Psychotherapy for Addictive Disorders

“A long-standing debate has roiled over whether addicts have a choice over their behaviors. The disease creates distortions in thinking, feelings, and perceptions, which drive people to behave in ways that are not understandable to others around them. Simply put, addiction is not a choice. Addictive behaviors are a manifestation of the disease, not a cause.”

–Dr. Raju Hajela, former president of the Canadian Society of Addiction Medicine

A common misconception is that addiction is a choice, and addicts are often labeled as individuals who lack morals, willpower, or responsibility. However, addiction is a clinical disorder that must be treated with the support of a health care professional. Although many people who are exposed to potentially addictive substances and behaviors continue life unaltered by their experiences, some people are fueled by these experiences and spiral out of control. In your role as the psychiatric mental health nurse practitioner, you must be prepared to not only work with these individuals who struggle with addiction, but also help them and their families overcome the social stigmas associated with addictive behavior.

This week, as you explore psychotherapy for addiction, you assess clients presenting with addictive disorders. 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.

  

Learning Objectives

Students will:

· Develop diagnoses for clients receiving psychotherapy*

· Evaluate the efficacy of motivational interviewing techniques for clients*

· Analyze legal and ethical implications of counseling clients with psychiatric 

  disorders*

   Select a client whom 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 motivational interviewing 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.

·  Support your approach with evidence-based literature.

· NOTE: PLEASE SEE THE ATTACHED Practicum Journal Template AND JOURNAL SAMPLE (TIME LOG & JOURNAL ENTRIES) FOR WRITING THIS ASSIGNMENT…..ALSO FOR THE TIME LOG AND JOURNAL ENTRIES, JUST MAKE UP A REASONABLE INFORMATION AND CLIENT INFORMATION IN MENTAL HEALTH NURSING.

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 7, “Motivational Interviewing” (pp. 299–312)
• Chapter      16, “Psychotherapeutic Approaches for Addictions and Related Disorders”      (pp. 565–596)

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

Albrecht, U., Kirschner, N. E., & Grusser, S. M. (2007). Diagnostic instruments for behavioral addiction: An overview. German Medical Science Psycho-Social-Medicine, 4, 1–11. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2736529/

Fisher, M. A. (2016). The ethical ABCs of conditional confidentiality. In Confidentiality limits in psychotherapy: Ethics checklists for mental health professionals (pp. 13–25). Washington, DC: American Psychological Association. doi:10.1037/14860-002

PLEASE, PAY ATTENTION TO THE QUESTIONS AND INCLUDE OTHER NEEDED INFORMATION THAT WERE NOT ADDED IN THE  EXAMPLE

  

                                                           Application: Systems Theory

As noted in the Learning Resources, systems theory provides a meaningful and beneficial means of examining challenges in health care organizations. To do this effectively, however, it is essential to assess all system components, as some may be relatively healthy while others are problematic.

For this Assignment, you apply systems theory to the examination of a problem in a department or a unit within a health care organization. (Note: You may use the same problem you identified for the Discussion as long as it meets the criteria for this assignment.)

To prepare:

· Review the Meyer article, “Nursing Services Delivery Theory: An Open System Approach,” in this week’s Learning Resources. Focus especially on the information presented in Table 1 (p. 2831) and Figure 2 (p. 2833).

· Reflect on your organization or one with which you are familiar. Within a particular department or unit in this organization, identify a problem the staff is encountering.

· Using Table 1 in the Meyer article as a guide, analyze the department or unit, identifying inputs, throughput, output, cycles of events, and negative feedback. Consider whether the problem you have selected relates to input, throughput, output, cycles of events, and/or negative feedback.

· Think about how you could address the problem: Consider what a desired outcome would be, then formulate related goals and objectives, and translate those goals into policies and procedures.

· Research professional standards that are pertinent to your identified problem.

· Reflect on the organization’s mission statement and values. In addition, consider how addressing this problem would uphold the mission and values, while improving the organizational culture and climate. (Depending on the organization you have selected, you may have explored these in the Week 1 Discussion.)

To complete:

Write a 3- to 5-page paper (page count does not include title and reference page) that addresses the following:

· Describe a department or unit within a health care organization using systems theory terminology. Include a description of inputs, throughput, output, cycles of events, and negative feedback.

· Describe the problem you identified within the department or unit using an open- systems approach, and state where the problem exists using the systems theory model (input, throughput, output, cycles of events, or negative feedback).

· Based on this information, explain how you would address the problem as follows:

o Formulate a desired outcome.

o Identify goals and objectives that would facilitate that outcome.

o Translate those goals and objectives into policies and procedures for the department or unit.

o Describe relevant professional standards.

· Explain how your proposed resolution to the problem would uphold the organization’s mission and values and improve the culture and climate.

                                                                 Learning Resources

Required Readings

Marquis, B. L., & Huston, C. J. (2017). Leadership roles and management functions in nursing: Theory and application (9th ed.). Philadelphia, PA: Lippincott, Williams & Wilkins.

• Review Chapter 7,      “Organizational Planning”

• Chapter 8, “Planned Change”

o Organizational Change Associated With Nonlinear Dynamics

Read this section of Chapter 8 on planned change. Consider the role of leaders in effectively managing planned change.

• Chapter 12, “Organizational      Structure”

o “Organizational Culture”

There are many structures organizations take, and these structures influence how the organization functions. This chapter discusses many different organizational structures and provides insights into how these structures influence the change process, as well as leadership and management.

Johnson, J. K., Miller, S. H., & Horowitz, S. D. (2008). Systems-based practice: Improving the safety and quality of patient care by recognizing and improving the systems in which we work. Retrieved from http://www.ahrq.gov/downloads/pub/advances2/vol2/Advances-Johnson_90.pdf

This article addresses the importance of systems-based practice (SBP) in health care workplaces. The authors state that SBP knowledge is one of six core competencies that physicians have to know in order to provide safe and proper care for their patients.

Manley, K., O’Keefe, H., Jackson, C., Pearce, J., & Smith, S. (2014). A shared purpose framework to deliver person-centred, safe and effective care: Organisational transformation using practice development methodology. FoNS 2014 International Practice Development Journal 4-(1).

Meyer, R. M., & O’Brien-Pallas, L. L. (2010). Nursing services delivery theory: An open system approach. Journal of Advanced Nursing, 66(12), 2828–2838.

Retrieved from the Walden Library databases.

In this article, the authors examine the effects of nursing services delivery theory in large-scale organizations. Among other benefits, this theory supports multilevel phenomena and cross-level studies, and it can guide future research and the management of nursing services.

Optional Resources

Glennister, D. (2011, July). Towards a general systems theory of nursing: A literature review. Paper presented at the 55th Annual Meeting of the International Society for the System Sciences, Hull, United Kingdom. Retrieved from http://journals.isss.org/index.php/proceedings55th/article/viewFile/1717/569

Hayajneh, Y. (2007). Management for health care professionals series: Systems & systems theory. Retrieved from http://www.hayajneh.org/a/readings/Systems-Theory.pdf