Posted: December 14th, 2022
NURS 6650: Psychotherapy With Groups and Families.
Counselling of children and adolescents in group settings presents unique experiences and complexity when compared to administration of mental therapy to the general adult population. The child psychologist helps the children and adolescents in coping with stresses and cognitive issues related to learning, disabilities and development (Riedinger et al, 2017). They assess and treat the clients for any psychological and emotional disturbances. This paper presents a reflection of an assessment of clients presenting in the adolescent and children group psychotherapy and the evaluation of the effectiveness of the therapy. NURS 6650: Psychotherapy With Groups and Families.
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Child and adolescent group
The child and adolescent group that I was counseling was a process group. It consisted of 6 members aged between 7 and 15 years. It was a process group that sought to assist the members in working through psychosocial stressors in a supportive and safe environment. The children and adolescents in this group had experienced bullying by peers at school following their parent’s divorces which left them under the care of only one parent. They all suffered anxiety, anger, confusion and panic attacks as well as emotional sensitivity. Some of them experienced insomnia and were contemplating substance use. This group focused on assessing members and treating them, sharing of experiences, empowerment and creation of awareness of mental issues (Brown, 2018). It also addressed the clients’ abilities to build trust towards others and as well accept supportive feedback to and from peers.
Client Description
One of the clients from this group was James John, a 7 year old African male child, who had presented to the clinic with anxiety, aggression, insomnia, attention and concentration issues. His academic performance was also deteriorating and he was no longer interested in social activities, playing with his peers and missed school often. He has been bullied in school and presents low self-esteem. This client does not demonstrate adequate progress from the group therapy compared to the other members. This is attributed to the fact that he is the youngest in the group and feels intimidated by the older clients who he fears might not understand his problems. NURS 6650: Psychotherapy With Groups and Families.
Therapeutic approach
In order to improve the outcomes of James during the group sessions, I engaged the group in a talk that assured them that it was normal to deal with stresses and that there was no judgment involved in opening up (Blake, 2018). Therefore, no one was supposed to feel embarrassed to open up since recovery will begin with acceptance. Moreover, I took the child’s emotions, experiences and concerns seriously thus engaging him in an individual session so as to understand his underlying issues. In the group, I also talked about the things that they were experiencing and the role of therapist in providing help and support. These approaches were effective in building trust and increasing the client’s self-esteem regardless of his small age among older members (Higa-McMillan et al., 2016). Reassurance was important in facilitating open up and sharing of experiences within the group.
Additional Information
The additional information about the group and client that may potentially impact the expected outcomes includes his age. The client was the youngest in the therapy group which made it difficult to keep up with the elderly members. In addition, his cognitive development was lower and hence could take more time to comprehend and resolve his mental issues (Shechtman, 2017). This could cause confusion to the client hence undermining the effectiveness of the therapy. On the other hand, fear of opening up and being criticized by other members could challenge the therapy.
NURS 6650: Psychotherapy With Groups and Families
Effective group treatment with children and adolescents rests upon three essential considerations: the clients that compose the group, the therapists responsible for conducting the group, and the setting in which the group occurs.
—Dr. Mark Stone, Cognitive-Behavior Group Therapy with Children and Adolescents
Group therapy may be beneficial for children and adolescents, because it often provides an environment that normalizes clients’ thoughts, feelings, and behaviors. However, as with any therapeutic approach, group therapy might not be appropriate for every client, every setting, or even every therapist. When selecting therapies, you must always consider the psychodynamics of the client and your own skill set.
This week, as you assess and develop diagnoses for clients presenting for child and adolescent group psychotherapy, you examine the effectiveness of this therapeutic approach. You also consider legal and ethical implications of counseling children and adolescent clients with psychiatric disorders.
Learning Resources
Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.
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.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
Note: Retrieved from Walden Library databases.
McGillivray, J. A., & Evert, H. T. (2014). Group cognitive behavioural therapy program shows potential in reducing symptoms of depression and stress among young people with ASD. Journal of Autism and Developmental Disorders, 44(8), 2041–2051. doi:10.1007/s10803-014-2087-9
Note: Retrieved from Walden Library databases.
Restek-Petrović, B., Bogović, A., Mihanović, M., Grah, M., Mayer, N., & Ivezić, E. (2014). Changes in aspects of cognitive functioning in young patients with schizophrenia during group psychodynamic psychotherapy: A preliminary study. Nordic Journal of Psychiatry, 68(5), 333–340. NURS 6650: Psychotherapy With Groups and Families. doi:10.3109/08039488.2013.839738
Note: Retrieved from Walden Library databases.
Document: Group Therapy Progress Note
Required Media
Microtraining Associates (Producer). (2009). Leading groups with adolescents [Video file]. Alexandria, VA: Author.
Note: You will access this media from the Walden Library databases. The approximate length of this media piece is 140 minutes.
Psychotherapy.net (Producer). (2002). Adlerian parent consultation [Video file]. Mill Valley, CA: Author.
Note: You will access this media from the Walden Library databases. The approximate length of this media piece is 117 minutes.
Optional Resources
Psychotherapy.net (Producer). (2012). Group counseling with adolescents: A multicultural approach [Video file]. Mill Valley, CA: Author.
Discussion: Clinical Supervision
In Week 3, 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 children and adolescents in group settings. Psychotherapy with these clients is often more complex than psychotherapy with the general adult population. Personal reflection and discussion with colleagues are essential to your development and success as a psychiatric mental health nurse practitioner. For this clinical supervision, consider a child or adolescent client you are counseling who you do not think is adequately progressing according to expected clinical outcomes.
Learning Objectives
Students will:
To prepare:
Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the Post to Discussion Question link and then select Create Thread to complete your initial post. Remember, once you click submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking Submit!
Note about Uploading Media: Refer to the Kaltura Media Uploader instructions document located in the menu bar. It provides guidance on how to upload media for the Clinical Supervision Discussions.
By Day 3
Post a 3- to 5-minute Kaltura video that addresses the following:
Note: Nurse practitioners must have strong oral communication skills. This Discussion is designed to help you hone these skills. When filming your Kaltura video, be sure to dress and speak in a professional manner.
View a selection of your colleagues’ responses.
By Day 6
Respond to at least two of your colleagues by providing constructive feedback concerning their presentations of their client groups and by recommending alternative therapeutic approaches that may be used with the groups. Support your feedback with evidence-based literature and/or your own experiences with clients. NURS 6650: Psychotherapy With Groups and Families.
Submission and Grading Information
Grading Criteria
To access your rubric:
Week 10 Discussion Rubric
Post by Day 3 and Respond by Day 6
To participate in this Discussion:
Week 10 Discussion
Assignment 1: Practicum – Client Termination Summary
Although termination is an inevitable part of the therapeutic process, it is often difficult for clients. However, by discussing termination throughout therapy, you can better prepare your clients for life without you. Once a client has achieved his or her therapeutic goals, termination sessions should be held and documented in a client termination summary. For this Assignment, you have the opportunity to practice writing a termination summary for a client with whom you have worked during your practicum experience.
Learning Objectives
Students will:
To prepare:
The Assignment
With the client you selected in mind, address in a client termination summary (without violating HIPAA regulations) the following:
By Day 7
Submit your Assignment.
Submission and Grading Information
To submit your completed Assignment for review and grading, do the following:
Grading Criteria
To access your rubric:
Week 10 Assignment 1 Rubric
Check Your Assignment Draft for Authenticity
To check your Assignment draft for authenticity:
Submit your Week 10 Assignment draft and review the originality report.
Submit Your Assignment by Day 7
To submit your Assignment:
Week 10 Assignment 1
Assignment 2: Practicum – Week 10 Journal Entry
Learning Objectives
Students will:
Select two clients you observed or counseled this week during a group therapy session for children and adolescents. Note: The two clients you select must have attended the same group session. If you select the same group you selected for the Week 8 or Week 9 Journal Entries, you must select different clients. NURS 6650: Psychotherapy With Groups and Families.
Then, address in your Practicum Journal the following:
By Day 7
Submit your Assignment.
Submission and Grading Information
To submit your completed Assignment for review and grading, do the following:
Grading Criteria
To access your rubric:
Week 10 Assignment 2 Rubric
Check Your Assignment Draft for Authenticity
To check your Assignment draft for authenticity:
Submit your Week 10 Assignment 2 draft and review the originality report.
Submit Your Assignment by Day 7
To submit your Assignment:
Week 10 Assignment 2
Assignment 3: Practicum – Week 8 Journal Entry
By Day 7
Submit your Assignment. Refer to Week 8 for additional guidance.
Submission and Grading Information
To submit your completed Assignment for review and grading, do the following:
Grading Criteria
To access your rubric:
Week 10 Assignment 3 Rubric
Check Your Assignment Draft for Authenticity
To check your Assignment draft for authenticity:
Submit your Week 10 Assignment 3 draft and review the originality report.
Submit Your Assignment by Day 7
To submit your Assignment:
Week 10 Assignment 3
Assignment 4: Board Vitals
This week you will be responding to twenty Board Vitals questions that cover a broad review of your Nurse Practitioner program courses up to this point.
These review questions will provide practice that is critical in your preparation for the national certification exam that’s required to certify you to practice as a nurse practitioner. These customized test questions are designed to help you prepare for your Nurse Practitioner certification exam. It is in your best interest to take your time, do your best, and answer each question to the best of your ability.
You can access Board Vitals through the link sent to you in email or by following the link below:
https://www.boardvitals.com/
By Day 7
Complete the Board Vitals questions.
Practicum Reminder
Time Logs
You are required to keep a log of the time you spend related to your practicum experience and enter every patient you see each day. You can access your time log from the Welcome Page in your Meditrek account. You will track time individually for each patient you work with. Please make sure to continuously input your hours throughout the term.
Making Connections
Now that you have:
Next week, you will:
Looking Ahead: Week 11 Discussion
In a standard Discussion thread, you will discuss an older adult group you have observed and/or counseled during your practicum experience. Be sure to make arrangements with your preceptor so you can fulfill the requirements of the Discussion. Refer to the Week 11 Discussion for additional guidance. NURS 6650: Psychotherapy With Groups and Families.
To go to the next week:
Week 11
Psychotherapeutic approaches to group therapy
Part 1. Identify the psychotherapeutic approach that the group facilitator is using, and explain why she might be using this approach.
A review of the Levy family sessions reveals that the group facilitator is using the psychodynamic model to delivery psychotherapy and moderate interactions with the family members. The model has allowed the facilitator to clarify the behavior, development and growth of the family members as they relate to the presenting problem. This seen in the way that the facilitator engages the group members and collects information to indicate the progression of the treatment and how much of the addiction effects have been addressed. To be more previse, the facilitator collects contextual information during the group sessions, with the information helping in improving the awareness about the family members as unique individuals who have diverse needs that may converge or diverge. Through the use of the psychodynamic model, the facilitator has gained the capacity to evaluate the social functioning of the group members, with emphasis on how the functioning has progressed over time as they attend more psychotherapy sessions. In addition, the model has offered the facilitator the capacity to evaluate the treatment progress in the face of unconscious influences that directly impact the amount of effort, energy and motivation put into addressing the addiction. Overall, the model allows the facilitator to look at the group members as individuals thus laying the foundation for a targeted approach that addresses the psychotherapy needs of all the group members. Besides that, the model allows the facilitator to have a close therapeutic relationship with the group members since she develops acceptance, understanding and empathy that motivates the members to disclose more information (American Nurses Association, 2014). NURS 6650: Psychotherapy With Groups and Families.
Part 2. Determine whether or not you would use the same psychotherapeutic approach if you were the counselor facilitating this group, and justify your decision.
Although the psychodynamic model might appear ideal for the present group since it emphasizes targeted approaches that provide individual care, it is not appropriate for the present group. That is because the model seeks to change unconscious thought processes since it functions on the premise that behavior is resultant from unconscious thought. The model postulates that there are logical sequential steps that can be applied in psychotherapy environments to manipulate the unconscious thought processes of the group members thus addressing the root cause of the presenting issue (American Nurses Association, 2014).
The psychodynamic model could work for Levy family, but a more appropriate model is the person centered approach. The person centered approach acknowledges that addiction is a behavior that can be influenced through deliberate thought processes. In applying this approach, the first step would be to identify the root cause of the addiction. The background information on the family indicates that the root cause is Mr. Levy’s PTSD. As a former soldier who experienced the horrors of war and even saw his friends die as he survived, Mr. Levy appears to have not gotten over the war. In fact, he was unprepared for a civilian life. He was discharged from the army, and came back home to find that there was no work. This caused him to develop depression and anxiety. He turned to alcohol as a coping mechanism, and over time he drank more alcohol and become addicted. Applying the person centered approach would first address the PTSD as the root cause of the family problems before going on to address the anxiety, depression and addiction. This would allow Mr. Levy to better adjust to a civilian life while improving his moral, social, physical and intellectual capacities so that he has positive social interactions with the rest of the family members (American Psychiatric Association, 2013; Wheeler, 2014). NURS 6650: Psychotherapy With Groups and Families.
Part 3. Identify an alternative approach to group therapy for addiction, and explain why it is an appropriate option.
Group therapy is appropriate for the present case. However, there is a need to supplement group therapy with medication. That is because group therapy has good effects, but the effects are only felt after many sessions. Pharmacotherapy should be used as an alternative to psychotherapy, complementing other approaches since it produces more immediate results. It involves the use of chemical agents that change the brain and body chemistry. These chemical agents would be prescribed to address the anxiety, depression, addiction, and withdrawal symptoms (Cautin & Lilienfield, 2015). NURS 6650: Psychotherapy With Groups and Families.
Week 9: Group Therapy for Addiction
Consider the following scenario:
The psychiatric mental health nurse practitioner is working for a community health clinic that offers state mandated “intensive outpatient rehabilitation” services for individuals who face incarceration for driving while under the influence. Mr. Smith, a 24-year-old male patient, shows up for his initial intake appointment and says, “Look, this sounds like it’s going to be an AA meeting. Can’t I just go there? I only had a couple of drinks. I don’t know why the judge was such a jerk.”
Clients with addictive disorders may present for therapy for various reasons. Some, like Mr. Smith, attend because it is court mandated. Some attend because family or friends have pushed them to do so, while others may attend because life has become unmanageable. Regardless of clients’ reasons for presenting for therapy, to reach these clients and effectively treat them, you must be able to break down barriers, establish relationships, and help them see the benefits of this therapeutic approach.
This week, you explore psychotherapeutic approaches to group therapy for addiction. You also develop diagnoses for clients receiving psychotherapy for addiction and consider legal and ethical implications of counseling these clients.
Learning Resources
Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.
Required Readings
American Nurses Association. (2014). Psychiatric-mental health nursing: Scope and standards of practice (2nd ed.). Washington, DC: Author.
Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice. New York, NY: Springer.
Yalom, I. D., & Leszcz, M. (2005). The theory and practice of group psychotherapy (5th ed.). New York, NY: Basic Books.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
Note: Retrieved from Walden Library databases.
Gamble, J., & O’ Lawrence, H. (2016). An overview of the efficacy of the 12-step group therapy for substance abuse treatment. Journal of Health & Human Services Administration, 39(1), 142–160. Retrieved from http://jhhsa.spaef.org/
Note: Retrieved from Walden Library databases.
Kim, J. W., Choi, Y. S., Shin, K. C., Kim, O. H., Lee, D. Y., Jung, M. H., … Choi, I. (2012). The effectiveness of continuing group psychotherapy for outpatients with alcohol dependence: 77-month outcomes. Alcoholism: Clinical & Experimental Research, 36(4), 686–692. doi:10.1111/j.1530-0277.2011.01643.x
Note: Retrieved from Walden Library databases.
Document: Group Therapy Progress Note
Required Media
Allyn & Bacon (Producer). (2000). Motivational interviewing [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 102 minutes.
Laureate Education (Producer). (2013d). Levy family: Sessions 1-7 [Video file]. Baltimore, MD; Author
Psychotherapy.net (Producer). (2015). Group therapy for addictions: An interpersonal relapse prevention approach [Video file]. Mill Valley, CA: Author.
Note: You will access this media from the Walden Library databases. The approximate length of this media piece is 83 minutes.
Psychotherapy.net (Producer). (2015). Group therapy for addictions: An interpersonal relapse prevention approach [Video file]. Mill Valley, CA: Author.
Week 9: Group Therapy for Addiction
Consider the following scenario:
The psychiatric mental health nurse practitioner is working for a community health clinic that offers state mandated “intensive outpatient rehabilitation” services for individuals who face incarceration for driving while under the influence. Mr. Smith, a 24-year-old male patient, shows up for his initial intake appointment and says, “Look, this sounds like it’s going to be an AA meeting. Can’t I just go there? I only had a couple of drinks. I don’t know why the judge was such a jerk.”
Clients with addictive disorders may present for therapy for various reasons. Some, like Mr. Smith, attend because it is court mandated. Some attend because family or friends have pushed them to do so, while others may attend because life has become unmanageable. Regardless of clients’ reasons for presenting for therapy, to reach these clients and effectively treat them, you must be able to break down barriers, establish relationships, and help them see the benefits of this therapeutic approach.
This week, you explore psychotherapeutic approaches to group therapy for addiction. You also develop diagnoses for clients receiving psychotherapy for addiction and consider legal and ethical implications of counseling these clients.
Learning Resources
Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.
Required Readings
American Nurses Association. (2014). Psychiatric-mental health nursing: Scope and standards of practice (2nd ed.). Washington, DC: Author.
Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice. New York, NY: Springer.
Yalom, I. D., & Leszcz, M. (2005). The theory and practice of group psychotherapy (5th ed.). New York, NY: Basic Books.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
Note: Retrieved from Walden Library databases.
Gamble, J., & O’ Lawrence, H. (2016). An overview of the efficacy of the 12-step group therapy for substance abuse treatment. Journal of Health & Human Services Administration, 39(1), 142–160. Retrieved from http://jhhsa.spaef.org/
Note: Retrieved from Walden Library databases.
Kim, J. W., Choi, Y. S., Shin, K. C., Kim, O. H., Lee, D. Y., Jung, M. H., … Choi, I. (2012). The effectiveness of continuing group psychotherapy for outpatients with alcohol dependence: 77-month outcomes. Alcoholism: Clinical & Experimental Research, 36(4), 686–692. doi:10.1111/j.1530-0277.2011.01643.x
Note: Retrieved from Walden Library databases.
Document: Group Therapy Progress Note
Required Media
Allyn & Bacon (Producer). (2000). Motivational interviewing [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 102 minutes.
Laureate Education (Producer). (2013d). Levy family: Sessions 1-7 [Video file]. Baltimore, MD; Author
Psychotherapy.net (Producer). (2015). Group therapy for addictions: An interpersonal relapse prevention approach [Video file]. Mill Valley, CA: Author. NURS 6650: Psychotherapy With Groups and Families.
Note: You will access this media from the Walden Library databases. The approximate length of this media piece is 83 minutes.
Psychotherapy.net (Producer). (2015). Group therapy for addictions: An interpersonal relapse prevention approach [Video file]. Mill Valley, CA: Author.
Note: You will access this media from the Walden Library databases. The approximate length of this media piece is 83 minutes.
Optional Resources
NURS 6650: Psychotherapy With Groups and Families.
Optional Resources
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