Week 11: Cultural Competence/Awareness, Vulnerable Populations, and Other Special

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JOURNAL ENTRY

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Week 11: Cultural Competence/Awareness, Vulnerable Populations, and Other Special

Considerations

Student Name

College of Nursing-PMHNP, Walden University

NRNP 6645: Psychotherapy with Multiple Modalities Practicum

Faculty Name

Assignment Due Date

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Introduction

Anxiety disorders, depression, schizophrenia, compulsive behaviors, and eating disorders

are just a few examples of the vast range of mental health illnesses and disorders that may be

treated with medication and psychotherapy, including what is known as mental illness.

Preceptors in my clinical rotation were excellent, and I learned a tremendous lot from them about

effectively treating patients with mental illness or dysfunctional behavior throughout their lives.

The practicum was a necessary experience to work with clients as they transformed or changed

from the beginning of therapy and advanced positively with some hurdles throughout the

sessions to the completion of treatment with excellent results and satisfaction.

Goals Achieved

During the practicum rotation, I was able to meet my objectives in a big way: I

interviewed many clients and their families and gathered a lot of material that helped with the

treatment of patients. While working with clients and others, I honed my interviewing abilities. I

performed many in-depth psychological or psychiatric histories on individuals, families, and

groups of people—a significant accomplishment during the clinical rotation.

To achieve this goal, it was necessary to identify and recognize each participant’s issues

and perspectives, empower support, encourage participation, listen attentively to each

participant, and address the concerns and worries with positive outcomes. This goal was

accomplished. The fact that I was able to keep lines of communication open, reach consensus on

solutions to difficulties, show compassion to clients, handle interpersonal disputes in my family

and workgroups, and ask open-ended questions to understand better situations was a significant

accomplishment.

Challenging Patients During the Practicum Experience

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Many people deal with mental health issues at some point in their lives. Continuous

indications and symptoms, on the other hand, produce unrelenting stress and impair the patient’s

ability to work or function, transforming a mental health problem into dysfunctional behavior.

Mental health issues have many causes, and each patient has a unique set of symptoms and a

unique diagnosis. These people exhibited erratic behavior, lacked interpersonal skills, and

engaged in outlandish emotional outbursts. After a month in the Medical Intensive Treatment

Unit, the family of a therapy group member who had lost his kid in a suicide attempt or self-

destruction attempt withdrew care. Nobody could participate in the group meeting since the

member was so engrossed in the treatment session. I was sympathetic to the member’s plight and

sought to find out whether anybody else in the group had experienced anything similar and, if so,

how they would handle it so that the meeting could continue as planned. It turned out that

everyone had similar experiences and was adept at dealing with them. Thanks to this information

exchange, the member was able to control his emotions and continue with the treatment group

until the end of the meeting session.

A patient suffering from depression, who felt the sessions were insufficient and

ineffective, said that performing exercises and assignments was a waste of time. Adherence to a

treatment plan and completing assigned tasks are linked to improved treatment outcomes and

inspire and motivate patients (Jensen et al. 2020). Non-adherent patients may find it challenging

to progress since tasks aim to reduce symptoms, increase adaptability abilities, behavior

modification, and intellectual or cognitive rebuilding. Tasks or assignments that are completed

promptly enhance learning objectives and facilitate learning transfer outside of therapy sessions.

When siblings and a relative were not getting along at home, and the parents were unable to

come up with a solution, this was my third hurdle with family therapy, and I overcame it. When

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things disappeared around the house, the siblings immediately pointed the finger at the relative

who had just moved in with them. Since the mother and siblings did not want to be in the same

room as their brother, the father and a distant relative sought family counseling for the situation.

Many people were encouraged to go, but it did not work out. For the sake of the whole family’s

well-being, each member was personally contacted, interrogated, and persuaded to attend family

therapy.

Lesson Learned

Psychotherapists must have strong interpersonal skills and effectively communicate with

their patients to effectively assess and treat their patients’ relationships and build rapport and

compatibility with them. Therapeutic correspondence encourages patients to express their

feelings and thoughts, making it easier for the practitioner to assess a patient’s indications,

investigate various treatment options, evaluate current best evidence, and inspire patient desire or

need (Areán, Renn, & Ratzliff, 2021). Therapy sessions for individuals, families, and groups

were scheduled for 50 minutes to an hour each, while each session lasted from 90 minutes to two

hour

Available Resources and Evidence-Based Practices

During the practicum, clients had access to other therapists and practitioners who could

offer assistance, leaflets, and other community resources. The Walden University library

provided clinical preliminaries on Cognitive Behavioral Therapy, Dialectical Behavioral

Therapy, and Trauma-focused Therapy with convenient and evidence-based practice research

articles. This facilitated the clinical rotation by providing the necessary supportive information.

Psychosis symptoms can be managed with the help of a wide range of therapies, including

cognitive-behavioral therapy, person-centered therapy, and correspondence and communication.

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What Can Be Done Differently

To perform at one’s best and develop prosperity and healing, psychotherapy may help

alleviate or regulate uncomfortable or disturbing symptoms. This is something I learned so much

about throughout my clinical rotation. I would want to improve the flow of patients and the

amount of time I spend with each of them during treatment sessions. To help the underserved

communities, I would want to improve their healthcare options, as most people in society do not

have access to quality treatment.

Managing Patient Flow and Volume during Therapy

During the practicum, significant time was set aside for patient treatment, including

individual therapy, family therapy, group therapy, and evaluations of new clients. During

admission for therapy, a treatment plan and projected release date were established, and revisions

were made as the patient progressed. It was an effective and strong approach to communication

with excellent and successful results for some patients who were not related or tangential. It

encouraged and empowered clients to engage, acknowledge feelings and thoughts, pay undivided

attention, and refocus patients on the issue.

With the help of this practicum, I have been able to increase my ability to communicate

with people dealing with mental illness. I have also gained a better understanding of mental

disease personally and professionally. I am grateful for the chance to work in this sector and

better understand the problems faced by people with mental disorders or dysfunctional behavior.

I look forward to using what I learn to help others.

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References

Areán, P. A., Renn, B. N., & Ratzliff, A. (2021). Making psychotherapy available in the United

States: implementation challenges and solutions. Psychiatric Services, 72(2), 222-224.

https://ps.psychiatryonline.org/doi/full/10.1176/appi.ps.202000220

Browning, S., & Hull, R. (2018). Utilizing the genogram to integrate systems and psychoanalytic

thinking. Journal of Psychotherapy Integration, 28(4), 567.

https://psycnet.apa.org/record/2018-24927-001

Jensen, A., Fee, C., Miles, A. L., Beckner, V. L., Owen, D., & Persons, J. B. (2020). Congruence

of patient takeaways and homework assignment content predicts homework compliance

in psychotherapy. Behavior Therapy, 51(3), 424-433.

https://www.sciencedirect.com/science/article/abs/pii/S000578941930084X

McManus, J., Tsivos, Z., Woodward, S., Fraser, J., & Hartwell, R. (2018). Compassion focused

therapy groups: evidence from routine clinical practice. Behaviour Change, 35(3), 167-

173. https://www.cambridge.org/core/journals/behaviour-change/article/compassion-

focused-therapy-groups-evidence-from-routine-clinical-

practice/14479C591FB202991381514B964D2556

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