NU-664C-02-23PCS3 FamilyPsychiatric Ment.Hlth I
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- Week 9: Trauma
- Week 9 Discussion 1: Psychotherapeutic Strategies
Week 9 Discussion 1: Psychotherapeutic Strategies
Done: Make forum posts: 1
Value: 100 points
Due: In an effort to facilitate scholarly discourse, create your initial post by Day 4, and reply to at least two of your classmates, on two separate days, by Day 7.
Grading Category: Discussions
Note: In this type of discussion, you will not see the responses of your classmates until after you have posted your own response to the question below.
Initial Post
In your initial post, discuss the clinical parameters for identifying, assessing, and using psychotherapeutic strategies with people who have experienced trauma. Include research and education implications related to the psychiatric-mental health nurse practitioner’s approach to the treatment of people who have experienced trauma and/or been diagnosed with a personality disorder. Be sure to complete the readings prior to your initial posting.
Replies
Reply to at least two of your classmates. Identify something in your peer’s post you think is missing and offer a scholarly resource to back up your observation. Your reply posts should build on the original post and demonstrate substantive reflection.
Pick out an idea from your peers’ initial post that you find most interesting and tell how you will use this information in practice.
Please refer to the Grading Rubric for details on how this activity will be graded. The described expectations meet the passing level of 80%. Students are directed to review the Discussion Grading Rubric for criteria which exceed expectations.
Re: Week 9 Discussion 1: Psychotherapeutic Strategies
by Cindy Faraguna – Monday, 26 June 2023, 4:55 PM
Patients who suffer from trauma present with various symptoms. The trauma screening is initiated by determining if the patient has a history of trauma and if he/she is experiencing trauma-related symptoms (SAMHSA, 2014). Trauma and related mental health conditions are triggered by external traumatic events which can be witnessed or experienced, such as sexual assault, threatened or actual death, and/or serious injury (mentally, emotionally, physically) (Sweeny et al., 2018). Adverse Childhood Experiences (ACEs) Scale is what I have been using during clinics to help determine patient trauma. This has been helpful to know how to navigate the conversation and determine areas requiring more attention. Policymakers and providers increasingly recognize that exposure to traumatic events, especially as children, heightens patients’ health risks long afterward (Menschner & Maul, n.d.). There are several assessment tools that can be used based on the patient and need. For example, there is the Brief Trauma Questionnaire (BTQ), Combat Exposure Scale (CES), COVID-19 Exposure Scale, Life Events Checklist for DSM-5 (LEC-5), Stressful Life Events Screening Questionnaire (SLESQ), and Trauma History Screen (THS) (U.S. Department of Veterans Affairs, 2018). Working with a patient experiencing trauma comes with a different set of challenges. Many survivors of trauma are at risk for various negative psychological outcomes, such as depression, suicidal ideations, anxiety, personality disorders, substance abuse, posttraumatic stress disorder (PTSD), and revictimization (Scoglio et al., 2015). Studies suggest that first-line treatment is trauma-focused psychotherapy rather than other types of therapies or pharmacologic management (Stein & Norman, 2021). Psychotherapy strategies will provide support and compassion while building therapeutic alliances.
Psychiatric mental health nurse practitioner (PMHNP) approach to patients who have experienced trauma is to shift the thought of “What is wrong with you?†to “What happened to you?†(Sweeney et al., 2018). Learning broad-based definitions of trauma will help the provider gain insight and understanding of trauma-informed approaches (Sweeny et al., 2018). The plan when treating patients with trauma is to assess their level of care and address safety needs, diagnosis, disability, strengths and skills, support network, and cultural context (SAMHSA, 2014). PMHNP’s success in treating patients experiencing trauma is proficient screening, diagnosis of mental health conditions, and being well-versed in community-based resources which patients can utilize for optimal outcomes (Kameg, 2019).ReferencesKameg, B. N. (2019). Management of mental health conditions in refugee youth: An overview for the psychiatricâ€mental health nurse practitioner. Journal of Child and Adolescent Psychiatric Nursing, 32(4), 179–186. https://doi.org/10.1111/jcap.12253
Menschner, C. and Maul, A. (n.d.) Key ingredients for successful trauma-informed care implementation. SAMHSA. https://www.samhsa.gov/sites/default/files/programs_campaigns/childrens_mental_health/atc-whitepaper-040616.pdf (Accessed: 26 June 2023).
Scoglio, A. A., Rudat, D. A., Garvert, D., Jarmolowski, M., Jackson, C., & Herman, J. L. (2015). Self-compassion and responses to trauma: The role of Emotion Regulation. Journal of Interpersonal Violence, 33(13), 2016–2036. https://doi.org/10.1177/0886260515622296
Stein, M., & Norman, S. (2021, November 5). Psychotherapy and psychosocial interventions for posttraumatic stress disorder in adults. UpToDate. https://www.uptodate.com/contents/psychotherapy-and-psychosocial-interventions-for-posttraumatic-stress-disorder-in-adults
Substance Abuse and Mental Health Services Administration. (2014). Screening and assessment – trauma-informed care in behavioral health services. https://www.ncbi.nlm.nih.gov/books/NBK207188/
Sweeney, A., Filson, B., Kennedy, A., Collinson, L., & Gillard, S. (2018). A paradigm shift: Relationships in trauma-informed mental health services. BJPsych Advances, 24(5), 319–333. https://doi.org/10.1192/bja.2018.29
U.S. Department of Veterans Affairs. (2018). Trauma and Stressor Exposure Measures. https://www.ptsd.va.gov/professional/assessment/te-measures/index.asp
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