NUR2107 Person Centered Mental Health Care

Question:

Sources relevant to Mental Health Nursing (MHN);

Angelina can help you discuss with the MHN how to use therapeutic engagement skills.

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Discuss the various therapeutic treatments that Angelina can receive on the ward.

Answer:

Introduction

According to the MHN, most chronic mental illnesses in Australia are caused by depression. This can be either economic or social (Reich 2015).

Bipolar disorder and schizophrenia have both been increasing since the early 2000s. The federal government has been liaising closely with the MHN after which the state governments intervened through regulation and Medicare Levy and Medicare Safety Net (Dzipora & Ahern, 2013).

The WHO reported that more native Australians have mental health disorders than foreigners. This is a result of colonial rule that oppressed natives (World Health Organization Dept.

2014, Mental Health and Substance Abuse.

Angelina Parker (18 years old) is the focus of this case. She is a first year nursing student at Melbourne University.

Angelina initially indicated that she was in stable mental health. She also performed well as a student. But, later, her roommates discovered that she is depressed and has thoughts about suicide.

Angelina’s parents contact her and she is taken to an intensive inpatient ward.

The article will show Angelina the MHN’s treatment modalities and therapeutic engagement skills.

There will be two major sections in the paper that examine the level of engagement expertise as well as the treatment modalities.

The article will summarize the thesis statement and other ideas as illustrated below.

Integration of Therapeutic Engagement Skills

The following section will describe therapeutic communication in mental healthcare.

A definition of engagement is also provided.

This section will also identify and explain how engagement skills can be used to build rapport, cross cultural communication, questioning techniques, communication and partnership with health care providers, get it right from the perspective of the service user, and what to do if communication becomes difficult.

Therapeutic communication in mental illness is the process by which health care providers provide a holistic service to the patient, with consent from both patients and their families (Fartinash und Worret (2014)).

Engaged in treatment is the process of integrating values, beliefs and attitudes into care delivery (Videbeck 2013).

Angelina can benefit from the following engagement skills.

The first is to build a rapport.

Angelina should feel valued and respected by you as a caretaker.

Start by taking the time to introduce yourself and Angelina, paying particular attention to details like name, profession, time commitments, etc.

You can then ask Angelina for her opinions on how you would like to be addressed.

Angelina should be able to trust you and include her family in your decision making.

As a care provider, it is important to listen to the conversation and capture details. Townsend, 2014.

The care provider should not use mental health jargon in order to keep the conversation on the last page. Instead, they should use simple language.

Second, Angelina’s care provider should be proficient at questioning in order to avoid offending her family.

Robson and colleagues (2013) recommend that the care provider use appropriate questioning techniques to encourage assertiveness, where both verbal as well as nonverbal communication cues can coexist.

Angelina showed a reduced level of concentration and thoughts of suicide, which increased the chances of disagreements and stressful conversations.

Anger and her emotional nature can obscure the information, making it difficult to evaluate the situation and offer solutions.

Angelina can be helped if her care provider is keen to understand her physiological responses and gives her time to relax before asking her questions.

Thirdly, confrontations with Angelina during interactions are a useful tool for therapeutic communication. Angelina might shout or throw objects in the ward.

Angelina may lose her cool and start confronting the nurse. The nurse will need to keep her silent and explain the relationship between Angelina’s words and her behavior.

Rosenhan stated in 2016 that people will make a change when they learn to recognize differences in interpersonal communication.

Angelina will face the care provider to defend herself.

Instead of focusing on Angelina’s personality, the nurse should concentrate on her actions to provide the best medical solution.

It is also important for nurses to provide information in order to fulfill patient’s needs.

Angelina is seeking to know why she is unable to focus on school. To that end, the doctor can offer guidance and a manual along with her family members.

This information also helps her to think differently about school.

Angelina will enjoy a conversation that is funny, provided there are appropriate acknowledgments.

Recent studies have shown that humor makes people laugh. This is a plan to reduce muscle tension and stress (Mohr, et al. 2013, 2013).

Malchiodi 2013, believes laughter stimulates body physiological processes like respiration, strengthening the heart rate, and also serves a homeostatic purpose in activating endorphins to improve mood.

Angelina should have a good relationship with the caregiver so that they can identify humor’s effectiveness.

If she reacts in an unusual way, the nurse should be prepared to leave to avoid any violence.

This paper focuses its attention on Angelina’s treatment methods as shown below.

Therapeutic Treatment Methods

The MHN is keen for Australia to recognize the important role of individualised treatment using different treatment modalities.

According to the WHO, some treatments are more effective than other based on the severity of mental illness.

Angelina should be treated using the following modalities:

Cognitive Behavioral Therapy

The model is engaging and focuses on Angelina’s thoughts, feelings, and behavior.

Cognitive behavioral therapy (abbreviated CBT) allows the nurse, who is interacting with Angelina, to identify and correct her negative thoughts and patterns.

CBT allows Angelina to show care providers the positive aspects of her behavior.

Angelina can now distinguish between negative and positive thoughts and behavior after the therapy is over.

Dialectical Behavior Therapy

DBT, or dialectical behavioral therapy, is a skill-oriented approach that focuses on emotion regulation. This helps patients and caregivers communicate effectively.

Barker (2013) has shown that this model can be used to treat a person with borderline personality disorder.

Angelina is able to overcome her emotions when DBT is integrated with her case.

DBT gives nurses the opportunity to be active listeners.

Motivational Interviewing

Motivational interviewing, a type of treatment that emphasizes the patient’s will to change, is an option. (Galanter. et al. 2014).

Following this, the model recommends that the patient-centered plan be implemented to address all aspects of the patient’s life (Barker, 2013,).

Motival interviewing for Angelina will enable analysis of her ethnic background, education level, and past medical history. This will help to identify the causal agent of depression.

Angelina can also choose to accept or reject certain aspects of the form, even though it focuses on the best behavioral aspects.

Recreation Therapy

Recreation therapy, which is a form of treatment that seeks to restore concentration by removing the patient from his or her daily routines (Australian 2017, 2017).

Professional care providers are trained to take advantage of natural resources such as rivers, mountains, and parks for therapeutic activities.

Reciprocity therapy allows for ideas to be exchanged because the team includes people with different cultures and perspectives.

Angelina will use her most energy to build social skills that are beneficial at an individual level.

Music Therapy

Music therapy has been shown to be more effective in treating patients than any other treatment.

Cunningham et. al. (2014) state that the brain is composed of social constructs and responds to music therapy. This can help patients relax and heal faster.

Therapy is provided by certified professionals from accredited institutions. They use music programs to target the needs of patients or groups.

Equine Therapy

Equine therapy, which involves patients being associated with horses, is a highly effective therapy.

A patient can develop interpersonal communication skills, problem-solving skills, and self-confidence through the interaction with the horse.

After therapy, the horse will often be submissive to the patient. This is an indication that the patient has built trust and can manage his/her emotions.

Different stages of change

The model argues that patients change in stages, and not in one large change. (Happell und Gaskin 2013, 2013).

The therapy includes several steps, including pre-contemplation. This is a phase in which a patient has not accepted that there is a behavior change that needs to be addressed.

Contemplation is the time when a person acknowledges that they have a behavior problem, but isn’t ready for change.

Determination is when the patient is prepared to receive counseling or reform.

Action is the stage that shows how the patient has responded to the guidelines.

Maintenance is a time when the patient adheres to the behavioral change.

Relapse: This is when the patient fails to monitor their progress and returns to the original behavior.

You are looking for safety

The corrective measures are used to recognize signs of depression or trauma early on and offer a guideline to help patients recover (Videbeck, 2013,).

The model can be used at both an individual and group level.

This measure is highly recommended, as it focuses on changing an individual’s emotional state, increasing participation in groups, and increasing safety feelings.

Angelina might have difficulties with verbal expression so it is recommended to use art therapy.

Art therapy fosters creativity by allowing individuals to express their opinions in a creative way.

You can use different materials, such as pencil and paper, to make sure the idea is clear.

Sign language is also available in severe cases.

Conclusion

According to me, the current trends in Australian Mental Health indicate that real efforts are being made to address the problem.

The WHO and MHN reports show how serious the nation is about ensuring that individuals with mental disorders and their families have access to the highest quality services.

Angelina Parker is a case that allows you to see the potential outcomes of mental nursing treatment. It also shows where family-communal psychiatric and mental health nursing can play a crucial role.

This allows us to see that the Australian mental healthcare nurse is strategically placed to deal with future mental problems, given their current trends and background analysis.

References

Royal Australian and New Zealand College of Psychiatrists clinical practices guidelines for schizophrenia and related disorders.

Australian & New Zealand Journal of Psychiatry.

The Tidal model: developing an empowered, person-centered approach to recovery in psychiatric nursing and mental health nursing.

Journal of psychiatric, mental and health nursing, 8(3). 233-240.

Williams Obstetrics, 24e.

Review of research to determine what constitutes a good therapeutic relationship in psychiatric/mental healthcare nursing.

Internet Journal of Advanced Nursing Practice (10(1)), 7-7.

Psychiatric nursing.

American Psychiatric Publishing textbook for substance abuse treatment.

A systematic review of the attitudes and practices of undergraduate nursing students toward mental health nursing.

Journal of clinical Nursing, 22(1): 148-158.

Expressive therapies.

Guilford Publications.

Behavioral intervention technology: Evidence review and future recommendations in mental health research.

Encyclopedia of bioethics.

Mental health nursing and the provision of physical health care: Cross-sectional analysis of nurses’ attitudes and practice and their perceptions about how they can provide care for those with severe mental illness.

International Journal of Mental Health Nursing 22, 509-417.

The career in mental healthcare is still a very unlikely choice for nurses: A longitudinal replicated study.

International Journal of Mental Health Nursing 22, 3: 213-220.

Principles and practice for psychiatric nurses.

Psychiatric mental healthcare nursing: Concepts of care within evidence-based practices.

FA Davis.

World Health Organization.

Department.

2005. Mental health atlas.

World Health Organization.

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