I NEED A RESPONSE FOR THIS ASSIGNMENT

2 REFERENCES

Group Therapy with Older Adults

Psychotherapy, according to Wheeler (2014), can be used to treat varying psychological disorders throughout the lifespan of an individual. In general, psychotherapy must be adapted to address and fit the specific needs of the age groups. Researches have indicated in older group therapy that one can socialize with peers who share similar symptoms. It also creates an opportunity to increase one’s altruism and empathy and feel useful by helping others (Tavares & Barbosa, 2018). However, the elderly often may have neurological deficits and comorbidities that may affect their ability to fully participate and benefit from psychotherapy (Wheeler, 2014). Studies indicated that some of these older adults live in isolation and have lost their relationships, occupation, and capacity. Group therapy allows them to connect to people and be useful while receiving help (Wheeler, 2014). The discussion will include a description of a group therapy session with older adults, the group’s stage, any issues or resistances present, therapeutic modalities utilized, and challenges resulting from working with the group.

Group Description

This group includes ten members whose ages range from 64 to 80, including females and males, each with different diagnoses such as depression, sleep disorders, anxiety disorders, personality disorders, alcohol, drug use disorders, and neurocognitive disorders. Some of the patients were hyperactive, while some were depressed. Currently, the group comprises patients in different stages, such as forming, storming, norming, performing, and adjourning. The orientation stage still ongoing as new members joins the group while some are in their terminal adjourning phase. This group did not follow the predictable pattern of the average group staging. However, the patients introduce their names, ages, professions, and family backgrounds. The group went back and forth, elaborating on more background aspects of individual lives. Individuals were encouraged to share as much as they feel comfortable sharing. The group ran for 60 minutes, from 1030 to 1130 in the morning. It is modified to bring the best out of the patients. The therapy session time was divided and organized to allow note-taking, summarization, memory aids, and mnemonics devices to help in their recovery (Tavares & Barbosa, 2018).

Resistance or Issues Present

The cohesiveness of the group met a few resistances. One group member, a 70-years-old male, did comment on the newness of therapy. His comment was: “back in the day; people did not meet with each other to talk about everyday life hurdles; we dealt with it, that is what is expected of us as men.” I had a 65-year-old female who said she is not crazy and should not be in the group; this was her second day. She laughs, smiles, and shakes her head when others are speaking. She moved her chair further away from how the chairs were spaced-out due to the coronavirus pandemic. 

The compilation of both hyperactive and depressed patients made it often difficult for every patient to participate and achieve their expected goal at the same time. Some patients were hyperactive, intrusive, and monopolizing. They tried to control everything and respond to every question asked, which sometimes increased anxiety and tension to other group patients. While depressed and quiet, patients feel irritated, intimidating, and sad. 

Therapeutic Techniques

Cognitive-behavioral therapy (CBT) is a practical approach for a wide range of problems affecting older adults (Secker et al., 2020). As a therapeutic approach in group therapy sessions, CBT has proven to be beneficial to the elderly. It helps them build an interpersonal relationship with others, improve socializing skills, improve the symptoms of depression, and help manage stressful life events (Tavares & Barbosa, 2018). CBT aims to have the patients and the counselor in agreement on markers of progress in therapy. Domhardt and Baumeister (2018) stated that the CBT coping strategy helps the patient identify negative thoughts and replace more functional views. CBT equips the patients with internal resources and enhances their coping skills (Wheeler, 2014). In this manner, the individual’s symptoms reduce, and behaviors change as they learn to control their feelings.

Challenges

I encountered different challenges in conducting therapy with the age group. There was an issue with the seat arrangement; because of COVID-19, the patients were spaced six fits apart to maintain social distance. With some of the patients being intrusive and exhibiting poor boundary behavior, it became difficult to keep the space. Some patients had physical declines that affected therapy, some with cognitive impairment, hearing impairment, and decreased eyesight. Thus, requiring the facilitator to speak more slowly, louder and to explain more clearly. To accommodate those with low vision, I had to provide large print worksheets for the patients. Some patients remained in the forming and storming stages for a prolonged period due to their cognitive state. The group dynamic also affected this group outcome due to new admissions and discharges, which hinder the group’s progress.

No matter what population of people being counseled, it is necessary to recognize the challenges they face and change practices accordingly. CBT is feasible and highly effective in geriatric patients. Early diagnosis, good access to psychotherapy, and early intervention could improve care for older patients.

References

Domhardt, M., & Baumeister, H. (2018). Psychotherapy of adjustment disorders: current state and future directions. The World Journal of Biological Psychiatry, 19(sup1), S21-S35.

Hummel, J., Weisbrod, C., Boesch, L., Himpler, K., Hauer, K., Hautzinger, M., … & Dutzi, I. (2017). AIDE–acute illness and depression in elderly patients. Cognitive-behavioral group psychotherapy in geriatric patients with comorbid depression: A randomized, controlled trial. Journal of the American Medical Directors Association, 18(4), 341-349.

Secker, D. L., Kazantzis, N., & Pachana, N. A. (2020). Cognitive behavior therapy for older adults: Practical guidelines for adapting therapy structure. Journal of rational-emotive and cognitive-behavior therapy, 22(2), 93-109.

Tavares, L. R., & Barbosa, M. R. (2018). Efficacy of group psychotherapy for geriatric depression: A systematic review. Archives of gerontology and geriatrics, 78, 71-80.

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

• Within your community, there has been a large increase in teenage smoking, and community leaders are developing a plan to decrease the incidence of smoking. To help them, you will:

A) Develop a research question to address the problem.
B) Determine what kind of study should be undertaken.
C) Design a study to decrease the incidence of smoking in teenagers.

2 

You are working in an ICU where a 16-year-old girl is in critical condition after an auto accident. Her mother comes in and begins to sing, sprinkle tobacco around the bed, hang eagle feathers and crystals around the room, and move her hands back and forth above the girl’s body. The girl’s nurse tells the mother that visiting time is over and that she should take all these dirty things out of the room. The mother insists on staying by the bedside and says that if she had placed rosary beads or Bibles in the room she would not have been questioned.

What cultural and spiritual issues are evident in this situation?

Cultural care is a type that involves the delivery of care in a non-conventional where care should be delivered in a way to accommodate the patient’s preference. The way that transcends cultural boundaries and considers a client’s culture as it affects health, illness and lifestyle, communication, dietary preferences, and dress are influenced. In this case, hang eagle feathers and crystals around the room can be accommodated if it will not interfere with scientific care.

Apply cultural competence to this case

Cultural competence is the ability of nurses to understand and address the entire cultural context of each client within the realm of the care they deliver. The nurse should be able to allow cultural exceptions for the patient and her mother. The patient’s mother’s faith was tied to the artifacts that she brought and will help the girl get better the moment she sees those things.

Discuss complementary therapies evident in this situation

In this situation, the mother is applying holistic/cultural care to the conventional scientific care the nurse is providing. This accommodation is will enhance nurse-patient interaction and relationships.

How would you incorporate spiritual care?

Nurses can provide spiritual care by attending to several important spiritual elements. This includes supporting the patient’s spiritual beliefs and needs and individualizing spiritual care to the patient. I would start by taking cues from the patient including but not limited to asking for the patient’s preferences. Also, supporting the patient within the limits of their faith and share encouraging thoughts or words.

How would you approach this situation?

I will approach this situation with caution and respect. I will create accommodations with the hospital policy in mind. By attending to the patient’s several important spiritual elements. The patient’s family acknowledges the higher powers and believes in the intervention of higher power. I will not stand in the way.

What principles would guide you?

I will base my guide on the ethical principles of patient-centeredness, holism, discretion, accompaniment, and tolerance. These are the core principles that guide spiritual care.

References

Hodge, D. R., & Limb, G. E. (2011). Spiritual assessment and Native Americans: establishing the social validity of a complementary set of assessment tools. Social Work, 56(3), 213–223.https://doi-org.resu.idm.oclc.org/login.aspx?direct=true&db=mdc&AN=21848086&site=ehost-live

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***Please use the NEW APA 7th Edition. Please reference this guide when completing assignment.***

***USE the ATTACHED PDF document to complete this assignment***

1) Discuss how geopolitical and phenomenological place influence the context of a population or community assessment and intervention. 

2)Describe how the nursing process is utilized to assist in identifying health issues (local or global in nature) and in creating an appropriate intervention, including screenings and referrals, for the community or population.

Instructions

Implementation of the Care Plan

In a Microsoft Word document of 2-3 pages formatted in APA style, you will develop a plan to implement your care plan by answering the questions below.

• The first step to effective implementation is planning. As you go about this task, utilize the following questions applying them to your aggregate:
  • What group have you selected (for example, three families with young children, and so on)?
  • What made you select this particular group?
  • What intervention(s) of the plan will you implement in the group?
  • What health risk do you expect to address by implementing this intervention?
  • What results do you expect?
  • How do you plan to implement this intervention?
    • Do you have any specific strategy in mind?
    • What resources will you need?
  • How long do you think it will take for the results to be seen?
  • What resources do you need?
• The second step is to mobilize the resources you need, talk to the small group, recruit volunteers, etc.
• Finally, when your resources are in place, put your plan into action.

On a separate references page, cite all sources using APA format. Helpful APA guides and resources are available in the South University Online Library. Below are guides that are located in the library and can be accessed and downloaded via the South University Online Citation Resources: APA Style page. The American Psychological Association website also provides detailed guidance on formatting, citations, and references at APA Style.

• APA Citation Helper
• APA Citations Quick Sheet
• APA-Style Formatting Guidelines for a Written Essay
• Basic Essay Template

Please note that the title and reference pages should not be included in the total page count of your paper.