There are 2 discussions: Topic 1 & Topic 2 (They both require references please) 

Discussion Topic 1: Third-party Payment 

How does third-party payment distort the market for health care? If it is so distorted why does every wealthy country insist on using third-party intermediaries to purchase health care? Why do we carve out a separate payment program for our elder citizens? 

Discussion Board:  Minimum 200 words, APA Style, Time New Roman,  Font 12,   (3 references- in text citations) not older than (2012-2017). No Plagiarism 

please.

Discussion Topic 2: Medicaid and Medicare 

Summarize ways in which health insurance fails, as people get older. Distinguish between Medicaid and Medicare. Determine whether your state has expanded Medicaid. Why would states choose not to participate in Medicaid expansion?  

Discussion Board:  Minimum 200 words, APA Style, Time New Roman,  Font 12,   (3 references- in text citations) not older than (2012-2017). No Plagiarism please

  

Week 9: Psychotherapy With Children and Adolescents

Approximately 1 in 5 children and adolescents have a mental health disorder, which may lead to issues at home, school, and other areas of their lives (Prout & Fedewa, 2015). When working with this population, it is important to recognize that children and adolescents are not “mini adults” and should not be treated as such. Psychotherapy with these clients is often more complex than psychotherapy with the general adult population, particularly in terms of communication. As a result, strong therapeutic relationships are essential to success.

This week, as you explore psychotherapy with children and adolescents, you assess clients presenting with disruptive behaviors. You also examine therapies for treating these clients and consider potential outcomes. Finally, you develop diagnoses for clients receiving psychotherapy and consider legal and ethical implications of counseling these clients.

Photo Credit: [dolgachov]/[iStock / Getty Images Plus]/Getty Images

  

Learning Resources

Required Readings

Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (2nd ed.). New York, NY: Springer Publishing Company.

• Chapter      17, “Psychotherapy With Children” (pp. 597–624)

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

Note: You will access this text from the Walden Library databases.

Bass, C., van Nevel, J., & Swart, J. (2014). A comparison between dialectical behavior therapy, mode deactivation therapy, cognitive behavioral therapy, and acceptance and commitment therapy in the treatment of adolescents. International Journal of Behavioral Consultation and Therapy, 9(2), 4–8. doi:10.1037/h0100991

Note: You will access this article from the Walden Library databases.

Koocher, G. P. (2003). Ethical issues in psychotherapy with adolescents. Journal of Clinical Psychology, 59(11), 1247–1256. PMID:14566959

Note: You will access this article from the Walden Library databases.

McLeod, B. D., Jensen-Doss, A., Tully, C. B., Southam-Gerow, M. A., Weisz, J. R., & Kendall, P. C. (2016). The role of setting versus treatment type in alliance within youth therapy. Journal of Consulting and Clinical Psychology, 84(5), 453–464. doi:10.1037/ccp0000081

Note: You will access this article from the Walden Library databases.

Zilberstein, K. (2014). The use and limitations of attachment theory in child psychotherapy. Psychotherapy, 51(1), 93–103. doi:10.1037/a0030930

Note: You will access this article from the Walden Library databases.

Required Media

Laureate Education (Producer). (2013a). Disruptive behaviors – Part 1 [Multimedia file]. Baltimore, MD: Author. 

Laureate Education (Producer). (2013a). Disruptive behaviors – Part 2 [Multimedia file]. Baltimore, MD: Author. 

Walker, R. (n.d.). Making child therapy work [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 95 minutes.

Optional Resources

Bruce, T., & Jongsma, A. (2010a). Evidence-based treatment planning for disruptive child and adolescent behavior [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 63 minutes.

  

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.

Learning Objectives

Students will:

• Assess      clients presenting with disruptive behavior
• Analyze      therapeutic approaches for treating clients presenting with disruptive      behavior
• Evaluate      outcomes for clients presenting with disruptive behavior

To prepare:

• Review      this week’s Learning Resources and reflect on the insights they provide.
• View      the media, Disruptive Behaviors. Select one of the four case      studies and assess the client.
• For      guidance on assessing the client, refer to pages 137-142 of the Wheeler      text in this week’s Learning Resources.

Note: To complete this Discussion, you must assess the client, but you are not required to submit a formal Comprehensive Client Assessment.

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 cannot post anonymously. Please check your post carefully before clicking Submit!

By Day 3

Post an explanation of your observations of the hyperactive adolescent in the case study you selected, including behaviors that align to the criteria in DSM-5. Then, explain therapeutic approaches you might use with this client, including psychotropic medications if appropriate. Finally, explain expected outcomes for the client based on these therapeutic approaches. Support your approach with evidence-based literature.

Read a selection of your colleagues’ responses.

In nursing practice, accurate identification and application of research is essential to achieving successful outcomes. Being able to articulate the information and successfully summarize relevant peer-reviewed articles in a scholarly fashion helps to support the student’s ability and confidence to further develop and synthesize the progressively more complex assignments that constitute the components of the course change proposal capstone project.  For this assignment, the student will provide a synopsis of eight peer-reviewed articles from nursing journals using an evaluation table that determines the level and strength of evidence for each of the eight articles. The articles should be current within the last 5 years and closely relate to the PICOT statement developed earlier in this course. The articles may include quantitative research, descriptive analyses, longitudinal studies, or meta-analysis articles. A systematic review may be used to provide background information for the purpose or problem identified in the proposed capstone project. Use the “Literature Evaluation Table” resource to complete this assignment.  While APA style is not required for the body of this assignment, solid academic writing is expected, and in-text citations and references should be presented using APA documentation guidelines, which can be found in the APA Style Guide, located in the Student Success Center.  

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.  

You are not required to submit this assignment to Turnitin. 

NRS-490-RS-LiteratureEvaluationTable.docx

  

Measuring Quality Guidelines and Grading Rubric

In an 8 to 10-page paper, APA format and 5 references, describe three rate based measurements of quality.

Select three rate based measurements of quality that you will use as the primary basis for this paper.

These measurements must relate to some aspect of clinical or service quality that directly relates to patient care or the patient’s experience of care.  For the purposes of this assignment, an analysis of staffing levels is not permitted.  You can find useful information on quality indicators that are of interest to you on these websites and resources.  You may choose only one of the three measures to be some form of patient satisfaction measure. 

Deconstruct each measure to include descriptions of the each of the following as numbered below: 

1) The definition of the measure 

2) The numerical description of how the measurement is constructed (the numerator/denominator measure counts, the formula used to construct the rate, etc.)  

3) Explain how the data for this measure are collected 

4) Describe how the measurement is compared externally to other like settings; differentiate between the actual rate and a percentile ranking.  

5) Explain whether the measure is risk adjusted or not.  If so, explain briefly how this is accomplished.  

6) Describe how goals might be set for each measure in an aggressive organization, which is seeking to excel in the marketplace. 

Describe the importance of each measure to a chosen clinical organization and setting. 

Using these websites and resources you can choose a hospital, a nursing home, a home health agency, a dialysis center, a health plan, an outpatient clinic or private office; a total population of patient types is also acceptable, but please be specific as to the setting. That is, if you are interested in patients with chronic illness across the continuum of care, you might home in a particular health plan, a multispecialty practice setting or a healthcare organization with both inpatient and outpatient/clinic settings. Faculty appointments and academic settings are not permitted for this exercise. For all other settings, consult the instructor for guidance. You do not need actual data from a given organization to complete this assignment. 

Relate each measure to patient safety, to the cost of poor quality, and to the overall cost of healthcare.

Required Readings

Joshi, M.S., Ransom, E.R., Nash, D.B., & Ransom, S.B., (Eds.). (2014). The Healthcare Quality Book, 3rd ed. Chicago, IL: Health Administration Press.

Chapter 5: “Data Collection”

Chapter 6: “Statistical Tools for QI”

Park, J., Konetzka, R. T., & Werner, R. M. (2011). Performing well on nursing home report cards: Does it pay off? Health Services Research, 46(2), 531–554. doi:10.1111/j.1475-6773.2010.01197.x

1. The study in this article evaluates whether or not nursing homes benefit from improvements in quality measures. Four financial outcomes are measured before and after the improvements are enacted. The study shows that the nursing homes that improved quality measures benefited financially.

Suchy, K. (2010). A lack of standardization: The basis for the ethical issues surrounding quality and performance reports. Journal of Healthcare Management, 55(4), 241–251.

Because performance reports are easily found online, this article supports creating ethical guidelines for the performance reports of the health care industry. It compares nearly ten different organizations that provide performance reporting, and then it proposes an ethical framework and principles for public quality reporting.

Wachter, R. M., & Pronovost, P. J. (2009). Balancing “no blame” with accountability in patient safety. New England Journal of Medicine, 361(14), 1401–1406.

This article addresses the issue of individual accountability in health care organizations. It suggests moving from a culture within health care that does not place blame on individuals to a culture where individuals become more accountable.

Centers for Medicare & Medicaid Services. (n.d.). Quality initiatives: Overview. Retrieved from http://www.cms.gov/QualityInitiativesGenInfo/

Created by the U.S. Department of Health & Human Services, this website overviews quality initiatives that affect the health care industry. It also provides information and downloadable PDFs on the Post-Acute Care Reform Plan and Development of Quality Indicators for Impatient Rehabilitation Facilities (IRF).

Required Media

Video: Laureate Education, Inc. (Executive Producer). (2011). Organizational and systems leadership for quality improvement: External quality improvement. Baltimore: Author.

Note: The approximate length of this media piece is 10 minutes.

The presenters in this video discuss various external organizations involved in quality, and examine the enforcement of standards by governmental agencies versus voluntary organizations. This program also addresses the publication of quality information and why organizations should do their own reporting in addition to mandated reporting. Licensing, credentialing, and certification are discussed as they relate to the social compact that health care providers have for quality and safety.