Hi,

 i need 2-3 paragraphs:

 

After reading the article selected and applying the Qualitative CASP tool, use the following questions to guide your participation in the discussion forum:

• What have been your prior experience(s) in journal club participation?  If you have had previous exposure, what was your overall impression of the utility of journal clubs for nurses?
• What were significant differences you found in this qualitative approach versus a quantitative approach?
• If you had to identify a preference, do you think you lean more toward a qualitative or quantitative approach to research?(FYI: “approach” is a deliberate choice of words; the word method is not interchangeable. Method speaks to specific blueprint of a study whether a quantitative or qualitative approach)
• What are your thoughts regarding the implementation of the CASP tool? Have you used the CASP previously?
• Article specific questions: (article that you used to complete the CASP tool)
  • What are your initial thoughts on specific topics found in the selected qualitative study?
  • What were the strengths & weaknesses of this study? If you could make changes or modifications of the study, what might they consist of in making research revisions?
  • How do the results relate to current practice and how might they influence future practice in your nursing work environment?
  • Do you envision these study results changing the landscape of clinical practice or redirecting research in this field? If so, how?.
  • Articulate your  thoughts regarding the rigor and credibility of this qualitative study

 

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See The Attached Assignment/ Homework of Disc – WK 10(A)

 

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                     Discussion: Group Therapy with Older  Adults

 

Group therapy with older adults, like group therapy with children and adolescents, presents unique challenges. Many older adults have had a lifetime of not sharing their inner feelings with others, and they are often fearful of being judged. However, when the group setting is properly facilitated, older adults may embrace the setting, find comfort in their peers, and benefit from this therapeutic approach. In your role, how might you maximize the benefits of group therapy for your older adult clients?

This week, as you explore group therapy with older adults, you examine your own group therapy sessions with older adult clients. You also recommend strategies for improving the effectiveness of this therapeutic approach.

As the population continues to age, more and more older adults will require therapy for various mental health issues. While the group setting offers many benefits and makes therapy more accessible to those in need of services, this therapeutic approach may not be effective for all clients. For this Discussion, as you examine your own practicum experiences with older adults in group therapy settings, consider strategies to improve the effectiveness of your sessions.

  To prepare:

· Review this week’s Learning Resources, and consider the insights provided on group  

  therapy with older adults.

· Reflect on your practicum experiences with older adults in group therapy settings.

 

                                                          Assignment 

Post a description of a group therapy session with older adults, including the stage of the group, any resistances or issues that were present, and therapeutic techniques used by the facilitator. Explain any challenges that may occur when working with this group. Support your recommendations with evidence-based literature.

PLEASE REMEMBER TO INCLUDE INTRODUCTION, CONCLUSION AND REFERENCES USING APA FORMAT. 

                                              Learning Resources

Required Readings

Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice. New York, NY: Springer.

· Chapter      18, “Psychotherapy with Older Adults” (pp. 62–660)

Bonhote, K., Romano-Egan, J., & Cornwell, C. (1999). Altruism and creative expressions in a long-term older adult psychotherapy group. Issues in Mental Health Nursing, 20(6), 603–617. doi:10.1080/016128499248394

  

Cheston, R., & Jones, R. (2009). A small-scale study comparing the impact of psycho-education and exploratory psychotherapy groups on newcomers to a group for people with dementia. Aging & Mental Health, 13(3), 420–425. doi:10.1080/13607860902879409

 

Krishna, M., Honagodu, A., Rajendra, R., Sundarachar, R., Lane, S., & Lepping, P. (2013). A systematic review and meta-analysis of group psychotherapy for sub-clinical depression in older adults. International Journal of Geriatric Psychiatry, 28(9), 881–888. doi:10.1002/gps.3905

 

Krishna, M., Jauhari, A., Lepping, P., Turner, J., Crossley, D., & Krishnamoorthy, A. (2011). Is group psychotherapy effective in older adults with depression? A systematic review. International Journal of Geriatric Psychiatry, 26(4), 331–340. doi:10.1002/gps.2546

 
Rice, A. (2015). Common therapeutic factors in bereavement groups. Death Studies, 39(3), 165–172. doi:10.1080/07481187.2014.946627

  

Wang, C., Tzeng, D., & Chung, W. (2014). The effect of early group psychotherapy on depressive symptoms and quality of life among residents of an apartment building for seniors. Psychogeriatrics: The Official Journal of the Japanese Psychogeriatric Society, 14(1), 38–46. doi:10.1111/psyg.12037

 

Watkins, R., Cheston, R., Jones, K., & Gilliard, J. (2006). ‘Coming out’ with Alzheimer’s disease: Changes in awareness during a psychotherapy group for people with dementia. Aging & Mental Health, 10(2), 166–176. doi:10.1080/13607860500312209

   

 

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                             Psychiatric Assessment of the Adult and Older Adult

Many assessment principles are the same for children and adults; however, with adults/older adults, consent for participation in the assessment comes from the actual client and not parents or guardians. The exception to this is adults/older adults who have been determined incapacitated by a court of competent jurisdiction. Some adults may be easier to assess than children/adolescents as they are more psychologically minded. That is, they have better insights into themselves and their motivations than children/adolescents (although this is not universally true).

Older adults present some of their own unique assessment challenges in that they may have higher levels of stigma associated with seeking psychiatric care. Additionally, there are higher rates of neurocognitive disorders superimposed on other clinical conditions such as depression or anxiety, which creates additional diagnostic challenges.

This week, you will develop your own personal format for initial interviews of mental health clients. You also will explore the restrictions and limitations for practice as a PMHNP in your home state and create a plan for passing the national certification exam.

Week 1-developing skills in interviewing and diagnostic reasoning

As we begin Week 1, the module is focused on developing an interview format that provides you with questions/responses that you will use in your work-ups and diagnostic assessments or some call them Psychiatric H & P. By now, you have seen many different formats and ways that providers conduct interviews. 

For this document, I encourage you to think of your personal style as well as assure that all relevant information is collected in the first interview. Do not use a template that you find online or that your preceptor uses in the office. The purpose of this assignment is for you to think through how you interview patients. There are many examples online to use as a guide. The key elements are similar to a medical H &P, HPI, PPH, PMH, FH, SH, ROS (psychiatric), MSE, Clinical Assessment and Formulation, Diagnosis, and Plan. This will be your ‘bread and butter’, so to speak for your entire career. It is worth spending some time and effort on this. If you put in a canned template, I will not accept your work.
 

My personal style is what I would call ‘conversational’. I try to engage in some social conversation to get the visit started and then as the patient talks, I make notes on follow-up questions. I keep a list of the basic things that I need for my write-up: HPI, PPH, PMH, Soc/Dev, Substance use, Medication history, Stressors, coping abilities, therapy history. At the end of what I consider ‘the interview’ I review my list to make sure that I have all the information and I sometimes say to patients, “let me make sure that I got all the information that I need to make an accurate diagnosis and develop a treatment plan”. Then, I will say to the patient, “do you have anything that you’d like to add?”

This conversational style is not for everyone and I know many providers that use more of a ‘checklist’ style. Think about what you want and how you will feel most comfortable. Feel free to provide feedback to your colleagues –there are no right or wrong styles. 

Instructions- Week 1: 

Despite what you may believe (or may have been told), there is no such thing as one “right” way to do an interview. In fact, there are numerous books written about the various ways of conducting the clinical interview. In actual clinical practice, you will find the format that “works” best for you and addresses your unique strengths and the needs of the client.

In this Discussion, you will practice finding the interview format that works for you and share those ideas with your colleagues for feedback.

                                                                      Learning Objectives

Students will:

• Develop formats for initial interviews of mental health clients

To prepare for this Discussion:

• Review  the Learning Resources.
• Develop an interview format you would use for an initial interview of a client.

                                                           ASSIGNMENT

• Attach  the interview format document you would use for an initial interview of a client.
• Describe      what interview format your preceptor uses for the initial interview of a  client.
• Describe      which element of your interview format is most helpful in your practice.

                                               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.

• Section 5.1, “Psychiatric Interview, Mental Status      Examination” (pp. 192–211)
• Section 5.2, “The Psychiatric Report and Medical      Record” (pp. 211–217)
• Section 5.3, “Psychiatric Rating Scales” (pp. 217–236)
• Section 5.5, “Personality Assessment: Adults and      Children” (pp. 246–257)
• Section 5.7, “Medical Assessment and Laboratory Testing      in Psychiatry” (pp. 266–275)
• Chapter      6, “Classification in Psychiatry” (pp. 290–308)

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

• “Cautionary Statement for Forensic Use of DSM-5”
• “Assessment Measures”
• “Cultural Formulation”
• “Glossary of Technical Terms”
• “Glossary of Cultural Concepts of Distress”

Barton Associates. (2017). Nurse practitioner scope of practice laws. Retrieved from https://www.bartonassociates.com/locum-tenens-resources/nurse-practitioner-scope-of-practice-laws/

American Psychiatric Association. (2016). Practice guidelines for the psychiatric 

evaluation of adults. Retrieved from http://psychiatryonline.org/doi/pdf/10.1176/appi.books.9780890426760

Required Media

Laureate Education (Producer). (2017b). Working with Adults and Older Adults” [Video file]. Baltimore, MD: Author.

Hagen, B. (Producer). (n.d.-a). Conducting a mental status exam [Video file]. Mill Valley, CA: Psychotherapy.net.

Optional Resources

American Psychological Association. (2008). Assessment of older adults with diminished capacity. Retrieved from https://www.apa.org/pi/aging/programs/assessment/capacity-psychologist-handbook.pdf 

Rosen, S. L., & Reuben, D. B. (2011). Geriatric assessment tools. Mount Sinai Journal of Medicine, 78(4), 489–497. doi:10.1002/msj.20277

Substance Abuse and Mental Health Services Administration (SAMHSA). (2015). TIP 59: Improving cultural competence. Retrieved from http://store.samhsa.gov/product/TIP-59-Improving-Cultural-Competence/SMA15-4849

 

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