Developing Autonomous Practise in Mental Health - Essay Example

?Developing Autonomous Practise in Mental Health - Cognitive Behaviour Therapy Formulation for Patient in Early Intervention in Psychosis Services Table of Contents 1. Describe the Chosen Individual’s Background and History to Date. 4 2. Provide A Detailed Formulation Of The Individuals’ Current Psychological, Physical And Social Needs At This Time By Selecting And Using Published Therapeutic/Theoretical Approach/S. 5 Cognitive Behavioural Therapy (CBT) 6 3. Demonstrate How the Therapeutic/Theoretical Approaches Chosen in Part Two Can Provide A Structure or Guide the Nursing Care 7 a.Assessment of Needs 7 b.Identification of Aims/Goals 8 SMART Analysis 8 c.Therapeutic Nursing Interventions 10 d.Clinical Review 11 Formulation, Implementation and Evaluation of the Care Plan 12 1.Building Relationship and Effective Care Environment 12 2.Providing Adequate Information 12 3.Engaging MH Service Users, their Families and Care Givers 13 4.Evaluating Rehabilitation Program through MDT 14 4. Explore The Therapeutic Efficacy Of The Current Clinical Environment Or Service Where Care Is Being Provided. Consider Possible Alternative Service Provision Options And Discuss Whether They May Or May Not Be More Beneficial For The Individual. 14 Cognitive Analytical Therapy 15 Pharmacology or Drug Therapy 15 References 17 Bibliography 21 1. Describe the Chosen Individual’s Background and History to Date. The case is based upon a story of a 25 years old young adult girl named Sandra, who is currently having psychological disorder and depression that eventually led her to experience Mental Health (MH) services. With reference to the case, it can be viewed that various situations have been faced by Sandra from her childhood to adult age. The reasons for prescribing MH services to Sandra include disruptive demographic conditions, family conflicts, problems associated with personal life and social influencing factors. During her early childhood period, Sandra had experienced dramatic challenges with her two younger brothers who are 19 and 22 years old respectively. In this regard, it can be stated that the demographic condition of Sandra was also a major factor which turned her to experience significant crisis and made her involved in conducting different unfair acts such as taking cocaine and possession of knives among others at a very young age. The prejudicial acts of Sandra and other members of her family had also led Sandra as well as her mother to spend 24hrs in the police custody. Moreover, breaching of relationship with her boyfriend has also formed depressions that further led towards formation of critical challenges in her life. The social influences as well as contradictive voices of the people can also be considered as major factors that driven Sandra to take mental health treatments or MH services. In accordance with social influences, she was viewed to be accused by the people due to her conduct of irresponsible acts towards her 2 years old daughter. In addition, significant economic crisis, poor demographic condition as well as continuous conflicts in both family and personal life are the primary causes of Sandra that eventually made her to acquire MH services by a greater extent. It is worth mentioning that the MH services are generally prescribed to the users who are mentally depressed and likely to involve in performing various unjustifiable and unwanted acts. The disruptive situations that are faced by the service users such as economic crisis, family conflicts as well as social influences, weak living standard and continuous consumption of abusive drugs among others are likely to be addressed or mitigated by delivering MH services to them (Langan & Lindow, 2004). In various cases, it has often been witnessed that the implementation or the application of MH services provide adequate support to the service users in addressing and mitigating several risks that are associated with various critical aspects such as past family conflicts, recent history along with demographic and economic crises (Tait & Lester, 2005). With regard to the case scenario, it can be affirmed that Sandra would be provided with MH services due to her dramatic mental depression which derived from demographic and economic challenges. 2. Provide A Detailed Formulation Of The Individuals’ Current Psychological, Physical And Social Needs At This Time By Selecting And Using Published Therapeutic/Theoretical Approach/S. An effective therapeutic process or implementation of appropriate theoretical approaches can provide adequate support to an individual in efficiently dealing with various sorts of psychological changes and disorder symptoms. In relation to the development of various psychotherapeutic approaches, it has been viewed that there are significant number of needs that can impose extensive impact upon the individuals towards addressing depressions and other psychological syndromes at large (World Health Organisation, 2003). In this regard, the major influencing factors that are encompassed within psychotherapeutic processes generally involve psychological needs, physical needs and social or community needs. Therefore, an effective and highly beneficial therapeutic approach which is highly effective in terms of identifying appropriate needs of t MH service users has been illustrated in the following discussion. Cognitive Behavioural Therapy (CBT) The Cognitive Behavioural Approach (CBT) can be duly considered as one of the widely used and most effective psychotherapeutic processes which tend to comply with the physiological needs along with enhancing psychological behaviours of the clients. The approach i.e. CBT generally depict certain adequate action courses that are highly effective for the NH service providers to identify the needs and address different psychological changes or disorders of the clients (Centre for Applied Research in Mental Health and Addiction, 2007).The basic concept of CBT can be fundamentally defined as an effective and most successful psychological therapy which helps the individuals to manage different anxieties through changing their way of thinking and behavioural skills. The treatment process under CBT helps to effectively manage problems in a more optimistic manner and encourages individuals to examine actions affecting their thinking capability at large (Zinbarg & Uliaszek, 2008). Therefore, on the basis of the above discussion, it can be affirmed that the adoption and the execution of an effective CBT approach would provide adequate support to MH service staffs in addressing physical, social and psychological needs of Sandra. The process has been observed to play a decisive part for an individual in terms of dealing with anxieties, disorders relating to post-traumatic stress along with other depression related scenarios (National Health Service, 2008). Moreover, the approach is highly beneficial for the therapists and the other nursing staffs as it highly focuses on splitting problems of the users into different characteristics and enables the service users to effectively address distressing thoughts and beliefs (McGraw-Hill Education, n.d.). The therapy generally involves identifying current problems, instead of reflecting past issues of the individuals and also tends to focus on demonstrating practical techniques through improving their state of mind on a regular basis. Therefore, it can be affirmed that the implementation of an effective CBT practice would eventually provide Sandra to develop her psychological turbulences and enable to reshape her life with her 2 years old daughter named Tanya. Moreover, the therapy would also facilitate the nursing staffs through identifying mental, physical along with social needs of Sandra through fragmenting her various problems leading towards increased depression and psychological ailment (Grant & et. al., 2010). 3. Demonstrate How the Therapeutic/Theoretical Approaches Chosen in Part Two Can Provide A Structure or Guide the Nursing Care a. Assessment of Needs The incorporation of an effective therapeutic or psychotherapeutic approach can essentially ensure to render adequate support to MH service staffs in developing mental state of the users or the clients. In relation to determine the structure of MH service providers, I would highly focus on obtaining adequate support from the senior Multi-Disciplinary Team (MDT) members in order to deliver effective MH service to the potential client i.e. Sandra. MDT plays a decisive role in terms of providing better services to the MH users. In order to make sure the deliverance of appropriate care to the service users, I would act in a professional way and provide adequate supportive services through using my own nursing knowledge, skills and capabilities (Manchester City Council, 2013). Therefore, the assessment process of my MH service would highly focus on recognising the needs as well as the anticipations of Sandra along with her family members by a considerable level. The assessment of performing MH services in accordance with the needs of the users would ultimately raise the reliability and will also help me to deliver effective psychological process as well as instruments to develop physical and psychological state of the user (Department of Health and Human Service, 2012). With reference to the case scenario, the incorporation of psychotherapeutic or theoretical approach of CBT would facilitate me to improve the current psychological and physical disorder challenges faced by Sandra. b. Identification of Aims/Goals The incorporation of an effective CBT approach would be more effective for me to understand the psychological patterns and formulate effective care plan for Sandra enabling her to reduce depression and disruptive behaviours. Therefore, in this regard, the following SMART analysis would clearly justify the desired goals and the objectives ensuring appropriate MH services to the potential clients. SMART Analysis Specific The primary intent of the MH service users would be focussing upon fostering effective relationship with the MDT members and availing realistic as well as evidence based psychological treatment processes from them. Measurable The formulation of building effective relationship with the MDT members would facilitate Sandra for availing adequate care. The MH user (Sandra) would also be facilitated to obtain quality treatments that are agreed or accepted by the client, his/her family members and community as well. Achievable The objective of promoting different MH services that can improve the physical and the psychological needs of the MH users would be performed through involving different media tools such as news release, press or media. Therefore, the primary object of the MH services would further focus on obtaining different information and ideas from community and the family members of Sandra. The process would enable our MDT members to identify effective measures and implementation process developing the psychological and the behavioural patterns of Sandra by a certain degree. Realistic The aspect of fostering better affiliation with the MDT members and cooperating with the MH services would further facilitate the service users such as Sandra to gain better psychological state of mind and reduce depressive and disruptive behaviour. Moreover, the involvement of community and different media tools would further enable our MDT team to implement appropriate CBT based psychotherapeutic processes and develop Sandra’s current psychological pattern. Time-Bound In relation to offer effective and quality based MH services, the implementation of different effective CBT activities would enable the MDT members to understand appropriate assessment enhancing the psychological patterns of Sandra at large. Moreover, the implementation of an effective CBT approach would enable to perform appropriate psychotherapies in a feasible time frame. This can be justified that the approach comprises appropriate techniques and procedures within a short interval lessening disruptive psychological behaviours of the MH users by a certain extent. The continuous focus on promoting MH services within the community and fostering relationship with the MH providers would be made on a continuous basis by the service users. c. Therapeutic Nursing Interventions The involvement of CBT approach would facilitate the MH service providers to identify their desired goals and objectives. The activities performed underneath CBT approach significantly incorporates evidence based practices that enable the MDT members or the MH service providers to maintain transparency in developing their respective treatment processes (Kettles & et. al., 2001). Moreover, the CBT approach also encompasses each aspect of human life within the treatment process that enable the MDT care team it to clearly identify the problems of the users and provide effective psychological treatment to them (Robertson, 2010). With reference to the case scenario, the implementation of an effective and comprehensive CBT approach would enable me to improve the psychological disorder symptoms of Sandra by a certain degree. Owing to the stated concern, the rehabilitation processes performed in the CBT approach involve conducting practices of identifying psychoanalytical nature of the clients and differentiating their problems into separate entity. The differentiation of the problems instigating anxiety or depression related complexities are generally characterized in accordance with physical feelings, thoughts, emotions and behavioural changes of the clients (Greenberg & Mitchell, 1983). Therefore, the psychotherapeutic steps would certainly enable me to identify the primary cause of different psychological challenges faced by Sandra. Besides, the CBT approach tends to emphasize the aspect of psycho-education as one of its preliminary as well as most effective components in terms of resolving cognitive distorted behaviour of the individuals (Neenan & Dryden, 2010). Therefore, it might facilitate my psychotherapeutic process to recognise and develop different intrinsic psychological distorted behaviour of Sandra along with aiding in enhancing her physical and mental status through eliminating the use of illegal drugs or cocaine. d. Clinical Review In relation to the present psychological condition of Sandra, it has been recognised that she is facing traumatic mental disorder symptoms due to her past experiences of tragic family conflicts, social influences and continuous habit of consuming cocaine (Smith, n.d.). Moreover, the dramatic challenges relating to demographic crises as well as conflicts within her personal life have also been witnessed to create significant mental depressions and turned her to acquire effective MH services (Nichols, 2006). Therefore, a comprehensive integration of CBT approach would provide effective support to me for improving my skills and therapeutic processes of developing psychologically distorted behaviours of Sandra. Formulation, Implementation and Evaluation of the Care Plan 1. Building Relationship and Effective Care Environment Building relationship signifies the process of providing MH services in a partnership approach that incorporates users of MH services, their families and other care givers (National Institute for Health and Clinical Excellence, 2011). In this context, the practice of promoting MH care and treatment process with an optimistic manner might enable me to build an empathetic as well as a non-judgemental relationship with Sandra. Moreover, fostering autonomy of the MH user and promoting their active participation in decision-making procedure would further improve my psychotherapeutic practices and make me competent to reduce the disruptive attitude, and disruptive behavioural patterns of Sandra. Maintaining incessant development of therapeutic relationship can also ensure to improve MH care services by a significant level (Wright & Davis, 1994). It can be affirmed that the development of communication facilities would further enable me towards strengthening the relationship with Sandra and improving her psychological changes in a positive manner. In this regard, the incorporation of a comprehensive CBT approach would also facilitate me to identify problems as well as other depression related symptoms and formulate effective rehabilitation programs along with psychology development activities. Moreover, the adherence of maintaining dignity, privacy as well as confidentiality of the MH user would also enable me in developing psychological disorder symptoms of Sandra. 2. Providing Adequate Information The deliverance of adequate information regarding the types of MH services and various treatment facilities to the community members could improve the MH services rendered by any organisation (NHS Security Management Service, 2005). In this context, I would highly focus on ensuring that the process or treatment services which would be delivered to the MH user are voluntarily available and accomplished by the MDT care team families of the MH users, communities along with other groups of stakeholders. The adequate practice of CBT approach would further enable me to become much familiar with different valuable information sources (SAMSHA-HRSA Center for Integrated Health Solution, n.d.). The practice would increase my nursing skills and knowledge regarding effective utilisation of the accessible resources. Therefore, the process would improve the psychological activities that need to be implemented to develop the mentally distorted behaviours of Sandra enabling her to competently act with different situations. 3. Engaging MH Service Users, their Families and Care Givers The incorporation of CBT approach within the background of MH service would facilitate the overall MDT care team to build effective interrelation with both Sandra and her family members. In relation to the process of CBT approach, the aspect generally involves effective way of separating depressive attributes or problems of the MH users into different parts (Cully & Teten, 2008). Therefore, the involvement of the users’ families would provide effective support for the MDT care team to identify different psychological problems and prescribe effective MH services to Sandra in lessening her depressions and other psychologically distorted symptoms by a certain degree. 4. Evaluating Rehabilitation Program through MDT The involvement of multi disciplinary team (MDT) in the CBT based MH service can be duly considered as one of the major entity of the overall patient care practices. An effective MDT within the context of MH services generally involves multiple members who are likely to perform numerous roles to identify, develop and monitor psychological development of the MH users (British Uro-Oncology Group, 2013). With regard to the case scenario, the MDT care team can play a decisive role in terms of identifying psychologically distorted behaviours of Sandra. In this context, few of the MDT care members would be executed within the intervention process in order to clearly recognise different psychological behaviours that conducted by Sandra. Moreover, the members would also liable to appropriately implement different activities in the intervention process and monitor the psychological changes of Sandra. From the above discussion, it can be affirmed my care plan is quite better as compared to other plan. This might be owing to the reason that the aforesaid significant aspects which have been taken into concern in the plan possess the capability to address and mitigate depression and disruptive behavioural attitudes of the individuals making smooth patient recovery procedure. 4. Explore The Therapeutic Efficacy Of The Current Clinical Environment Or Service Where Care Is Being Provided. Consider Possible Alternative Service Provision Options And Discuss Whether They May Or May Not Be More Beneficial For The Individual. In relation to the present day context, the development of cognitive and behavioural skills has been recognised as an essential practice for each individual to build a healthy and prosperous life. The psychological ailments or any type of mentally distorted behaviour of any individual generally occur due to physical, demographical and social factors among others. In this regard, the integration of CBT approach can be regarded as one of the holistic models or interventions which ensure development of psychological disorder symptoms of the MH users at large. Therefore, the provided care plan for Sandra would enable the MDT care team to proactively recognise the disruptive psychological patterns of Sandra and facilitate to deliver appropriate psychotherapeutic rehabilitation program to her in an effective manner. However, certain other approaches can also be recognised to play a crucial role in terms of developing different disruptive behaviours of the MH clients. A few of the major alternative psychotherapeutic approaches or interventions of CBT have been briefly highlighted hereunder. Cognitive Analytical Therapy The concept of cognitive analytical therapy (CAT) is regarded as an effective psychological development approach which helps the caregivers to reduce disruptive behavioural patterns of the users by a certain degree. The process underneath CAT is often viewed to be a long-term practice wherein the service providers are likely to steadily re-educating psychological thoughts and beliefs of the clients (UTOCOPA, 2013). In relation to the case scenario, the integration of CAT would not be appropriate as Sandra has performed self-harm activities due to her mental depression which rose by different social and demographic factors. Pharmacology or Drug Therapy The pharmacology or drug therapy is also effective for the MH users in terms of reducing depressions and anxiety related syndromes. In this particular process, the carers are likely to prescribe different medicines to minimise the psychological disorder symptoms of the MH users (Manchester City Council, 2013). However, in various cases, it has been witnessed that the psychological distractive patterns would still remain much active after the course of the drug therapy. In relation to determine the psychological disordered patterns in Sandra, the implementation of pharmacology or drug therapy would enable in developing her behavioural patterns by a considerable level. Additionally, the other theoretical approaches or interventions under MDT such as Adlerian therapy, humanistic psychotherapy and person-centred aspects would also ensure development of an individual experiencing acute anxiety and depression that are formed due to certain aspects such as family conflicts or disruptive personal situations (UTICOPA, 2013). It is worth mentioning that the psychoanalytical development approaches in MH services would further provide adequate assistance to the nursing staffs in developing the disruptive behavioural patterns of Sandra and developing her recovery process by a considerable level. References British Uro-Oncology Group, 2013. Multi-disciplinary Team (MDT) Guidance for Managing Bladder Cancer. Integrated Care and the Multi-disciplinary team (MDT). [Online] Available at: http://www.actiononbladdercancer.org/downloads/36904mdtguidanceformanagingbladdercancer2013.pdf [Accessed September, 09, 2013]. Centre for Applied Research in Mental Health and Addiction, 2007. Cognitive Behavioral Therapy. Core Information Document, pp. 1-136. Cully, J. A. & Teten, K. L., 2008. A Therapists Guide to Brief-Cognitive Behavioral Therapy. The Department of Veterans Affairs, South Central Mental Illness Research, Education, and Clinical Center. Department of Health and Human Service, 2012. Mental Health Services. 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