• What are the characteristics of the consumers that you regularly see in your current work environment? What are some ways in that they are impacted by the other identified healthcare stakeholders?

• What effect has ACA had on stakeholders? Explain what strategies a nurse leader might adopt that would make it more effective?

• What is important for nurse leaders to share with their staff regarding payers? Why?

• Who are the various regulators that affect your healthcare organization? What is your role in the respective regulatory process?

This PowerPoint® (Microsoft Office)

Complete your Week 6 required discussion prompt.

• An 86-year-old male parishioner is on hospice care at home, and his daughter, who is a nurse, has been trying to meet all his physical needs around the clock. The pastor, who made a home visit, calls the faith community nurse to express his concern that the daughter is becoming “burned out.” How can the faith community nurse engage the faith community as a whole to provide volunteer support to this family?

TOPIC OF THE ESSAY IS  “ETHICAL dilemma  OF THERAPEUTIC COMMUNICATION”

 FOR THE INTRODUCTION IT SHOULD INCLUDE the following

1. Why is this topic important to investigate?
2. What is the scope, context and significance of the topic as an ethical dilemma?
3. Highlight the importance of the problem/issue and make general statements about the problem/issue
4. Summarize the current understanding and background information about the topic
5. Include one referenced source that will support your introductory thoughts about your topic.
6. APA 7th edition format; full sentences, attention to grammar
7. ATTACHED IS THE RUBRIC

* The first attachment will be the homework

* the second attachment will be the list of industries you will choose ( i want you to pick KPMG Company)

*the third attachment will be example of how to do the hmw

*the forth attachment will be example of how to do it too

 I NEED A RESPONSE TO THIS ASSIGNMENT

3 REFERENCES

Cognitive Behavioral Therapy (CBT)

The goal of CBT is to identify unhealthy thought patterns which lead to negative emotions and behaviors, when the therapist and client can identify the unhealthy thoughts and impulses we can then begin to reframe and restructure them so that we can have a more positive response to our life stressors. Part of this process involves disproving untrue beliefs about ourselves, Socratic questioning, reattributing blame for the negative assumptions about the stressor, thought stopping, self exploration and cognitive restructuring (Wheeler, 2014). CBT is aimed at changing a pattern of thinking which is irrational in nature and assisting the client to identify the rational and real event or emotion and reduce the emotional response to be more proportionate to what actually happened or is still happening (David, Cotet, Matu, Mogoase & Stefan, 2018). While the approach may differ minimally between family and individual CBT processes, because there will be more persons involved in the family approach, the overall idea is the same: cognitive thought restructuring. 

While traditional CBT practitioners focus on individual interpersonal relationships and subsystems which the client identifies as the main stressor, CBT in families takes a much more thorough approach by identifying negative belief and thought patterns that are reinforced by family members (Nichols & Davis, 2020). Nichols and Davis (2020) also explain that doing CBT with an individual who return home to a family in which reinforces the negative thought and belief patterns about themselves sets the stage for failure for the client. CBT in families and romantic couples shows strong evidence of success and can greatly improve relationship dynamics, interactions, mindfulness of each other’s emotions and have long-term positive outcomes for the family or romantic couple (Nichols & Davis, 2020). 

Practicum Experience

CBT in my practicum experience has been… very interesting. I am doing my clinical hours at a long-term care psychiatric facility, it is much like an AFC home, but it is a 20 bed facility with much more staff and resources than a typical AFC, many of the clients are stepped down there from the state hospital or a long-term hospitalization. A lot of the counseling that my preceptor and I do is helping the residents navigate relationships with their roommates, peers, staff and families in order to prepare them for those interactions in the real world when they are hopefully released to begin their more independent journeys. Counseling two roommates who are struggling to co-exist has a lot of the same hallmarks as couples or family counseling when the clients are living together long-term (at least one year), but with so much acuity and other dynamics in the facility, achieving those cognitive changes can be very challenging when they are immediately disproven by the behavior of other clients on the unit. With one set of roommates in particular, we have been working with them on setting firm boundaries, communicating assertively, helping them to reframe their thoughts and feelings toward each other and identify the positive aspects of their relationship. Achieving these outcomes, especially in clients with serious and persistent mental illness, is very challenging, but because of that heightened challenge comes a lot of reward, as after five weeks now I have slowly begun to see the results of drilling some of these healthy changes into each and every individual and group counseling sessions. I consider it a very good day when we witness a behavior and another client in the facility yells “you need to set better boundaries”! (haha)

Challenges In the Family Setting

CBT in the family setting can be very challenging for the family and for the therapist – the therapist is working to rewire years of taught and learned behavior, evaluate subsystems within the family and address those toxic relationships, evaluating the structure of the family and determining how that affects cognitive thought patterns in the home. Patterson (2014) writes that sometimes in family therapy there is a risk of evaluating cause and effect patterns which may ignore the signs or protection of an actual victim-perpetrator relationship, such as in domestic violence cases, and through the use of a CBT approach increases the likelihood of safety and independence of for the victim of abuse. There are many moving parts and pieces to family CBT and there is a lot of conflict that must be worked through before one can start to change those thought patterns and in-turn their behavior and reactions toward one-another.