Journal Entry

I NEED A RESPONSE FOR THIS ASSIGNMENT 

ZERO PREGIARISM

3 REFERENCES

Each therapist and focusing on their professional development (Alfonsson et al., 2017).  The purpose of this week's discussion is to describe a client who is not adequately progressing according to expected clinical outcomes.  An explanation of the therapeutic approach used with the client, perceived effectiveness, and identification of information about the client that may impact expected outcomes.

JJ is a 36-year-old AA female who presented for a follow-up therapy session.  The client has a history of PTSD (F43.10), depression (F32.9), and anxiety (F41.1) (Association, n.d.). The client presents today with anxiety, environmental stressors, and irritable mood.  The client reports over the weekend she had an argument with her family, and she felt out of control. The client reported she thought she would be doing better by now, she becomes irritated and easily angered.  She reported they know what buttons to push to get her worked up. 

JJ is not progressing on pharmacology and CBT.  It has been six weeks and I would have expected the client to change some of her behaviors regarding her PTSD, anxiety, and depression.  The client reported she is not using the coping mechanisms we discussed and is not compliant with her medications.  The therapeutic approach used with the client is CBT.

CBT was chosen for JJ based on evidence-based practice, client preference, and therapist knowledge. CBT focuses on the client becoming aware of their negative and inaccurate thoughts and to respond more effectively.  This approach emphasizes changing the client’s attitudes and behavior by focusing on the thoughts, images, beliefs, and attitudes that are in their cognitive processes and how they relate to the way they behave and deal with emotional problems (David et al., 2018).  CBT helps the client to identify triggers, and ways to avoid them using coping techniques.  The perceived effectiveness was based on the client’s compliance with diaphragmatic breathing, journal, and various techniques discussed during sessions; and medication compliance. 

Additional information that could impact the client’s outcome includes exploring why the client is non-compliant with medications.  Find out why the client is forgetful and if she needs a gentle reminder.  Explore the reason why the client is not utilizing the techniques learned in therapy.  Ask the client if she would consent to family therapy to help with her healing process.   Lastly, encourage the client to actively participate in the healing process. Emphasize it is a collective process to include, being open, honest, completing homework, and being compliant with the treatment plan.          

References

Alfonsson, S., Spännargård, Å., Parling, T., Andersson, G., & Lundgren, T. (2017). The effects of clinical supervision on supervisees and patients in cognitive-behavioral therapy: A study protocol for a systematic review. Systematic Reviews, 6(1). https://doi.org/10.1186/s13643-017-0486-7

Association, A. P. (n.d.). Diagnostic and statistical manual of mental disorders, 5th edition: Dsm-5 (5th ed.). American Psychiatric Publishing.

David, D., Cristea, I., & Hofmann, S. G. (2018). Why cognitive behavioral therapy is the current gold standard of psychotherapy. Frontiers in Psychiatry, 9. https://doi.org/10.3389/fpsyt.2018.00004

Wheeler, K. (2018). The nurse psychotherapist and a framework for practice. In Psychotherapy for the advanced practice psychiatric nurse. Springer Publishing Company. https://doi.org/10.1891/9780826110084.0001