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I would like it grammatically corrected edited and bold typing centered, APA 6th edition references redo_journal_4.doc redo_journal_1.doc redo_journal_2.doc Unformatted Attachment Preview Journal Four Student Name: Nina S Davis E-mail Address: nina.davis2@waldenu.edu Practicum Placement Agencys Name: Carl R Darnall Army Medical Center Preceptor’s Name: LTC Jennifer Schenck Preceptor’s Telephone: 254 553 6627 Preceptor’s E-mail Address: jennifer.m.schenck.mil@mail.mil Journal Four Walden University NUNP-6640A-4, Psychotherapy Individ.2020 Winter Quarter Dr. Tabitha Perrigo December 23, 2019 © 2014 Laureate Education, Inc. Page 1 of 7 Journal Four Time Log Week Dates Times Total Hours for This Time Frame Activities/Comments Learning Objective(s) Addressed 4 12/16/ 2019 162100 5 Observed 2 clients, admitted 2 clients from the clinic, with suicidal ideation/anxiety 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 (Wheeler,.2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (2nd ed.). New York, NY: Springer Publishing Company. 4 12/17/ 2019 162100 5 Clients/Supervised Clients/ 2 transfer to off-post facility Observed three clients depression/grieving Explain any legal and/or ethical implications related to counseling this client. Nahum, D., Alfonso, C. A., & Sönmez, E. (2019). Common factors in psychotherapy. In Advances in Psychiatry (pp. 471-481). Springer, Cham. 4 12/18/ 2019 162100 5 Observed Clients completed three intakes Suicidal ideation/psychotic features/anxiety Describe the client (without violating HIPAA regulations) and identify any pertinent history or medical information, including prescribed medications. 4 12/19/ 2019 162100 5 Intake of 2 clients discussed CBTwith 2 clients with the preceptor. Explain any legal and/or ethical implications related to counseling this client (American Psychiatric Association, DSM V.2013)_ © 2014 Laureate Education, Inc. Page 2 of 7 Journal Four Time Log 4 12/20/ 2019 162100 5 CBT individual therapy one client Create timelines for practicum activities; Total Hours Completed:20 This is a 30-year-old Hispanic Female, who presents to emergency department center with primary complaints” feeling depressed and tearful.” She reports “sleeping a lot and eating more,” denies drinking or substance abuse. The client is alert oriented x 3, with a flat affect, disorganized, initially with incoherent thought process; The client became tearful, not maintaining eye contact and distracted. The client is disheveled, with mild body odor, reports being “very unhappy” and” feeling alone.” The client recently found fiancée “cheated with old girlfriend” “and he moved out.” The client report onset began shortly after, about three months ago (Bachem, & Casey 2018).She stated “does not want to go to work, just want to stay in bed, with the covers over my head.” The client is employed in the Army as a Staff Seargent/E6 in the Army. Her job is a 42A, Human Resources Specialist and EO advocate for the unit. She has four children with three different fathers. 1 father is imprisoned and the other 2 fathers provides minimal financial support, however is not on the children’s lives for emotional support. She is the sole provider for her household. This is her first-time presentation to behavioral health, and the client denies medical history or psychiatric history, the client uses nova ring for birth control. Diagnosis © 2014 Laureate Education, Inc. Page 3 of 7 Journal Four Adjustment Disorder with Depressed Mood F43.21 As we began to talk, the client expressed, lack of motivation “doesn’t want to go to work”, became tearful and did not make eye contact. The client stated “I was fine till he cheated on me” “ I can handle a lot, but he keeps cheating on me and just left me, right before Christmas” “he didn’t say anything, I didn’t see it coming”. The client is reacting to a situation, that is out of her control, her significant other cheating, moving out and calls off the engagement, before the holidays, has tremendous strife In her life. The client experieced loss and now she is grieving, The client is “eating to feel better” and “sleeping a lot” The client reports feeling sad , tearful, and hopeless and experiencing a lack of pleasure, short term 90 days reaction to circumstances (APA,2013). The client did not report suicidal/homicidal intent but did states “I just want to go away”. The reaction to the stressor is unhealthy The diagnosis based on the criteria is Adjustment Disorder with Depressed Mood (DSM-V, 2013), The diagnosis is characterized by depressed mood: predominant symptoms are low self esteem, tearfulness, anhedonia with feelings of hopelessness. Adjustment disorder with depressed mood is conditional upon a particular situation, a life change or a stressor of some sort. The stressor can be of any severity, but it must cause disruption to the person’s life (Kramer, et al 2015).. Based on the diagnosis, CBT would be more effective than REBT Kramer, et al 2015). CBT has a positive impact on clients with Adjustment Disorder with Depressed Mood The goal of CBT is accepting the circumstances and setting objectives. Also, selfhelp groups and group for single parents are recommended for this diagnosis . For the best results, sessions need to be more than 90 mins as longer sessions are more effective in improving symptoms than shorter ones © 2014 Laureate Education, Inc. Page 4 of 7 Journal Four Goals and Objectives 1. individual therapy three times weekly, 60 minutes/4 weeks (Kramer et al. 2015).Objective: Redirecring the feelings associated with the stressor (identify the negative thoughts, and replace with more realistic ones). The client will tell me one positive thought or coping skill she has weekly. 2. Resources for self help groups and referred to a single parents group (Kramer, et al 2015). Objective:To provides an opportunity for clients to share personal experiences and feelings and coping strategies. group meets on a consistent schedule, groups provide stability routine and often become a commitment, that client will want to live up to, also the client will feel she is not by herself. 3. Refer to the dietician for a meal plan to prevent weight gain, increase activites (ie start back running and exercising 3 times weekly). The client wil stay with her weight and reports feeling better. Ethical and Legal Implications When treating a client with Adjustment Disorder with Depressed Mood with bipolar disorder, two things need to be kept in mind, that the client’s judgment may be impaired and the risk of suicide. Due the nature of the disorder the patient’s ability to make good judgments and decisions can be severely impacted (Barnhorst, et al 2018).. Establish a safety plan. In cases like this, in order for the client to remain autonomous a confidant can be assigned. Ideally a family member or someone else who is close, the confidant can assist the providers on the treatment and action plan when the patient is compromised. In addition, this will also keep medical confidentiality which with exception such when the client is exhibiting suicidal or homicidal thoughts. Additionally © 2014 Laureate Education, Inc. Page 5 of 7 Journal Four the client has the right to accept or reject any parts of treatment, at any time (Barnhorst, et al 2018). References American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author © 2014 Laureate Education, Inc. Page 6 of 7 Journal Four Bachem, R., & Casey, P. (2018). Adjustment disorder: A diagnosis whose time has come. Journal of affective disorders, 227, 243-253. Barnhorst, A., Wintemute, G., & Betz, M. E. (2018). How should physicians make decisions about mandatory reporting when a patient might become violent?. AMA journal of ethics, 20(1), 29-35. Kramer, U., Pascual-Leone, A., Despland, J. N., & de Roten, Y. (2015). One minute of grief: Emotional processing in short-term dynamic psychotherapy for adjustment disorder. Journal of Consulting and Clinical Psychology, 83(1), 187. Peterson, T. (2016, February 11). Adjustment Disorder with Depressed Mood, HealthyPlace. Retrieved on 2020, January 2 from https://www.healthyplace.com/ptsdand-stress-disorders/adjustment-disorder/adjustment-disorder-with-depressed-moo 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 © 2014 Laureate Education, Inc. Page 7 of 7 Journal One Student Name: Nina S Davis E-mail Address: nina.davis2@waldenu.edu Practicum Placement Agencys Name: Carl R Darnall Army Medical Center Preceptor’s Name: LTC Jennifer Schenck Preceptor’s Telephone: 254 553 6627 Preceptor’s E-mail Address: jennifer.m.schenck.mil@mail.mil Journal One Walden University NUNP-6640A-4, Psychotherapy Individ.2020 Winter Quarter Dr. Tabitha Perrigo November 29, 2019 © 2014 Laureate Education, Inc. Page 1 of 8 Journal One Time Log Week Dates Times Total Hours for This Time Frame Activities/Comments Learning Objective(s) Addressed 1 11/27 /2019 162100 20 Orientation of clinic/hospital with preceptor Intake of 5 clients observed preceptor completed orders and intake from ED Analyze nursing and counseling theories (Wheeler,.2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (2nd ed.). New York, NY: Springer Publishing Company. 2 12/25/201 9 162100 20 Discussed CBT with clients from 8/27 of clients admitted to behavioral health. Shadowing preceptor Established timelines Nahum, D., Alfonso, C. A., & Sönmez, E. (2019). Common factors in psychotherapy. In Advances in Psychiatry (pp. 471-481). Springer, Cham. 3 12/913/20 19 162100 20 Intake of 4 clients and initiated goals of therapy with clients; Shadowing preceptor Support your approach with evidence-based literature; Nahum, D., Alfonso, C. A., & Sönmez, E. (2019). Common factors in psychotherapy. In Advances in Psychiatry (pp. 471-481). Springer, Cham 4 12/16 20/20 19 162100 20 Intake of 3 clients discussed CBT with 2 clients with depression and suicidal ideation. Develop diagnoses for clients receiving psychotherapy; Analyze legal and ethical implications of counseling clients with psychiatric disorders (American Psychiatric Association, DSM V.2013) _ 4 12/16 20/20 162100 20 Observed Clients Create timelines for practicum activities; © 2014 Laureate Education, Inc. Page 2 of 8 Journal One Time Log 19 4 12/16 20/20 19 162100 20 Observed Clients Describe the client (without violating HIPAA regulations) and identify any pertinent history or medical information, including prescribed medications. Receiving psychotherapy clients with psychiatric disorder; (Wheeler,.2014). = Total Hours Completed:20 . As a future Psychiatric and Mental Health Nurse Practitioner, I should understand the importance of psychotherapy and the use, with clients suffering from various mental illnesses as an essential part of the treatment plan. (Wheeler, 2014). Psychotherapy is a necessary form of treatment allowing the client to gain trust discuss, their difficulties in maneuvering and maintaining through life situation, in a professional setting. (Wheller,2014). T I started my practicum with one question in mind. Does the mind affect the body? If a client is emotionally and mentally out of balance, it affects the physiological and psychosocial system of the body and vice versa. The purpose of the journals, during my clinical period is to attain my goal of proper therapeutic counseling for my clients. This journal will focus on my clinical objectives and goal and also my timeline during my clinical rotation for this term. I will embrace, their minds and their © 2014 Laureate Education, Inc. Page 3 of 8 Journal One being , through honesty, understanding and compassion. Although this my beginning, I am working on developing the expertise to care for this unique clientele. Promotion of Self Care There are several nurse theorists and practices to psychotherapy, but the one nursing theory whom, with similar hypotheses is Doretha Orems cognitive theory (Kurtz & Schmidt 2016) The self-care theory is conditioned on the developmental stage, life experience, health, socio-cultural and available resources. The five concepts are universal self-care requisites that includes human structure and functioning (Mlinac & Feng2016). Two concepts that stand out with cognitive theory are balance between solitude/social interaction and prevention of hazards with life and wellbeing (Gibbons, et al 2019). The cognitive theory focuses, the mind, body and spirit, all works in unison for optimal health. When I evaluate a client, I will establish a trusting relationship, ensure the client is safe, secure and gather information to ensure optimal therapeutic relationship for goals to assist in the clients mental and emotional healing. I may discuss experiences and events, which may trigger emotional response. However, this will create a solution that will be effective for problem-solving (Kurtz & Schmidt 2016) . Orem’s theory provides social, interpersonal interaction based on client centered care. Foremost, communication will be adjusted to age and health status (Kurtz & Schmidt 2016). This will help to maintain interpersonal relationships for the coordination of care. I will always, maintain a therapeutic relationship for a holistic treatment plan. One therapeutic technique, which I may use more, with this population is Rational Emotive Behavioral Theory (REBT). © 2014 Laureate Education, Inc. Page 4 of 8 Journal One Rational Emotive Behavirol Theory REBT is being used as an effective technique for resilience for service members with history of PTSD and depression (Dryden & Bernard 2019). The fundamental contention of REBT , people are influenced by how they think, feel and perception of others. the goal of REBT is to assist clients in altering irrational beliefs and negative thinking patterns in order to overcome psychological problems and mental distress (Ellis, 2019). REBT utilizes the ABC of model of psychotherapy, addressing the activating event (circumstances,person,or behavior), the developed belief in the event, and the consequences of those beliefs.Once the client acknowledege the beleifs, the goal is to develop a positive change, towards irrational thinking /beliefs, this is done by dsputing the thinking/belief and create a new way of thinking (Dryden & Bernard 2019). . The client will discover the connection between the trigger the emotional and/or behavioral consequences which can cause ncreased distress or conflict (Dryden & Bernard 2019). Objective and Goals Goals and Objectives 1.I will create a trusting relationship with my clients so they can fully engage in the therapy process and provide all the necessary information so I can provide effective counseling, within the next 8 weeks of my clinical © 2014 Laureate Education, Inc. Page 5 of 8 Journal One 2. I will become familiar with different psychotropic medications that are the best fit for each diagnose. (Objective 1. Research various categories of medications using the resources within the medical center system by week 11. 3. I will increase my ability to interview clients, comfortably and therapeutically and create effective treatments for different diagnoses. (Objective 3 speak with my preceptor on techniques and ways improve for best results.) 4. .I will approach each clients situation differently as people come in with different problems and need distinct care. 7. I will Understand and discuss at least five psychotropic classifications and to be able to use them to the fullest ability by Week 11 of class. 8. Correctly identifying techniques to de-escalation cleints , by asking at each appointment session; Is there anything you would like to discuss? Is there anything bothering you right now? Is there anything or anyone makin you uncomofortable? 9. Establish and maintain a safety plan for my clients, by asking at each session and appointment, are you suicidal or homicidal? If so do you have a plan? Is there anyone hurting you? Are you hurting yourself? 10. I will provide a proper communication forum for both the client and I, so both of us can have time to talk and listen to each other appropriately. 11. I will help the clients to develop their own coping skills that they can use to manage stressors or other challenging situations 12. I will observe my preceptor on various psychotherapy and instructive techniques use on clients. 13. I will apply my classroom understanding into my clinical rotation and combine it with my preceptor’s training in order to acquaint myself with different psychotherapy options. © 2014 Laureate Education, Inc. Page 6 of 8 Journal One 14. I will engage and educate my client on the theory of self-care approach and psychoanalytic theory where client will be able to develop their own coping skills and use their past experience to manage their present situation (Kurtz & Schmidt .2016). Timeline The general timeline for this clinical is, educating myself on different psychotherapy approaches and conduct some psychotherapies by myself and experience the feeling of assisting someone who are having mental health issues. . References © 2014 Laureate Education, Inc. Page 7 of 8 Journal One American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author Barnhorst, A., Wintemute, G., & Betz, M. E. (2018). How should physicians make decisions about mandatory reporting when a patient might become violent? AMA journal of ethics, 20(1), 29-35. Dryden, W., & Bernard, M. E. (Eds.). (2019). REBT with Diverse Client Problems and Populations. Springer. Ellis, D. J. (2019). The Power and Compassion of Rational Emotive Behavior Therapy (REBT). In Scientific Concepts Behind Happiness, Kindness, and Empathy in Contemporary Society (pp. 178-189). IGI Global. Gibbons, M. B. C., Gallop, R., Thompson, D., Gaines, A., Rieger, A., & Crits-Christoph, P. (2019). Predictors of treatment attendance in cognitive and dynamic therapies for major depressive disorder delivered in a community mental health setting. Journal of Consulting and Clinical Psychology, 87(8), 745–755. https://doiorg.libproxy.umflint.edu/10.1037/ccp0000414 Hein, C. (2018). The Wounded Warrior: Resilience Factors Minimizing Suicide Risk in Veterans with Posttraumatic Stress Disorder. Kurtz, C., & Schmidt, N. (2016). Conceptualizing cognitive-behavioral therapy as a supportive-educative nursing system for patients with insomnia. Self-Care and Dependent-Care Nursing, 22(1) Mlinac, M. E., & Feng, M. C. (2016). Assessment of activities of daily living, self-care, and independence. Archives of Clinical Neuropsychology, 31(6), 506-516. 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 © 2014 Laureate Education, Inc. Page 8 of 8 Journal Two Student Name: Nina S Davis E-mail Address: nina.davis2@waldenu.edu Practicum Placement Agencys Name: Carl R Darnall Army Medical Center Preceptor’s Name: LTC Jennifer Schenck Preceptor’s Telephone: 254 553 6627 Preceptor’s E-mail Address: jennifer.m.schenck.mil@mail.mil Journal 2 Nina S Davis Walden University NUNP-6640A-4, Psychotherapy Individ.2020 Winter Quarter Dr. Tabitha Perrigo December 06, 2019 © 2014 Laureate Education, Inc. Page 1 of 7 Journal Two Time Log Week Dates Times Total Hours for This Time Frame Activities/Comments Learning Objective(s) Addressed 2 12/2/2 019 162100 5 Observed Clients 2 Intakes form the ED initiat ... Purchase answer to see full attachment