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Supportive and Interpersonal Psychotherapy

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Nursing homework help
Week 7: Supportive and Interpersonal Psychotherapy
Amelia, a 16-year-old high school sophomore, presents with symptoms of weight loss and a very obvious concern for her weight. She has made several references to being “fat” and “pudgy” when, in fact, she is noticeably underweight. Her mother reports that she is quite regimented in her eating and that she insists on preparing her own meals as her mother “puts too many fattening things in the food” that she cooks. After discovering that during the past 3 months Amelia has lost 15 pounds and is well under body weight for someone of similar age/sex/developmental trajectory, the psychiatric mental health nurse practitioner diagnosed Amelia with anorexia nervosa.
Evidence-based research shows that clients like Amelia may respond well to supportive psychotherapy and interpersonal psychotherapy. So which approach might you select? Are both equally effective for all clients? In practice, you will find that many clients may be candidates for both of these therapeutic approaches, but factors such as a client’s psychodynamics and your own skill set as a therapist may impact their effectiveness.
This week, you continue exploring therapeutic approaches and their appropriateness for clients as you examine supportive psychotherapy and interpersonal psychotherapy. You also assess progress for a client receiving psychotherapy and develop progress and privileged psychotherapy notes for the client.
Photo Credit: Laureate Education
Learning Resources
Required Readings
Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (2nd ed.). New York, NY: Springer Publishing Company.
· Chapter 5, “Supportive and Psychodynamic Psychotherapy” (pp. 238–242)
· Chapter 9, “Interpersonal Psychotherapy” (pp. 347–368)
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
Note: You will access this text from the Walden Library databases.
Abeles, N., & Koocher, G. P. (2011). Ethics in psychotherapy. In J. C. Norcross, G. R. VandenBos, D. K. Freedheim, J. C. Norcross, G. R. VandenBos, & D. K. Freedheim (Eds.), History of psychotherapy: Continuity and change (pp. 723–740). Washington, DC: American Psychological Association. doi:10.1037/12353-048
Note: You will access this resource from the Walden Library databases.
Cameron, S., & Turtle-Song, I. (2002). Learning to write case notes using the SOAP format. Journal of Counseling and Development, 80(3), 286–292. Retrieved from the Academic Search Complete database. (Accession No. 7164780)
Note: You will access this article from the Walden Library databases.
Nicholson, R. (2002). The dilemma of psychotherapy notes and HIPAA. Journal of AHIMA, 73(2), 38–39. Retrieved from http://library.ahima.org/doc?oid=58162#.V5J0__krLZ4http://library.ahima.org/doc?oid=58162#.V5J0__krLZ4
U.S. Department of Health & Human Services. (n.d.). HIPAA privacy rule and sharing information related to mental health. Retrieved from http://www.hhs.gov/hipaa/for-professionals/special-topics/mental-health/
Required Media
Sommers-Flanagan, J., & Sommers-Flanagan, R. (2013). Counseling and psychotherapy theories in context and practice [Video file]. Mill Valley, CA: Psychotherapy.net.
Note: For this week, view Reality Therapy, Feminist Therapy, and Solution-Focused Therapy only. You will access this media from the Walden Library databases.
Stuart, S. (2010). Interpersonal psychotherapy: A case of postpartum depression [Video file]. Mill Valley, CA: Psychotherapy.net.
Note: You will access this media from the Walden Library databases. The approximate length of this media piece is 110 minutes.
Assignment 1: Supportive Psychotherapy Versus Interpersonal Psychotherapy
Although supportive psychotherapy and interpersonal psychotherapy share some similarities, these therapeutic approaches have many differences. When assessing clients and selecting therapies, it is important to recognize these differences and how they may impact your clients. For this Assignment, as you compare supportive and interpersonal psychotherapy, consider which therapeutic approach you might use with your clients.
Learning Objectives
Students will:
· Compare supportive psychotherapy and interpersonal psychotherapy
· Recommend therapeutic approaches for clients presenting for psychotherapy
To prepare:
· Review the media in this week’s Learning Resources.
· Reflect on supportive and interpersonal psychotherapeutic approaches.
The Assignment
In a 1- to 2-page paper, address the following:
· Briefly describe how supportive and interpersonal psychotherapies are similar.
· Explain at least three differences between these therapies. Include how these differences might impact your practice as a mental health counselor.
· Explain which therapeutic approach you might use with clients and why. Support your approach with evidence-based literature.
Note: The School of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the Walden Writing Center provides an example of those required elements (available at

Does the development of community programs and providing health education, reduce Disparities in Hypertension in predominately African American Communities versus a more diverse community?

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Nursing homework help
Problem Statement: African Americans have the highest population of people diagnosed with hypertension.
Research Question: Does the development of community programs and providing health education, reduce Disparities in Hypertension in predominately African American Communities versus a more diverse community?
By Saturday, October 14, 2017 write a 2–3-page paper addressing the sections below of the research proposal. Citation/References within 5 years.
Methodology
Extraneous Variables (and plan for how controlled).
Instruments: Description, validity, and reliability estimates, which have been performed (on a pre-established measure). Include plans for testing validity and reliability of generating your own instrument(s).
Description of the Intervention
Data Collection Procedures
Assignment 2 Grading CriteriaMaximum Points
Identifies extraneous variables and plan for how controlled.5
Instrument is appropriate to address research question.5
Includes description of the selected instrument(s), validity, and reliability estimates.5
Description of the Intervention is fully addressed.5
Data Collection Procedures are clear and succinct.5
Followed APA guidelines for writing style, spelling and grammar, and citation of sources.5
Total:30
Measurement Theory Concepts
Measurement is the process of assigning numbers to objects (or events or situations) in accord with some rule. Numbers assigned can indicate numerical values or categories.
Instrumentation, a component of values or categories is performed consistently from one subject (or event) to another and, eventually, if the measurement strategy is found to be meaningful, from one study to another. Begins by clarifying the object, characteristic, or element to be measured.
Directness of Measurement: can be a person’s height or BMI—this is a concrete form of measurement
Indirect measurement: Aimed at abstract concepts, such as pain, depression, self-care
The instrument used in the study must match the conceptual definition.
There is no perfect measure. Error is inherent in any measurement strategy.
Measurement error
Measurement error is the difference between what exists in reality and what is measured by a research instrument.
Two types of measurement error:
Random error: causes individuals’ observed scores to vary around their true score. For example, one’s observed score may be higher than the true score.
Systematic error: This is error that is not random. For example, use of a weight scale that weighed subjects 2 lb. more than their true weights. All of the body weights would be higher and thus, the mean would be higher than it should be.
Levels of Measurement
Nominal: lowest level, used when data is organized into categories.
Ordinal: Data that is assigned to categories of an attribute that can be ranked. Categories (as in nominal) must be exclusive. Example: Degrees of coping, intensity of pain, daily amount of exercise.
Interval: Distances between intervals of the scale are numerically equal. Must be mutually exclusive, and rank ordered. Assumed to be a continuum of values. Fahrenheit temperatures are an example.
Ratio: This is the highest level of measurement and meets all rules (mutually exclusive categories, rank ordering, equal spacing between intervals, and continuum of values) and adds an absolute zero point. Weight, length, and volume are common examples. Each has an absolute zero point, at which a value of zero indicates the absence of the property being measured.
Reference of Measurement
Norm-Referenced Testing: Test performance standards that have been carefully developed over years with large, representative samples using a standardized test with extensive reliability and validity.
Criterion-Referenced Testing: Comparison of a subject’s score with a criterion of achievement that includes the definition of target behaviors. When behaviors are mastered, the subject is considered proficient in the behaviors.
What is reliability?
Reliability is concerned with how consistently the measurement technique measures the concept of interest. Reliability testing is usually expressed as a form of correlation coefficient.
Types of Reliability
Stability—is concerned with the consistency of repeated measures or test-retest reliability
Equivalence—is focused on comparing two versions of the same instrument (alternate forms reliability) or two observers (interrater reliability) measuring the same event.
Homogeneity—addresses the correlation of various items within the instrument or internal consistency; determined by split-half reliability or Cronbach’s alpha coefficient.
What is validity?
The extent to which an instrument reflects the concept being examined.
Types of Validity
Content-Related Validity: supports the extent to which the instrument measures all relevant dimensions of the construct, often referred to as the universe or domain of the construct.
Criterion-Related Validity: supports the relationship between scores on the research instrument and another measure, known as the criterion.
Construct Validity: refers to the degree to which scores obtained from the use of an instrument are related to the concept of interest to the researcher.
Physiologic Measures
Physical Measurement Methods
Pulse, Blood Pressure
Chemical/biochemical
Blood glucose
Cortisol
Microbiological
Smears
Cultures
Observational Measurement
Unstructured Observations
Involves spontaneously observing and recording what is seen with a minimum of planning.
Structured Observations
Defines carefully what is to be observed. Concern is directed toward how the observations are made, recorded, and coded.
Interviews
Unstructured Interviews
Used primarily in descriptive and qualitative studies. May be initiated by asking a broad question such as, “Describe for me your experience with….”
Structured Interviews
This includes strategies that provide increasing amounts of control by the researcher over the content of the interview. Questions are designed before initiation of data collection.
Unstructured or Open ended:
Tell me about…..
What has been your experience with….?
What was it like to hear you have cancer?
Structured or Closed ended:
Response alternatives fixed
Which would you rather do, x or y?
Questionnaires
Administration
In person/on phone
Self-administered
Mail
Scales
Rating Scales: crudest form of measurement which lists an ordered series of categories of a variable that are assumed to be based on an underlying continuum. A numerical value is assigned to each category. Commonly used by the general public. “On a scale of 1 to 10, I would rate that . . . “
Likert Scales: designed to determine the opinion or attitude of a subject and contains a number of declarative statements with a scale after each statement.
Semantic Differentials: consists of two opposite adjectives with a seven point scale between them. Hot – – – – – – – Cold
Visual Analog Scales: used to measure mood, anxiety, alertness, craving, quality of sleep, etc. Stimuli must be defined in a way that is understandable to the subject. Only one major cue should appear for each scale. The scale is a line 100 mm in length with right-angle stops at each end.
No pain I——————————————————————–I Pain as bad as it possibly can be
Instrument Selection
Best to use existing instruments.
Buros Mental Measurement Institute: http://www.unl.edu/buros
There are several large volumes of test reviews. The reviews cover critical evaluation of the test (e.g., validity, reliability, etc.), and provide information on cost and publisher.
FAQ on Psychological Tests: http://www.apa.org/science/faq-findtests.html
Information on testing considerations from the APA.

write a report on the significance of patient safety and the impact of organizational culture on quality and safety initiatives.

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Nursing homework help

In this assignment you will write a report on the significance of patient safety and the impact of organizational culture on quality and safety initiatives. Share quality and safety experiences that you have encountered in your current or former organization.
You will also create a one-page questionnaire designed to survey co-workers on the organization’s patient safety culture. It will consist of Likert Scale questions. Review the following website for more information on Likert Scaling: https://www.socialresearchmethods.net/kb/scallik.php
Your well-written assignment should meet the following requirements:
· Two-page report, not including the cover or reference pages.
· One-page questionnaire, with 15 Likert Scale questions.
· Formatted per APA.
· Provide support for your work with in-text citations from a minimum of five scholarly articles. Two of these sources may be from the class readings, textbook, or lectures, but two must be external.
· Provide full APA references for the sources used, along with appropriate in-text citations.
· Utilize headings to organize the content in your work.

consider how you might assess and treat pediatric clients presenting symptoms of a mental health disorder.

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Nursing homework help
or this Assignment, as you examine the client case study in this week’s Learning Resources, consider how you might assess and treat pediatric clients presenting symptoms of a mental health disorder.
The Assignment:
Examine Case 2: You will be asked to make three decisions concerning the diagnosis and treatment for this client. Be sure to consider co-morbid physical as well as mental factors that might impact the client’s diagnosis and treatment.
At each Decision Point, stop to complete the following:
Decision #1: Differential Diagnosis
Which Decision did you select?
Why did you select this Decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this Decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #1 and the results of the Decision. Why were they different?
Decision #2: Treatment Plan for Psychotherapy
Why did you select this Decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this Decision? Support your response with evidence and references to
the Learning Resources.
Explain any difference between what you expected to achieve with Decision #2 and the results of the Decision. Why
were they different?
Decision #3: Treatment Plan for Psychopharmacology
Why did you select this Decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this Decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?
Also include how ethical considerations might impact your treatment plan and communication with clients and their families.
Note: Support your rationale with a minimum of three academic resources. While you may use the course text to support your rationale, it will not count toward the resource requirement.
Case #2
Anxiety disorder, OCD, or something else?
8-year-old black male
BACKGROUND
Tyrel is an 8-year-old black male who is brought in by his mother for a variety of psychiatric complaints. Shaquana, Tyrel’s mother, reports that Tyrel has been exhibiting a lot of worry and “nervousness” over the past 2 months. She states that she notices that he has been quite “keyed up” and spends a great deal of time worrying about “germs.” She states that he is constantly washing his hands because he feels as though he is going to get sick like he did a few weeks ago, which kept him both out of school and off the playground. He was also not able to see his father for two weekends because of being sick. Shaquana explains that although she and her ex-husband Desmond divorced about 2 years ago, their divorce was amicable and they both endeavor to see that Tyrel is well cared for.
Shaquana reports that Tyrel is irritable at times and has also had some sleep disturbances (which she reports as “trouble staying asleep”). She reports that he has been more and more difficult to get to school as he has become nervous around his classmates. He has missed about 8 days over the course of the last 3 weeks. He has also stopped playing with his best friend from across the street.
His mother reports that she feels “responsible” for his current symptoms. She explains that after he was sick with strep throat a few weeks ago, she encouraged him to be more careful about washing his hands after playing with other children, handling things that did not belong to him, and especially before eating. She continues by saying “maybe if I didn’t make such a big deal about it, he would not be obsessed with germs.”
Per Shaquana, her pregnancy with Tyrel was uncomplicated, and Tyrel has met all developmental milestones on time. He has had an uneventful medical history and is current on all immunizations.
OBJECTIVE
During your assessment of Tyrel, he seems cautious being around you. He warms a bit as you discuss school, his friends at school, and what he likes to do. He admits that he has been feeling “nervous” lately, but when you question him as to why, he simply shrugs his shoulders.
When you discuss his handwashing with him, he tells you that “handwashing is the best way to keep from getting sick.” When you question him how many times a day he washes his hands, he again shrugs his shoulders. You can see that his bilateral hands are dry. Throughout your assessment, Tyrel reveals that he has been thinking of how dirty his hands are; and no matter how hard he tries to stop thinking about his “dirty” hands, he is unable to do so. He reports that he gets “really nervous” and “scared” that he will get sick, and that the only way to make himself feel better is to wash his hands. He reports that it does work for a while and that he feels “better” after he washes his hands, but then a little while later, he will begin thinking “did I wash my hands well enough? What if I missed an area?” He reports that he can feel himself getting more and more “scared” until he washes his hands again.
MENTAL STATUS EXAM
Tyrel is alert and oriented to all spheres. Eye contact varies throughout the clinical interview. He reports his mood as “good,” admits to anxiety. Affect consistent to self-reported mood. He denies visual/auditory hallucinations. No overt delusional or paranoid thought processes were apparent. He denies suicidal ideation.
Lab studies obtained from Tyrel’s pediatric nurse practitioner were all within normal parameters. An antistreptolysin O antibody titer was obtained for reasons you are unclear of, and this titer was shown to be above normal parameters.
Decision Point One
BASED ON THE INFORMATION PROVIDED IN THE SCENARIO ABOVE, WHICH OF THE FOLLOWING DIAGNOSES WOULD THE PMHNP GIVE TO TYREL?
In your write-up of this case, be certain to link specific symptoms presented in the case to DSM–5 criteria to support your diagnosis.
Generalized Anxiety Disorder (GAD)
Obsessive Compulsive Disorder
Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (“PANDAS”)
ANSWER CHOSEN: Obsessive Compulsive Disorder
Decision Point Two
BASED ON THE ABOVE IN FORMATION, SELECT YOUR NEXT ACTION. BE CERTAIN TO DISCUSS THE RATIONALE FOR YOUR DECISION.
https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6660/05/mm/decision_tree/img/pill-red.pngBegin Zoloft 50 mg orally daily
https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6660/05/mm/decision_tree/img/pill-blue.pngBegin Fluvoxamine immediate release 25 mg orally at bedtime
https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6660/05/mm/decision_tree/img/pill-yellow.pngBegin Fluvoxamine controlled release 100 mg orally in the morning
ANSWER CHOSENhttps://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6660/05/mm/decision_tree/img/pill-blue.pngBegin Fluvoxamine immediate release 25
mg orally at bedtime
RESULTS OF DECISION POINT TWO
· Client returns to clinic in four weeks
· Upon return to the clinic, Tyrel’s mother reported that he has had some
decrease in his symptoms. She states that the frequency of the handwashing
has decreased, and Tyrel seems a bit more “relaxed” overall.
· She also reports that Tyrel has not fully embraced returning to school, but that
his attendance has improved. She reported that over this past weekend, Tyrel
went outside to play with his friend from across the street, which he has not
done in a while.
Decision Point Three
BASED ON THE ABOVE INFORMATION, SELECT YOUR NEXT ACTION. BE CERTAIN TO DISCUSS THE RATIONALE FOR YOUR DECISION.
https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6660/05/mm/decision_tree/img/pill-red.pngIncrease Fluvoxamine to 50 mg orally at bedtime
https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6660/05/mm/decision_tree/img/pill-blue.pngAugment with an atypical antipsychotic such as Abilify
https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6660/05/mm/decision_tree/img/pill-yellow.pngAugment treatment with cognitive behavioral therapy
ANSWER CHOSEN: https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6660/05/mm/decision_tree/img/pill-red.pngIncrease Fluvoxamine to 50 mg orally at
bedtime
Guidance to Student
In terms of an actual diagnosis, the child’s main symptoms are most consistent with obsessive-compulsive disorder. There may also be an element of social phobia developing, but at this point, the PMHNP has not assessed the nature of the school avoidance—that is, why is the child avoiding school. Notice that nothing in the scenario tells us that the PMHNP has assessed this.
Fluvoxamine immediate release is FDA-approved for the treatment of OCD in children aged 8 years and older. Fluvoxamine’s sigma-1 antagonist properties may cause sedation and as such, it should be dosed in the evening/bedtime.
At this point, it would be appropriate to consider increasing the bedtime dose, especially since the child is responding to the medication and there are no negative side effects.
Atypical antipsychotics are typically not used in the treatment of OCD. There is also nothing to tell us that an atypical antipsychotic would be necessary (e.g., no psychotic symptoms). Additionally, the child seems to be responding to the medication, so there is no rationale as to why an atypical antipsychotic would be added to the current regimen.
Cognitive behavioral therapy is the psychotherapy of choice for treating OCD. The PMHNP should augment medication therapy with CBT. If further assessment determines that Tyrel has social anxiety disorder, CBT is effective in treating this condition as well.
Learning Resources
Required Readings
Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer. Chapter 31, “Child Psychiatry” (pp. 1253–1268)
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author “Anxiety Disorders”
American Academy of Child & Adolescent Psychiatry (AACAP). (2012a). Practice parameter for the assessment and treatment of children and adolescents with obsessive-compulsive disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 51(1), 98–113. Retrieved from http://www.jaacap.com/article/S0890-8567(11)00882-3/pdf
McClelland, M., Crombez, M-M., Crombez, C., Wenz, C., Lisius, M., Mattia, A., & Marku, S. (2015). Implications for advanced practice nurses when pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) is suspected: A qualitative study. Journal of Pediatric Health Care, 29(5), 442–452. doi:10.1016/j.pedhc.2015.03.005
Stahl, S. M. (2014). Prescriber’s Guide: Stahl’s Essential Psychopharmacology (5th ed.). New York, NY: Cambridge University Press.
To access information on the following medications, click on The Prescriber’s Guide, 5th Ed. tab on the Stahl Online website and select the appropriate medication.
SEE ATTACHECD DECISION TREE ASSIGNMENT EXAMPLE