapy and rational emotive behavioral therapy
  • Recommend cognitive behavioral therapies for clients

To prepare:

  • Review the media in this week’s Learning Resources.
  • Reflect on the various forms of cognitive behavioral therapy.

Note: The School of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the Walden Writing Center provides an example of those required elements (available at http://writingcenter.waldenu.edu/57.htm). All papers submitted must use this formatting

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