NURS6640 Full Course Latest

NURS6640 Psychotherapy With Individuals
Week 1 Discussion
Does
Psychotherapy Have a Biological Basis?
Many
studies have found that psychotherapy is as effective as psychopharmacology in
terms of influencing changes in behaviors, symptoms of anxiety, and changes in
mental state. Changes influenced by psychopharmacology can be explained by the
biological basis of treatments. But how does psychotherapy achieve these
changes? Does psychotherapy share common neuronal pathways with
psychopharmacology? For this Discussion, consider whether psychotherapy also
has a biological basis.
NURS6640 Psychotherapy With Individuals
Week 2 Discussion
Assessment
Tools
Assessment
tools have two primary purposes: 1) to measure illness and diagnose clients,
and 2) to measure a client’s response to treatment. Often, you will find that
multiple assessment tools are designed to measure the same condition or
response. Not all tools, however, are appropriate for use in all clinical
situations. You must consider the strengths and weaknesses of each tool to
select the appropriate assessment tool for your client. For this Discussion, as
you examine the assessment tool assigned to you by the Course Instructor,
consider its use in psychotherapy.
NURS6640 Psychotherapy With Individuals
Week 5 Discussion
Posttraumatic
Stress Disorder
It is
estimated that more than 6% of the U.S. population will experience
posttraumatic stress disorder (PTSD) in their lifetime (National Center for
PTSD, 2010). This debilitating disorder often interferes with an individual’s
ability to function in daily life. Common symptoms of anxiousness and
depression frequently lead to substance abuse issues and even physical
ailments. For this Discussion, as you examine the Thompson Family Case Study in
this week’s Learning Resources, consider how you might assess and treat clients
presenting with PTSD.
NURS6640 Psychotherapy With Individuals
Week 8 Discussion
Clinical
Supervision
Clinical
Supervision is an essential component of your development as a psychiatric
mental health nurse practitioner. It provides an opportunity for professional
collaboration as you share experiences with and gain insights from colleagues.
For this Clinical Supervision, consider a client whom you do not think is
adequately progressing according to expected clinical outcomes.
NURS6640 Psychotherapy With Individuals
Week 9 Discussion
Counseling
Adolescents
The
adolescent population is often referred to as “young adults,” but in some ways,
this is a misrepresentation. Adolescents are not children, but they are not yet
adults either. This transition from childhood to adulthood often poses many
unique challenges to working with adolescent clients, particularly in terms of
disruptive behavior. In your role, you must overcome these behaviors to effectively
counsel clients. For this Discussion, as you examine the Disruptive Behaviors
media in this week’s Learning Resources, consider how you might assess and
treat adolescent clients presenting with disruptive behavior.
NURS6640 Psychotherapy With Individuals
Week 10 Discussion
Clinical
Supervision
Personal
reflection and discussion with colleagues is essential to your development as a
psychiatric mental health nurse practitioner. In Week 8, you collaborated with
colleagues as you participated in your first Clinical Supervision. This week,
you have the opportunity to continue your collaboration as you reflect on and
discuss your experiences with counseling older adults. Keep in mind that
although there may be challenges to counseling this population, these clients
offer unique learning opportunities. For this Clinical Supervision, consider an
older client you are counseling whom you do not think is adequately progressing
according to expected clinical outcomes.
NURS6640 Psychotherapy With Individuals
Week 11 Discussion
Therapy for
Clients With Personality Disorders
Clients
with personality disorders often find it difficult to overcome their problems
and function in daily life. Even when these clients are aware that they have a
dysfunction with their personality and are open to counseling, treatment can be
challenging for both the client and the therapist. For this Discussion, as you
examine personality disorders, consider therapeutic approaches you might use
with clients.
NURS6640 Psychotherapy With Individuals
Week 3 Assignment 1
Applying
Current Literature to Clinical Practice
Literature
in psychotherapy differs from other areas of clinical practice. Generally,
there are no clinical trials in psychotherapy because it is often neither
appropriate nor ethical to have controls in psychotherapy research. This
sometimes makes it more difficult to translate research findings into practice.
In your role, however, you must be able to synthesize current literature and
apply it to your own clients. For this Assignment, you begin practicing this
skill by examining current literature on psychodynamic therapy and considering
how it might translate into your own clinical practice.
Learning
Objectives
Students
will:
Evaluate
the application of current literature to clinical practice
To prepare:
Review this
week’s Learning Resources and reflect on the insights they provide.
Select one
of the psychodynamic therapy articles from the Learning Resources to evaluate
for this Assignment.
Note: In
nursing practice, it is not uncommon to review current literature and share
findings with your colleagues. Approach this Assignment as though you were
presenting the information to your colleagues.
The
Assignment
In a 5- to
10-slide PowerPoint presentation, address the following:
Provide an
overview of the article you selected.
What
population is under consideration?
What was
the specific intervention that was used? Is this a new intervention or one that
was already used?
What were
the author’s claims?
Explain the
findings/outcomes of the study in the article. Include whether this will
translate into practice with your own clients. If so, how? If not, why?
Explain
whether the limitations of the study might impact your ability to use the
findings/outcomes presented in the article. Support your position with
evidence-based literature.
Note: The
presentation should be 5–10 slides, not including the title and reference
slides. Include presenter notes (no more than ½ page per slide) and use tables
and/or diagrams where appropriate. Be sure to support your work with specific
citations from the article you selected. Support your approach with
evidence-based literature.
By Day 7
Submit your
Assignment.
Submission
and Grading Information
To submit
your completed Assignment for review and grading, do the following:
Please save
your Assignment using the naming convention “WK3Assgn1+last name+first
initial.(extension)” as the name.
Click the
Week 3 Assignment 1 Rubric to review the Grading Criteria for the Assignment.
Click the
Week 3 Assignment link. You will also be able to “View Rubric” for grading
criteria from this area.
Next, from
the Attach File area, click on the Browse My Computer button. Find the document
you saved as “WK3Assgn1+last name+first initial.(extension)” and click Open.
If
applicable: From the Plagiarism Tools area, click the checkbox for I agree to
submit my paper(s) to the Global Reference Database.
Click on
the Submit button to complete your submission.
NURS6640 Psychotherapy With Individuals
Week 3 Assignment 2
Practicum –
Assessing Clients
Learning
Objectives
Students
will:
Assess
clients presenting for psychotherapy
Develop
genograms for clients presenting for psychotherapy
To prepare:
Select a
client whom you have observed or counseled at your practicum site.
Review
pages 137–142 of the Wheeler text and the Hernandez Family Genogram video in
this week’s Learning Resources. Reflect on elements of writing a Comprehensive
Client Assessment and creating a genogram for the client you selected.
The
Assignment
Part 1:
Comprehensive Client Family Assessment
With this
client in mind, address the following in a Comprehensive ClientAssessment
(without violating HIPAA regulations):
Demographic
information
Presenting
problem
History or
present illness
Past
psychiatric history
Medical
history
Substance
use history
Developmental
history
Family
psychiatric history
Psychosocial
history
History of
abuse/trauma
Review of
systems
Physical
assessment
Mental
status exam
Differential
diagnosis
Case
formulation
Treatment
plan
Part 2:
Family Genogram
Prepare a
genogram for the client you selected. The genogram should extend back by at
least three generations (great grandparents, grandparents, and parents).
By Day 7 of
Week 3
Submit your
Assignment.
Submission
and Grading Information
To submit
your completed Assignment for review and grading, do the following:
Please save
your Assignment using the naming convention “WK3Assgn2+last name+first
initial.(extension)” as the name.
Click the
Week 3 Assignment 2 Rubric to review the Grading Criteria for the Assignment.
Click the
Week 3 Assignment 2 link. You will also be able to “View Rubric” for grading
criteria from this area.
Next, from
the Attach File area, click on the Browse My Computer button. Find the document
you saved as “WK3Assgn2+last name+first initial.(extension)” and click Open.
If
applicable: From the Plagiarism Tools area, click the checkbox for I agree to
submit my paper(s) to the Global Reference Database.
Click on
the Submit button to complete your submission.
NURS6640 Psychotherapy With Individuals
Week 4 Assignment 1
Cognitive
Behavioral Theory Versus Rational Emotive Behavioral Theory
While
cognitive behavioral therapy (CBT) and rational emotive behavioral therapy
(REBT) have many similarities, they are distinctly different therapeutic approaches.
When assessing clients and selecting one of these therapies, you must recognize
the importance of not only selecting the one that is best for the client, but
also the approach that most aligns to your own skill set. For this Assignment,
as you examine the similarities and differences between CBT and REBT, consider
which therapeutic approach you might use with your clients.
Learning
Objectives
Students
will:
Compare
cognitive behavioral therapy and rational emotive behavioral therapy
Recommend
cognitive behavioral therapies for clients
To prepare:
Review the
media in this week’s Learning Resources.
Reflect on
the various forms of cognitive behavioral therapy.
The
Assignment
In a 1- to
2-page paper, address the following:
Briefly
describe how cognitive behavioral therapy (CBT) and rational emotive behavioral
therapy (REBT) are similar.
Explain at
least three differences between CBT and REBT. Include how these differences
might impact your practice as a mental health counselor.
Explain
which version of cognitive behavioral therapy 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
http://writingcenter.waldenu.edu/57.htm). All papers submitted must use this
formatting.
By Day 7
Submit your
Assignment.
Submission
and Grading Information
To submit
your completed Assignment for review and grading, do the following:
Please save
your Assignment using the naming convention “WK4Assgn1+last name+first
initial.(extension)” as the name.
Click the
Week 4 Assignment 1 Rubric to review the Grading Criteria for the Assignment.
Click the
Week 4 Assignment 1 link. You will also be able to “View Rubric” for grading
criteria from this area.
Next, from
the Attach File area, click on the Browse My Computer button. Find the document
you saved as “WK4Assgn1+last name+first initial.(extension)” and click Open.
If
applicable: From the Plagiarism Tools area, click the checkbox for I agree to
submit my paper(s) to the Global Reference Database.
Click on
the Submit button to complete your submission.
NURS6640 Psychotherapy With Individuals
Week 4 Assignment 2
Practicum –
Week 1 Journal Entry and Journal Submission
Learning
Objectives
Students
will:
Analyze
nursing and counseling theories to guide practice in psychotherapy
Develop
goals and objectives for personal practicum experiences
Create
timelines for practicum activities
Develop
diagnoses for clients receiving psychotherapy
Analyze
legal and ethical implications of counseling clients with psychiatric disorders
Develop
diagnoses for clients receiving psychotherapy
Evaluate
the efficacy of cognitive behavioral therapy for clients
Analyze
legal and ethical implications of counseling clients with psychiatric disorders
The
Learning Objectives are related to the Practicum Journal Assignments presented
in Weeks 1, 2, and 4.
Week 4
Journal Entry
Select a
client that you observed or counseled this week. Then, address the following in
your Practicum Journal:
Describe
the client (without violating HIPAA regulations) and identify any pertinent
history or medical information, including prescribed medications.
Using the
DSM-5, explain and justify your diagnosis for this client.
Explain
whether cognitive behavioral therapy would be effective with this client.
Include expected outcomes based on this therapeutic approach. Support your
approach with evidence-based literature.
Explain any
legal and/or ethical implications related to counseling this client.
Note: Be
sure to use the Practicum Journal Template, located in the Learning Resources.
By Day 7
Submit your
Practicum Journal entries for Weeks 1, 2, and 4. Refer to the weekly instructions
for additional guidance.
Submission
To submit
your completed Assignment for review and grading, do the following:
Please save
your Assignments using the following naming convention:
“WK4Journal1+lastname+firstinitial,”
“WK4Journal2+lastname+firstinitial,” and“WK4Journal4+lastname+firstinitial.”
Click the
Week 4 Assignment 2 link.
Next, from
the Attach File area, click on the Browse My Computer button. Find the document
you saved as “WK4Journal1+last name+first initial.(extension)” and click Open.
Repeat for each of the Practicum Journal submissions.
Click on
the Submit button to complete your submission.
NURS6640 Psychotherapy With Individuals
Week 6 Assignment
Assessing
Clients With Addictive Disorders
Addictive
disorders can be particularly challenging for clients. Not only do these
disorders typically interfere with a client’s ability to function in daily
life, but they also often manifest as negative and sometimes criminal
behaviors. Sometime clients with addictive disorders also suffer from other
mental health issues, creating even greater struggles for them to overcome. In
your role, you have the opportunity to help clients address their addictions
and improve outcomes for both the clients and their families. For this
Assignment, as you examine the Levy Family video in this week’s Learning
Resources, consider how you might assess and treat clients presenting with
addiction.
Learning
Objectives
Students
will:
Assess
clients presenting with addictive disorders
Analyze
therapeutic approaches for treating clients with addictive disorders
Evaluate
outcomes for clients with addictive disorders
To prepare:
Review this
week’s Learning Resources and consider the insights they provide.
Review the
Levy Family video Episodes 1 through 5.
The
Assignment
In a 2- to
3-page paper, address the following:
After
watching Episode 1, describe:
What is Mr.
Levy’s perception of the problem?
What is
Mrs. Levy’s perception of the problem?
What can be
some of the implications of the problem on the family as a whole?
After
watching Episode 2, describe:
What did
you think of Mr. Levy’s social worker’s ideas?
What were
your thoughts of her supervisor’s questions about her suggested therapies and
his advice to Mr. Levy’s supervisor?
After
watching Episode 3, discuss the following:
What were
your thoughts about the way Mr. Levy’s therapist responded to what Mr. Levy had
to say?
What were
your impressions of how the therapist worked with Mr. Levy? What did you think
about the therapy session as a whole?
Informed by
your knowledge of pathophysiology, explain the physiology of deep breathing (a
common technique that we use in helping clients to manage anxiety). Explain how
changing breathing mechanics can alter blood chemistry.
Describe
the therapeutic approach his therapist selected. Would you use exposure therapy
with Mr. Levy? Why or why not? What evidence exists to support the use of
exposure therapy (or the therapeutic approach you would consider if you
disagree with exposure therapy)?
In Episode
4, Mr. Levy tells a very difficult story about Kurt, his platoon officer.
Discuss how
you would have responded to this revelation.
Describe
how this information would inform your therapeutic approach. What would you
say/do next?
In Episode
5, Mr. Levy’s therapist is having issues with his story.
Imagine
that you were providing supervision to this therapist, how would you respond to
her concerns?
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
http://writingcenter.waldenu.edu/57.htm). All papers submitted must use this
formatting.
By Day 7
Submit your
Assignment.
Submission
and Grading Information
To submit
your completed Assignment for review and grading, do the following:
Please save
your Assignment using the naming convention “WK6Assgn+last name+first
initial.(extension)” as the name.
Click the
Week 6 Assignment Rubric to review the Grading Criteria for the Assignment.
Click the
Week 6 Assignment link. You will also be able to “View Rubric” for grading
criteria from this area.
Next, from
the Attach File area, click on the Browse My Computer button. Find the document
you saved as “WK6Assgn+last name+first initial.(extension)” and click Open.
If
applicable: From the Plagiarism Tools area, click the checkbox for I agree to
submit my paper(s) to the Global Reference Database.
Click on
the Submit button to complete your submission.
NURS6640 Psychotherapy With Individuals
Week 7 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
http://academicguides.waldenu.edu/writingcenter/templates ). All papers submitted
must use this formatting.
By Day 7
Submit your
Assignment.
Submission
and Grading Information
To submit
your completed Assignment for review and grading, do the following:
Please save
your Assignment using the naming convention “WK7Assgn1+last name+first
initial.(extension)” as the name.
Click the
Week 7 Assignment Rubric to review the Grading Criteria for the Assignment.
Click the
Week 7 Assignment 1 link. You will also be able to “View Rubric” for grading
criteria from this area.
Next, from
the Attach File area, click on the Browse My Computer button. Find the document
you saved as “WK7Assgn1+last name+first initial.(extension)” and click Open.
If
applicable: From the Plagiarism Tools area, click the checkbox for I agree to
submit my paper(s) to the Global Reference Database.
Click on
the Submit button to complete your submission.
NURS6640 Psychotherapy With Individuals
Week 7 Assignment 2
Practicum –
Assessing Client Progress
Learning
Objectives
Students
will:
Assess
progress for clients receiving psychotherapy
Differentiate
progress notes from privileged notes
Analyze
preceptor’s use of privileged notes
To prepare:
Reflect on
the client you selected for the Week 3 Practicum Assignment.
Review the
Cameron and Turtle-Song (2002) article in this week’s Learning Resources for
guidance on writing case notes using the SOAP format.
The
Assignment
Part 1:
Progress Note
Using the
client from your Week 3 Assignment, address the following in a progress note
(without violating HIPAA regulations):
Treatment
modality used and efficacy of approach
Progress
and/or lack of progress toward the mutually agreed-upon client goals (reference
the Treatment plan—progress toward goals)
Modification(s)
of the treatment plan that were made based on progress/lack of progress
Clinical
impressions regarding diagnosis and/or symptoms
Relevant
psychosocial information or changes from original assessment (i.e., marriage,
separation/divorce, new relationships, move to a new house/apartment, change of
job, etc.)
Safety
issues
Clinical
emergencies/actions taken
Medications
used by the patient (even if the nurse psychotherapist was not the one
prescribing them)
Treatment
compliance/lack of compliance
Clinical
consultations
Collaboration
with other professionals (i.e., phone consultations with physicians,
psychiatrists, marriage/family therapists, etc.)
Therapist’s
recommendations, including whether the client agreed to the recommendations
Referrals
made/reasons for making referrals
Termination/issues
that are relevant to the termination process (i.e., client informed of loss of
insurance or refusal of insurance company to pay for continued sessions)
Issues
related to consent and/or informed consent for treatment
Information
concerning child abuse, and/or elder or dependent adult abuse, including
documentation as to where the abuse was reported
Information
reflecting the therapist’s exercise of clinical judgment
Note: Be
sure to exclude any information that should not be found in a discoverable
progress note.
Part 2:
Privileged Note
Based on
this week’s readings, prepare a privileged psychotherapy note that you would
use to document your impressions of therapeutic progress/therapy sessions for
your client from the Week 3 Practicum Assignment.
The
privileged note should include items that you would not typically include in a
note as part of the clinical record.
Explain why
the items you included in the privileged note would not be included in the
client’s progress note.
Explain
whether your preceptor uses privileged notes, and if so, describe the type of
information he or she might include. If not, explain why.
By Day 7
Submit your
Assignment.
Submission
To submit
your completed Assignment for review and grading, do the following:
Please save
your Assignment using the following naming convention:
“WK7Assgn2+lastname+first initial”.
Click the
Week 7 Assignment 2 link.
Next, from
the Attach File area, click on the Browse My Computer button. Find the document
you saved as “WK7Assgn2+last name+first initial.(extension)” and click Open. If
you are submitting multiple files, repeat until all files are attached.
Click on
the Submit button to complete your submission.
NURS6640 Psychotherapy With Individuals
Week 7 Assignment 3
Practicum –
Week 5 and Week 6 Journal Submission
Learning
Objectives
Students
will:
Develop
diagnoses for clients receiving psychotherapy*
Evaluate
the efficacy of therapeutic approaches for clients*
Analyze
legal and ethical implications of counseling clients with psychiatric
disorders*
By Day 7
Submit your
Journal Entries for Week 5 and Week 6. Refer to Week 5 and Week 6 for additional
guidance.
Submission
To submit
your completed Assignment for review and grading, do the following:
Please save
your Assignments using the following naming convention:
WK7Journal1+lastname+first initial,” and “WK7Journal2+lastname+firstinitial.”
Click the
Week 7 Assignment 3 link.
Next, from
the Attach File area, click on the Browse My Computer button. Find the document
you saved as “WK7Assgn3+last name+first initial.(extension)” and click Open.
Repeat for each of the Practicum Journal submissions. If you are submitting
multiple files, repeat until all files are attached.
Click on
the Submit button to complete your submission.
NURS6640 Psychotherapy With Individuals
Week 10 Assignment 1
Practicum –
Client Termination Summary
Learning
Objectives
Students
will:
Develop
client termination summaries
To prepare:
For guidance
on writing a Client Termination Summary, review pages 693–712 of the Wheeler
text in this week’s Learning Resources.
Identify a
client who may be ready to complete therapy.
The
Assignment
With the
client you selected in mind, address the following in a client termination
summary (without violating HIPAA regulations):
Identifying
information of client (i.e., hypothetical name, age, etc.)
Date
initially contacted therapist, date therapy began, duration of therapy, and
date therapy will end
Total
number of sessions, including number of missed sessions
Termination
planned or unplanned
Presenting
problem
Major
psychosocial issues
Types of
services rendered (i.e., individual, couple/family therapy, group therapy,
etc.)
Overview of
treatment process
Goal status
(goals met, partially met, unmet)
Treatment
limitations (if any)
Remaining
difficulties and/or concerns
Recommendations
Follow-up
plan (if indicated)
Instructions
for future contact
Signatures
By Day 7
Submit your
Assignment.
Submission
To submit
your completed Assignment for review and grading, do the following:
Please save
your Assignment using the following naming convention:
“WK10Assgn1+lastname+first initial”.
Click the
Week 10 Assignment 1 link.
Next, from
the Attach File area, click on the Browse My Computer button. Find the document
you saved as “WK10Assgn1+last name+first initial.(extension)” and click Open.
If you are submitting multiple files, repeat until all files are attached.
Click on
the Submit button to complete your submission.
NURS6640 Psychotherapy With Individuals
Week 10 Assignment 2
Practicum –
Week 8 Journal Entry
Students
will:
Develop
diagnoses for clients receiving psychotherapy
Evaluate
the efficacy of existential-humanistic therapy for clients
Analyze
legal and ethical implications of counseling clients with psychiatric disorders
Analyze
clinical supervision experiences
Analyze how
nursing and counseling theories guided personal practice in psychotherapy
Analyze
goals and objectives for personal practicum experiences
Analyze the
impact of psychotherapy on social change
The
Learning Objectives are related to the Practicum Journal Assignments presented
in Weeks 8, 9, and 10.
Week 10
Journal Entry
Reflect on
your overall practicum experience in this course. Then, address the following
in your Practicum Journal:
Explain
whether your therapeutic theory has changed as a result of your practicum
experiences. Recall the theories you selected in Week 1.
Explain how
you integrated the therapeutic approaches from this course in your clinical practice.
Include how this helped you achieve the goals and objectives you developed in
Week 1.
Explain how
you might impact social change through your work with clients who have mental
health issues.
Support
your approach with evidence-based literature.
Note: Be
sure to use the Practicum Journal Template, located in the Learning Resources.
By Day 7
Submit your
Practicum Journal entries for Weeks 8, 9, and 10. Refer to the weekly
instructions for additional guidance.
Submission
To submit
your completed Assignment for review and grading, do the following:
Please save
your Assignments using the following naming convention:
“WK10Journal1+lastname+first initial,” “WK10Journal2+lastname+first initial,”
and “WK10Journal3+lastname+first initial.”
Click the
Week 10 Assignment 2 link.
Next, from
the Attach File area, click on the Browse My Computer button. Find the document
you saved as “WK10Journal1+last name+first initial.(extension)” and click Open.
Repeat for each of the Practicum Journal submissions.
Click on
the Submit button to complete your submission.
NURS6640 Psychotherapy With Individuals
Midterm Exam
Question 1The
PMHNP is mentoring a student. After working with a patient during a session,
the student laments about all the things she should have, or could have, said
to the patient. “I feel guilty that I didn’t speak up more about the patient’s
concern toward her son,” says the student. The PMHNP understands that the
student is exhibiting signs of which therapeutic concept?
Question 2 The
PMHNP is working with a 56-year-old man who is being seen because of his
anxiety and depression. During the therapy sessions, the PMHNP assists the
patient in discussing his experiences and expanding on his thoughts and
feelings. He tells the PMHNP stories about how he used to be teased by his
coworkers at the office for becoming too anxious in large conference rooms. The
PMHNP listens to the patient and helps focus on his strengths to promote
self-understanding. Which principle best accounts for the PMHNP’s interactions
with the patient?
Question 3 During
a therapy session the patient is asked how she currently deals with stress, and
she says, “Well, I don’t. I just let it build and build.” The PMHNP responds by
asking how well this has been working out for her. The patient states, “Well,
to be honest, it just feels like I’m drowning, you know what I mean.”
Illustrating idiosyncratic meaning, the PMHNP responds with:
Question 4 The
PMHNP is working with a 43-year-old male patient who develops idiosyncratic
transference over weeks of therapy. The best way for the PMHNP to respond to
this patient is to ___________ :
Question 5 The
PMHNP is working with a patient who has insomnia and battles going to sleep.
The patient reports consistent self-defeating behaviors, and hates trying to go
to sleep. Which action made by the PMHNP demonstrates the use of a paradoxical
intervention?
Question 6
The PMHNP
understands that anxiety and depression are two disorders in which their
symptoms may overlap. When discussing this, you explain that the autonomic
nervous system is activated and further helps distinguish anxiety symptoms by
making the following points:
Question 7
A new
patient has been informed of the limits of confidentiality, and has signed
informed consent forms. No consent, however, has been obtained for voluntary
“Release of Information.” The patient is 20 years old and still lives at home
with his parents. He is being treated for depression, which he attributes to
the trouble he’s had finding employment.
True or
false: If the patient’s mother calls the PMHNP to check up on her son to see
how he is doing, the therapist is required to protect patient confidentiality
and not disclose information. Selected Answer:
Question 8
A PMHNP is
taking a history and wants to assess how the patient copes with adversity. To
do so, the therapist asks questions about the patient’s belief system. What
would be an appropriate question to ask?
Question 9
In your
office, you see a 58-year-old patient with PTSD who reports having nightmares,
making it impossible for her to sleep. What recommendations based on principles
of sleep hygiene will the PMHNP make?
Question 10
A patient
who has borderline personality disorder is meeting with the PMHNP. When asked
about future goals, the patient responds, “I’d like to go back to school to do
what you
do. You
know, talk to people all day about their problems. It seems pretty easy.” How
does the PHMNP respond to the client in a way that is free from any
stigmatizing beliefs or judgments?
Question 11
A
62-year-old patient has been diagnosed with borderline personality disorder.
Upon assessment, the PMHNP learns that he
participates in spending sprees and occasional binge eating, accompanied
by rapid changes in self-image. Which evidence-based psychotherapeutic model
does the PMHNP identify as effective and beneficial?
Question 12
An elderly
patient in a nursing home has been losing interest in activities and now
refuses to leave his room. After a physical exam, he is referred to a PMHNP for
an initial assessment.
True or
false: After speaking with the patient, an appropriate screening tool for the
PMHNP to use would be the Geriatric
Depression Scale.
Question 13
A PMHNP has
been working with a young female patient who suffers from depression to change
self-defeating behaviors. By creating a presence of acceptance and using good
listening skills, the PMHNP’s overall goal is to __________.
Question 14
The PMHNP
is working with a school-aged child who has been diagnosed with depression. The
child has attended several sessions with the PMNHP, but recently presents with
avoidant behavior by showing increased distress and being late to sessions.
What approach does the PMHNP need to employ with the child to continue making
therapeutic progress?
Question 15
A PMHNP’s
patients have already signed confidentiality agreements, including limits that
will be imposed on confidentiality. Months later, the state’s laws have changed
that affect confidentiality promises the PMHNP has already made. What is an
appropriate step for the PMHNP to take after finding out this information?
Question 16
An initial
evaluation reveals that an 11-year-old patient has moved to a new school after
her parents’ recent divorce, and is having trouble making friends. The patient
has normal mental status and exhibits appropriate behavior. What is the most
appropriate scale for the PMHNP to use
to get more information?
Question 17
During
cognitive behavioral therapy (CBT), a 64-year-old male patient, states, “My
wife hates me! She’s just waiting for me to die.” Using Socratic dialogue (SD)
the PMHNP demonstrates understanding of analysis when she responds:
Question 18
A
41-year-old male patient is meeting with the PMHNP and reveals that he is
homosexual. He begins telling the PMHNP about his feelings as a homosexual,
middle-aged man. The PMHNP nods understandingly. Before long, the patient asks,
“Are you gay? Are you married? Do you have kids?” What is the best response by
the PMHNP?
Question 19
The PMHNP
is working with a patient who is living in poverty and abusing substances.
According to the treatment hierarchy framework, what needs does the PMHNP need
to attend to first?
Question 20
The PMHNP
is having a therapy session with Charlotte, a 20-year-old victim of date rape.
The patient states, “I shouldn’t have been there; I should have just gone home.
This was all my fault; how could I have been so stupid?” Using the Socratic
method, what is the PMHNP’s best response?
Question 21
The PMHNP
is working with an adult patient who has somatic complaints caused by a history
of childhood abuse. As part of the therapeutic process, what does the PMHNP do
to assess and organize a trauma history?
Question 22
The PMHNP
employs psychodynamic psychotherapy with a patient who experiences anxiety and
depression. As the process enters the psychoanalytic end of the psychodynamic
continuum, the PMNHP will focus on:
Question 23
True or
false: A PMHNP may ask his patient to describe her relationship with her
father, both as a child and now, in order to assess interpersonal style.
Question 24
A
35-year-old patient has been seeking treatment for depression for several
months. The PMHNP does an assessment to see if processing has led to adaptive
change. The patient’s self-references are positive in relation to past events,
work is productive, relationships are adaptive, and there is congruence between
behavior, thoughts, and affect. Based on this information, the PMHNP decides
the patient ____________.
Question 25
A
65-year-old patient has suffered the loss of his wife. He is in a state of
hyperarousal with increased sympathetic nervous system arousal. One or more
interventions may help the patient to deal with this arousal. To decrease
sympathetic nervous system arousal, the PMHNP’s treatment strategy is
___________.

NURS6640 Psychotherapy With Individuals
Final Exam
• Question 1 The PMHNP is caring for
a young adult patient with whom the PMHNP decides to use a dynamic supportive
therapy approach in addition to pharmacological intervention. Which therapeutic
action will the PMHNP take to employ the strategy of holding and containing the
patient?
• Question 2 A PMHNP is using Gestalt
therapy to communicate with a 42-year-old patient who is upset with her mother.
She says, “I want to tell her how hurt I feel when she doesn’t call me, but I
don’t want to upset her.” What technique can the PMHNP use to help Sasha
express herself?
• Question 3 A 43-year-old single
mother is seeing the PMHNP at the request of her sister. “My sister thinks I
need to come here to talk about my feelings,” the patient reports. The PMHNP
learns that the patient has three children from three different men, but is
unable to collect appropriate child support payments from any of the biological
fathers. Additionally, the woman is barely able to afford her apartment or
utilities payments. What is the appropriate response from the PMHNP when using
the psychodynamic psychotherapy technique?
• Question 4 A PMHNP has been
treating a 9-year-old patient who was referred by her school. Students are
asked to raise their hands before speaking during group discussion, but the
patient seems to blurt out what she wants to say without being called on. She
also interrupts other children while they are talking instead of waiting her
turn. When the patient gets frustrated, she has trouble controlling her
emotions and cries often. Based on the initial information provided, the first
focus by PMHNP is the child’s ____________.
• Question 5 A PMHNP has been
treating a 14-year-old patient using interpersonal psychotherapy. The patient
has been depressed since the death of his grandmother. To help the patient
recover, the PMHNP has told the parents:
• Question 6 The PMHNP has been
treating a patient who is now being transferred to another provider. What is
the appropriate action made by the PMHNP?
• Question 7 The PMHNP is meeting
with a patient who has been diagnosed with depression. The patient is having
trouble adjusting to her new job and hasn’t made any new friends there. What
would an appropriate response be by the PMHNP using the interpersonal
psychotherapy approach?
• Question 8 A patient is finishing
the active treatment phase of interpersonal psychotherapy (IPT). After the
PMHNP reminds the patient that she has three sessions left, the patient says
nothing, but looks distressed. What would be the best reply by the PMHNP
following IPT protocol?
• Question 9 The PMHNP is initiating
a plan of care for Holly, a 73-year-old female patient who has late-life
bipolar disorder and reports consuming alcoholic beverages four times per week.
What is the focus of Holly’s therapy going to be?
• Question 10 A cocaine-addicted
female patient is entering residential treatment for substance abuse. Using the
10 guiding principles of recovery, an appropriate step by the PMHNP is to
______________.
• Question 11 The PMHNP has been
providing interpersonal psychotherapy (IPT) for a patient who the PMHNP
observes implementing new ways of being, such as interacting more with peers
and being less isolated in social scenarios. The PMHNP understands that the
patient is approaching termination. How does the PMHNP address termination with
this patient?
• Question 12 A 55-year-old patient
recovering from substance abuse tells the PMHNP, “It’s impossible to meet new
people. I really hate being single.” Using existential psychotherapy, what
might the PMHNP say next?
• Question 13 A PMHNP is treating a
10-year-old boy who is exhibiting signs of aggression and attention problems.
What type of intervention will the PMHNP consider using a common elements
approach?
• Question 14 The PMHNP is
interviewing a patient with a history of substance abuse. He has attempted to
stop abusing drugs three times before. He states to the PMHNP, “I just cannot
change. How can you help me?!” As it applies to change, the PMHNP understands
the principle of evocation to mean:
• Question 15 A 38-year-old patient
has been having trouble communicating with his teenage daughter. Using a
solution-focused therapy approach, the PMHNP responds by saying, “When was a
time that a communication problem could have occurred, but did not?” In this
case, what type of question is the PMHNP asking?
• Question 16 A PMHNP is assessing a
40-year-old patient named Sarah who has a severe cocaine addiction and mild
depression. Using the four-quadrant model, what would be the most appropriate
setting to help the patient?
• Question 17 A PMHNP is using
emotion-focused therapy to help a 38-year-old patient who says, “I’ve been
feeling angry lately, but I’m not sure why.” The first attempt by the PMHNP is
to say:
• Question 18 An 8-year-old has been
having trouble making friends at school. His parents initiated treatment when
he also started acting out at home. Which is the most appropriate step that the
PMHNP takes during the assessment process when using an integrated approach?
• Question 19 The PMHNP meets with a
31-year-old woman who reports feeling as though she is “at her breaking point”
with work. The PMHNP learns that the woman works 12-hour days, including one
day on the weekend, because she is nervous about company layoffs. “I feel like
I need to work myself to death in order to prove that I am valuable to the
organization,” the woman says. Using the supportive psychodynamic therapy
approach, how does the PMHNP respond?
• Question 20 The PMHNP continues to
meet with Gerald, who is the patient with depression and mood disorder. The
PMHNP uses the CBT approach. Gerald is now meeting with the PMHNP for his fifth
session and feels comfortable with how the therapy works. What does the PMHNP
plan to do with Gerald over the course of the next several sessions?
• Question 21 While assessing a
patient using a humanistic-existential approach, a patient tells the PMHNP,
“For the past few weeks, I’ve felt anxious almost every single day.” What would
be an appropriate next step by the PMHNP?
• Question 22 The PMHNP is assessing
an older adult male patient with depression and comorbidities. According to the
medical chart, the patient takes medication to manage joint and bone pain. The
patient reports feeling “forgetful” and complains that he has a hard time
remembering where he puts things. What is the primary action by the PMHNP?
• Question 23 A 13-year-old patient
and his parents are meeting with a PMHNP. When the PMHNP says hello, the boy
just nods. His parents tell the PMHNP that he didn’t want to come to the
session, but they insisted. They explain that their son has been moody and
depressed at home, but is still getting good grades at school. Which of the
following would be the best response by the PMHNP?
• Question 24 The PMHNP is assessing
a new geriatric patient who reports symptoms of depression. The PMHNP wants to
identify the patient’s symptom severity over time. Which assessment tool will
the PMHNP use to collect this data on the patient?
• Question 25 The PMHNP is caring for
a geriatric patient who expresses symptoms of gastrointestinal problems, aches
and pains, and loss of appetite. The patient reports feeling lonely, as more of
his friends have been passing away over the recent months and years. The PMHNP
focuses on which therapeutic approach for this patient?