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Therapeutic Engagements

Discuss about the Clinical Psychology and Psychotherapy.

Handling patients with mental health form one of the heighted duties which MHNs have in clinical centers. It needs a lot of commitment and dedication to come out with the best outcome.  Mentally ill patients need different services like medical and legal to improve their lives. However, the ways they get handled depend on some factors like age or even gender.  Patients and carers face different kinds of stigma when experiencing the issue of mental illness however; there exist diverse modalities used to treat mentally ill patients, for instance, the cognitive theory which points out that thoughts have the capability to impact all behavior on its own (Cross et al., 2015). It is utilized in the treatment of depressions, eating disorder and anxiety. Angelina needed different engagement skills to improve her condition.MHN should consider empathy, being genuine and also better communication to improve her condition. The mental health nurses should avoid the discrimination against Angelina (Szabo et al., 2015). The independence of the patient also should be respected.  Laws which are guidelines on the prejudices against the mental illness should be followed by the nurses as much as possible. The paper will address therapeutic engagement skills and therapeutic treatment modalities which should be used for Angelina who is suffering from mental illness in the ward.

Angelina suffers from mental illness meaning that her mental health needs lots of attention. The mental health is the concept linked to the emotional and social wellbeing of a person or community. It relates to an enjoyment of capability and to adopt with stresses and sadness, a sense of a relation with others and achievements of goals. Mental services focus on the treatment of mental illness (Rogers & Pilgrim, 2014). It is a desirable quality that has a great worth than mental illness. Mental illness occurs in the different forms, and each one of them occurs under different severity. These encompass the anxiety, depression, psychotic disorders, personality disorders and eating disorders. Also, a mental health issue can interfere with the cognitive, social and emotional capabilities of an individual but it cannot meet criteria for a diagnosed mental illness.

The MHN will have to apply different therapeutic skills to handle the case of Angelina. First and for most, the MHN  should consider using ethnography engagement skill which is meant to realize how Angelina  as a member of a particular culture  see, organize, and understands her experiences with the mental illness. The skill aims at getting vivid description of her life experiences and in order to achieve this, MHN will have to question her relevant kinds of questions in a correct manner. Various types of ethnographic probes and questions are planned to encourage Angelina to uncover the way she integrates her experiences to develop sense of meaning and coherence.

Therapeutic Treatment Modalities

Motivational interviewing (MI) is a client focused therapeutic method which is meant to enhance intrinsic motivation for change through helping clients to resolve and restore ambivalence. By using MI skill, it will elicit the motivation of Angelina for change. Due to depressive nature of Angelina, she would be ambivalent to for attend her medications and MI therapy will form an appropriate therapy for her engagement.(MacAndrew et al., 2014)

However, MHN should consider Angelina just like any another individual who lives behind her mental illness and this will assist her to feel valued.  MHN should be controlled by his/her values, pre-understanding of Angelina mental health using ideas well. Support provision also is another way which MHN should use in handling Angelina.  For this particular case, Angelina should feel safe and comfortable for their relationship to evolve. For Angelina to feel safe, she should get a supportive environment which MHN should create. These can happen through feedbacks and suggestions which show signs of hope and indicating concern in Angelina's voice and also providing her reassurance (Davis et al., 2014). By participating together with the patient in doing things such as collecting sheets, sharing some drinks or even taking her to shopping will show support to Angelina. MHN also should offer Angelina physical support such as hugging her. The idea here is that Angelina will feel connected and she will recover from depression with quick response. Also by comforting her via the touch of hands forms techniques which can assist her to get relieved from depressions. MHN should also consider employing legal issues to tackle the issues which Angelina is facing.


Based on the Victoria mental health act 2014, the legislative process of evaluation and treatment of persons with mental illness within the scheme of public health should be provided to her. It came out with a framework to promote the recovery-oriented practice, support people's lives and reduce the compulsory treatment of people with mental disorders (Vine & Komiti, 2015). They encompass the rights to make communications privately with individuals outside the mental health service comprising lawyers. MHN also should focus on nomination of support people who can assist the decision-making. MHN should request for the opinions of psychiatrists and also the statement of rights during assessment or when they have an order about mental illness treatment (Knox et al., 2014).  The mental health nurses should avoid the discrimination against Angelina. The autonomy of the patient also should be respected.  Laws which are guidelines on the prejudices against the mental illness should be adhered by the nurses as much as possible

The MHN presence brings lots of impacts to Angelina; MHN should invest lots of time with her. The idea will assist both to develop a close connection that brings comfort to Angelina. It will form an excellent time for her MHN to listen to the story and it could be the basis for the treatment of her disorders. Another therapeutic engagement MHN should consider is the issue of being genuine. It will assist the MHN to be authentic within their interaction (Davis et al., 2014). The MHN also should be congruent with their beliefs and values, and Angelina will view MHN as a true friend. MHN also should encourage equality by bringing their power down to the level of the patient. MHN should offer expert knowledge via teaching and monitoring.

Self awareness also is significant engagement skill which MHN should use. The personalities of MHN could have an effect on how they response to Angelina thus MHN should be aware of to know the way to approach interactions with her. In addition, interpersonal skills form relationships with her could be acquired via learning about one self (Mewton et al., 2014). The clinical supervisions should foster self awareness where nurses should reflect the relationships to which should improve clinical skills and also assist in tackling difficult situations faced by Angelina. In addition, by engaging on good communication skills with Angelina, she will be in position to realize that she is cared and she will respond quickly to the provided therapies.

Angelina faces acute mental illness, and she needs quick assistance to bring her condition to the normal. MHN needs to do MSE first to realize the issue with Angelina. MSE purposely aims at achieving comprehensive cross-section description of the mental condition of the patient of which when integrated with the historical and biographical information of psychiatric history, will offer chance a clinician to come up with correct formulation and diagnosis (Chinman, et al., 2014). Based on the cognitive theory which outlines that the thoughts have the capability to impact all behavior on its own it will apply in the treatment of depressions, eating disorder and anxiety of Angelina. All that she is need to do is bringing her thoughts down through counseling and engagement and eventually all her behaviors will get affected. She will get relieved of anxiety, depression and will eat well (Cross et al., 2015). However, due to the presence of friends, family and MHN, group therapy formed the best modality to use in the ward. At least one MHN manages it, and it concentrates on the interpersonal dynamics and the relational links between people in the group. Also, inpatient modality fits the case of Angelina. MHN will put her in rooms with other patients under the same condition and subjected to different therapies such as playing and eating together (Gurman & Kniskern, 2014). She will get engaged, and due to closeness offered by MHN as well as other patients, she will get relieved from her conditions.

MHN should consider employing Psychoanalysis. This particular principle operates under basic principles. The first principle states that the current behavior of an individual is affected by the childhood events. The second law points out that unconscious direct many behaviors and also impacts the conscious mind significantly (Anthony, 2015). Psychoanalysis is forecasted on the idea that psychological clash in the form of defense strategy must overcome to treat the mental health disorders. MHN should consider asking the childhood behaviors of Angelina and Psychoanalysis should assist in knowing the best approach of treating her. Angelina should be treated immediately so that she could be able to come out of unconscious mind which could greatly affect conscious mind (Goldstein et al., 2015). However, the MHN should also use behavioral modification therapy. This principle points out that negative and positive reinforcements can be utilised to change the behavior of a patient via regular practices meant for people who have ADHD (Falloon, 2015). Due to the depression which Angelina is going through, he modality can assist her where MHN should consider engaging her through system of positive or negative consequences, Angelina will learn the correct set of responses for any provided stimulus. The modality has many offshoots that try to change behavior via diverse events and has developed throughout many years. 

Before Angelina is discharged, she needs risk assessment done to her. It forms the significant area which involves, intake, and discharge during that particular time when there is a change or improvement in her mental condition (Swanson et al., 2015).  It comprises principal components and concentrates on the kind of harm which can happen, the time frame and also the conditions which can occur and also the probability that it can happen.

Conclusions

Mental illness and mental health are two different issues that also correlate in many ways. They aim to offer services to people suffering from anxiety, depression, psychotic disorders, personality disorders and eating disorders. Mental illness needs diverse modalities to get treated. As for the case of Angelina, she needs cognitive theory, family therapy and inpatient modality. However, for MHN to engage her well, he/she needs to offer support, being genuine, empathy and understanding. Through all these Angelina will feel loved and she responds positively to the therapeutic modalities offered (Tucker et al., 2016). The Victoria mental health provides guidelines on ethics and laws pertaining mentally ill patients. Therefore, at the time of engaging Angelina, MHN should consider practicing ethics to avoid prejudice and discrimination.

References

Anthony, K. (2015). Psychoanalysis online: mental health, teletherapy, and training.

Ben-Zeev, D., Wang, R., Abdullah, S., Brian, R., Scherer, E. A., Mistler, L. A. & Choudhury, T. (2015). Mobile behavioral sensing for outpatients and inpatients with schizophrenia. Psychiatric services, 67(5), 558-561

Chinman, M., George, P., Dougherty, R. H., Daniels, A. S., Ghose, S. S., Swift, A., & Delphin-Rittmon, M. E. (2014). Peer support services for individuals with serious mental illnesses: assessing the evidence. Psychiatric Services, 65(4), 429-441

Cross, S., Mellor?Clark, J., & Macdonald, J. (2015). Tracking responses to items in measures as a means of increasing therapeutic engagement in clients: A complementary clinical approach to tracking outcomes. Clinical psychology & psychotherapy, 22(6), 698-707

Davis, M. L., Thwaites, R., Freeston, M. H., & Bennett?Levy, J. (2015). A measurable impact of a self?practice/self?reflection programme on the therapeutic skills of experienced cognitive?behavioural therapists. Clinical psychology & psychotherapy, 22(2), 176-184.

Falloon, I. R. (Ed.). (2015). Handbook of behavioural family therapy. Routledge.

Goldstein, T. R., Fersch-Podrat, R. K., Rivera, M., Axelson, D. A., Merranko, J., Yu, H., ... & Birmaher, B. (2015). Dialectical behavior therapy for adolescents with bipolar disorder: results from a pilot randomized trial. Journal of child and adolescent psychopharmacology, 25(2), 140-149.

Gurman, A. S., & Kniskern, D. P. (2014). Handbook of family therapy. Routledge.

Knox, K., Fejzic, J., Mey, A., Fowler, J. L., Kelly, F., McConnell, D., ... & Wheeler, A. J. (2014). Mental health consumer and caregiver perceptions of stigma in Australian community pharmacies. International Journal of Social Psychiatry, 60(6), 533-543.

McAndrew, S., Chambers, M., Nolan, F., Thomas, B., & Watts, P. (2014). Measuring the evidence: Reviewing the literature of the measurement of therapeutic engagement in acute mental health inpatient wards. International journal of mental health nursing, 23(3), 212-220.

Mewton, L., Sachdev, P., Anderson, T., Sunderland, M., & Andrews, G. (2014). Demographic, clinical, and lifestyle correlates of subjective memory complaints in the Australian population. The American Journal of Geriatric Psychiatry, 22(11), 1222-1232.

Rogers, A., & Pilgrim, D. (2014). A sociology of mental health and illness. McGraw-Hill Edu

Swanson, J. W., McGinty, E. E., Fazel, S., & Mays, V. M. (2015). Mental illness and reduction of gun violence and suicide: bringing epidemiologic research to policy. Annals of epidemiology, 25(5), 366-376.

Szabo, K. A., White, C. L., Cummings, S. E., Wang, R. S., & Quanbeck, C. D. (2015). Inpatient aggression in community hospitals. CNS spectrums, 20(03), 223-230.

Tucker, A. R., Widmer, M. A., Faddis, T., Randolph, B., & Gass, M. (2016). Family Therapy in Outdoor Behavioral Healthcare: Current Practices and Future Possibilities. Contemporary Family Therapy, 38(1), 32-42.

Vine, R., & Komiti, A. (2015). Carer experience of Community Treatment Orders: implications for rights based/recovery-oriented mental health legislation. Australasian Psychiatry, 1039856214568216

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