NRNP-6640-14 Psychotherapy Individuals Week 1-2Week 1: Foundations of PsychotherapyWhile working wit

NRNP-6640-14 Psychotherapy Individuals Week 1-2

Week 1: Foundations of Psychotherapy

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.

NRNP-6640-14 Psychotherapy Individuals Week 1-2 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/PMC4207360/

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 

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

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: Midterm Exam Study Guide (Word document)

Document: Final Exam Study Guide (Word document)

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.

Accessible player

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.

Accessible player

Credit: Provided courtesy of the Laureate International Network of Universities.

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.

Accessible player

Credit: Provided courtesy of the Laureate International Network of Universities.

Sommers-Flanagan, J., & Sommers-Flanagan, R. (2012). Clinical interview: Intake, assessment, & therapeutic alliance [Video file]. Mill Valley, CA: Psychotherapy.net.

Sommer-Flanagan, J., & Sommers-Flanagan, R. (2013). Counseling and psychotherapy theories in context and practice [Video file]. Mill Valley, CA: Psychotherapy.net.

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.

Biological Basis and Ethical/Legal Considerations of Psychotherapy Example

Psychotherapy is a commonly used intervention in the management of mental health issues. It is often recommended as the first-line treatment before other options, such as psycho-pharmacotherapy in some conditions, such as anxiety. It is a collaborative treatment intervention that relies heavily on the care provider-patient relationship. Various types of psychotherapy include cognitive behavioral therapy and family therapy. Debates on the effectiveness of psychotherapy and the biological basis of psychotherapy exist. This essay evaluates the biological basis of psychotherapy and evaluates individual, group, and family therapy.

Psychotherapy has a biological basis, like psychopharmacological interventions, due to its therapeutic ability. Research affirms that psychotherapy changes brain connectivity and activity. Deits-Lebehn et al. (2020) state that well-perched psychotherapy provides adequate psychological stimulation, promoting new growth, neuron connectivity, and better blood supply. Research also shows that psychotherapy stimulates hormone release, which can be successful in offsetting negative emotions and moderating these emotions, such as over-excitation (arousal) and stress (depression) (Deits-Lebehn et al., 2020). Repeated cycles of psychotherapy assist in many instances, such as depression and anxiety, and anger management. 

Researchers argue that erasing unhelpful schemas and beliefs helps showcase transformational change in psychotherapy (Kramer et al., 2020). For example, psychotherapy has successfully managed bullying behavior in children and adolescents, leading to complete transformation, indicating that psychotherapy could have a biological basis. Cultural, social-economic, and religious practices also affect an individual’s view of the effectiveness of psychotherapy. Some cultures do not encourage speaking up or discussing personal problems, which may limit their perception and acceptance of psychotherapy (Wheeler, 2020). Thus, individual perspectives may embrace or disregard practices, hence the need to be culturally sensitive as a care provider.

Legal and ethical considerations differ in the individual, family, and group therapy settings. Like all other care interventions, individual therapy follows all ethical and legal principles. Informed consent, justice, veracity, fidelity, self-respect, autonomy, beneficence, and non-maleficence are all vital individual therapy (Sanghvi & Pandley, 2019). Despite sharing personal information, group therapy sessions maintain confidentiality in that patients only share the information they are comfortable with (Hahn et al., 2022). 

The group participants voluntarily participate hence altruism and other ethical issues such as justice and confidentiality. Information shared restricts deep-message sharing and entails what is significant to others. In addition, these groups are led by competent professionals who ensure that legal and ethical considerations are duly followed. They help handle group differences and ensure objective achievement despite the differences among group members.  

In family therapy, confidentiality is also vital, and unlike individual therapy, only the information the patient is willing to share is discussed. Family therapy often entails how the family members can promote quality outcomes for the patient or problem (Barnett & Jacobson, 2019). In family therapy, the intervention conceptualizes the origin of a problem as a dysfunctional process. Barnett and Jacobson (2019) note that the focus of family therapy is thus addressing these dysfunctional patterns, especially relationships between family members. Cultural awareness, informed consent, and confidentiality (except when concealed information can lead to family harm) are essential considerations in family therapy.

Conclusion

All these articles used were sourced from current and reputable journals in psychiatry, and most were pulled from the American Psychological Association website. The APA website is a reliable database for sourcing peer-reviewed work. The articles are peer-reviewed and current (produced within the last five years). From the evidence presented above, psychotherapy has a biological basis due to the changes in areas such as memory and behavior and physical brain changes observed after psychotherapy. Understanding the biological basis of psychotherapy helps care providers plan and utilize psychotherapy to achieve the desired outcomes. Ethical and legal issues differ in individual, family, and group therapy. Understanding their differences and similarities can help professionals implement psychotherapy with minimal ethical and legal problems in these groups.

References

Barnett, J. E., & Jacobson, C. H. (2019). Ethical and legal issues in family and couple therapy. In APA handbook of contemporary family psychology: Family therapy and training, Vol. 3 (pp. 53–68). American Psychological Association. https://doi.org/10.1037/0000101-004

Deits-Lebehn, C., Baucom, K. J., Crenshaw, A. O., Smith, T. W., & Baucom, B. R. (2020). Incorporating physiology into the study of the psychotherapy process. Journal of Counseling Psychology, 67(4), 488. https://doi.org/10.1037/cou0000391

Hahn, A., Paquin, J. D., Glean, E., McQuillan, K., & Hamilton, D. (2022). Developing into a group therapist: An empirical investigation of expert group therapists’ training experiences. American Psychologist, 77(5), 691–709. https://doi.org/10.1037/amp0000956

Kramer, U., Beuchat, H., Grandjean, L., & Pascual-Leone, A. (2020). How personality disorders change in psychotherapy: A concise review of process. Current Psychiatry Reports, 22, 1-9. https://doi.org/10.1007/s11920-020-01162-3

Sanghvi, P., & Pandey, S. (2019). Ethical and Legal Constraints in Psychotherapy. Journal of Psychosocial Research, 14(1). https://doi.org/10.32381/JPR.2019.14.01.2

Wheeler, K. (2020). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (3rd ed.). Springer Publishing.

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.

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.

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/practice_parameters/psychiatric_assessment_practice_parameter.pdf

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.books.9780890426760

Walden Library. (2017). NURS 6640 week 2 discussion guide. Retrieved from http://academicguides.waldenu.edu/nurs6640week2discussion

Walden University. (n.d.). Tests & measures: Home. Retrieved February 6, 2017, from http://academicguides.waldenu.edu/library/testsmeasures

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.

Accessible player

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 assessment 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.

Also Read: NRNP 6650 Psychotherapy With Groups and Families

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