NURS 6640: Psychotherapy With Individuals

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NURS 6640: Psychotherapy With Individuals

NURS 6640 Entire Course Weekly Discussions And Assignments

NURS 6640 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.

NURS 6640: Psychotherapy With Individuals

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.

By Day 6

Respond to at least two of your colleagues by providing an additional scholarly resource that supports or challenges their position along with a brief explanation of the resource.

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NURS 6640 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.

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.

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.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues by comparing your assessment tool to theirs.

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NURS 6640 Week 3: Psychodynamic Psychotherapy Introduction

Contemporary psychodynamic psychotherapy, also referred to as psychoanalytic therapy, is rooted in Dr. Sigmund Freud’s proposal that unconscious thought processes, or thoughts and feelings outside of our conscious awareness, are responsible for mental health issues. This therapeutic approach is unique because its goal is to help clients achieve changes in personality and emotional development. Like most therapeutic approaches, however, psychodynamic psychotherapy is not appropriate for every client. In your role as a psychiatric mental health nurse practitioner, you must be able to properly assess clients to determine whether this therapeutic approach would improve their clinical outcomes.

This week, as you explore psychodynamic psychotherapy, you examine the application of current literature to clinical practice. You also assess clients presenting for psychotherapy.

Assignment 1: Applying Current Literature to Clinical Practice

Literature in psychotherapy differs from other areas of clinical practice. Generally, there are no clinical trials in psychotherapy because it is often neither appropriate nor ethical to have controls in psychotherapy research. This sometimes makes it more difficult to translate research findings into practice. In your role, however, you must be able to synthesize current literature and apply it to your own clients. For this Assignment, you begin practicing this skill by examining current literature on psychodynamic therapy and considering how it might translate into your own clinical practice.

Learning Objectives

Students will:

Evaluate the application of current literature to clinical practice

To prepare:

Review this week’s Learning Resources and reflect on the insights they provide.
Select one of the psychodynamic therapy articles from the Learning Resources to evaluate for this Assignment.

Note: In nursing practice, it is not uncommon to review current literature and share findings with your colleagues. Approach this Assignment as though you were presenting the information to your colleagues.

The Assignment

In a 5- to 10-slide PowerPoint presentation, address the following:

Provide an overview of the article you selected.
- What population is under consideration?
- What was the specific intervention that was used? Is this a new intervention or one that was already used?
- What were the author’s claims?
Explain the findings/outcomes of the study in the article. Include whether this will translate into practice with your own clients. If so, how? If not, why?
Explain whether the limitations of the study might impact your ability to use the findings/outcomes presented in the article. Support your position with evidence-based literature.

Note: The presentation should be 5–10 slides, not including the title and reference slides. Include presenter notes (no more than ½ page per slide) and use tables and/or diagrams where appropriate. Be sure to support your work with specific citations from the article you selected. Support your approach with evidence-based literature.

By Day 7

Submit your Assignment.

Assignment 2: Practicum – Assessing Clients

Learning Objectives

Students will:

Assess clients presenting for psychotherapy
Develop genograms for clients presenting for psychotherapy

To prepare:

Select a client whom you have observed or counseled at your practicum site.
Review pages 137–142 of the Wheeler text and the Hernandez Family Genogram video in this week’s Learning Resources. Reflect on elements of writing a Comprehensive Client Assessment and creating a genogram for the client you selected.

NURS 6640: Psychotherapy With Individuals

The Assignment Part 1: Comprehensive Client Family Assessment

With this client in mind, address the following in a Comprehensive Client Assessment (without violating HIPAA regulations):

Demographic information
Presenting problem
History or present illness
Past psychiatric history
Medical history
Substance use history
Developmental history
Family psychiatric history
Psychosocial history
History of abuse/trauma
Review of systems
Physical assessment
Mental status exam
Differential diagnosis
Case formulation
Treatment plan

Part 2: Family Genogram

Prepare a genogram for the client you selected. The genogram should extend back by at least three generations (great grandparents, grandparents, and parents).

By Day 7 of Week 3

Submit your Assignment.

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NURS 6640 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.

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.

The Assignment

In a 1- to 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.

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.

By Day 7

Submit your Assignment.

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

Submit your Practicum Journal entries for Weeks 1, 2, and 4. Refer to the weekly instructions for additional guidance.

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NURS 6640: Psychotherapy With Individuals

NURS 6640 Week 5: Psychotherapy With Trauma

Disorders resulting from trauma are significantly different from other psychiatric mental health issues. Unlike disorders such as schizophrenia or major depressive disorder, trauma-related disorders do not occur randomly in the population. Instead, trauma is something that occurs as a result of the lived experience of a traumatic event. According to the National Center for PTSD, more than half of the population will experience trauma during their lifetime (National Center for PTSD, 2010). Although most people will recover from the trauma on their own, some require therapeutic interventions. While there are medications that can help individuals with trauma and posttraumatic stress disorder (PTSD), the foundation of treatment continues to be psychotherapy.

This week, as you explore psychotherapy with trauma, you assess clients presenting with posttraumatic stress disorder. You also examine therapies for treating these clients and consider potential outcomes. Finally, you develop diagnoses for clients receiving psychotherapy and consider legal and ethical implications of counseling these clients.

Discussion: Posttraumatic Stress Disorder

It is estimated that more than 6% of the U.S. population will experience posttraumatic stress disorder (PTSD) in their lifetime (National Center for PTSD, 2010). This debilitating disorder often interferes with an individual’s ability to function in daily life. Common symptoms of anxiousness and depression frequently lead to substance abuse issues and even physical ailments. For this Discussion, as you examine the Thompson Family Case Study in this week’s Learning Resources, consider how you might assess and treat clients presenting with PTSD.

Learning Objectives

Students will:

Assess clients presenting with posttraumatic stress disorder
Analyze therapeutic approaches for treating clients presenting with posttraumatic stress disorder
Evaluate outcomes for clients with posttraumatic stress disorder

To prepare:

Review this week’s Learning Resources and reflect on the insights they provide.
View the media Academic Year in Residence: Thompson Family Case Study, and assess the client in the case study.
For guidance on assessing the client, refer to pages 137–142 of the Wheeler text in this week’s Learning Resources.

Note: To complete this Discussion, you must assess the client, but you are not required to submit a formal Comprehensive Client Assessment.

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 on or before Day 3 an explanation of your observations of the client William in Thompson Family Case Study, including behaviors that align to the PTSD criteria in DSM-5. Then, explain therapeutic approaches you might use with this client, including psychotropic medications if appropriate. Finally, explain expected outcomes for the client based on these therapeutic approaches. Support your approach with evidence-based literature.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues by providing one alternative therapeutic approach. Explain why you suggest this alternative and support your suggestion with evidence-based literature and/or your own experiences with clients.

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NURS 6640: Psychotherapy With Individuals

NURS 6640 Week 6: Psychotherapy for Addictive Disorders

“A long-standing debate has roiled over whether addicts have a choice over their behaviors. The disease creates distortions in thinking, feelings, and perceptions, which drive people to behave in ways that are not understandable to others around them. Simply put, addiction is not a choice. Addictive behaviors are a manifestation of the disease, not a cause.”

–Dr. Raju Hajela, former president of the Canadian Society of Addiction Medicine

A common misconception is that addiction is a choice, and addicts are often labeled as individuals who lack morals, willpower, or responsibility. However, addiction is a clinical disorder that must be treated with the support of a health care professional. Although many people who are exposed to potentially addictive substances and behaviors continue life unaltered by their experiences, some people are fueled by these experiences and spiral out of control. In your role as the psychiatric mental health nurse practitioner, you must be prepared to not only work with these individuals who struggle with addiction, but also help them and their families overcome the social stigmas associated with addictive behavior.

This week, as you explore psychotherapy for addiction, you assess clients presenting with addictive disorders. You also examine therapies for treating these clients and consider potential outcomes. Finally, you develop diagnoses for clients receiving psychotherapy and consider legal and ethical implications of counseling these clients.

Assignment 1: Assessing Clients With Addictive Disorders

Addictive disorders can be particularly challenging for clients. Not only do these disorders typically interfere with a client’s ability to function in daily life, but they also often manifest as negative and sometimes criminal behaviors. Sometime clients with addictive disorders also suffer from other mental health issues, creating even greater struggles for them to overcome. In your role, you have the opportunity to help clients address their addictions and improve outcomes for both the clients and their families. For this Assignment, as you examine the Levy Family video in this week’s Learning Resources, consider how you might assess and treat clients presenting with addiction.

Learning Objectives

Students will:

Assess clients presenting with addictive disorders
Analyze therapeutic approaches for treating clients with addictive disorders
Evaluate outcomes for clients with addictive disorders

To prepare:

Review this week’s Learning Resources and consider the insights they provide.
Review the Levy Family video Episodes 1 through 5.

The Assignment

In a 2- to 3-page paper, address the following:

After watching Episode 1, describe:
- What is Mr. Levy’s perception of the problem?
- What is Mrs. Levy’s perception of the problem?
- What can be some of the implications of the problem on the family as a whole?
After watching Episode 2, describe:
- What did you think of Mr. Levy’s social worker’s ideas?
- What were your thoughts of her supervisor’s questions about her suggested therapies and his advice to Mr. Levy’s supervisor?
After watching Episode 3, discuss the following:
- What were your thoughts about the way Mr. Levy’s therapist responded to what Mr. Levy had to say?
- What were your impressions of how the therapist worked with Mr. Levy? What did you think about the therapy session as a whole?
- Informed by your knowledge of pathophysiology, explain the physiology of deep breathing (a common technique that we use in helping clients to manage anxiety). Explain how changing breathing mechanics can alter blood chemistry.
- Describe the therapeutic approach his therapist selected. Would you use exposure therapy with Mr. Levy? Why or why not? What evidence exists to support the use of exposure therapy (or the therapeutic approach you would consider if you disagree with exposure therapy)?
In Episode 4, Mr. Levy tells a very difficult story about Kurt, his platoon officer.
- Discuss how you would have responded to this revelation.
- Describe how this information would inform your therapeutic approach. What would you say/do next?
In Episode 5, Mr. Levy’s therapist is having issues with his story.
- Imagine that you were providing supervision to this therapist, how would you respond to her concerns?
Support your approach with evidence-based literature.

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.

By Day 7

Submit your Assignment.

Exam: Midterm Exam

Learning Objectives

Students will:

Assess knowledge of concepts and principles related to the psychotherapy of individuals

This exam is a test of your knowledge in preparation for your certification exam. No outside resources including books, notes, websites, or any other type of resource are to be used to complete this exam. You are expected to comply with Walden University’s Code of Conduct.

This exam will cover the following topics, which relate to psychotherapy with individuals in the Wheeler textbook and the Fisher textbook excerpts:

The Nurse Psychotherapist and a Framework for Practice
Confidentiality Limits in Psychotherapy: Ethics Checklists for Mental Health Professionals
Assessment and Diagnosis
The Initial Contact and Maintaining the Frame
Cognitive Behavioral Therapy
Supportive and Psychodynamic Psychotherapy
Stabilization for Trauma and Dissociation
Motivational Interviewing
Psychotherapeutic Approaches for Addictions and Related Disorders

By Day 7

Complete the Midterm Exam.

Assignment 2: Practicum – Week 6 Journal Entry

Learning Objectives

Students will:

Develop diagnoses for clients receiving psychotherapy*
Evaluate the efficacy of motivational interviewing techniques 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 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 motivational interviewing 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.

By Day 7 of Week 7

Submit your Assignment.

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NURS 6640: Psychotherapy With Individuals

NURS 6640 Week 7: Supportive and Interpersonal Psychotherapy

Amelia, a 16-year-old high school sophomore, presents with symptoms of weight loss and a very obvious concern for her weight. She has made several references to being “fat” and “pudgy” when, in fact, she is noticeably underweight. Her mother reports that she is quite regimented in her eating and that she insists on preparing her own meals as her mother “puts too many fattening things in the food” that she cooks. After discovering that during the past 3 months Amelia has lost 15 pounds and is well under body weight for someone of similar age/sex/developmental trajectory, the psychiatric mental health nurse practitioner diagnosed Amelia with anorexia nervosa.

Evidence-based research shows that clients like Amelia may respond well to supportive psychotherapy and interpersonal psychotherapy. So which approach might you select? Are both equally effective for all clients? In practice, you will find that many clients may be candidates for both of these therapeutic approaches, but factors such as a client’s psychodynamics and your own skill set as a therapist may impact their effectiveness.

This week, you continue exploring therapeutic approaches and their appropriateness for clients as you examine supportive psychotherapy and interpersonal psychotherapy. You also assess progress for a client receiving psychotherapy and develop progress and privileged psychotherapy notes for the client.

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Assignment 1: Supportive Psychotherapy Versus Interpersonal Psychotherapy

Although supportive psychotherapy and interpersonal psychotherapy share some similarities, these therapeutic approaches have many differences. When assessing clients and selecting therapies, it is important to recognize these differences and how they may impact your clients. For this Assignment, as you compare supportive and interpersonal psychotherapy, consider which therapeutic approach you might use with your clients.

Learning Objectives

Students will:

Compare supportive psychotherapy and interpersonal psychotherapy
Recommend therapeutic approaches for clients presenting for psychotherapy

To prepare:

Review the media in this week’s Learning Resources.
Reflect on supportive and interpersonal psychotherapeutic approaches.

The Assignment

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

Briefly describe how supportive and interpersonal psychotherapies are similar.
Explain at least three differences between these therapies. Include how these differences might impact your practice as a mental health counselor.
Explain which therapeutic approach you might use with clients and why. Support your approach with evidence-based literature.

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 athttp://academicguides.waldenu.edu/writingcenter/templates ). All papers submitted must use this formatting.

By Day 7

Submit your Assignment.

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.

By Day 7

Submit your Assignment.

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NURS 6640: Psychotherapy With Individuals

NURS 6640 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.

Discussion: Clinical Supervision

Clinical Supervision is an essential component of your development as a psychiatric mental health nurse practitioner. It provides an opportunity for professional collaboration as you share experiences with and gain insights from colleagues. For this Clinical Supervision, consider a client whom you do not think is adequately progressing according to expected clinical outcomes.

Learning Objectives

Students will:

Assess clients presenting for psychotherapy
Evaluate effectiveness of therapeutic approaches for clients receiving psychotherapy
Apply existential-humanistic therapy to clients with psychiatric disorders

To prepare:

Review this week’s media and consider the insights provided.
Reflect on the clients you are currently counseling at your practicum site.

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 a 3- to 5-minute Kaltura video that addresses the following:

Describe a client you are counseling whom you do not think is adequately progressing according to expected clinical outcomes.

Note: Do not use the client’s actual name.

Explain your therapeutic approach with the client, including the perceived effectiveness of your approach.
Identify any additional information about this client that may potentially impact expected outcomes.

Note: Nurse practitioners must have strong oral communication skills. This Discussion is designed to help you hone these skills. When filming your Kaltura video, be sure to dress and speak in a professional manner.

View a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues by providing feedback based on an existential-humanistic therapeutic perspective. Support your feedback with evidence-based literature and/or your own experiences with clients.

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NURS 6640: Psychotherapy With Individuals

NURS 6640 Week 9: Psychotherapy With Children and Adolescents

Approximately 1 in 5 children and adolescents have a mental health disorder, which may lead to issues at home, school, and other areas of their lives (Prout & Fedewa, 2015). When working with this population, it is important to recognize that children and adolescents are not “mini adults” and should not be treated as such. Psychotherapy with these clients is often more complex than psychotherapy with the general adult population, particularly in terms of communication. As a result, strong therapeutic relationships are essential to success.

This week, as you explore psychotherapy with children and adolescents, you assess clients presenting with disruptive behaviors. You also examine therapies for treating these clients and consider potential outcomes. Finally, you develop diagnoses for clients receiving psychotherapy and consider legal and ethical implications of counseling these clients.

NURS 6640: Psychotherapy With Individuals exam help

Discussion: Counseling Adolescents

The adolescent population is often referred to as “young adults,” but in some ways, this is a misrepresentation. Adolescents are not children, but they are not yet adults either. This transition from childhood to adulthood often poses many unique challenges to working with adolescent clients, particularly in terms of disruptive behavior. In your role, you must overcome these behaviors to effectively counsel clients. For this Discussion, as you examine the Disruptive Behaviors media in this week’s Learning Resources, consider how you might assess and treat adolescent clients presenting with disruptive behavior.

Learning Objectives

Students will:

Assess clients presenting with disruptive behavior
Analyze therapeutic approaches for treating clients presenting with disruptive behavior
Evaluate outcomes for clients presenting with disruptive behavior

To prepare:

Review this week’s Learning Resources and reflect on the insights they provide.
View the media, Disruptive Behaviors. Select one of the four case studies and assess the client.
For guidance on assessing the client, refer to pages 137-142 of the Wheeler text in this week’s Learning Resources.

Note: To complete this Discussion, you must assess the client, but you are not required to submit a formal Comprehensive Client Assessment.

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 your observations of the client in the case study you selected, including behaviors that align to the criteria in DSM-5. Then, explain therapeutic approaches you might use with this client, including psychotropic medications if appropriate. Finally, explain expected outcomes for the client based on these therapeutic approaches. Support your approach with evidence-based literature.

Read a selection of your colleagues’ responses.

By Day 6

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*

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

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.

By Day 7 of Week 10

Submit your Assignment.

NURS 6640: Psychotherapy With Individuals

Assignment 2: Board Vitals

This week you will be responding to twenty Board Vitals questions that cover a broad review of your Nurse Practitioner program courses up to this point.

These review questions will provide practice that is critical in your preparation for the national certification exam that’s required to certify you to practice as a nurse practitioner. These customized test questions are designed to help you prepare for your Nurse Practitioner certification exam. It is in your best interest to take your time, do your best, and answer each question to the best of your ability.

You can access Board Vitals through the link sent to you in email or by following the link below:

https://www.boardvitals.com/

By Day 7

Complete the Board Vitals questions.

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NURS 6640: Psychotherapy With Individuals

NURS 6640 Week 10: Psychotherapy With Older Adults

According to the Institute of Medicine, more than 20% of the growing older adult population has a mental health disorder (IOM, 2012). In the past, many older adults avoided psychotherapy because of the associated social stigma, but with the growing acceptance of therapy and awareness of mental health issues, more of this population is seeking the help they need. In your role, as the psychiatric mental health nurse practitioner, you have the opportunity to help these older adult clients overcome challenges that may have plagued them for a lifetime.

This week, as you explore psychotherapy with older adults, you assess clients and consider the appropriateness of various therapeutic approaches. You also examine the theories, goals, and objectives that guided your practicum experience throughout this course.

NURS 6640: Psychotherapy With Individuals

Discussion: Clinical Supervision

Personal reflection and discussion with colleagues is essential to your development as a psychiatric mental health nurse practitioner. In Week 8, you collaborated with colleagues as you participated in your first Clinical Supervision. This week, you have the opportunity to continue your collaboration as you reflect on and discuss your experiences with counseling older adults. Keep in mind that although there may be challenges to counseling this population, these clients offer unique learning opportunities. For this Clinical Supervision, consider an older client you are counseling whom you do not think is adequately progressing according to expected clinical outcomes.

Learning Objectives

Students will:

Assess clients presenting for psychotherapy
Evaluate effectiveness of therapeutic approaches for clients receiving psychotherapy

To prepare:

Review this week’s media and consider the insights provided.
Reflect on the clients you are currently counseling at your practicum site.

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 a 3- to 5-minute Kaltura video that addresses the following:

Describe an older client you are counseling whom you do not think is adequately progressing according to expected clinical outcomes.

Note: Do not use the client’s actual name.

Explain your therapeutic approach with the client, including the perceived effectiveness of your approach.
Identify any additional information about this client that may potentially impact expected outcomes.

Note: Nurse practitioners must have strong oral communication skills. This Discussion is designed to help you hone these skills. When filming your Kaltura video, be sure to dress and speak in a professional manner.

View a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues by sharing additional insights or alternative perspectives. Support your feedback with evidence-based literature and/or your own experiences with clients.

Note about uploading media: Refer to the Kaltura Media Uploader instructions document, which provides guidance on how to upload media for the Clinical Supervision Discussions.

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

Submit your Assignment.

NURS 6640: Psychotherapy With Individuals exam help

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.

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

By Day 7

Submit your Practicum Journal entries for Weeks 8, 9, and 10. Refer to the weekly instructions for additional guidance.

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NURS 6640: Psychotherapy With Individuals

NURS 6640 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.

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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!

By Day 3

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.

Read a selection of your colleagues’ responses.

By Day 6

Exam: Final Exam

Learning Objectives

Students will:

Assess knowledge of concepts, principles, and theories related to the psychotherapy of individuals

This exam will cover the following topics from the Wheeler textbook, which relate to psychotherapy of individuals:

Supportive and Psychodynamic Psychotherapy
Interpersonal Psychotherapy
Humanistic-Existential and Solution-Focused Approaches to Psychotherapy
Psychotherapy With Children
Psychotherapy With Older Adults
Termination and Outcome Evaluation

By Day 7

Complete the Final Exam.

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