Category: Nursing

  • LEADERSHIP THEORIES IN NURSING PRACTICE

    No matter where you work and what you do, it is important to have great leadership to achieve common goals, inspire each other, and succeed as a team. It is hard to simply define what leadership is because it varies depending on a person’s characteristics, behaviors, situations, etc. Zonneveld and others (2021) divided transformational leaders into three types: relationship-dependent leadership, task-oriented leadership, and context-dependent leadership. It could be challenging to be a leader and have the balance of behaviors of all three leadership types in the healthcare system because there are many things you have to take into consideration, such as quality of care, organizational profit, trust from employees, quality of life, and cost-effectiveness, to name a few. This is how important it is to have a good leader for a team and for an organization. We need a leader.

    The two key insights that leaders have to have are their ability to build trust relationships between leaders and team members and to provide a supportive and encouraging work environment. “Followers have trust and respect for the leader and are motivated to do more than is formally expected of them to achieve organizational goals” (Uslu Sahan & Terzioglu, 2022). A leader needs to be a person whom we can get inspired, learn from, and trust. “No matter how brilliant the strategy or how productive the actions, if leaders do not hold the trust and act in the best interests of those they serve, they are not competent” (Broome & Marshall, 2021). One example of building trust and rapport is listening to them. I had a great figure of a leader in my previous workplace. She was a unit manager who’d been working there since she was a CNA a few decades ago. When I had just started working there, I noticed that her office was like a counseling office; everyone, including the charge nurse, floor nurses, doctors, CNAs, or even the director, would go and talk to her about anything. When I had a chance to have a conversation with her, I realized how good she is at listening. She would stop whatever she was doing at the time and give me the impression that she was paying 100% attention to me, trying to feel sympathy and understand my perspective of view. And this was the time that I thought of her as a great leader.

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    The second insight of leadership is encouragement and support towards team members. “Leadership is the discipline and art of guiding, directing, motivating, and inspiring a group or organization toward the achievement of common goals” (Broome & Marshall, 2021). My current director is inspiring nurses to grow professionally. She would precept nurses who are in master’s programs and encourage nurses to get LPS 5150 to write the involuntary psychiatric holds on psychiatric patients by offering us training to learn details about the legal process and stuff. A leader needs to motivate and support team members to grow and become better personally and professionally. It could affect their commitment to the organization and increase their job satisfaction, which leads to better performance in practice (Uslu Sahan & Terzioglu, 2022).

     

     

    Broome, M., & Marshall, E. S. (2021). 
    Transformational leadership in nursing: From expert clinician to influential leader
     (3rd ed.). New York, NY: Springer.

    Uslu Sahan, F., & Terzioglu, F. (2022). Transformational leadership practices of nurse managers: the effects on the organizational commitment and job satisfaction of staff nurses. 
    Leadership in Health Services
    , 
    35
    (4), 494–505. https://doi.org/10.1108/LHS-11-2021-0091

    Zonneveld, N., Pittens, C., & Minkman, M. (2021). Appropriate leadership in nursing home care: a narrative review. 
    Leadership in Health Services
    , 
    34
    (1), 16–36. https://doi.org/10.1108/LHS-04-2020-0012

     
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    Morayo Oloidi

    Morayo Oloidi

    Dec 23, 2022
    Dec 23, 2022 at 9:52am

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    Hello Aleyna,

    You have a great post! I totally agree with you that great leadership helps achieve common goals. Leadership is such an important issue facing the healthcare industry. Effective leadership is needed to achieve the quadruple aim in healthcare. The need for better quality care, more accessible access to care, better patient outcomes, and provider and consumer satisfaction will require nurses to focus on bedside care and leadership skills. I agree that transformational and EI leadership skills are effective styles that employees respond to (Broome & Marshall, 2021).

    Leaders are needed in all factions of organizations. The best leaders are not defined by position or title but rather by the ability to be a visionary that can inspire others. To strengthen leadership skills, knowledge is essential to understand our leadership strengths (Walden University L., 2018). Good leaders can get people to follow them down paths they may be hesitant to go. Through communication, respect, and integrity, strong leadership can effect change which is the future of healthcare (Walden University L., 2014).

    As the largest healthcare worker segment, nurses must actively pursue leadership roles. Due to their experience in the field, nurses have the knowledge to show up and participate in improving our craft. It requires speaking up, persistence, and determination. As a group, we need to stand up, take ownership, and take on problems. (Foundation, n.d.).

     

    References

    Broome, M. E., & Marshall, E. S. (2021). 
    Transformational Leadership in Nursing
     (3rd ed.). New York, N?y/: Springer Publishing Company.

    Foundation, M. (n.d.). 
    Nurses Share Lessons in Leadership
    . Retrieved from https://www.youtube.com: https://www.youtube.com/playlistlist=PLopRJP06GaifsYPGP_jcWXZzU10H3Aax7

    Walden University, L. (2012). Ethical, Moral, and Legal Leadership {Video File}. Baltimore, MD.

    Walden University, L. (Producer), & Walden University, L. [. (Director). (2014). 
    Leadership
     [Motion Picture].

    Walden University, L. (2018). Moral Leadership. Baltimore, MD.

    Walden University, L. (Producer), & Walden University, ,. L. (Director). (2018). 
    The Leader in you [Video File]
     [Motion Picture].

     
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    Shawntel Wright

    Shawntel Wright

    Dec 23, 2022
    Dec 23, 2022 at 7:13pm

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               Hello Aleyna; this was a very educational post. Having a leader take time to listen to their staff is very important. I didn’t see where there was always an exact resolution to each problem you discussed. “Problem-solving ability is related to a person’s critical thinking skills, and the development of these skills is considered a prerequisite.” (Kocoglu, et al) The leadership you described in your facilities unit manager describes my facility’s DON. She has been at my facility since she was an LPN, and many staff members can trust and rely on her leadership skills due to her therapeutic ways. It is easy to feel overwhelmed in this career but knowing that you have good structure and leadership guidance to fall back on makes improving worthwhile. My current work tends to have the opposite effect of encouragement to its team members sometimes, making it challenging to work in the environment when this happens. Therefore, it is essential to have the structure and support you mentioned. “The four main themes indicated that nurses experienced their workplace as non-supportive. Themes such as poor organizational climate, low social dignity, poor work conditions, and managers’ ignorance of individual and professional values were considered inhibitory support factors.” (Sodeify,2013)

     

     

     

                                                                 References

    Problem solving training for first line nurse managers
    . (n.d.). Retrieved December 24, 2022, from http://www.internationaljournalofcaringsciences.org/docs/24_kokoglu_originial_9_3.pdf

    Sodeify, R., Vanaki, Z., & Mohammadi, E. (2013, May). Nurses ‘experiences of perceived support and their contributing factors: A qualitative content analysis. Iranian journal of nursing and midwifery research. Retrieved December 23, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3748536/

     
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    Pauline Atianjoh

    Pauline Atianjoh

    Dec 24, 2022
    Dec 24, 2022 at 3:56pm

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    Aleyna,

    Additionally, I have also learned that different leadership styles affect every part of the organization right from the workplace morale to the overall effectiveness of the institution or the healthcare system. In healthcare, leadership styles are categorizations that describe the fundamental processes behind the actions of the leader (Fahlevi et al., 2022). For instance, in the transformational leadership style, there is a tendency of focusing on the shared values and ideas of forging relationships. These leaders have a strong vision and practice what they preach. The rational-legal authority leadership is where the authority of the leader is based on bureaucracy and legal legitimacy it can be tied to following rules and regulations in making decisions based on shared goals (Ofei & Paarima, 2022). In transactional leadership, there is an exchange between the leaders and the staff members who can form part of managerial leaders.

    References

    Fahlevi, M., Aljuaid, M., & Saniuk, S. (2022). Leadership Style and Hospital Performance: Empirical Evidence From Indonesia. Frontiers in Psychology, 13, 911640. https://doi.org/10.3389/fpsyg.2022.911640

    Ofei, A. M. A., & Paarima, Y. (2022). Nurse manager’s leadership styles and intention to stay among nurses at the unit in Ghana. The International journal of health planning and management, 37(3), 1663–1679. https://doi.org/10.1002/hpm.3433

     

     

     
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    Heather Fechko

    Heather Fechko

    Dec 21, 2022
    Dec 21, 2022 at 12:31am

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    MAIN POST

     

    The Impact of Leadership Behaviors in Creating Healthy Work Environments

    The world needs effective, visionary, and wide leaders to advance effective healthcare for society. (Broome & Marshall, 2021, pg. 3). Healthcare is constantly changing, which brings forth the need for leaders who can work with various health systems and in many different healthcare settings. Leaders are needed to transform healthcare systems, create solutions, collaborate with other leaders, improve patient care, and to inspire the next generation of healthcare leaders. (Broome & Marshall, 2021, pg. 4).

    One key insight that stands out to me by Mudallal et. al (2017) is that leadership is considered a key factor in creating workplace empowerment and maintaining a positive workplace. Many nurses have been forced to work as leaders, rather than leading in a position where they are experienced and trained in. Workplace empowerment pertains to an employee’s ability to access necessary information, resources, and support to perform their duties. The influence of leader empowering behaviors can improve nurses job satisfaction, quality of care provided, and reduce the level of nurse burnout. Mitigating the impact of burnout is key in improving nurse satisfaction to improve quality of patient care and decrease turnover rates (Mudallal et. al., 2017).

    Another key insight is how health-promoting leadership focuses on identifying leadership behaviors that positively influence the working environment (Jimenez, et. al., 2017). Creating positive working conditions that enhance and support employee health are important factors of health-promoting leadership. The authors also state that the six areas of work life that hold the highest organizational risk factors for burnout are community, control, fairness, reward, values, and workload. These work life factors are the key aspects of health-promoting leadership to have a positive effect on employee health and create a healthy working environment

     

    Leadership Through Example

               
    I worked with a wonderful leader during my first travel nursing contract. My favorite charge nurse taught me so many useful clinical skills. Instead of performing skills himself that he could have easily completed quickly, he would always take the time to teach me how to do it myself. For example, I had a patient that required a nasogastric tube placement. I was very quick to ask him to do the task and told him that I was not comfortable and had a bad experience in the past, which resulted in a negative patient outcome. He listened to me, but assured me that with the correct skills, the task would be performed correctly. He told me that he no longer wanted me to feel unconfident in this skill and that we would perform it together. First, he educated me with the policy and a video to review, if possible. Then, he allowed me to perform the skill, hands on, while instructing me through the process.

     

    Extent of Effectiveness and Practice Impaction of the Workplace

                
     The leadership skills demonstrated by the charge nurse at my travel contract was greatly effective in inspiring me to learn and perform duties outside of my comfort zone. He never made me feel embarrassed for not knowing something, but instead he gave me courage and satisfaction from the knowledge I gained during my contract. This leader gave me support in accessing the resources and information necessary to perform my job to the best of my ability. He empowered me to be a better nurse, which improved the care I provided to patients and increased my base of knowledge. Improving my skillset and the care that I provided to patients led to improved satisfaction in my job and career as a nurse. Due to the satisfaction and comfort I felt at this workplace, I extended my contract and continued providing nursing care at this facility.

     

    References

    Broome, M., & Marshall, E. S. (2021). 
    Transformational Leadership in Nursing: From Expert

             Clinician to Influential Leader
     (3rd ed.). New York, NY: Springer.

     

    Jiménez, P., Winkler, B., & Dunkl, A. (2016) Creating a healthy working environment

    with leadership: the concept of health-promoting leadership, 
    The International Journal of

               Human Resource Management,
     28
    :17, 2430-2448, 
    https://doi.org/10.1080/09585192.2015.1137609
    Links to an external site.

     

    Mudallal, R. H., Othman, W. M., & Al Hassan, N. F. (2017). Nurses’ Burnout: The Influence of

    Leader Empowering Behaviors, Work Conditions, and Demographic Traits. 
    Inquiry : A

              Journal of Medical Care Organization, Provision and Financing
    , 
    54
    , 46958017724944.

    https://doi.org/10.1177/0046958017724944
    Links to an external site.

     
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    Jacqueline Keener

    Jacqueline Keener

    Dec 21, 2022
    Dec 21, 2022 at 8:19am

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    Heather,

    It sounds like you have had the opportunity to work with a wonderful nurse leader as well! I appreciate that you mentioned a policy and video review before performing a task supervised. This is such an important step that I feel sometimes gets overlooked. Stucky, Wymer, & House (2022) also emphasize workplace empowerment and the importance of strong interprofessional relationships. It helps me to remember that the interactions I have with my team are those of a working relationship. I must stay aware of appropriate interactions and ensuring I am thinking of the team rather than myself. It’s a good reminder to think of our mission and values. I enjoy how you described feeling inspired by your travel nurse leader to get out of your comfort zone. Tschannen et al. (2021) describe the importance of nurse leaders to encourage and inspire “frontline staff and APRNs to be engaged in improvement initiatives to truly make a difference in quality.” This is just another example of the importance of nurse leaders to get all levels of staff involved with quality and improvement! Thank you for another great discussion post this week!

    Jackie K

    References

    Stucky, C. H., Wymer, J. A., & House, S. (2022). Nurse Leaders: Transforming Interprofessional Relationships to Bridge Healthcare Quality and Safety. 
    Nurse Leader
    , 
    20
    (4), 375–380. 
    https://doi.org/10.1016/j.mnl.2021.12.003
    Links to an external site.

    Tschannen, D., Alexander, C., Taylor, S., Tovar, E. G., Ghosh, B., Zellefrow, C., & Milner, K. A. (2021). Quality improvement engagement and competence: A comparison between frontline nurses and nurse leaders. 
    Nursing Outlook
    , 
    69
    (5), 836–847. https://doi.org/10.1016/j.outlook.2021.02.008

     
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    Carolyn Hart

    Carolyn Hart

    Dec 21, 2022
    Dec 21, 2022 at 3:48pm

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    Heather,

    You very clearly illustrate something that we will look at later on in this course: the role of a leader in creating a healthy work environment. While we cannot control things like the shortage of nurses and pandemics, we can control our response. Good leaders hold their unit together and keep things on a positive note no matter the circumstances. Poor leaders retreat and do not support staff. In the former (as Heather notes in her post) nurse retention is high and you have a great work environment. In the latter, you can see a toxic work culture develop. Remember this as we move into our analysis of work environments!

    Dr. Hart

     
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    Heather Fechko

    Heather Fechko

    Dec 22, 2022
    Dec 22, 2022 at 10:07pm

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    Thank you, Dr. Hart.

    I look forward to learning more about the role of a leader in creating a healthy work environment.

    Heather

     
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    Aleyna Soyoung Shin

    Aleyna Soyoung Shin

    Dec 22, 2022
    Dec 22, 2022 at 12:17am

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    Hi Heather, thanks for sharing your thoughts and information. Having empowering and positively influencing leaders in nursing advances effective healthcare for the community. Sadly, I have to agree with you that in many cases, people get forced to become leaders because they do not want to take all the responsibility and extra duties as leaders of the team. One of the charge nurses I have worked with said, “if I work at different places, I will make way more money. I’m only staying because they need me”. This did not give me a good impression of the work environment at the hospital; by looking at the leaders of the organizations, we can tell what kind of workplace cultures they are in. Empowerment is such an important concept in nursing as in teamwork is a key factor. Nurse leaders’ empowering behaviors can “promote positive outcomes, including quality patient care and stabilization of the nursing workforce,” promoting collaborative work environment (Cziraki et al., 2020). Also, empowering leaders is highly related to increased trust in management, job satisfaction among nurses, and reduced level of burnout (Rola et al., 2017). I actually had a great figure of an empowering leader in my first job. She was my preceptor who became a charge nurse a year later. She was one of the most experienced nurses on the floor and the “IV person” on the floor. Whenever I had new procedures or skills I’d never done, she would explain step by step, demonstrate for me for the first time and let me do the hands-on with her supervising next to me. Even after she became a charge nurse, she was my go-to person whenever I had questions or had a hard time performing some skills, and she was more than happy to teach me. She also commented that she was proud that I was her preceptee and I was becoming like her. It was such a compliment to hear that she was proud of me because I admired and respected her professionally and personally. I ended up staying in that hospital more than I expected, and she was one of the main reasons that I could not leave. I really do not think I could have become the nurse I am now if I did not have her when I started my nursing career.

     

    Cziraki, K., Wong, C., Kerr, M., & Finegan, J. (2020). Leader empowering behaviour: relationships with nurse and patient outcomes. Leadership in Health Services (1751-1879), 33(4), 397–415. https://doi.org/10.1108/LHS-04-2020-0019

    Mudallal, R., Othman, W., & Hassan , N. (2017). Nurses’ Burnout: The Influence of Leader Empowering Behaviors, Work Conditions, and Demographic Traits. Inquiry: The Journal of Health Care Organization, Provision, and Financing, 54. https://doi.org/10.1177/0046958017724944

     

     
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    Julie Baker

    Julie Baker

    Dec 24, 2022
    Dec 24, 2022 at 9:28am

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    Aleyna,

    It sounds like your preceptor is an excellent mentor. I am the type of person who must actually do the tasks to learn. You can tell me something over and over but until I put it into practice, it doesn’t really click for me. Learning new skills in the workplace versus school labs help nurses be more prepared to work independently as graduate nurses (Hägg-Martinell et al., 2020). Putting this concept into practice has propelled me to try to be involved in any learning opportunity that I could and now I’m the “IV person” in facilities I travel to. I also believe that nursing leaders should encourage lifelong learning opportunities because this will lead to development of competency and better patient care outcomes (Qalehsari et al., 2017).

     

    Hägg-Martinell, A., Hult, H., Henriksson, P., & Kiessling, A. (2020, January 13). 
    Nursing students learn to handle stress and to prioritize in a complex context during workplace learning in Acute Internal Medicine Care – an ethnographic study
    . Advances in medical education and practice. Retrieved December 24, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6971285/

    Qalehsari, M. Q., Khaghanizadeh, M., & Ebadi, A. (2017, October 25). 
    Lifelong learning strategies in nursing: A systematic review
    . Electronic physician. Retrieved December 24, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5718860/

     
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    Kandice Waters

    Kandice Waters

    Dec 24, 2022
    Dec 24, 2022 at 1:47pm

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    Module 3. Response 2.

    Hello Heather, 

    As nurses, we are often limited in time and tasked with an overwhelming workload. A poor leader would have done the task themselves to save time. In your situation, however, your charge nurse demonstrated the true definition of a transformational leader by motivating you to learn the task, which helped to promote positive long-term change. Transformational leadership is a style of leadership that can inspire and influence positive outcomes (Walden, 2014). A transformational leader will also help guide and direct team members toward achieving their goals (Broome & Marshall, 2021). 
     

    References

    Broome, M., & Marshall, E. S. (2021). 
    Transformational leadership in nursing: From expert clinician to influential leader
     (3rd ed.). New York, NY: Springer.

    Walden University, LLC. (Producer). (2014). Leadership [Video file]. Baltimore, MD: Author

     
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    Hanna Sacher

    Hanna Sacher

    Dec 23, 2022
    Dec 23, 2022 at 2:13pm

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    Response #1

    Hi Heather,

    As you stated, healthcare is always evolving and requires the employment of leaders that can work with a variety of health systems in different settings. The word that comes to my mind to describe this necessity when reading your post is adaptability. Without the ability to adapt to different not only healthcare environments but different patient personalities, the leader must be able to adapt to a variety of possibilities. This leads to the best possible patient outcomes in addition to a healthy work environment for the leader and their employees. Joel Sauer (2020) states that it is of significant importance that leaders in healthcare embrace environments of adaptability as this contributes to the survival of an organization.

    I think it’s great that your charge nurse taught you by having you perform the clinical activity as opposed to performing the task for you as most nurses are hands on learners. There have been many times where one of my clinical instructors would show me by performing the task themselves, and when I attempted to do it independently, I felt clueless! As a nurse, this is very intimidating. “Behaviorists believe that learning is a change in an observable behavior and it happens when the communication occurs between the two events, a stimulus and a response” (Aliakbari et al., 2015) Observing a process and learning it by creating a response from a stimulus, otherwise known as hands-on learning is greatly beneficial in learning a variety of processes efficiently.

    References

    Aliakbari, F., Parvin, N., Heidari, M., & Haghani, F. (2015). Learning theories application in nursing education. https://doi.org/10.4103/2277-9531.151867.

    Joel Sauer, M. B. A. (2020, August 27). 
    Adaptability as a permanent attribute of health care
    . Cardiac Interventions Today. https://citoday.com/articles/2020-july-aug/adaptability-as-a-permanent-attribute-of-health-care#:~:text=Even%20beyond%20a%20pandemic%2C%20it%20is%20imperative%20that,top%20of%20the%20organization%20or%20require%20its%20approval.

     

     

     
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    Morayo Oloidi

    Morayo Oloidi

    Dec 24, 2022
    Dec 24, 2022 at 4:16pm

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    Hello Heather, your post is well organized and informative. Leadership plays a vital role in any organization. I want to add that the practice of transformational leadership refers to a type of leadership in which leaders encourage, inspire, and motivate workers to innovate and create change that will contribute to the growth and future success of the firm. Transformational executives are known as transformational leaders (Asbari et al., 2020). It is possible to achieve this goal through demonstrating leadership at the senior level, fostering a robust sense of corporate culture, encouraging employee ownership, and fostering a culture of independence in the workplace. Transformational leaders can inspire and motivate their workforce without micromanagement because they have faith in their employees’ ability to make decisions independently within the context of their jobs. It’s a type of management meant to free up workers’ creative potential, encourage them to keep an eye on the future and inspire them to come up with novel answers to age-old issues (Broome & Marshall, 2021). Mentorship and training will be provided to employees on the leadership track to develop the skills necessary to become transformative leaders themselves.

     

                                                                                                             References

    Asbari, M., Santoso, P. B., & Prasetya, A. B. (2020). Elitical And Antidemocratic Transformational Leadership Critics: Is It Still Relevant?(A Literature Study). 
    INTERNATIONAL JOURNAL OF SOCIAL, POLICY AND LAW
    , 
    1
    (1), 12-16.

    Broome, M., & Marshall, E. S. (2021). 
    Transformational leadership in nursing: From expert clinician to influential leader
     (3rd ed.). New York, NY: Springer.

     
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    Yvonne Oglesby-Moore

    Yvonne Oglesby-Moore

    Dec 24, 2022
    Dec 24, 2022 at 10:45pm

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    Response #2

    Hi Heather,

    Thank you for your post. Leaders should be visionary and have the ability to recognize talent. I like an authentic leader who is transparent and keeps communication open. Broome and Marshall (2021), describe the authentic leadership model as one that emphasizes relationships between leaders and followers to accomplish goals. It is important for leaders to understand their staff and their needs to be effective. Deveau and McGill (2016), explain that frontline management is essential to mentoring and educating staff to have positive outcomes. I think all leaders should guide their staff according to the mission and vision.

     

    Broome, M., & Marshall, E. S. (2021). 
    Transformational leadership in nursing: From expert clinician to influential leader
     (3rd ed.). New York, NY: Springer.

    Deveau, R. & McGill, P. (2016). Impact of practice leadership management style on staff experience in services for people with intellectual disability and challenging behavior: a further examination and partial replication
    . Research in Development Disabilities
    . (56) 160-164.

     

     
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    Ashtyn Mcquaid

    Ashtyn Mcquaid

    Dec 21, 2022
    Dec 21, 2022 at 8:44am

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    Main Post

    Transformational Leadership

     

    Transformational leadership is a style of leadership that can inspire, motivate, and influence positive outcomes (Walden, 2014). Transformational leaders rely on past experiences, emotional intelligence, and individual traits to foster a positive work environment (Walden, 2014).  The best transformational leaders will be able to build positive relationships with their staff. In her article 
    Transformational leadership in nursing: a concept analysis
     Shelly Fischer concludes that transitional leaders are associated with “high-performing teams and improved patient care” (2016).

    One of my past assistant managers was a transitional leader. She would help us on the unit in any way because she’s “still a nurse”. She’d fill in as charge or on an assignment. As stated in the article by Doody & Doody, one of the keys of transitional leadership is “supportive environments where responsibility is shared” (2020).

    I make sure I follow this model in my practice. When I am the charge nurse, I help the other nurses in whatever ways I can. It always seems to make the shift smoother when everyone works together to keep the patients safe and happy.

     

    References

    Doody, O., & Doody, C. M. (2012). Transformational leadership in nursing                practice. 
    British journal of nursing, 21(20),
     1212–1218.                https://doi.org/10.12968/bjon.2012.21.20.1212

    Fischer S. A. (2016). Transformational leadership in nursing: a concept                analysis. 
    Journal of advanced nursing, 72(11),
     2644–2653.                https://doi.org/10.1111/jan.13049

    Walden University, LLC. (Producer). (2014). Leadership [Video file]. Baltimore,                MD: Author

     
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    Kandice Waters

    Kandice Waters

    Dec 21, 2022
    Dec 21, 2022 at 10:06am

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    Week 4. Main Discussion Post

    Transformational leadership is a leadership style that empowers people to 
    accomplish positive change 
    through big vision, inspiration, and a call to action (Baker, 2022). Leadership expert James Burns defined transformational leaders as “Those who seek to change existing thoughts, techniques, and goals for better results and the greater good.” (
    What Is Transformational Leadership
    , 2014). 

    A leader I have selected that I have seen such behaviors includes my clinical nurse manager (CNM) Sarah. Sarah is an excellent transitional leader; she always seeks to improve patient care and teammate dynamics. One example of how she demonstrated transitional leadership was our clinic’s approach to introducing patients to home hemodialysis. 

    Most patients are unaware that they have ESRD and end up in the hospital with fluid overload and shortness of breath. Patients are told to do dialysis in-center three times a week to survive; however, they are not educated on different modality choices. Sarah identified a lack of modality education as a significant problem within our clinic. Sarah collaborated with the intradialytic team to address the lack of patient modality education. She introduced several solutions, starting with the need for a nephrologist to educate patients on modality choices while they are still admitted to the hospital. The patient, therefore, can bypass being placed in-center and is more involved in modality choice, ultimately leading to better patient outcomes. 

    One of the critical advocacies of transformational leaders is to challenge the current organizational culture to determine ways to improve organizational practices and procedures (Hill, 2013). Sarah challenged the entire intradialytic team to change our approach to how patients are being educated on modality and provided techniques and goals for better patient outcomes and the greater good. She is truly an inspiration and a prime example of a transformational leader. 

    References

    Baker, C. (2022, December 16). 
    What Is Transformational Leadership?
     Leaders. 

    What Is Transformational Leadership?


    Links to an external site.

    Hill, N. (2013, May 17). 
    Four Components of the Transformational Leadership Style
    . Passion for Fresh Ideas. 

    FOUR COMPONENTS OF THE TRANSFORMATIONAL LEADERSHIP STYLE


    Links to an external site.

    What is Transformational Leadership? How New Ideas Produce Impressive Results
    . (2014, November 25). STU Online. 

    What is Transformational Leadership? How New Ideas Produce Impressive Results


    Links to an external site.

     
    Reply
    Reply to Comment

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    Carolyn Hart

    Carolyn Hart

    Dec 24, 2022
    Dec 24, 2022 at 11:43am

    Manage Discussion Entry

    Kandace,

    Great post!! In talking about the effect of a great leader on staff, you made me think about something that had  not come up in discussion posts (yet). Do we really take time to think about ourselves as leaders? 
    Price-Dowd (2020) 
     
    Links to an external site.
    wrote a very short article about why it is important to take time and think through a self assessment. Here is a link to her article.

    Kandace and class, We are going to start moving in to new topics in this course with one of them being a greater understanding of yourself as a leader. Based on Price-Dowd’s article, why would I want you to do this?

    Dr. Hart

     

     
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    Kandice Waters

    Kandice Waters

    Dec 23, 2022
    Dec 23, 2022 at 8:52pm

    Manage Discussion Entry

    Module 3. Response 1.

    Hello Ashtyn,

    Transformational nurse leaders motivate and empower their teammates to reach their professional goals and are often mentors that lead by example (
    Transformational Leadership in Nursing
    , 2021). I used to have a manager that would work remotely; I would only see her once every other week. I would receive random emails regarding my performance, needs for improvement, and clinical evaluation scores. I was highly frustrated and felt like I was being micromanaged based on clinical statistics rather than having a leader who was actively involved. A leader must be actively engaged with their team and, as stated above, lead by example.

    Another essential component of being a transformational leader includes individualized consideration. The leader must provide individual feedback and recognition and ensure that each team member knows their voice is valued in the organization (Hill, 2013). I never felt I had appropriate feedback or recognition because my manager was absent. I am glad you had a manager that was actively involved in teamwork.

    References

    Hill, N. (2013, May 17). 
    Four Components of the Transformational Leadership Style
    . Passion for Fresh Ideas. 

    FOUR COMPONENTS OF THE TRANSFORMATIONAL LEADERSHIP STYLE


    Links to an external site.

    Transformational Leadership in Nursing
    . (2021, February 26). The University of Alabama in Huntsville. 
    https://online.uah.edu/degrees/nursing/msn-administration/transformational-leadership/
    Links to an external site.

     

     
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    Aleyna Soyoung Shin

    Aleyna Soyoung Shin

    Dec 24, 2022
    Dec 24, 2022 at 1:06am

    Manage Discussion Entry

    Hi Ashtyn, thanks for sharing your thoughts and information. To be a good transformational leader, I think one needs to have experience, be knowledgeable and patient, be supportive of team members, and stay positive. The most important part of it is that the leader is trusty. Building trust relationships with other staff is fundamental, yet essential for transformational leaders to create a supportive and positive work environment for the whole team. “No matter how brilliant the strategy or how productive the actions, if leaders do not hold the trust and act in the best interests of those they serve, they are not competent” (Broome & Marshall, 2021). Your past assistant manager knows how to gain the trust of team members. Instead of stepping out, saying, “I’m a manger. I do not work on the floor,” a leader can show that we work as a team, and he or she will be there to help and support the team when it’s needed, not leaving anyone behind. By doing so, team nurses would be able to trust this leader’s capability to lead the team successfully. Loss of trust in a leader can lead to environmental toxicity, but in contrast, “high-trust environments correlate positively with high degrees of staff engagement, commitment, and organizational success”

     

     

    Broome, M., & Marshall, E. S. (2021). 
    Transformational leadership in nursing: From expert clinician to influential leader
     (3rd ed.). New York, NY: Springer.

    Sherman, R. (2016). Building trust in your leadership. 
    American Nurse. https://www.myamericannurse.com/building-trust-in-your-leadership/#:~:text=Nurses%20deeply%20value%20leaders%20who,%2C%20commitment%2C%20and%20organizational%20success.

     
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    Tyesha L Sullivan

    Tyesha L Sullivan

    Dec 21, 2022
    Dec 21, 2022 at 11:27am

    Manage Discussion Entry

    “Few nurses would argue that practice innovation, quality improvement, and effective care delivery require leadership” (Miles and Scott, 2019). Leadership is essential for the future of nursing and healthcare in general. Marshall and Broome states that, ” there is a growing need for better leadership in healthcare” (2017). Whats makes a leader great or even good? Two traits of a great leader are identified as having knowledge and being self-aware.

    One leader I have encountered who encompasses the leadership skills of knowing, doing, and being is a nurse manager whom I have worked with for the past 5 years in the ED. He consistently exhibits the ability to influence others and facilitates shared objectives amongst the nurses he leads. One “lead by example” aspect of his leadership has been his ability to develop protocols for our organization to follow. “Wise leaders are purpose driven to serve others, ask different questions, seek multiple perspective and see and think systems” (Pesut and Thompson, 2017). He consistently asks the appropriate and thoughtful questions to our administrators to keep our organization in best practice. Another example is him meeting with the administrators to establish for our care standards within our clinics. The development of leadership skills and ultimately, wisdom, is accomplished through intentional learning, experience, reflection, insight, coaching, and mastery of different action logics (Pesut and Thompson, 2017).

    References

    Marshall, E., & Broome, M (2017). Transformational leadership in nursing: From expert clinician to influential leader (2nd ed.). New York, NY: Springer

    Miles, J. M., & Scott, E. S. (2019). A New Leadership Development Model for Nursing Education. 
    Journal of Professional Nursing, 35
     (1), 5-11. 
    https://doi.org.ezp.waldenlibrary.org/10.1016/j.profnurs.2018.09.009
     
    Links to an external site.

    Pesut, D. J., & Thompson, S. A. (2018). Nursing leadership in academic nursing:The wisdom of development and the development of wisdom. 
    Journal of Professional Nursing, 34 
    (2), 122-127. 
    https://doi-org.ezp.waldenlibrary.org/10.1016/j.profnurs.2017.11.004
     
    Links to an external site.

     
    Reply
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    Harmon Mann

    Harmon Mann

    Dec 21, 2022
    Dec 21, 2022 at 1:07pm

    Manage Discussion Entry

    To become a successful leader in nursing it’s essential that you have the skills and behaviors necessary to make you an effective leader. Some of these include “ seeking feedback, shared decision making and interpersonal communication” (Razavi, et.al, 2022). It’s very important for a leader to have good communication skills so they are able to discuss matters with their staff and resolve any problems that may arise.

    In Moura, et.al, 2019, the researchers concluded that a “ charismatic leadership is considered an important skill for nursing professionals as they generate a positive influence on followers, especially in times of crisis and changes.”  A charismatic leader is able to communicate efficiently with their staff and is able to motivate their staff to meet their goals. They are able to have good relationships with their staff and offer help when it’s needed. When there is a crisis they are able to work with their staff and come up with a solution.

    In Pal, 2022, a pacesetting leadership was discussed which is another type of leadership style that is effective in the nursing field. It’s a type of leadership that gets results fast, by solving problems right when they arise. A leader will likely jump in and help out staff so they can complete the tasks fast. This type of leader will likely discuss goals for the day and discuss how the goals will be met and what steps need to be taken. If anyone needs help getting the goals done they will likely jump in and offer their assistance.

    The supervisor on our med-surg/telemetry floor had a combination of both of these leadership skills. She was very charismatic and everyone loved having her as our supervisor, because she would listen to our problems, got along with everyone and was always there to help. Before she would go off the floor anywhere she would always ensure everyone was okay and no one needed anything. At the beginning of our shift she would go through the assignments and make sure they were fair for all the nurses. She would jump in and help whenever there was a code and she was always the first call whenever anyone had a problem they needed help with. She was a great leader for our floor, because not only did she always offer help when anyone needed it, but she listened to our problems and would discuss any issues we had with the manager to get it resolved. Having her as our supervisor was great, because I always felt at ease going in for my shift. I knew if there was a problem or if I had questions about anything I could always approach her and she would help me with everything. She also always remained calm whenever there was a crisis, which helped the staff remain calm and get things done that needed to be done. She was always just a call away and if you called and said you needed her help she would be there within minutes.

     

    Moura, A., Hayashida, K., Bernardes, A., Zanetti, A., & Gabriel, C. (2019, February 27). 
    Charismatic leadership among nursing professionals: An integrative review
    . Revista brasileira de enfermagem. Retrieved from 
    https://pubmed.ncbi.nlm.nih.gov/30942378/
    Links to an external site.

    Pal, R. K. (2022, October). Leadership: An Introductory Overview. 
    Journal homepage: www. ijrpr. com ISSN
    , 
    2582
    , 7421.

    Razavi, N., Jalili, M., Sanders, J., & Gandomkar, R. (2022, February 14). 
    Leadership behaviors in Health Care Action Teams: A Systematized Review
    . Medical journal of the Islamic Republic of Iran. Retrieved from https://pubmed.ncbi.nlm.nih.gov/35999940/

  • Noah Caputo dermatology shadow health objective data

    Noah Caputo dermatology shadow health objective data

    Objective Data Collection: 8 of 8 (100.0%)

     Correct

     Partially correct

     Incorrect

     Missed

     Inspected General Appearance

    1 of 1 point

    Clothing 
    (1/3 point)

     Clean clothing, appropriate for age, fit, season and occasion

     Dirty, disheveled, or inappropriate to age, fit, season or occasion

    Noah Caputo dermatology shadow health objective data

    Odor 
    (1/3 point)

     Odor detected

     No odor detected

    Posture 
    (1/3 point)

     Upright posture without tension or rigidity

     Bent or hunched posture, tension or rigidity

     Inspect Head

    1 of 1 point

    Inspect Skin Head 
    (1/1 point)

     Benign

     Abrasions

     Dandruff

     Erythema

     Lice

     Macules

     Papules

     Pustules

     Skin Breakdown

     Vesicles

    PLACE YOUR ORDER NOW

     Inspect Arms

    1 of 1 point

    Inspect Skin Arms 
    (1/1 point)

     Benign

     Abrasions

     Erythema

     Lice

     Macules

     Papules

     Pustules

     Skin Breakdown

     Vesicles

     Inspect Torso

    1 of 1 point

    Inspect Skin Torso 
    (1/1 point)

     Benign

     Abrasion

     Erythema

     Lice

     Macules

     Papules

     Pustule

     Skin Breakdown

     Vesicles

     Inspect Legs

    1 of 1 point

    Inspect Skin Legs 
    (
    1/1 point
    )

     Benign

     Abrasions

     Erythema

     Lice

     Macules

     Papules

     Pustules

     Skin Breakdown

     Vesicles

     Auscultate Heart

    1 of 1 point

    Heart Sounds 
    (1/4 point)

     S1 and S2 audible

     S1, S2 and S3 audible

     S1, S2, and S4 audible

     S1, S2, S3, and S4 audible

    Noah Caputo dermatology shadow health objective data

    Extra Heart Sounds 
    (1/4 point)

     No extra heart sounds

     Gallups

     Murmur

     Friction rubs

    Rate 
    (1/4 point)

     Regular rate

     Irregular rate

    Rhythm 
    (1/4 point)

     Regular rhythm

     Irregular rhythm

     Auscultate Lungs

    1 of 1 point

    Appearance 
    (1/4 point)

     Accessory muscle use

     No distress

    Symmetry 
    (1/4 point)

     Symmetrical chest rise and fall

     Asymmetrical chest rise and fall

    Breath Sounds 
    (1/4 point)

     Clear in all areas

     Diminished in some areas

     Absent in some areas

    Adventitious Sounds 
    (1/4 point)

     No adventitious sounds

     Wheezing

     Crackles

     Stridor

     Rhonchi

     Palpate Rash

    1 of 1 point

    Palpated Rash 
    (1/2 point)

     Tenderness with palpation

     Non-tender with palpation

    Temperature 
    (1/2 point)

     Cold

     Warm

     Hot

    Noah Caputo dermatology shadow health
    objective data

  • NRNP/PRAC 6645 Comprehensive Psychiatric Evaluation Note Template

    NRNP/PRAC 6645 Comprehensive Psychiatric Evaluation Note Template

    NRNP/PRAC 6645 Comprehensive Psychiatric

    Evaluation Note Template

    CC
    (chief complaint): “Chaos at her household”

    HPI
    : Mrs. P is a 40-year-old Iranian female who presented to the psychiatric unit due to chaos in her household. She is accompanied by her 23-year-old daughter for therapy. The patient is an immigrant from Iran, as she moved to the United States 12 years back with 4 of her children as one was left behind at the age of 8 years. She however got her visa 2 years ago and was able to bring the fifth child to the Country. She reports a history of trauma from domestic violence and physical abuse from her husband. The child who was left behind in Iran was also sexually assaulted by her father. The mother feels overwhelmed, hopeless and helpless, as her daughters blame her for the traumatic events. She claims that her daughters are out of control. The family has attended family therapy sessions twice. Mrs. P reports that she has been leading a traditional lifestyle, separate from her children who have adopted a different lifestyle and failing to spend time with her. She is currently disabled from two feet surgeries. She is lonely and helpless as she lives alone NRNP/PRAC 6645 Comprehensive Psychiatric Evaluation Note Template.

    BUY PLAGIARISM-FREE WORK HERE

    Past Psychiatric History
    :

    G
    eneral Statement: The patient is lonely and depressed from living alone without seeing her children every day.

    C
    aregivers (if applicable): three daughters and two sons, who help support the patient.

    H
    ospitalizations: Reports a history of foot surgeries done twice.

    M
    edication trials: None

    P
    sychotherapy or
    P
    revious Psychiatric Diagnosis: The family has a history of traumatic experiences and reports taking part in both individual and family therapy.

    Substance Current Use and History:
    None provided. Can be collected through interviews. Helpful in determining the risks of substance use disorder.

    Family Psychiatric/Substance Use History:
    The patients report a history of physical and sexual abuse from her husband. Her daughter who was left in Iran, was also sexually and physically abused by her father.

    Psychosocial History:
    Mrs. P was born and raised in Iran. She was married to an abusive husband the made her migrate to the United States. She has five children, three daughters, and two sons. She is Muslim, with a traditional lifestyle. She likes watching religious teaching and playing video games when alone.

    Medical History:

     

    Current Medications
    : None. This information is important in selecting a medication for the management of the present mental illness.

    Allergies
    : None

    Reproductive Hx
    : Heterosexual. Normal birth of five children, two sons, and three daughters.

    ROS
    : None provided. A review of systems through interviewing the patient is crucial in ruling out comorbid medical conditions.

    Physical exam:
    The patient’s vitals and examination of the musculoskeletal system are necessary for further assessment of her disability from the previous surgeries NRNP/PRAC 6645 Comprehensive Psychiatric Evaluation Note Template.

    Diagnostic results
    : The following lab works would be necessary to help rule out comorbid medical conditions: TSH, CMP, CBC, and Testing for infections like hep C, and HIV. The  Beck Depressive Inventory and Hamilton-anxiety rating scale can be utilized among all family members for the development of differential diagnosis (Salas-Wright et al., 2018).

    Assessment

    Mental Status Examination: The mental status examination of the patient and her daughter was not provided. However, from the information shared in the video, they seemed both well-groomed and appropriately oriented in time place, and person. They were cooperative during the interview, maintaining eye contact and appropriate use of other nonverbal cues. The mood was appropriate for the situation. The affect was full range. Logical thought process. Intact short-term and long-term memory. Appropriate judgment. They however both displayed depressed and anxious moods. No history of hallucination, suicidal or homicidal ideation NRNP/PRAC 6645 Comprehensive Psychiatric Evaluation Note Template.

    Differential Diagnoses:

    Major depressive disorder: The patient reports feeling lonely, hopeless, and helpless which are indicating signs of MDD (Kennedy, 2008). She also reports a history of trauma which might have triggered the depression.

    Reactive attachment disorder: The patient reports that her daughters are out of control. One of them got married, while the others are leading an independent lifestyle leaving her alone with the last-born son (Bruce et al., 2018).

    Adjustment disorder: The patient’s oldest daughter was sexually abused by her father for two years when she was left in Iran by her mother. Moving to the United States might have contributed to a combination of mental and emotional disturbances including depression and anxiety (O’Donnell et al., 2019).

    Case Formulation and Treatment Plan:

    The case involves a depressed mother who feels lonely and helpless as she is disabled and living with only her youngest son, with her other four children away from her home. She feels like her daughters are out of control, leading to a chaotic situation (Salas-Wright et al., 2018).

    Treatment Plan: Psychotherapeutic interventions including family therapy and cognitive behavioral individual therapy is appropriate to help the family overcome their difficulties in communication and manage their history of trauma (Franz & McKinney, 2018).

    Reflections:
    The provided video demonstrates a middle age Iranian female, as a victim of physical and sexual abuse, together with her firstborn daughter. She moved to the United States, where she had her other four children, and is currently experiencing a chaotic household. The main cause of the chaotic environment is the difference in their lifestyle, as their mother follows the Muslin value, while her daughters have adopted the western lifestyle (Franz & McKinney, 2018). However, with continuous family therapy, they will develop appropriate skills to help promote a common understanding and support each other in overcoming their history of trauma NRNP/PRAC 6645 Comprehensive Psychiatric Evaluation Note Template.

    References

    Bruce, M., Young, D., Turnbull, S., Rooksby, M., Chadwick, G., Oates, C., Nelson, R., Young-Southward, G., Haig, C., & Minnis, H. (2018). Reactive Attachment Disorder in maltreated young children in foster care. 
    Attachment & Human Development
    , 
    21
    (2), 152–169.
    https://doi.org/10.1080/14616734.2018.1499211

    Franz, A. O., & McKinney, C. (2018). Parental and Child Psychopathology: Moderated Mediation by Gender and Parent–Child Relationship Quality. 
    Child Psychiatry & Human Development
    , 
    49
    (6), 843–852.
    https://doi.org/10.1007/s10578-018-0801-0

    Kennedy, S. H. (2008). Core symptoms of major depressive disorder: relevance to diagnosis and treatment. 
    Dialogues in Clinical Neuroscience
    , 
    10
    (3), 271–277.
    https://doi.org/10.31887/dcns.2008.10.3/shkennedy

    O’Donnell, M. L., Agathos, J. A., Metcalf, O., Gibson, K., & Lau, W. (2019). Adjustment Disorder: Current Developments and Future Directions. 
    International Journal of Environmental Research and Public Health
    , 
    16
    (14), 2537.
    https://doi.org/10.3390/ijerph16142537

    Salas-Wright, C. P., Vaughn, M. G., Goings, T. C., Miller, D. P., & Schwartz, S. J. (2018). Immigrants and mental disorders in the united states: New evidence on the healthy migrant hypothesis. 
    Psychiatry Research
    , 
    267
    , 438–445. https://doi.org/10.1016/j.psychres.2018.06.039 NRNP/PRAC 6645 Comprehensive Psychiatric Evaluation Note Template

    ‌

  • Biological basis and ethical/legal considerations of psychotherapy discussion essay

    Biological basis and ethical/legal considerations of psychotherapy discussion essay

    BY DAY 3

    Post
     an explanation of whether psychotherapy has a biological basis. Explain how culture, religion, and socioeconomics might influence one’s perspective on the value of psychotherapy treatments. Describe how legal and ethical considerations for group and family therapy differ from those for individual therapy, and explain how these differences might impact your therapeutic approaches for clients in group, individual, and family therapy. Support your rationale with at least three peer-reviewed, evidence-based sources and explain why each of your supporting sources is considered scholarly. Attach the PDFs of your sources.

    Read
     a selection of your colleagues’ responses.

    BY DAY 6

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

       Week 1 Discussion: Psychotherapy

    Psychotherapy relates to a psychological procedure associated with verbal interaction between a mental health expert and a patient to understand the prognosis of the mental condition. Psychotherapy has a biological basis as it is associated with understanding the patient’s behavior following a particular healthcare condition. Through psychotherapy, a mental health expert taps into the patient’s receptors, modulators, and neurotransmitters (Javanbakht & Alberini, 2019). The three are critical biological regulations in brain response. Psychotherapy equally has a biological basis because it realigns an individual’s perception of the self by creating changes to a patient’s emotions and cognitive reasoning processes.

    The concepts of culture, socioeconomics, and religion have a significant impact on a patient’s perspective of psychotherapy treatments. Culture is quite critical because every patient would want to be treated in a culturally competent manner (Levi et al., 2018). Thus, the attending mental health expert should understand the background of the patient to ensure that culturally competent care is provided. Providing culturally competent care also creates a good rapport between the patients and the mental health expert.

    The concept of religion is equally critical in the treatment of mental health conditions. Some patients would prefer to be attended to by mental health experts who have similar religious beliefs as them. It is also critical for mental health experts to understand a patient’s religious beliefs because they are related to various beliefs that might impact treatment (Levi et al., 2018). The beliefs may impact religious practices such as meditation. The socioeconomic status of the patient is equally important because it is associated with social determinants of health. Knowledge about socioeconomic status helps in understanding how exposed the patient is to mental health conditions.

    Legal and ethical considerations for group and family therapy differ from those of individual therapy. For individual therapies, the interaction is between the one patient and the attending and mental health expert (Stoll et al., 2020). Thus, the mental health expert guarantees the total confidentiality as per HIPAA regulations. In case the confidentiality of the patient is breached in individual therapy, the therapist is fully liable. When working attending to an individual client, I will have an understanding of the fact that it is my responsibility to keep the patient’s information confidential. On the other hand, the ethical considerations in group dynamics are quite different (Stoll et al., 2020). Ideally, all the group and family members are liable for the confidentiality of the provided information. While working with a family or a group, I will make them understand that confidentiality is not binding because of the third-party rule.

     

     

    References

    Javanbakht, A., & Alberini, C. M. (2019). Neurobiological models of psychotherapy. 
    Frontiers in Behavioral Neuroscience
    , 
    13
    , 144.

    Levi, U., Laslo-Roth, R., & Rosenstreich, E. (2018). Socioeconomic status and psychotherapy: A cognitive-affective view. 
    J Psychiatry Behav Health Forecast. 2018; 1 (2)
    , 
    1008
    .

    Stoll, J., Müller, J. A., & Trachsel, M. (2020). Ethical issues in online psychotherapy: A narrative review. 
    Frontiers in Psychiatry
    , 
    10
    , 993.

     

     

    PDF 1.zip

     
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    Tessie Harris

    Tessie Harris

    Nov 30, 2022
    Nov 30, 2022 at 8:37pm

    Manage Discussion Entry

    great post Aisha, could you give an example of how knowledge about socioeconomic status helps in understanding how exposed the patient is to mental health conditions. 

     
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    Aisha Adigun

    Aisha Adigun

    Dec 2, 2022
    Dec 2, 2022 at 1:06pm

    Manage Discussion Entry

    Thanks Dr. Harris.

    An individual’s socioeconomic status is essential in understanding a patient’s exposure to mental health conditions. Individuals of lower economic status are more exposed to mental health conditions compared to those of higher socioeconomic status (Reiss et al., 2019). The higher rates of mental health conditions among individuals living in lower socioeconomic status are tied to their exposure to stress and life pressures. An individual living in poverty, for example, has to deal with stressful situations such as lack of food, unemployment, and homelessness, among other problems. The poverty situation creates a negative environment that leads to negative emotions (Kivimäki et al., 2020). The build-up of negative emotions puts such an individual at significant risk of a mental health condition. On the flip side, individuals of higher socioeconomic status do not have to deal with stressful situations related to living conditions. Their ability to meet daily needs limits stress, pressure, and negative emotions.

    References

    Kivimäki, M., Batty, G. D., Pentti, J., Shipley, M. J., Sipilä, P. N., Nyberg, S. T., … & Vahtera, J. (2020). Association between socioeconomic status and the development of mental and physical health conditions in adulthood: a multi-cohort study. 
    The Lancet Public Health
    , 
    5
    (3), e140-e149.

    Reiss, F., Meyrose, A. K., Otto, C., Lampert, T., Klasen, F., & Ravens-Sieberer, U. (2019). Socioeconomic status, stressful life situations and mental health problems in children and adolescents: Results of the German BELLA cohort-study. 
    PloS One
    , 
    14
    (3), e0213700.

     

     
    Reply
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    Maxine Fomunung

    Maxine Fomunung

    Dec 1, 2022
    Dec 1, 2022 at 3:56pm

    Manage Discussion Entry

    Hi Aisha

    I agree with you that psychotherapy taps into the verbal interaction of the clinician and the patient. I however feel that psychotherapy could also entail activities such as relaxation techniques that help in some disorders such as generalized anxiety disorders. Some interventions such as exposure- exposure used in management of some phobias could also be considered a form of psychotherapy. I agree with you that psychotherapy taps into the emotional component of the patient and through helps in elevating the negative and positive symptoms of some disorders such as depression. This is through the modification of various neurotransmitters that are involved in major psychiatric disorders.

    I agree with you on the concept of cultural influence in which every individual is unique in their approach to treatment as guided by their cultural beliefs. A clinician who understand the cultural practices of a patient will be more likely to gain the confidence and confidentiality of a patient compared to one who has bias or prejudice. For instance, understanding that some native communities do not find mental illnesses to be medical but rather spiritual warfare it would be important to first educate the patients and their families on the condition before forcing treatment on them without the required knowledge(Levi et al., 2018).

    I agree with you that different religions have different approaches to mental illnesses. Some religions belief that mental illness is a form of haunting or possession by spirits that require spiritual intervention and these patients would be reluctant to engage in medical treatment. People who have a good religious base are more likely to have a good social support system and are more likely to recover faster in the community rather than in secluded places (Levi et al., 2018). Some religions such as the Hindu and other Asian also value therapies such as relaxation techniques and yoga.

    I agree with you that group therapy abolishes the confidentiality in patient care and the clinician should make the patient aware of this to avoid legal litigations according to the HIPAA regulations (Stoll et al., 2020).

     

    References

    Levi, U., Laslo-Roth, R., & Rosenstreich, E. (2018). Socioeconomic status and psychotherapy: A cognitive-affective view. J Psychiatry Behav Health Forecast. 2018; 1 (2), 1008.

    Stoll, J., Müller, J. A., & Trachsel, M. (2020). Ethical issues in online psychotherapy: A narrative review. Frontiers in Psychiatry, 10, 993.

     
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    Basirat Shomuyiwa

    Basirat Shomuyiwa

    Dec 3, 2022
    Dec 3, 2022 at 6:06pm

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    Respond to Maxime

    Discussion Response

    Hello, following a review of your discussion post on the biological basis and ethical considerations of psychotherapy, I concur with you that psychotherapy has a biological basis. For instance, according to Carey et al. (2020), psychotherapy is a complex mode of treatment that targets an entire biological regulation underlying complex brain responses. Additionally, psychotherapy targets abnormalities in brain adaptation and substitutes this maladaptation with new neural circuits that enhance positive behavior and coping strategies. Finally, psychotherapy is bracketed with structural brain changes.

    Similarly, I agree with you that culture, religion, and socioeconomic status influence psychotherapy. As discussed, the diverse nature of psychiatric patients necessities that PMHNPs develop cultural competency to practice competently. Cultural competency facilitates the accurate delivery of psychotherapy and enhances positive therapeutic alliance which improves health-seeking behaviors (Gopalkrishnan, 2018). Religion may undermine the value of psychotherapy as patients may opt for spiritual and divine intervention. Additionally, individuals from poverty-stricken areas less often seek psychotherapy due to cost considerations and limited knowledge of the benefits of psychotherapy (Fonagy & Luyten, 2021).

    As with other modes of psychotherapy, ethical and legal considerations must be observed while delivering group and family therapy. Pertinent issues such as informed consent, privacy, confidentiality, and therapeutic alliance during the delivery of these therapies cannot be overstated. PMHNPs must practice according to their professional code of ethics and conduct. Finally, I agree with you that the references used are considered scholarly as they are peer-reviewed journal articles from recommended sources.

     

     

    References

    Carey, T. A., Griffiths, R., Dixon, J. E., & Hines, S. (2020). Identifying functional mechanisms in psychotherapy: A scoping systematic review. 
    Frontiers in Psychiatry
    , 
    11
    , 291. 
    https://doi.org/10.3389/fpsyt.2020.00291
    Links to an external site.

    Fonagy, P., & Luyten, P. (2021). Socioeconomic and sociocultural factors affecting access to psychotherapies: the way forward. 
    World Psychiatry: Official Journal of the World Psychiatric Association (WPA)
    , 
    20
    (3), 315–316. 
    https://doi.org/10.1002/wps.20911
    Links to an external site.

    Gopalkrishnan, N. (2018). Cultural diversity and mental health: Considerations for policy and practice. 
    Frontiers in Public Health
    , 
    6
    , 179. 
    https://doi.org/10.3389/fpubh.2018.00179
    Links to an external site.

     

     

     
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    Esther Fakayode

    Esther Fakayode

    Dec 1, 2022
    Dec 1, 2022 at 6:30pm

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    Hello Aisha,

    Great, and well-put-together discussion post, It is very important as a PMHNP to understand how culture, religion, and socioeconomic status can impact clients’ perspectives about mental illness. To properly diagnose and treat each client, either with medication management, or psychotherapy, advanced practitioners must have a thorough understanding of their various cultures, religions, and socioeconomic status (Wheeler, 2014). Different cultures with the same disease or mental illness may not manifest symptoms the same as other cultures. Therefore, it is essential to have a good understanding and knowledge of different cultures to help provide quality and effective treatment (Wheeler, 2014). In most cases, cultures impact how some clients identify and report their physical and emotional symptoms. Some cultures may feel more comfortable talking to a therapist or clinicians and getting psychotherapy, but people from other cultures may turn to religious beliefs or conservative ways to improve their symptoms. It is important to remember that some clients may have more than one culture that impacts their lifestyle. The advanced practitioner should take the time to understand different cultures, even if that means directly asking the client about them. A cultural competence model is a good tool for practitioners to use. It has several questions that an NP can ask themselves to measure their level of competence (Wheeler, 2014).

    Socioeconomic status can be defined by income, level of education, and occupation, to reflect a person’s social, material, and psychological resources. Low socioeconomic status is associated with poorer mental health and higher work disability rates due to mental disorders. In addition, people with lower socioeconomic status, especially those with lower education, tend to use mental health services less willingly or drop out of treatment due to poverty and poor education than those with higher socioeconomic status, even though the need may be greater (Leppänen, et al., 2022).

    References

    Finegan, M., Firth, N., Wojnarowski, C., & Delgadillo, J. (2018). Associations between

    socioeconomic status and psychological therapy outcomes: A systematic review and

    meta-analysis. 
    Depression and anxiety
    , 
    35
    (6), 560–573. https://doi.org/10.1002/da.22765

    Leppänen, H., Kampman, O., Autio, R., Karolaakso, T., Näppilä, T., Rissanen P., & Pirkola

    (2022). Socioeconomic factors and use of psychotherapy in common mental disorders

    predisposing to disability pension. meta-analysis. 
    Depression and anxiety
    , 
    35
    (6), 560–

    https://doi.org/10.1186/s12913-022-08389-1
    Links to an external site.

    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.

     
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    Sherill A Broderick

    Sherill A Broderick

    Dec 2, 2022
    Dec 2, 2022 at 8:39pm

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            Aisha,

    I agree that culture can have an impact on a patient’s perspective of psychotherapy treatment.  A study was carried out by Koduah et al., (2019), examining how sociocultural factors influence nurses’ health literacy practices. Here, it was noted that many Ghanaians firmly believe that mental illness is caused by the existence and manipulation of several demonic forces such as witches, ancestral spirits, sorcerers. As a result, in Sub-Sahara Africa, mental health issues are often too sensitive to discuss with patients and their families due to the shame and stigma associated with them. This context affects how health professionals deliver information and how patients and their relatives interpret it. In a study carried out by Huang et al., (2022), on caregivers’ burden, it was also noted that Asian-Americans are less likely to seek mental health services. The attitude of this population may potentially cause them to resist psychiatric treatment in general.

    Huang, Y., Nagao, C. A., Santos, K. M. B., & Werchowsky, M. I. (2022). Impact of Culture,

    Spirituality, and Mental Health Attitudes on Intergenerational Asian-American Caregivers: A

    Pilot Study. 
    American Journal of Occupational Therapy
    , 
    76
    (2), 1–7.

    https://doi.org/10.5014/ajot.2022.046912

    Koduah, A. O., Leung, A. Y. M., Leung, D. Y. L., & Liu, J. Y. W. (2019). “I Sometimes Ask

    Patients to Consider Spiritual Care”: Health Literacy and Culture in Mental Health Nursing

    Practice. 
    International Journal of Environmental Research and Public Health
    , 
    16
    (19).

    https://doi.org/10.3390/ijerph16193589

     
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    Norma Jacquez

    Norma Jacquez

    Dec 3, 2022
    Dec 3, 2022 at 5:42pm

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    Thank you for your post Aisha.  Your source content is interesting and highlights the focus of this assignment.  I agree with you about the biological basis of psychotherapy.  Much like pharmacological treatments, I agree that therapy influences the neurotransmitters and receptors that affect the central nervous system.  Wheeler supports this concept by stating that the mind and brain are both affected by medications and therapy (Wheeler, 2020).

    It’s important to maintain cultural competence and I agree with your position.  It is essential for the mental health provider to be aware of different cultures, customs, and religions and also be sensitive to socioeconomic differences in patients.  It is so important to establish a trusting relationship with each patient in order to improve rapport, and adherence to treatment, and ultimately for the patient to feel comfortable and safe when sharing important personal information.  Cultural competency should focus on understanding the patient’s background, beliefs, and culture in order to provide the patient with a feeling of being heard and understood.  This will empower the patient and promote positive patient outcomes (Chu, et al, 2016).

    Legal considerations are so important to protect the patient’s confidentiality at all times.  It’s important to always prioritize confidentiality and ensure the patient feels respected and safe.  Therefore, in considering individual versus group therapy, the patient must consent to information being shared.

    References

    Chu, J., Leino, A., Pflum, S., & Sue, S. (2016). A model for the theoretical basis of cultural competency to guide psychotherapy. Professional Psychology: Research and Practice, 47(1), 18. Retrieved from https://psycnet.apa.org/journals/pro/47/1/18.html?uid=2016-05588-002

    National Institute of Mental Health (2022) 
    https://www.nimh.nih.gov/health/topics/psychotherapies
    Links to an external site.

    Nichols, M. P. & Davis, Sean, D. (2020).  
    The essentials of family therapy  
    (7
    th
     ed.).   Pearson.

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

     

     
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    Maxine Fomunung

    Maxine Fomunung

    Nov 29, 2022
    Nov 29, 2022 at 4:16pm

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    Biological basis of psychotherapy treatments

    Neuroscience addresses the brain in the manner in which it truly develops, matures, and functions, which in essence, is the biological basis. Psychotherapy deactivates brain mappings that are maladaptive and stimulates the development of new pathways in the brain that are constructive. Psychiatric disorders are caused entirely by our temperaments’ reactions to stressful experiences as they are processed by our bodies. The problematic mappings that are brought up in therapy are deactivated, while the healthier ones are activated. The mappings of a traumatic experience are what produce the suffering that is associated with mental health conditions. Therefore, psychotherapy is a healing modality that accomplishes this by utilizing the biological processes of the brain (Jimenez et al., 2018).

    It has also been demonstrated that psychotherapy can alter the amount of activity found in the prefrontal cortex. According to the findings of a study conducted on depression, patients diagnosed with this illness exhibited an unusually elevated level of activity in the prefrontal cortex. Researchers observed that patients who took part in interpersonal therapy had lower levels of activity in their prefrontal cortex than those who did not engage.

    In addition, it has been demonstrated that psychotherapy has a biological basis that is analogous to the biological treatment that may be seen through the use of drugs. For instance, data has demonstrated that cognitive behavioral therapy (CBT) creates alterations in the brain that are similar to the changes that are caused in the brain by psychotropic medicines. This evidence was obtained through a study on brain imaging. As a consequence, this body of evidence demonstrates that psychological therapies are capable of bringing about changes in an individual’s symptoms. People who struggle with obsessive-compulsive disorder provide a good illustration of this phenomenon (OCD). Patients who suffer from OCD have been shown to have neuronal hyperactivity, which may be determined by an elevated rate of glucose metabolism. It has been demonstrated that psychotherapeutic treatments such as cognitive behavioral therapy (CBT) and psychotropic medicines such as Prozac can slow down the rate at which the body processes glucose and ameliorate OCD symptoms (Marano et al., 2012). Consequently, this gives the impression that cognitive behavioral therapy is as effective as other biological treatments, such as psychotropic drugs.

     

    How religion, culture, and socioeconomics influence psychotherapy management

    The mental health professional would need to consider the client’s culture, religion, and socioeconomic influences to determine how to deliver psychotherapy treatments to accurately identify and treat clients with mental illness. Because every culture has a unique perspective on numerous issues, a PMHNP should be familiar with the client’s history and culture. Hallucinations, for example, are viewed as a kind of divine contact in several civilizations. Instead of being stigmatized as mentally ill, people who have hallucinations are held in the highest regard. Therefore, in order to perform psychotherapy successfully, every PMHNP must possess cultural competency. As the therapeutic alliance and connection are strengthened, this will promote a positive client-practitioner relationship. Cultural influences on individuals’ healthcare-seeking behaviors will also come in handy when handling males who come in with mental illnesses. Some cultures would view men as being emotionally strong and will be expected to handle every situation in a strong manner. This, therefore, shows that few men would seek psychotherapy for their issues or come in with advanced mental illness with cognitive changes.

    The opinions, conclusions, and perceptions of an individual are frequently influenced by their cultural background. Contrarily, compared to nonreligious people, persons who practice a particular religion tend to have better mental health, fulfilling relationships, and physical health. Thus, it is believed that their faith contributes to the stabilization of psychological health. People with mental health issues who identify as members of a certain faith typically prefer to consult a psychologist who shares their beliefs. However, some want to see nonreligious therapists or psychologists so that they can receive treatment that is impartial to their psychological condition.

    In order to effectively address the client’s mental health during psychotherapy, there is an emphasis on the significance of recognizing socioeconomic disparity, the stress associated with poverty, and attending to the significant external and societal circumstances. In order to help clients understand the challenges they are facing with poverty-related stress, discussions about how to create coping mechanisms will be hard rather than how to make them happy about being poor. As a result, clients can learn how to make adjustments that will help them and their families advance. In addition, a lack of resources may prevent people from lower socioeconomic strata from accessing appropriate psychotherapy therapies. Living in poverty may psychologically impact some people, which may cause mental health problems.

    Furthermore, a sizable portion of people who struggle with mental health disorders do not get the mental health services they require. For instance, the study found that fewer kids who require mental health care and live in poverty obtain it than 15% of the time (Hodkinson, Godoy, Beers, Lewin, 2017). Even fewer kids finish their treatment. Lack of insurance, long travel times, and parental worries that their kids would be taken away from them because of their low-income status are just a few of the obstacles that prevent people from receiving mental health care.

     

    Ethical and legal considerations for group and family therapy

    Mental health therapists are required to make ethical decisions regarding whether or not their personal knowledge or connection to a particular patient should be disclosed. The client may need to be referred to another therapist because of a role conflict, which is one of the biological bases and ethical, and legal considerations of psychotherapy. A mental health counselor, for instance, should not give advice to someone who lives next door to them, especially when working in a rural environment setup (Kim et al., 2016).

    Various psychology bodies have approved the Ethics Code or other comparable ethical standards or rules for the professional conduct of clinicians. When providing services to more than one individual in a joint session, such as to a group of patients, couples, family, children, and caregivers, a clinician must begin the interaction by delineating the limits of confidentiality, so that information between the parties can be shared amongst themselves. This requirement applies to situations in which the clinician is providing services to a family or couple, for instance, or when the clinician is providing services to a family or couple, or when the clinician is providing services to In contrast to individual therapy, where clinicians are expected to adhere to HIPPA rules and regulations.

    One of the legal considerations in this aspect of family or group therapy is the clinician’s duty to warn, which was influenced by the Tarasoff decision. During family therapy, the clinician is responsible for warning the family members or the group if the patient poses a danger to other people, such as the risk of homicide and suicide. This will influence the level of expressed emotion that the family will accord the patient and help them to recover from the psychological illness.

     

     

    References

    Jiménez, J. P., Botto, A., Herrera, L., Leighton, C., Rossi, J. L., Quevedo, Y., Silva, J. R., Martínez, F., Assar, R., Salazar, L. A., Ortiz, M., Ríos, U., Barros, P., Jaramillo, K., & Luyten, P. (2018). Psychotherapy and Genetic Neuroscience: An Emerging Dialog. Frontiers in genetics, 9, 257. 
    https://doi.org/10.3389/fgene.2018.00257
    Links to an external site.
    .

    It is a scholarly article since it has been peer-reviewed, and the study findings have been supported by other studies and literature, as evidenced by the number of citations and references in the article. The information in the article is clear and precise and is written by research experts.

     

    Marano, G., Traversi, G., Nannarelli, C., Pitrelli, S., Mazza, S., & Mazza, M. (2012). Functional neuroimaging: points of intersection between biology and psychotherapy. Clin Ter, 163(6), e445-456.

    The article is considered scholarly as research experts did the research, and other experts have analyzed the results, and the research is based on the literature and findings of other studies found in the references. It was done to add information on the gaps that other studies have done on the subject matter.

     

    Hodgkinson, S., Godoy, L., Beers, L. S., & Lewin, A. (2017). Improving Mental Health Access for Low-Income Children and Families in the Primary Care Setting. Pediatrics, 139(1), e20151175. 
    https://doi.org/10.1542/peds.2015-1175
    Links to an external site.
    .

    The article is scholarly as it is based on the findings of other studies and information done on the same topic and has been reviewed by other research experts. The findings have also been shared and analyzed by other peers before publication.

     

    Kim, N. S., Ahn, W. K., Johnson, S. G., & Knobe, J. (2016). The influence of framing on clinicians’ judgments of the biological basis of behaviors. Journal of experimental psychology. Applied, 22(1), 39–47. 
    https://doi.org/10.1037/xap0000070
    Links to an external site.
    .

    The article is scholarly as it bases its objective and study questions on previous studies done in the field of psychology and aims at testing a hypothesis and supporting or refuting evidence and data from other articles. The article has been based on other literature, evidenced by the references and citations.

    References.pdf

     
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    Ana Tattersall Cocke

    Ana Tattersall Cocke

    Nov 30, 2022
    Nov 30, 2022 at 6:55pm

    Manage Discussion Entry

    Discussion #1, Reply #2, Day #1

    Hello, Maxine

    I agree that confirmation bias can influence how mental health providers affect group therapy. I wanted to review the literature to see how the transgender (TGD) community has dealt with this since it erupted on the scene in the last two years. Miles (2020) remarks TGD community should be treated equitably and somewhat like any other social group and be allowed to identify their individual goals and issues they must confront. Some of the problems that want to be addressed in the TGD community are stressors of being misgendered by parents, classmates, and society and suicidal ideation. One way this article shows support is to use their preferred pronouns (Miles, 2020) also believes group therapy can be a more cost-effective way to provide services for this discriminated community. The article then recommends further research on how to develop ethical decision-making models for the TGD community.

    References

    Miles, J. (2020) 
    Introduction to the Special Section on Group Psychotherapy and Gender Identity
    Links to an external site.
    . 
    International Journal of Group                        Psychotherapy
     70:4, pages 540-551.

     
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    Joy Obiokor

    Joy Obiokor

    Dec 2, 2022
    Dec 2, 2022 at 4:46pm

    Manage Discussion Entry

     

    Reply#1

     

    Hello Maxine,

    Great job on your post, I agree with the Tarasoff decision’s influence on the clinician’s duty to warn. In group and family therapy, ethical and legal issues is a big area we must consider if group participants can be more willing to uphold an ethical code if they take ownership of it, such as by signing a contract that promises confidentiality (Trachsel & Grosse Holtforth, 2019).

    A situation in which a therapist must consider their moral and legal obligations would be when a client expresses a desire to murder a coworker but does not name anyone in particular. The difficulties associated with group treatment and the goals of doing good and doing no harm make it essential to have informed consent. Before a client joins a group, the referring therapist should have a one-on-one discussion. Unlike group discussions, some people can voice their concerns or request explanations during one-on-one discussions. A more private conversation allows the counselor to assess the client’s perception of classification issues in a group setting. (Trachsel & Grosse Holtforth, 2019).

     

    Reference

    Trachsel, M., & Grosse Holtforth, M. (2019). How to Strengthen Patients’ Meaning Response by

    an Ethical Informed Consent in Psychotherapy. 
    Frontiers in psychology
    , 
    10
    , 1747.

    https://doi.org/10.3389/fpsyg.2019.01747
    Links to an external site.

    Understanding Group Therapy. Retrieved November 30, 2022, from

    https://www.apa.org/topics/psychotherapy/group-therapy

     

     
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    Sherill A Broderick

    Sherill A Broderick

    Dec 3, 2022
    Dec 3, 2022 at 11:50am

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    Maxine,

    I agree that socioeconomic status can affect psychotherapy. A study done by Blackshaw et al., (2018), shows how socio-economic status can negatively affect mental health and can be overlooked in psychotherapy. According to Blackshaw et al., (2018), psychotherapeutic intervention maybe an area of discomfort because of their lack of control over events and maybe challenging for the therapist to deliver effective therapy to shift patient circumstances. A study done by Krupnick (2012), shows some of the barriers that poor individuals face in obtaining psychotherapy treatment. These barriers present challenges for the clinicians are  working with this population.

    Blackshaw, E., Evans, C., & Cooper, M. (2018). When life gets in the way: Systematic review of life

    events, socioeconomic deprivation, and their impact on counselling and psychotherapy with children

    and adolescents. 
    Counselling & Psychotherapy Research
    , 
    18
    (2), 143–153.

    https://doi.org/10.1002/capr.12156

    Krupnick, J. L., & Melnikoff, S. E. (2012). Psychotherapy with low-income patients: Lessons learned from

    treatment studies. 
    Journal of Contemporary Psychotherapy: On the Cutting Edge of Modern

         Developments in Psychotherapy
    , 
    42
    (1), 7–15. https://doi.org/10.1007/s10879-011-9182-4

     
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    Ehikioya A Ofeinmun

    Ehikioya A Ofeinmun

    Dec 3, 2022
    Dec 3, 2022 at 7:53pm

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    Hello Maxine, very interesting discussion about psychotherapy. I agree with you that psychotherapy has biology basis. We live in a world made of many factors that impact our lives. Biological, environmental, gender, socioeconomic, culture, health, and other factors impact our lives daily. However, mental illness is a real increasing issue from childhood to adulthood. Nowadays, the number of individuals suffering from mental illness has increased leading to multiple approaches to resolve or reduce symptoms. My role as a PMHNP is to thoroughly assess and diagnose patients based on their symptoms. The use of psychotherapy and psychopharmacology is very important to achieve the desired goal (Jimenez et al., 2018). As you said, psychotherapy is a biological intervention that targets complex brain interactions to help regulate behavior, emotion, and cognitive processes (Malhotra & Sahoo, 2017).

    Cultural beliefs and practices should be included in psychotherapy as part of the treatment because culture defines a person. As you said, cultural beliefs and practices can influence distress tolerance, initiating treatment, and what information clients disclose. You added that Culture, religion, and socioeconomic status influence beliefs about mental illness and treatment (Huang & Zane, 2016). There is a variety of cultures that differ from each other. What can be accepted in some cultures can be rejected in others. Understanding someone’s culture will help understand better where the person came from, what is their perception, which approach to use, and what treatment to apply.

    Patient health information is regulated by many laws among which HIPAA stands for Health Insurance Portability and Accountability Act. Every clinician must respect HIPAA law by protecting patient information by keeping them private. I agree with you when you said that Individual therapy differs from group and family therapy in that during individual therapy the client’s information is shared between the provider and client, whereas information disclosed by clients in a group setting is shared among the group (Darby & Weinstock, 2018). Mental health is a difficult topic that we must embrace carefully from appropriately diagnosing patients to appropriately treating them (APA, 2022). Mental health disorders are often misdiagnosed or missed, and patients are stigmatized. Clinicians should carefully analyze all symptoms, culture, socioeconomic situations, and family dynamics to find the appropriate diagnosis.

    References

    American Psychiatric Association. (2022). 
    Diagnostic and statistical manual of mental disorders
     (5th ed., text rev.). 
    https://go.openathens.net/redirector/waldenu.edu?url=https://dsm.psychiatryonline.org/doi/book/10.1176/appi.books.9780890425787 Links to an external site.
    Links to an external site.

    Darby, W. C., & Weinstock, R. (2018). The limits of confidentiality: Informed consent and psychotherapy. 
    FOCUS
    , 
    16
    (4), 395–401. 
    https://doi.org/10.1176/appi.focus.20180020 Links to an external site.
    Links to an external site.

    Jimenez, J., Botto, A., Herrera, L., Leighton, C., Rossi, J., Vedo, Q., et. al. (2018). Psychotherapy and Genetic Neuroscience: An Emerging Dialog. Front. Genet. 9:257. doi.10.3389/fgene.2018.20257.

    Huang, C. Y., & Zane, N. (2016). Cultural influences in mental health treatment. 
    Current Opinion in Psychology
    , 
    8
    , 131–136. 
    https://doi.org/10.1016/j.copsyc.2015.10.009
    Links to an external site.
    .

    Malhotra, S., & Sahoo, S. (2017). Rebuilding the brain with psychotherapy. 
    Indian Journal of Psychiatry
    , 
    0
    (0), 0. https://doi.org/10.4103/0019-5545.217299.

     
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    Dathne Frazier-Sturdivant

    Dathne Frazier-Sturdivant

    Dec 4, 2022
    Dec 4, 2022 at 10:21am

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    Week 1 Response

    I enjoyed your post Maxine,

    Biological basis and ethical/legal considerations of psychotherapy discussion essay You clearly articulated how psychotherapy can have similar effects to a regimen of antidepressants and/or antipsychotics. Also, your evidenced based information on how the culture of each client must be considered when choosing the appropriate modality of pschotherapy was very enlightening.

    I was not familiar with the Tarasoff decision, but will absolutely carry out my due diligence when assessing and treating clients who may be potentially dangerous going forward. I will also maintain safety measures to protect myself and colleagues in the wake of the tragic stabbing death of a PMHNP by a client.

    As stated by Jimenez et. al, (2018), the ultimate goal of psychotherapy is the restoration of the patient’s social functioning i.e. the ability to maintain stable an d productive interpersonal relationships that promote physical and emotional health within the social environment in which the individual develops.

     

     

     

    Jiménez, J. P., Botto, A., Herrera, L., Leighton, C., Rossi, J. L., Quevedo, Y., Silva, J. R., Martínez, F., Assar, R., Salazar, L. A., Ortiz, M., Ríos, U., Barros, P., Jaramillo, K., & Luyten, P. (2018). Psychotherapy and Genetic Neuroscience: An Emerging Dialog. Frontiers in genetics, 9, 257. 
    https://doi.org/10.3389/fgene.2018.00257

     
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    Ana Tattersall Cocke

    Ana Tattersall Cocke

    Nov 29, 2022
    Nov 29, 2022 at 8:04pm

    Manage Discussion Entry

    Week #1 
    Discussion #1  
    NRNP-6645C-9/NRNP-6645-9 
    11/29/2022  
    Ana Tattersall Cocke

     
    An explanation of whether psychotherapy has a biological basis.

    Psychotherapy has a solid biological basis. Bambling (2013) explains how our brains adapt to environmental stimuli that can create pathways that can cause maladaptive behaviors, and psychotherapy has been proven to aid in restructuring brain mapping. PTSD is an excellent example of how one can rewire the brain with the physiological, primitive response to a certain. Neer et al. (2016) provided an example of a case study of a 31 y/o veteran who experienced PTSD with conversion disorder and could not eat solid food without alcohol.  He was provided with trauma management therapy (TMT) five times per week over three weeks that included daily exposure therapy (EXP) as well as daily social and emotion regulation (SER) group therapy to work on anger, depression, and social withdrawal. After the treatment Clinician-Administered PTSD Scale (CAPS) decreased from 63 at pre-treatment to 17 at posttreatment, noting that he no longer had PTSD symptomatology. The intensive exposure therapy allowed him to consume full meals without alcohol (Neer et al., 2016).

    Explain how culture, religion, and socioeconomics might influence one’s perspective on the value of psychotherapy treatments.

    Cultural elements of the Western world can promote confirmation bias because of the commonalities and similarities in our daily lives (Koch and Kafa, 2019). With the growth of non-Western migration, the assumptions that current psychotherapy models can be easily adapted need to be researched (Koch and Kara, 2019). Wheeler (2020) reports that mental health treatment needs to be patient-centered; secular psychotherapy may not be a good fit for some. Socioeconomic factors can impact how some of those with financial insecurity may have difficulty accessing psychotherapy (Nichols and Davis, 2020).

    Describe how legal and ethical considerations for group and family therapy differ from those for individual treatment, and

    In her presentation, Shuttlesworth (2013) states that informed consent is essential to move forward with any therapy process. Wheeler (2020) suggests that group therapy can be more economically affordable to some. In contrast, family and individual therapy may be more expensive if it must be afforded with out-of-pocket funds Biological basis and ethical/legal considerations of psychotherapy discussion essay.

    Explain how these differences might impact your therapeutic approaches for clients in group, individual, and family therapy
    .

    Nichols and Davis (2020) summarize the differences between individual and family therapy by focusing on where human behavior needs to be concentrated. Individual therapy focuses on internal personality forces that can impact the family dynamic, and this approach may make the individual feel most comfortable with confidentiality (Wheeler, 2020). By contrast, family therapy works on the external structure of the family because this may be needed to change the individual so that the dynamics will work. The differences between family and group therapy can be viewed through the lens of how some may feel more comfortable revealing themselves to strangers vs. a family member. Therapy groups have to promote an environment of cohesion and support, whereas family dynamics can still be pronounced (Nichols and Davis, 2020).

    References

    Bambling, M. (2013).
     
    Neurobiology of behavior change Links to an external site.
    Links to an external site.
    [Video/DVD] https://go.openathens.net/redirector/waldenu.edu?url=https://video.alexanderstreet.com/watch/neurobiology-of-behavior-changeKoç, V., & Kafa, G. (2019). Cross-Cultural Research on Psychotherapy: The Need for a Change. Journal of Cross-Cultural Psychology, 50(1), 100–115. https://doi.org/10.1177/0022022118806577

    Neer, S. M., Trachik, B., Munyan, B. G., & Beidel, D. C. (2016). Comprehensive Treatment: Intensive Exposure Therapy for Combat-Related PTSD and Comorbid Conversion Disorder. Clinical Case Studies, 15(5), 343–359. https://doi.org/10.1177/1534650116643401

    Nichols, M., & Davis, S. D. (2020). 
    The essentials of family therapy
     (7th ed.). Pearson.

    Shuttlesworth, M. (2013, August 14). 
    Ethical and legal issues in abnormal psychology Links to an external site.
    Links to an external site.
    [Video]. YouTube. https://www.youtube.com/watch?v=pRXibYiorQ0

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

     
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    Tessie Harris

    Tessie Harris

    Nov 30, 2022
    Nov 30, 2022 at 8:38pm

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    Great post Ana, what are some ways that the psychiatric nurse practitoner facilitating group therapy can promote an environment of cohesion and support.

     
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    Basirat Shomuyiwa

    Basirat Shomuyiwa

    Dec 1, 2022
    Dec 1, 2022 at 10:39pm

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      Respond to Ana

    This is an insightful post about the biological basis of psychotherapy. I agree with you that psychotherapy has a biological basis. This is attributed to the fact that psychotherapy is concerned with the brain development, maturation, and functions of the brain (Stern, 2020). Psychotherapy tends to follow the principles of evolutionary adaptation and so, it aims at the problematical adaptations of the brain.  On the other hand, culture, religion, and socioeconomics have a great impact on the perspective of individuals on the value of psychotherapy treatments.  Cultural beliefs impact the perception and healthcare-seeking behaviors of psychotherapy treatments (Dzokoto et al., 2021).  For instance, some cultures perceive psychotherapy treatment for mental health-related issues as disgraceful. This perception may prevent some people from going for psychotherapy treatments for mental health issues. Cultural delusion about psychotherapy can also impact the opinion of people by misleading them about psychotherapy. For instance, a person may be influenced to believe that mental health issue is a punishment or curse that can only be cured by religious powers but not psychotherapy treatments.

    Religious beliefs also have a great influence on the perspectives of individuals seeking psychotherapy treatments by advancing the powers of prayers and divine healing at the expense of psychotherapy treatments.  For instance, Christians believe in the healing power of God and Christians often resort to their faith as a coping tool to address their sufferings associated with mental health problems (Dzokoto et al., 2021). Finally, socio-economic is instrumental in influencing the perspective of individuals on psychotherapy treatments. People from higher socio-economic classes often have a higher tendency of seeking psychotherapy treatments compared to people from low socio-economic status.

    References

    Dzokoto, V., Anum, A., Affram, A. A., Agbavitoh, J. K., Dadzie, H. A., Mintah, R. K., … & Osei-Tutu, A. (2021). “A lot of Ghanaians really don’t understand the work we do”—Cultural adaptations and barriers in Ghanaian psychotherapy practice. 
    International Perspectives in Psychology: Research, Practice, Consultation
    . https://doi.org/10.1027/2157-3891/a000015

    Stern, D. N. (2020). 
    The motherhood constellation: A unified view of parent-infant psychotherapy
    . Routledge.

     

     
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    Hewan Mezgebu

    Hewan Mezgebu

    Dec 3, 2022
    Dec 3, 2022 at 8:47am

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    Discussion 1 reply 2

    Hi Anna,

    Thank you for your post. In addition to your post, group therapy helps individuals who share issues and experiences and are designated to target specific problems to treat different mental health issues (Rutan, 2021). The distinct advantage of group therapy is that it reduces the feeling of loneliness and isolation because you will meet people who are experiencing similar issues; therefore, they know what you are going through (Rutan, 2021). Also, in group therapy, you will learn new strategies by role-playing without judgment and get feedback on how you can become more self-aware. Some disadvantages of group therapy are that it could take longer to see results because the patient will not be the sole focus of the session, and treatment cannot be as effective (Rutan, 2021). In contrast, individual psychotherapy benefits from complete attention from the therapist. Confidentiality is maintained because trust is formed with one professional compared to others who are not sworn to a professional role in groups (Rutan, 2021).

    According to Reiss et al.2019, mental health problems in children depend on SES, such as parental education, household income, and occupation. For example, children dealing with less educated parents need more support in dealing with stressful situations such as parental illness or severe financial crises than children with higher-educated parents (Reiss et al., 2019). Biological basis and ethical/legal considerations of psychotherapy discussion essay This study found that individuals with a higher level of education have cognitive abilities to deal with stressful situations and better social positions (Reiss et al., 2019).

    References

    Reiss, F., Meyrose, A. K., Otto, C., Lampert, T., Klasen, F., & Ravens-Sieberer, U. (2019). Socioeconomic status, stressful life situations and mental health problems in children and adolescents: Results of the German BELLA cohort study. 
    PLOS ONE
    , 
    14
    (3), e0213700. 
    https://doi.org/10.1371/journal.pone.0213700
    Links to an external site.

    Rutan, J. S. (2021). Reasons for Suggesting Group Psychotherapy to Patients. 
    American Journal of Psychotherapy
    , 
    74
    (2), 67–70. 
    https://doi.org/10.1176/appi.psychotherapy.20200032
    Links to an external site.

     
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    Basirat Shomuyiwa

    Basirat Shomuyiwa

    Nov 30, 2022
    Nov 30, 2022 at 6:08am

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         Main Post

     

    Psychotherapy Nursing

    Psychiatric mental health practitioners undertake recovery-focused practice where they work with the long-term goal of the final recovery. As such, they take their time to learn more about the clients and offer support to their client’s endeavors, goals, and recovery. The psychotherapy techniques they apply are as effective as psychopharmacology (Greenway et al., 2020). A common question asked is how psychotherapy achieves the changes and whether it shares common neuronal pathways with psychopharmacology. As such, it is important to explore whether psychotherapy has a biological basis and the ways in which legal and ethical considerations differ in individual, family, and group therapy settings. Psychotherapy has a biological basis since the strategy focuses on brain aspects such as how it operates, brain maturation, and brain development (Wheeler, 2020). Psychotherapy applies evolutionary adaptation ideologies, thus targeting the adaptation complexities and repairs such. The implication is that the strategies disengage and solve the maladaptive brain adaptations and replace them with positive pathways.

    Culture religion and socioeconomics might influence one’s perspectives on the value of psychotherapy treatments. For instance, in some cultures, using psychotherapy to treat mental illnesses is stigmatized and regarded shameful, hindering individuals from using psychotherapy (Markin & Zilcha-Mano, 2018). Some believe that mental illness is a curse hence should be solved through divine strategies. In some religions, individuals believe that illnesses such as mental illnesses should be treated though prayers and divine healing, hence some individuals may frown at psychotherapy. Individuals with low socioeconomic status may find it difficult to seek for psychotherapy interventions due to cost issues

    Various legal and ethical considerations as associated with individual, family, and group therapy settings. However, these legal and ethical considerations differ depending on the setting. However, ethical and legal considerations in all settings have to be upheld to avoid any ethical or legal consequences. While the issue of confidentiality is more straightforward in the case of individual therapy, it is more complex in group and family therapy as the psychotherapists need to inform every participant of why it is key to uphold confidentiality and some of the consequences of the breach (Ezhumalai et al.,2018). The legal privilege is not applicable to family/group discussion, except in cases where it is provided by the state statute. The provider during family or group therapy is no more dedicated to an individual client and does not function entirely as the client’s agent. The provider hence participates in activities that focus on the overall community. The rules and guideline of handling the psychotherapy sessions therefore differ in each case.  The published sources used in this assignment are scholarly because they are peer reviewed.

     

     

    References

    Ezhumalai, S., Muralidhar, D., Dhanasekarapandian, R., & Nikketha, B. S. (2018). Group interventions. 
    Indian Journal of Psychiatry
    , 
    60
    (Suppl 4), S514. 
    https://doi.org/10.4103%2Fpsychiatry.IndianJPsychiatry_42_18
    Links to an external site.

    Greenway, K. T., Garel, N., Jerome, L., & Feduccia, A. A. (2020). Integrating psychotherapy and psychopharmacology: psychedelic-assisted psychotherapy and other combined treatments. 
    Expert Review of Clinical Pharmacology
    , 
    13
    (6), 655–670. 
    https://doi.org/10.1080/17512433.2020.1772054
    Links to an external site.

    Markin, R. D., & Zilcha-Mano, S. (2018). Cultural processes in psychotherapy for perinatal loss: Breaking the cultural taboo against perinatal grief. 
    Psychotherapy
    , 
    55
    (1), 20. https://psycnet.apa.org/doi/10.1037/pst0000122

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

    Nur 6645 Wk 1 pdf reference.pdf

     
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    Ana Tattersall Cocke

    Ana Tattersall Cocke

    Dec 1, 2022
    Dec 1, 2022 at 6:12pm

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    WK 1 Discussion, Reply #3, Day 5

     

    Hello, Basirat

    I agreed with your assessment and wanted to comment on how exercise and biological factors can impact the effectiveness of psychotherapy. Heinzel and Fydrich (2018) discuss how the neurobiology of the brain affected by depression can cause problems with memory storage. In this article, the authors reviewed The SPeED study (Sport/Exercise Therapy and Psychotherapy—evaluating treatment Effects in Depressive patients) was a randomized controlled trial that wanted to look at how CBT could be augmented with endurance exercise (Heinzel and Fydrich, 2018). The idea is that endurance exercise causes increased oxygen uptake and reduces the cortisol release that affects the hypothalamic–pituitary–adrenal axis, decreasing psychological stress. As the authors report, more research is needed on this topic.

    References

    Heinzel S, Rapp MA, Fydrich T, et al. Neurobiological mechanisms of exercise and psychotherapy in depression: The SPeED study—                       Rationale, design, and methodological issues. 
    Clinical Trials
    . 2018;15(1):53-64. doi:
    10.1177/1740774517729161
    Links to an external site.

    Neurobiological mechanisms of exercise and psychotherapy in depression.pdf

     
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    Hewan Mezgebu

    Hewan Mezgebu

    Dec 2, 2022
    Dec 2, 2022 at 9:09am

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    Discussion 1 reply 1

    Hello Basirat,

    Great post. Regarding ethical consideration, I agree that it differs depending on individual or group therapy settings. Psychotherapeutic ethics are the system of beliefs and values that constitute mental health (Lakin, 1985). Ethical challenges that affect individual therapy differ from group therapy. In individual therapy, the lack of patient autonomy which is unable to act independently or sometimes developing a strong attachment to the therapist, is a serious ethical concern (Lakin, 1985). The other ethical challenge in an individual setting is nonmaleficence (do no harm) which means therapists must refrain from engaging in acts that can harm their patients (Lakin, 1985). For example, discussing or revealing information about private therapy sessions without complying with HIPPA (Lakin, 1985).

    In contrast, the ethical challenge of group therapy requires members to interact with one another and have informed consent. The therapist has to make sure that growing members make an informed decision by understanding their rights, ethical obligation, freedom from group pressure, and any expectations that the group members have of them (Knauss & Knauss, 2012). A therapist maintaining one person’s confidential information in a couple or family therapy may conceal information vital to one’s partner’s decision and become triangulated in a family conflict (Knauss & Knauss, 2012). In group therapy, it is essential to openly discuss confidentiality and enforce it in the group to be valued and become part of the group process (Knauss & Knauss, 2012).

    References

    Knauss, L. K., & Knauss, J. W. (2012). Ethical issues in multiperson therapy. 
    APA Handbook of Ethics in Psychology, Vol 2: Practice, Teaching, and Research.
    , 29–43. https://doi.org/10.1037/13272-003

    Lakin, M. (1985). Ethical Challenges of Group and Dyadic Psychotherapies: A Comparative Approach. 
    Professional Psychology: Research and Practice
    , 
    17
    (5), 454–461. 
    https://doi.org/10.1037/0735-7028.17.5.454
    Links to an external site.

     
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    Brianna Vanderpool

    Brianna Vanderpool

    Dec 2, 2022
    Dec 2, 2022 at 8:09pm

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    Response #1

     

    Hi Basirat! Your post is articulate and informational, thank you so much for posting! I agree with your evaluation on the religious aspect of psychotherapy.  I think that at times it can definitely be difficult for people who are incredibly embedded within the religious community to allow themselves to get help.  It is my own personal belief that we certainly can be healed through prayer; however, I also believe that God gives us incredible human beings who are incredible at providing psychotherapy to patients and who put themselves out there to help.  According to Currier, J., Stevens, L., McDermot, R., et al, (2022) it was found in a study done regarding religion and psychotherapy, that the more authoritarian of a relationship was had with God and or religion, the higher the rate of depression/anxiety was found.  Whereas a more benevolent relationship provided lesser rates of depression/anxiety and were more open to therapy help.

     

    Currier, J. M., Stevens, L. T., McDermott, R. C., Hinkel, H. M., Salcone, S., Davis, E. B., Lacey, E. K., & Park, C. L. (2022). Exploring the roles of god representations in spiritual struggles among Christians seeking spiritually integrated psychotherapies. 
    Spirituality in Clinical Practice
    . https://doi.org/10.1037/scp0000302

     
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    Norma Jacquez

    Norma Jacquez

    Dec 4, 2022
    Dec 4, 2022 at 2:32pm

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    Discussion #1, Response #2

    Basirat,

    Thank you for your informative post.  It is concise and addresses all aspects of this assignment.  Like you, I agree that psychotherapy has a biological basis. While there is much controversy around the topic, multiple sources support the effects of psychotherapy as having a biological basis due to reflections on the central nervous system via neurotransmitters and receptors.  Wheeler does discuss in detail the effects of psychotherapy, much like pharmaceutical treatments (Wheeler, 2020).  One of the articles I read talked about the correlation of dual treatment with medication and therapy.  It basically stated that at times medication can assist the patient in being more open to participating in therapy, whether individual or group because of the effects on the central nervous system (Welberg, 2012).  It also states that through therapy, patients can become more adherent to their treatment with medications.  This review supports the use of dual therapy.  Therefore, both affect the patient in a positive way.

    Thanks for highlighting the cultural, religious, and socioeconomic perspectives of psychotherapy.  In my post, I focused more on the cultural awareness training for a mental health provider and how important it is to be patient-focused.  I’m glad you discussed the unfortunate stigma around mental health today.  This creates a barrier for patients to receive the much-needed therapy.  One of the studies I read talks about looking for “blind spots” in research about mental health stigma.  It talks about “what matters most” within a culture and applying a framework to avoid “blind spots” as we go forth with research.  Unfortunately, there are so many groups of people, like the transgender community, and veterans with PTSD, to name a few, who do not receive treatment due to shame from society (Schomerus, & Angermeyer, 2021).  We have to continue working to improve outreach to communities to provide the necessary treatment to patientsBiological basis and ethical/legal considerations of psychotherapy discussion essay.

    References:

    Nichols, M. P. & Davis, Sean, D. (2020).  
    The essentials of family therapy  
    (7
    th
     ed.).   Pearson.

    Schomerus, G., & Angermeyer, M. C. (2021). Blind spots in stigma research? Broadening our perspective on mental illness stigma by exploring ‘what matters most’ in modern Western societies. 
    Epidemiology and psychiatric sciences
    , 
    30
    , e26. https://doi.org/10.1017/S2045796021000111

    Welberg, L. (2012).  Why two is better than one.  
    Nature Reviews Neuroscience, 13
    (2).  
    https://www.nature.com/articles/nrn3181
    Links to an external site.

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

     

    PLACE YOUR ORDER HERE

     

    According to American Psychological Association (2022), individuals in participating psychotherapy work closely with their therapist to address their mental health concerns. Based on the conversation, it creates a safe space for someone to share their thoughts and feelings with someone who is impartial and will not pass judgment. Together, the patient and the psychologist will determine what kinds of thoughts and actions are contributing to the patient’s less-than-optimal emotional state, and then try to alter those. The changes that occur in the brain and body because of psychotherapy are what improve emotional and behavioral health.

     Biological Basis of Psychotherapy

    A large part of psychotherapy is devoted to understanding the neural bases of psychological phenomena. The human brain develops from a combination of genetic blueprints and environmental influences. Traumatic events, in contrast to good events, might alter one’s thinking, feeling, and controlling behaviors. Rather than focusing on just one or two receptors, neurotransmitters, or modulators, psychotherapy is an integrative biological treatment that activates all the systems responsible for regulating the brain’s complex reactions. The ultimate goal of this sort of intervention is to facilitate a re-elaboration of one’s holistic view of self and others through the acquisition of new knowledge and participation in novel experiences that engage one’s cognitive, emotional, and self-regulatory systems. Therapeutically effective interventions result in substantial, long-lasting, and quantitatively observable changes in the brain (Javanbakht & Alberini, 2019). Psychotherapy’s primary objective is to help people learn to adapt to their circumstances to foster healthier patterns of thought, feeling, and behavior.

    Culture, Religion, and Socioeconomic Influences

    Although it is essential to consider how the patient’s presenting problem and therapeutic interactions are influenced by the patient’s culture and cultural differences as part of diversity, it is equally crucial to analyze how institutional and economic influences shape these aspects. Distinct cultures’ members can and will have different points of view, leading to divergent accounts of how the human mind works and what constitutes acceptable behavior. Cultural background can influence the formation of mental illnesses as well as the reaction patterns that will eventually result in psychological disorders; thus, disorder symptoms, behavioral reaction levels, frequency with which illness occurs, perceptions and reactions toward illness, and willingness to receive psychotherapy can all be affected (Koç & Kafa, 2019). When comparing the understanding of psychotherapy in various nations, it is evident that their appreciation or worth varies considerably. Countries in the third world have very little effect in the field of psychotherapy, presenting a quite different picture. For example, some Muslims lack faith in the science of psychotherapy, in part due to psychotherapy’s image as a secular discipline that rejects the spiritual side of humanity; Muslims may fear that their beliefs will be studied and stripped away. Moreover, in Muslim psychology, the majority of errors in the field of psychology are attributed to faulty assumptions about human nature, spanning from the Darwinian perspective of human nature to the model of information processing units (Koç & Kafa, 2019).

    Equally, cultures have various rules for what constitutes normal behavior and how people should act, so people from different cultures will have different viewpoints on the world and mental health taboos and/or expectations. Therefore, psychotherapy may be appreciated in one culture and less embedded in another culture.

    Legal and Ethical Issues

    Issues of law and ethics are present in all types of therapy, including family, group, and individual. Legal and ethical considerations include, but are not limited to, the patient’s right to privacy, protection from abuse, violation of personal space, autonomy, and therapy adherence.

    A therapist’s ability to establish rapport with patients hinges on his or her empathy, openness, and willingness to listen. The therapist’s role in group and family therapy is to ensure that everyone has a chance to speak. Unless the patient poses an immediate threat to themselves or others, a therapist has a legal and ethical obligation to maintain the patient’s confidentiality.

    Finally, in order to provide an effective psychotherapy treatment plan, it is also crucial to have a thorough understanding of the patient’s worldview, cultural background, socio-economic background, and medical history.

     

    References

    American Psychological Association (2022). Understanding psychotherapy and how it works. 
    https://doi.org/10.1037/e502202022-001
    Links to an external site.

    Javanbakht, A., & Alberini, C. M. (2019). Editorial: Neurobiological Models of Psychotherapy. 
    Frontiers in behavioral neuroscience
    , 
    13
    , 144. https://doi.org/10.3389/fnbeh.2019.00144

    Kim, N. S., Ahn, W., Johnson, S. G. B., & Knobe, J. (2016). The influence of framing on clinicians’ judgments of the biological basis of behaviors. 
    Journal of Experimental Psychology: Applied, 22(1),
     39–47. 
    https://doi.org/10.1037/xap0000070
    Links to an external site.

    Koç, V., & Kafa, G. (2019). Cross-cultural research on psychotherapy: The need for a change. 
    Journal of Cross-Cultural Psychology
    , 
    50
    (1), 100–115. https://doi.org/10.1177/0022022118806577

    PDF2.pdf

     
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    Ana Tattersall Cocke

    Ana Tattersall Cocke

    Nov 30, 2022
    Nov 30, 2022 at 4:23pm

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    Discussion #1, First Reply, Day 4

    Hello, Martins

    I agree with your assessment that religion can play a predominant cultural factor which may cause some to turn away from the potential benefits of psychotherapy because of its secular approach. Hays and Aranda (2016) reviewed over 600 articles on the emergence of faith-based interventions amongst the African American population and found deficits in current practice. African Americans are less likely to reach out to social workers or other mental health providers for mental health treatment due to a cultural distrust and lack of belief that traditional mental health interventions work (Hays & Aranda, 2016). Many African Americans seek support from the church or ministers because of the support network often found in the community (Hayes & Aranda, 2016). However, it can be seen as a double edge sword because not all ministers may have mental health training to address emotional problems (Hayes & Aranda, 2016). The authors recommend that a way to reduce some of the disparities in mental health outcomes is to integrate traditional treatment and faith-based programs for increased acceptance in the African American community (Hayes & Aranda, 2016)

    Reference

    Hays, K., & Aranda, M. P. (2016). Faith-Based Mental Health Interventions With African Americans: A Review. Research on Social Work Practice, 26(7), 777–789. https://doi.org/10.1177/1049731515569356

    Faith-Based Mental Health Interventions With African Americans A Review.pdf

     
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    Porsha Kimbrough

    Porsha Kimbrough

    Dec 2, 2022
    Dec 2, 2022 at 9:30am

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    Week 1 Discussion, Response 1

    Hello, Ijeoma, great post! You provided some valuable information and made some excellent points. Confidentiality is critical when it comes to psychotherapy treatments. Confidentiality is a legal and ethical concern that keeps private information from being shared (Williams  & O’Connor, 2019). Patients want to feel like they are in a safe space and can share their private information without fear of exposure. Providers must maintain confidentiality and stay current on related laws, statutes, and regulations (BrintzenhofeSzoc & Gilbert, 2017). Ultimately, ethical practices concerning confidentiality protect patients’ secrets (Williams & O’Connor, 2019). However, maintaining confidentiality can present ethical concerns (Williams & O’Connor, 2019). For instance, in extreme circumstances, confidentiality may be trumped when safety is of concern (Williams & O’Connor, 2019). The safety concerns may involve issues surrounding abuse involving a child or adult who is dependent (Williams & O’Connor, 2019). Some secretive behaviors can negatively impact the patient and their treatment outcomes (Williams & O’Connor, 2019).  In general, counselors or providers providing psychotherapy must adopt confidentiality practices and make patients aware of when the right to privacy can be trumped,

    References

    BrintzenhofeSzoc, K., & Gilbert, C. (2017). Social workers have an obligation to all patients regarding confidentiality … however, for some patients, the obligation is greater. Social Work in Health Care, 56(9), 779–793. 
    https://doi.org/10.1080/00981389.2017.1343216
    Links to an external site.

    Williams, I. L., & O’Connor, P. (2019). Power in the counseling relationship: the role of ignorance. Journal of Human Services: Training, Research, and Practice, 4(2), Article 3. https://scholarworks.sfasu.edu/jhstrp/vol4/iss2/3

     
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    Falilat Bunmi Hambolu

    Falilat Bunmi Hambolu

    Nov 30, 2022
    Nov 30, 2022 at 12:21pm

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    Factors that demonstrate the biological basis of psychotherapy

    It is essential to have a thorough understanding of psychotherapy because this will help you apply it to patient care. Psychotherapy is described by Jimenez, Botto, & Luyten (2018) as an interpersonal process with the aim of changing dysfunctional feelings, actions, attitudes, and cognitions toward a person who is seeking help from a qualified professional. Studies on mental diseases have established a causal relationship between psychological and biological elements. There is general agreement that psychotherapy involves a certain kind of learning within the framework of an emotional connection that may result in epigenetic changes during various therapeutic interventions (Jimenez et al., 2018). This discussion aims to show that psychotherapy has a biological basis for treatment and how social, cultural, and religious issues might influence how important psychotherapy is. A comprehensive approach to psychotherapy involves considering both biological and psychological phenomena. Both the structure and the integration of the biological and psychological sciences create difficulties. According to Wheeler’s (2014) theory, humans have a biological element built into their brains that naturally processes experiences to a physiological state where information may be taken in for learning to take place. Numerous studies have demonstrated the efficacy of both pharmaceutical regimens and nonpharmacological treatments, including psychotherapy, in the treatment of mental diseases. Additionally, it has been demonstrated that psychotherapy has reduced the symptoms of mental diseases, which has benefited the affected person’s biology. According to Jimenez (2018), psychotherapy involves a certain kind of learning in the context of emotional relationships that can also result in epigenetic changes in various treatment methods, supporting the aforementioned claim. This is demonstrated by the capability to record various brain reactions utilizing physiological monitoring or testing instruments before, during, and after psychotherapy treatment (Fonzo et al., 2017). For instance, when a piece of new information is presented, specific brain regions may need to respond with an increase or reduction in activation. Additionally, it has been demonstrated that psychotherapy has reduced the symptoms of mental diseases, which has benefited the affected person’s biology. According to Jimenez (2018), psychotherapy involves a certain kind of learning in the context of emotional relationships that can also result in epigenetic changes in various treatment methods, supporting the aforementioned claim. This is demonstrated by the capability to record various brain reactions utilizing physiological monitoring or testing instruments before, during, and after psychotherapy treatment (Fonzo et al., 2017). For instance, when a piece of new information is presented, specific brain regions may need to respond with an increase or reduction in activation. Researchers claim improvement in a fraction of patients who present with a diagnosis of schizophrenia with the use of Metacognitive Narrative Psychotherapy in another study that provides proof that psychotherapy has a biological basis (Schweitzer, Greben, & Bargenquast, 2017). The biological underpinning for psychotherapy’s effectiveness is its propensity to mediate the reconnection and integration of previously dysfunctional neural networks in the brain brought on by stressful life events (Wheeler, 2014). There is general agreement that psychotherapy has a biological basis through the fields of neuroscience, cognitive science, and psychology (Jimenez et al., 2018). Aspects of Socioeconomic Perspective, Religion, and Culture in Psychotherapy. When addressing clients’ cultural and religious concerns, providers can be hesitant. A provider must have sufficient knowledge of or take into account the culture, religion, and socioeconomic status of the patient in order to diagnose and treat them for a mental disorder in an appropriate manner. Any form of treatment, including psychotherapy, must take into account a patient’s way of life, religion, and socioeconomic factors. A person from a different culture could report illnesses, ailments, or symptoms in a different way than other people. It is essential to learn about a client’s history because it will act as a guide for an accurate diagnosis and course of treatment. Although not required, having a working understanding of a client’s history and researching their varied cultures will help therapeutic outcomes (Wheeler, 2014). Cultural differences might affect how emotional and physical symptoms are recognized and reported. Some ethnic groups prefer to put up with the discomfort brought on by mental illness or any other problems; alternatively, they may seek the advice of their church priest or an alternative healthcare professional, such as a herbalist. Wheeler (2014) asserts that assumed generalizations or the assumption that all cultures are the same might be harmful to clients when trying to figure out how to interact with different groups. A thorough analysis of the questionnaire can serve as a guide to a thorough comprehension of the customer and the supplier. According to Dilip, Barton, and Elyn (2017), the capacity to understand a client’s beliefs and take them into account when developing a treatment plan improves professional communication in the therapeutic setting. In an individual’s culture or the guiding principles by which they process information, religious and spiritual aspects are fundamental, and judgment is essential in psychotherapy treatment. Some people who follow particular religions are opposed to receiving certain psychotherapy treatments. However, research have demonstrated that in order to ascertain or conclude the direct influences of religious or spiritual variables on outcomes, a clear and delineated definition of spiritual and religious components is a crucial component (Plante, 2016). Even though some religions forbid psychotherapy, numerous studies have shown that mindfulness-based stress reduction and contemplative activities help with other mental and physical health problems by reducing anxiety, tension, and sadness (Plante, 2016). Lack of essential resources in the socioeconomic context may result in insufficient care. The affordability of particular treatments or care or the inability to pay for them can discourage someone from seeking help. The most vulnerable members of society must be informed about available free or low-cost services. According to studies, the cultural relevance of socioeconomic status and its impact on the psychotherapy process have not received the necessary attention in the literature on mental health (Dougall & Schwartz, 2018). Higher socioeconomic status consumers are diagnosed with milder difficulties than those with lower socioeconomic status, according to research (Dougall & Schwartz, 2018).

    References

    Dilip V. J., Barton W. P., & Elyn R. S. (2017). Why We Need Positive Psychiatry for Schizophrenia and Other Psychotic                  Disorders. Schizophrenia Bulletin, (2), 227. doi: 10.1093/schbul/sbw184

    Dougall, J. L., & Schwartz, R. C. (2018). The influence of client Socioeconomic status on                                                                    Psychotherapists’ Attributional Biases and countertransference reactions.

    Fonzo, G. A., Goodkind, M. S., Oathes, D. J., Zaiko, Y. V., Harvey, M., Peng, K. K., … Etkin, A. (2017). PTSD                                      Psychotherapy Outcome Predicted by Brain Activation During Emotional Reactivity and Regulation. American                      Journal of Psychiatry, 174(12), 1163–1174. doi: 10.1176/appi.ajp.2017.16091072

    Jimenez, J. P., Botto, A., & Luyten, P. (2018). Psychotherapy and Genetic Neuroscience: An emerging dialog. Retrieved                from 
    https://www.ncbi.nih.gov/pmc/articles/PMC6056612/
    Links to an external site.
    .

    Plante, T. G. (2016). Beyond Mindfulness: Expanding integration of Spirituality and Religion into Psychotherapy. doi:                    10.1515/opth-2016-0011

    Schweitzer, R. D., Greben, M., & Bargenquast, R. (2017). Long-term outcomes of Metacognitive Narrative Psychotherapy             for people diagnosed with schizophrenia. Psychology & Psychotherapy: Theory, Research & Practice, 90(4), 668–                685. doi: 10.1111/papt.12132 k:100,3

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

  • Biological Basis and Ethical/Legal Considerations of Psychotherapy

    Week One Discussion: Biological Basis and Ethical/Legal Considerations of Psychotherapy

    Recognizing psychotherapy as the biological treatment alternative to psychopharmacological treatment for mental health disorders has been up for debate for many years historically according to research (Manthey et al, 2021).  Current technological advancements have innovatively integrated Telepsychiatry for online psychotherapy counselling services that have evolved into mental healthcare services ever since the COVID-19 pandemic posing legal and ethical concerns in Telepsychiatry (Pierce et al, 2022).  Although there are a multitude of psychotherapy approaches utilized as an alternative to psychopharmacological treatment to manage psychiatric conditions, it is important to understand as a PMHNP student if there is a biological basis for psychotherapy (Wheeler, 2020). For this discussion, I will consider whether psychotherapy has a biological basis and analyze how legal and ethical considerations vary in individual, family, and group therapy clinical settings.

    Biological Basis of Psychotherapy

    Conceptually understanding the paradigm of the biological basis of psychotherapy requires identifying the inherent multifactorial changes in the brain’s neurodynamic functioning impact on the psychopathological responses to stressful and traumatic stimuli (Manthey et al, 2021). Characteristically, this concept is controversial thus, it is further explained by the biophysical aspect in the theory and practice of psychotherapy dealing with the element of mind-body as a unified entity notable in the biological cycle of circadian rhythm signalling (somatic) automatic and (biophysical/psychological) nonautomatic control (Manthey et al, 2021). Reiterating the notion of this theory which denotes that the premise of psychotherapy in the essence of the biophysical mind generates biofeedback from inherent and innate neuronal electrical pathway communication systems in response to internal or external antagonistic variants of stress is key (Manthey et al, 2021).

    A prime example of this theory is substantiated by heritable genetic changes from traumatizing life encounters such as neglect, and sexual, emotional, and physical abuse experienced during early childhood research has shown that potentiates an epigenetic response inducing psychiatric symptomology and disorders for victims (Wheeler, 2020).  According to compounding evidence from research analysis of psychotherapy states, it is clinically effective as a modifier of the biological psychosomatic maladaptive responses to chronic medical/psychiatric disorders, stress, relapse, and remittent traumatic episodes that induce an altered state of the biochemical messaging network in the brain (Manthey et al, 2021).  Essentially, psychotherapy mediates these neuronal biological reactions in the brain, thus research findings suggest that are most vulnerable to exposure to stressful and traumatizing experiences by structurally deregulating mechanisms of neural inhibition (Manthey et al, 2021). Furthermore, the biological psychodynamics of psychotherapy are scientifically known to deactivate manifestations of neuronal dysfunction by transposing messenger molecules that encompass relevant structures located in the thalamus, hypothalamus, corpus callosum, amygdala, and cerebellum (Manthey et al, 2021).

    Particularly, changes in the prefrontal cortex of the brain are vital in disrupting the dopamine modulation of cognitive control hence thereby being influential in impulse inhibition, attention, cognitive reactivity, adaptability, and prospective memory (Manthey et al, 2021). Psychotherapy has been proven to enable extreme psychopathological benefits in the treatment of mental health problems such as generalized anxiety disorder, posttraumatic stress disorder, obsessive-compulsive disorders, and major depression (Manthey et al, 2021).  Primarily, psychotherapy can serve the central role in modifying maladaptive behavioral responses through cognitive behavioral therapy (CBT) and (PDT) Psychodynamic Therapy (Wheeler, 2020). Ultimately the biological basis of psychotherapy is deemed instrumental in the biological approach utilized to disinhibit the cognitive distortion of negative thought processes and the innate biological instincts cultivated by incidences of stressful adversities experienced throughout the lifespan (Wheeler, 2020).

     

    Cultural, Religious, and Socioeconomic Influence on Psychotherapy Treatments

    Psychosocially factors that influence integral decision-making are instinctively sculpted by social and cultural environmental and societal norms (Nichols & Davis, 2020). Primarily, psychosocial interrelationship dynamics of an individual or group’s religious, cultural beliefs, and socioeconomics are predetermining factors that play a key role in being impressionable on their perspectives, value system, misconceptions, and overall lifestyle choices (Shah et al, 2021). Therefore, without any preconceived notion, a PMHNP must be cognoscente of how an individual’s lifestyle choices involve the complexities of social determinants associated with their cultural/religious beliefs, and socioeconomic resources may increase their susceptibility to mental healthcare disparities (Wheeler, 2020).  Culturally, for example, the stigmatization affiliated with mental illness (represents having a curse or hexed in some cultures), homosexuality, HIV/AIDS, and drug addiction have been known as an underlying deterrent of societal norms (Stuart & Ward, 2018).  This may influence the prominence of those who are ostracized avoiding methods of psychotherapeutic treatment to the detriment of their overall emotional, psychosocial, physiological, and psychological well-being (Shah et al, 2021).  Religious influences are significantly important to understanding how individuals’ perception of psychotherapy correlates with their beliefs (Stuart & Ward, 2018).  For instance, those patients whose life may be heavily reliant on the belief in divine/supernatural intervention of worship may not seek psychotherapy but conform to spiritual counsel through church leadership and prayer (Stuart & Ward, 2018).

    Muslims and Christians are some typical examples of religious groups who may obey the religious principles of God being the ultimate healer of their indiscretions making psychotherapy an obsolete treatment option (Stuart & Ward, 2018). Furthermore, findings relative to the issues associated with cost-efficient barriers to access psychotherapy-related care are commonly experienced by individuals considered to be in the lower-income bracket versus those who are in a higher socioeconomic class (Shah et al, 2021).  Additionally, studies have shown that the probability of the likelihood of the misconception of psychotherapy being influenced by an individual’s knowledge deficit on treatment efficacy, socioeconomic, religious, and cultural dynamics is high in some communities as unique barriers impeding optimal mental healthcare outcomes (Shah et al, 2021). Theoretically, this is evident in the principle of the nature versus nurture concept that accounts for the innate and inherent biopsychosocial and environmental conditioning that subconsciously permeates all dimensions of our lives that impact pivotal choices to resist or receive psychotherapy (Wheeler, 2020).

    Legal and Ethical Considerations for Group and Family Therapy that Differs from Individual Therapy

    Considerations for the legal and ethical standards of psychiatric care among groups, families, and individuals differ characteristically in the realm of evidence-based psychotherapy practices (Nichols & Davis, 2020). Each of these classifications of therapy settings illustrates methods of treatment designated to facilitate informed consent and confidentiality agreements that a provider and participants are legally and ethically bound to abide by (Kivlighan et al, 2020).  Unlike group and family therapy involves where consumers have intrapersonal and interpersonal issues discussed in settings amongst multiple individuals that elicit a sense of community, thus it differs from individual therapy which focuses only involves one individual and the provider (Kivlighan et al, 2020). A provider must ensure that group, family, and individual treatment goals are met individually and collectively, which may pose challenges when multiple members are involved (Nichols & Davis, 2020). This can become a complicated process more so in family and group therapy than individual therapy. For instance, when the group/family therapy focus is diverted to the sole interest of an individual client and not moderated properly by the provider treatment is counterproductive (Kivlighan et al, 2020).

    Data from a meta-analysis research study uncovered findings that empirically indicate mutual behavioral influences are more prominent among group and family membership settings than in individual therapy relative to the nature of participation and attendance patterns (Kivlighan et al, 2020). The element of mutual influence of family and group membership is obliviously irrelevant in individual therapy (Kivlighan et al, 2020).  Educating members on the risks and benefits of group, family, and individual therapy is the sole responsibility of the clinician to establish a therapeutic milieu that reinforces standards of care which include nonmaleficence (no harm), confidentiality, and trust (Nichols & Davis, 2020). Ethically, confidentiality concerns present differently in group/family therapy settings versus individual therapy. Primarily, these concerns revolve around the aspect of a provider’s inability to guarantee the nondisclosure of shared information being maintained by a family or group member in group and family therapy sessions or a stranger if Telepsychiatry is used (Nichols & Davis, 2020).

    Therefore, further obligating the clinician to ensure that terms, conditions, and confidentiality agreements with online and in-person consultations are adhered to and not breached to protect the best interest of the group and/or individual (Nichol & Davis, 2020). Breached treatment agreements from group membership dynamics can, directly and indirectly, impact levels of treatment outcomes, such as frequent absenteeism, subtle or overt deliberate acts of antagonizing, disrespectfulness, and dismissive behaviors according to research (Kivlighan et al, 2020).   Intentionally being proactive in ensuring nonmaleficence (not harm) by prioritizing what is in the best interest of the consumer the provider must conduct individual consultations to provide an overview/reinforcement of the terms and conditions of the group, family, and individual psychotherapy (Kivlighan et al, 2020).

     

    Legal and Ethical Considerations Impact on Therapeutic Approaches

    Fundamentally, as a PMHNP adhering to the code of ethics is an integral component of facilitating clinical approaches to a group, family, and individual psychotherapy (Wheeler, 2020). Substantiating treatment modalities proven by evidence-based practice to enhance the efficacy of psychiatric treatment increases the probability of sustaining a therapeutic milieu (Manthey et al, 2021). Particularly, as a provider being committed to not being complicit in restricting patients’ rights to refuse psychiatric care if they are deemed legally responsible to do so in non-emergent and emergent circumstances is paramount (Nichols & Davis, 2020). Leading by example in avoiding any promotion of conflicts of interests is an ethical and legal obligation of a mental healthcare provider to not violate patients’ rights and be subjected to revocation of professional licensure as a PMHNP (Wheeler, 2020). Therefore, acquiring and adhering to the institutional psychotherapy policies and guidelines as a PMHNP is imperative to conduct high-quality clinical practice efforts in mental healthcare that are also legally and ethically abiding according to governing State regulations (Nichols & Davis, 2020).

    Prioritizing, all standards of care that illustrate the mindfulness of the risk factors associated with social determinants of care involving a person’s religious, cultural, socioeconomic background, and knowledge base will foster moral grounding of how this may influence their perspectives, biases on psychotherapy treatment (Wheeler, 2020).  It is vital to make sure patients understand that informed consent is a legally binding contract that holds them accountable for acknowledging the terms and conditions of their psychiatric treatment that also have consequences for nonadherence to those terms (Wheeler, 2020). Moreover, it is vital that as an aspiring PMHNP student I advocate, educate, and mitigate social determinants of barriers to access equitable mental healthcare for patients across the lifespan that will optimize high-quality patient outcomes (Wheeler, 2020).

     

    Conclusion

    Overall, being cognoscente of how the biological framework of psychotherapy impacts inherent and innate maladaptive responsiveness to adverse life experiences is crucial to facilitating group, family, and individualized psychiatric therapy services (Wheeler, 2020). This will all enable the PMHNP to address the perspectives and religious, cultural, and socioeconomic influences that impact a group, family, or individual’s options for psychotherapy to effectively mitigate their barriers to psychiatric care (Wheeler, 2020). Therefore, it is equally imperative for a PMHNP to establish and sustain a therapeutic milieu while considering the legal and ethical concerns associated with group/family therapy versus individual therapy dynamics (Nichols & Davis, 2020).

    References

    Kivlighan, D. M., Aloe, A. M., Adams, M. C., Garrison, Y. L., Obrecht, A., Ho, Y. C. S., Kim, J. Y. C., Hooley, I.W., Chan, L., & Deng, K. (2020). Does the group in group psychotherapy matter? A meta-analysis of the intraclass correlation coefficient in group treatment research. 
    Journal of Consulting and Clinical Psychology
    , 
    88
    (4), 322–337. https://doi.org/10.1037/ccp0000474

    Manthey, A., Sierk, A., Brakemeier, E.-L., Walter, H., & Daniels, J. K. (2021). Does trauma-focused psychotherapy change the brain? A systematic review of neural correlates of therapeutic gains in PTSD. 
    European Journal of Psychotraumatology
    , 
    12
    (1), 1929025. https://doi.org/10.1080/2008198.2021.1929025

    Nichols, M., & Davis, S. D. (2020). 
    The essentials of family therapy
     (7th ed.). Pearson.

    Pierce, B. S., Perrin, P. B., & McDonald, S. D. (2022). Pre-COVID-19 deterrents to practicing with videoconferencing telepsychology among psychologists who didn’t. 
    Psychological Services
    , 
    19
    (1), 157–166. 
    https://doi.org/10.1037/ser0000435
    Links to an external site.

    Shah, N., Walker, I. F., Naik, Y., Rajan, S., O’Hagan, K., Black, M., Cartwright, C., Tillmann, T., Pearce Smith, N., & Stansfield, J. (2021). National or population-level interventions addressing the social determinants of mental health – an umbrella review. 
    BMC Public Health
    , 
    21
    (1), 2118. 
    https://doi.org/10.1186/s12889-021-12145-1
    Links to an external site.

    Stuart, J., & Ward, C. (2018). The relationships between religiosity, stress, and mental health for Muslim immigrant youth. 
    Mental Health, Religion & Culture
    , 
    21
    (3), 246–261. https://doi.org/10.1080/13674676.2018.1462781

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

  • Sick Visit: Integumentary Felipe Barbosa Shadow Health Treatment Plan

    Sick Visit: Integumentary Felipe Barbosa Shadow Health Treatment Plan

    Treatment Plan: 38 of 40 (95.0%)

    Problem Selection

    6 out of 6

    Diagnosis

    Learner Selection

    Model Documentation

     Diagnosis: 
    Herpes Zoster

    Evidences:

     
    Burning pain at rash location

     
    Clustered rash with vesicular lesions

     
    History of chickenpox infection

     
    Recent period of severe mental stress

     
    Rash placement along the dermatome on one side of the body

    Learner Rationale:

    Above symptoms are consistent with Herpes Zoster

    Score: 
    6 
    out of
     6

     Diagnosis: 
    Herpes Zoster

    Evidences:

    Burning pain at rash location

    Clustered rash with vesicular lesions

    History of chickenpox infection

    Recent period of severe mental stress

    Rash placement along the dermatome on one side of the body

    Model Rationale:

    Herpes zoster is the most likely diagnosis for Mr. Barbosa given his signs and symptoms. The clustered rash of vesicular lesions, causing burning pain and occurring along the dermatome on one side of the body, is consistent with herpes zoster. Mr. Barbosa has previous history of a chickenpox infection, which is required in order for herpes zoster to be triggered. Additionally, the patient’s recent stress after losing his loved one provides a potential antecedent to the onset of the zoster outbreak Sick Visit: Integumentary Felipe Barbosa Shadow Health Treatment Plan.

    Plan of Care

    7 out of 7

    PLACE YOUR ORDER HERE

    Review your answers for the Plan of Care activity. You must select “Yes” or “No” for each of the seven care actions. You will receive one point for determining the correct answer for each care action.

    Learner Selection

    Model Documentation Sick Visit: Integumentary Felipe Barbosa Shadow Health Treatment Plan

    Pharmacological Intervention

    Selected:
    xx

    Learner Rationale:

    xx

    Score: 
    1 
    out of
     1

    Recommended:
    xx

    You will want to prescribe medication for the patient. You will conduct a medication selection in the next activity.

    Non-Pharmacological Intervention

    Selected:
    xx

    Learner Rationale:

    xx

    Score: 
    1 
    out of
     1

    Recommended:
    xx

    xx.

    Educate Patient

    Selected:
    xx

    Learner Rationale:

    xx

    Score: 
    1 
    out of
     1

    Recommended:
    xx

    You should xx; until this has happened, the patient should avoid sharing towels, clothing, and bedding, as such items can pass the virus to others who come in contact with them. The patient needs to return for an urgent follow-up if symptoms worsen, which include: exacerbated pain, fever, the appearance or spread of lesions near the eyes, inside the mouth, or on the genitals.

    Preventive Screening and Intervention

    Selected:
    xx

    Learner Rationale:

     

    Score: 
    1 
    out of
     1

    Recommended:
    xx

    At this time,xxx. Recommending preventative screens and interventions at this time are xx. Preventative screenings and interventions can be recommended during an xx

    Diagnostic Testing: Labs and Imaging

    Selected:
    xx

    Learner Rationale:

     

    Score: 
    1 
    out of
     1

    Recommended:
    xx

    As the patient’s diagnosis is evident, further diagnostic testing is needed.

    Sick Visit: Integumentary Felipe Barbosa Shadow Health Treatment Plan

    Referral of Care

    Selected:
     

    Learner Rationale:

     

    Score: 
    1 
    out of
     1

    Recommended:
     

    There’s evidence that the patient requires any referral to another healthcare provider at this time.

    Continued Care and Follow-up

    Selected:
     

    Learner Rationale:

    x

    Score: 
    1 
    out of
     1

    Recommended:
     

    You want to instruct the patient to follow up as needed for this condition and address any ongoing issues that arise with regards to pain management and medication changes. Additionally, it is good practice to remind patients to follow-up for their annual physicals and wellness checks.

    Medication Selection

    xx

    This activity represents your ability to synthesize subjective data, objective data, guidelines, drug interactions, and contraindications to select the most effective medications(s) for the patient’s problems. Your points are based on the selection of correct medication(s) for the patient’s indication(s), with some points being removed based on the number of attempted tries.

    Learner Selection

    Model Documentation

    Target:

    Herpes Zoster Treatment

    Selected Medication:

     
    acyclovir (800 mg 5x/day for 7 days)

    Score: 
    9 
    out of
     9

    Acyclovir, famciclovir, and valacyclovir are all appropriate choices for the treatment of Mr. Barbosa’s herpes zoster when prescribed with the correct dosing instructions. Antibiotics are an inappropriate selection because herpes zoster is a viral infection, which antibiotics cannot treat. The antivirals oseltamivir and remdesivir have not been proven effective in the treatment of herpes zoster Sick Visit: Integumentary Felipe Barbosa Shadow Health Treatment Plan.

  • Felipe Barbosa Sick Visit: Integumentary ShadowHealth Transcript

    Felipe Barbosa Sick Visit: Integumentary ShadowHealth Transcript

    Transcript

    Started:
    Feb 16, 2023 | 
    Total Time:
    102 min

    All Lines (82)
    Interview Questions (59)
    Statements (9)
    Exam Actions (14)

    Hello. I am xxx, I will interview and examine you.

    Greet

    02/19/23 5:47 PM EST

    Hi.

    What is your name?

    Question

    02/19/23 5:47 PM EST

    Felipe Barbosa

    Felipe Barbosa Sick Visit: Integumentary ShadowHealth Transcript

    What brings you here today?

    Question

    02/19/23 5:48 PM EST

    I’m here for this pain and rash on my back.

    I am sorry about that

    Empathize

    02/19/23 5:49 PM EST

    Thank you.

    How long have you had the pain and rash?

    Question

    02/19/23 5:51 PM EST

    The pain and rash has been going on for two days, though I had some tingling in the area four days ago . . . [AUDIO COMING SOON]

    Can you describe the rash?

    Question

    02/19/23 5:51 PM EST

    Yeah, the rash is red, has small blisters, and I feel a burning pain.

    How long does the pain last?

    Question

    02/19/23 5:52 PM EST

    The pain has been constant.

    How severe is your pain?

    Question

    02/19/23 5:53 PM EST

    Pain — 7 out of 10.

    PLACE YOUR ORDER HERE

    Where is the rash located?

    Question

    02/19/23 5:53 PM EST

    The rash is on my right lower back. I have pain there too, but it’s not radiating.

    What relieves your symptoms?

    Question

    02/19/23 5:53 PM EST

    I took some ibuprofen for the pain — that helped a little. I tried an ice pack, but that did nothing. I didn’t try any ointments or anything for the rash.

    I’m glad that ibupfrofen helped a little

    Empathize

    02/19/23 5:55 PM EST

    I appreciate that.

    What makes your symptoms worse

    Question

    02/19/23 5:56 PM EST

    Sweat and being hot make the pain feel worse. The pain is constant and in the area of the rash.

    What is your medical history?

    Question

    02/19/23 5:57 PM EST

    Aside from the rash and the pain, no other health issues.

    Any allergies?

    Question

    02/19/23 5:57 PM EST

    Nope, I don’t have allergies.

    Have you had a rash in the past?

    Question

    02/19/23 5:58 PM EST

    Yeah I have a rash and pain in my back.

    Are your immunizations up to date?

    Question

    02/19/23 5:58 PM EST

    Yup, I have all my shots.

    Any past history of skin conditions?

    Question

    02/19/23 5:59 PM EST

    I don’t have any skin conditions or other medical conditions. Just this rash. [AUDIO COMING SOON]

    Any history of chronic disease?

    Question

    02/19/23 6:02 PM EST

    Yeah, my family has some health issues — Dad has high cholesterol and hypertension. Mom has diabetes. They’re both living.

    Are you using any other medications? (Clarified to What other medications are you taking?.)

    Question

    02/19/23 6:03 PM EST

    I don’t have any prescriptions. I just take ibuprofen. (Clarified to what other medications I am taking.)

    Have you been sexually active

    Question

    02/19/23 6:03 PM EST

    Not totally sure how that relates, but yes . . . I’m sexually active with my husband. Not since I got this rash, though. [AUDIO COMING SOON]

    Some skin conditions are spread through contact

    Educate

    02/19/23 6:05 PM EST

    I’ll make a note of that.

    Any fever?

    Question

    02/19/23 6:05 PM EST

    No, I haven’t had a fever.

    Any history of eczema? (Clarified to Do you have a history of psychiatric illness?.)

    Question

    02/19/23 6:06 PM EST

    I don’t have any clinical mental health issues, but I’m grappling with a traumatic incident — my best friend died recently. (Clarified to if I have a history of psychiatric illness.)

    Am sorry about that

    Empathize

    02/19/23 6:07 PM EST

    Thanks.

    Are you using any supplements? (Clarified to Do you take vitamins or supplements?.)

    Question

    02/19/23 6:08 PM EST

    No, I don’t take vitamins or supplements. (Clarified to if I take vitamins or supplements.)

    Any recent travel?

    Question

    02/19/23 6:09 PM EST

    We haven’t traveled recently. Not since our honeymoon a few years ago. [AUDIO COMING SOON]

    Any history of surgeries?

    Question

    02/19/23 6:09 PM EST

    Nope, I’ve never had surgery before.

    Any history of hospitalizations?

    Question

    02/19/23 6:10 PM EST

    Nope, no hospitalizations.

    Any recent exposure to chemicals? (Clarified to Have you had any recent exposure to plants?.)

    Question

    02/19/23 6:13 PM EST

    No, I haven’t touched any strange plants or anything. [AUDIO COMING SOON] (Clarified to if I have had recent exposure to plants.)

    What is your diet like?

    Question

    02/19/23 6:13 PM EST

    I usually do a protein shake for breakfast and load it up with lots of stuff — I use some super greens powder, or fresh greens if I have them on hand, some fruit, oatmeal, yogurt . . . they keep me pretty full in the morning before my workouts. Lunch is usually something quick like a salad and pizza, or grain bowl. Dinner I’ll have some steak or fish with pasta and roasted vegetables. I snack too . . . nuts, chips and guacamole, a good cheese plate, an occasional doughnut Felipe Barbosa Sick Visit: Integumentary ShadowHealth Transcript.

    Healthy diet is good for your skin

    Educate

    02/19/23 6:15 PM EST

    Ah, alright, thanks.

    Any family history of skin conditions?

    Question

    02/19/23 6:16 PM EST

    I don’t think any skin diseases run in my family. [AUDIO COMING SOON]

    Any joint pain?

    Question

    02/19/23 6:18 PM EST

    I don’t have any joint issues.

    Any night sweats? Felipe Barbosa Sick Visit: Integumentary ShadowHealth Transcript

    Question

    02/19/23 6:18 PM EST

    I don’t get night sweats.

    Any vision problems?

    Question

    02/19/23 6:20 PM EST

    My eyes and vision are good. [AUDIO COMING SOON]

    Any numbness or tingling?

    Question

    02/19/23 6:21 PM EST

    I have some tingling sensations in the rash area. The tingling has been going on for about four days. The rash only showed up two days ago.

    Am sorry about that

    Empathize

    02/19/23 6:22 PM EST

    That’s nice of you.

    Any nausea?

    Question

    02/19/23 6:22 PM EST

    I haven’t been nauseated.

    Auscultated breath sounds: Breath sounds present in all areas with no adventitious sounds

    Exam Action

    02/19/23 7:09 PM EST

     Auscultated heart sounds: S1 and S2 audible with no extra heart sounds

    Exam Action

    02/19/23 7:10 PM EST

     Assessed location of rash.

    Exam Action

    02/19/23 7:12 PM EST

     Assessed character of rash.

    Exam Action

    02/19/23 7:13 PM EST

     Palpated abdomen light

    Exam Action

    02/19/23 7:13 PM EST

     Palpated spine: Spine and accessory muscles were nontender to palpation.

    Exam Action

    02/19/23 7:14 PM EST

     Palpated rash: Patient verbalized pain by saying “Ouch” upon palpation Felipe Barbosa Sick Visit: Integumentary
    ShadowHealth
    Transcript

    Exam Action

    02/19/23 7:14 PM EST

     Tested sensation in left and right legs: Expected sensation in left and right legs

    Exam Action

    02/19/23 7:15 PM EST

     Tested sensation of left and right feet: Tested sensation in feet. Expected sensation in left and right feet

    Exam Action

    02/19/23 7:15 PM EST

     Tested spine range of motion: Full range of motion performed without discomfort

    Exam Action

    02/19/23 7:15 PM EST

    Are you able to work?

    Question

    02/19/23 7:22 PM EST

    Well I’m a firefighter and I’ve been on my off schedule. I guess I’ll find out tomorrow when I’m back on shift if the pain is going to get in the way . . . I’ll grit through the pain.

    Can you stand? (No matching questions found.)

    Question

    02/19/23 7:25 PM EST

    Have the symptoms affected your sleep?

    Question

    02/19/23 7:25 PM EST

    Aside from the pain, I have a rash and I’ve been feeling a little tired.

    Any fatigue?

    Question

    02/19/23 7:26 PM EST

    Yeah, I’ve been tired lately.

    How many hours do you sleep per day?

    Question

    02/19/23 7:26 PM EST

    Usually 8 hours a night. [AUDIO COMING SOON]

    Any sore throat?

    Question

    02/19/23 7:27 PM EST

    My throat feels fine. [AUDIO COMING SOON]

    Any history of infection? (Clarified to Have you ever been diagnosed with an STD?.)

    Question

    02/19/23 7:28 PM EST

    Um . . . that’s sort of out of nowhere, but no, I don’t have an STD. [AUDIO COMING SOON] (Clarified to if I have been diagnosed with an STD.) Felipe Barbosa Sick Visit: Integumentary ShadowHealth Transcript

    Any stress? (Clarified to Have you been stressed recently?.)

    Question

    02/19/23 7:29 PM EST

    I recently lost my best friend . . . he died in the line of duty, he was a firefighter too. It’s been hard. (Clarified to if I have been stressed out lately.)

    Am sorry about that

    Empathize

    02/19/23 7:30 PM EST

    I appreciate it. Felipe Barbosa Sick Visit: Integumentary ShadowHealth Transcript

    Any history of back pain?

    Question

    02/19/23 7:34 PM EST

    Before the current pain in my right lower back, I haven’t had major back pain. [AUDIO COMING SOON]

    Are you depressed?

    Question

    02/19/23 7:34 PM EST

    I don’t have clinical depression or anything, but . . . I lost my best friend recently, and I’ve been in mourning. [AUDIO COMING SOON]

    Any history of HIV? (Clarified to Do you have a history of anxiety?.)

    Question

    02/19/23 7:35 PM EST

    I don’t have an anxiety disorder . . . but . . . and I don’t know if “anxiety” is the right word . . . I lost my best friend recently, and I’ve definitely been on edge. [AUDIO COMING SOON] (Clarified to if I have a history of anxiety.)

    Any history of childhood illnesses?

    Question

    02/19/23 7:36 PM EST

    Um, I had chickenpox as a kid.

    Does the pain radiate?

    Question

    02/19/23 7:42 PM EST

    The pain in the rash area is really only on my right lower back. It doesn’t go anywhere else.

    Do you work?

    Question

    02/19/23 7:43 PM EST

    Yeah, I’m firefighter.

    Felipe Barbosa Sick Visit: Integumentary ShadowHealth Transcript

  • Advancements in Nursing Informatics

    Advancements in Nursing Informatics

    Nursing informatics is not a new concept. Review the following timeline to understand the advancements in nursing informatics since the 1950s.

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    1950s – Harriet Werley, the first designated nurse researcher at the Walter Reed Army Research Institute, was asked by IBM to consult on the use of computers in health care.

    1960s – Critical care technology emerged in the form of mechanical ventilators and cardiac monitors.

    1970s – Computer-based information systems (CIS) were implemented in hospitals.

    1980s – The American Nurses Association (ANA) and the National League for Nursing established a council and forum on Computer Applications in Nursing.

    1990s – The ANA published the first versions of the Scope of Nursing Informatics Practice and the Standards of Nursing Informatics Practice.

    2006 – The
    HIMSS TIGER
    initiative began, focused on increasing the use of technology and informatics in practice, research, and education to improve patient care.

    2008 – The ANA released a revised scope and standards for practice in nursing informatics.

    2009 – The Health Information Technology for Economic and Clinical Health
    (HITECH) Act
    passed to provide the Department of Health and Human Services (HHS) the “authority to establish programs to improve health care quality, safety, and efficiency through the promotion of health IT, including electronic health records and private and secure electronic health information exchange.”

    2010 – The Institute of Medicines’
    Future of Nursing
    report is released listing “effective workforce planning and policy making require better data collection and information infrastructure” as one of its four key messages – having a direct impact on the field of informatics.

     

    Source

    Ozbolt, J. & Saba, V. (2008). A brief history of nursing informatics in the United States of America. Nursing Outlook, 56, 199-205.e2. doi: http://dx.doi.org/10.1016/j.outlook.2008.06.008 Advancements in Nursing Informatics

  • HSN/376: Health Information Technology For Nursing

    HSN/376: Health Information Technology for Nursing

    Course Information

    Description

    This course examines electronic modalities that assist in patient-centered health care management. Topics include informatics, automation of data management, and evaluation of information systems. A key focus is the relationship between technology in health care delivery and patient safety.

    Credits

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    Learning Outcomes

    In this course you will learn to:

    Where you will demonstrate your learning:

    Explain the role of information and data management in improving patient care.

    Wk 1
    – Summative Assessment: Information Technology, Safety, and Patient Outcomes

    Describe how clinical decision support systems are used to improve patient safety and care.

    Wk 3  – Summative Assessment: Solution Proposal: General Solution

    Analyze how consumer health information and informatics changes can redefine health advice and care.

    Wk 5  – Summative Assessment: Informatics Solution Proposal: Specific Solution Presentation HSN/376: Health Information Technology For Nursing

     

    Materials

    Textbook

    Hebda, T., Hunter, K., & Czar, P. (2019).
    Handbook of informatics for nurses and healthcare professionals
    (6th ed.). Prentice-Hall/Pearson.

     

     

     

    Schedule Overview

    Note: Assignments are due Monday unless indicated otherwise. Initial discussion posts are due Thursday and the 2 required responses are due Monday.

    Wk and Topic

    Activities

    Assignments and Points

    Wk 1 – Role of Technology and Informatics in Nursing

    Handbook of Informatics for Nurses and Healthcare Professionals
    , Ch. 1 and 7

    Advancements in Nursing Informatics

    P.A.T.C.H. Test (Pretest for Attitudes Toward Computers in Healthcare)

    Nursing Informatics: Beyond the Electronic Health Record

    HSN/376: Health Information Technology For Nursing

    University Library Resources

    Discussion – 40 points

    Summative Assessment: Information Technology, Safety, and Patient Outcomes
    – 150 points

    Wk 2 – Health Information System Overview

    Handbook of Informatics for Nurses and Healthcare Professionals
    , Ch. 3, 4, and 8

    Health Information System Components

    What is a Health Information System (HIS)?

    University Library Resources

    Discussion
    – 40 points

    Informatics Solution Proposal: Issue Identification – 150 points

    Wk 3 – Clinical Decision Support Systems

    Handbook of Informatics for Nurses and Healthcare Professionals
    , Ch. 10

    Clinical Decision Support

    University Library Resources

    Discussion – 40 points

    Summative Assessment: Informatics Solution Proposal: General Solution – 150 points

    Wk 4 – Consumer Education and Informatics

    Handbook of Informatics for Nurses and Healthcare Professionals
    , Ch. 18

    Consumer Health Informatics (CHI)

    Self-Paced Patient Education

    Consumer Health

    University Library Resources

    Discussion – 40 points

    Informatics Solution Proposal: Areas of Evaluation – 150 points

    Wk 5 – Future Trends in Health Care Technology

    Handbook of Informatics for Nurses and Healthcare Professionals
    , Ch. 19

    AI Technology in Healthcare

    The Future of Healthcare

    The Future of Nursing Technology

    Nursing Informatics: A Day in the Life

    University Library Resources

    Discussion – 40 points

    Summative Assessment: Informatics Solution Proposal: Specific Solution Presentation – 200 points

    HSN/376: Health Information Technology For Nursing

  • Health Care Information Systems

    Wk 2 Discussion – Health Care Information Systems [due Thurs]

    Discussion Topic

    Post a total of 3 substantive responses over 2 separate days for full participation. This includes your initial post and 2 replies to other students.

    Due Thursday

    As outlined in the case study at the end of Ch. 8 in the
     Handbook of Informatics for Nurses & Healthcare Professionals
    , take an inventory of the information systems in your organization or at an organization in which you were previously employed.

     

    Use your own observations and conversations with staff and leaders.

     

    Compare your list with the systems described in Ch. 8.

     

    Answer the following questions in a minimum of 175 words:

    How would you rate the information technology status of your organization?

    How would you improve your information systems?

     

    Due Monday  

    Post 2 replies to classmates or your faculty member. Be constructive and professional.

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