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NR605/ NR 605 Final Exam Review Weeks 5 - 8 Covered Diagnosis & Management in Psychiatric-, Exams of Investment Management and Portfolio Theory

West Chester University of Pennsylvania (WCUPA)Investment Management and Portfolio Theory

NR605/ NR 605 Final Exam Review Weeks 5 - 8 Covered Diagnosis & Management in Psychiatric-Mental Health across the Lifespan I Practicum NR605/ NR 605 Final Exam Review Weeks 5 - 8 Covered Diagnosis & Management in Psychiatric-Mental Health across the Lifespan I Practicum NR605/ NR 605 Final Exam Review Weeks 5 - 8 Covered Diagnosis & Management in Psychiatric-Mental Health across the Lifespan I Practicum

Typology: Exams

2024/2025

Available from 01/10/2025

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NR605/ NR 605 Final Exam Review
Weeks 5 - 8 Covered
Diagnosis & Management in Psychiatric-Mental Health across the Lifespan I Practicum
1.cognitive-behavioral therapy: -focus on how well individuals can adapt cogni-
tively and functionally to their environments
-short-term, structured, goal-oriented form of psychotherapy
-stresses necessity of challenging maladaptive thoughts that lead to behavioral problems
-first emerged in 1955
-most widely practiced psychotherapy
-help clients recognize and address cognitive distortions
•by Albert Ellis, widely known as the grandfather of cognitive behavior therapy
-
Beck
•originally trained in psychoanalysis, pioneered cognitive therapy in the 1960s,
through his research on depression
•also developed the popular Depression Inventory instrument
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NR605/ NR 605 Final Exam Review

Weeks 5 - 8 Covered

Diagnosis & Management in Psychiatric-Mental Health across the Lifespan I Practicum

  1. cognitive-behavioral therapy: -focus on how well individuals can adapt cogni- tively and functionally to their environments -short-term, structured, goal-oriented form of psychotherapy -stresses necessity of challenging maladaptive thoughts that lead to behavioral problems -first emerged in 1955 -most widely practiced psychotherapy -help clients recognize and address cognitive distortions
  • by Albert Ellis, widely known as the grandfather of cognitive behavior therapy
  • Beck
  • originally trained in psychoanalysis, pioneered cognitive therapy in the 1960s, through his research on depression
  • also developed the popular Depression Inventory instrument

2 / 50

  1. CBT Relationship to Nursing Theory: -Orem's self-care deficit nursing theory
  • provides a framework to view CBT as a supportive intervention
  • fosters effective self-care behaviors -Roy's Adaptation Theory
  • premise that individuals use coping mechanisms to adapt to stimuli, both internal and external
  • share underpinnings with CBT.
  1. Indications for CBT: -treatment of a wide range of diagnoses
  • depression
  • anxiety disorders
  • substance use disorders
  • eating disorders
  • severe mental illness

4 / 50 -help clients:

  • better understand the behaviors of others
  • develop improved coping skills
  • Psychoeducation
  • Homework
  • to help clients reinforce & build on what was learned during the therapy session
  1. motivational interviewing (MI): -helps individuals prepare for change -person-centered, evidence-based approach to behavior change -using a collaborative, goal-oriented communication style -empowers clients to draw on their meanings & capacities to facilitate change
  • addressing issues with ambivalence and resistance -grew out of William R. Miller's clinical practice working with clients with substance use disorders in the 1980s
  • collaborated with Stephen Rollnick to write book: Motivational interviewing

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  1. Indications for MI: -reduction of substance use and health promotion -improving medication adherence in clients with schizophrenia
  2. MI Guiding Principles: -acceptance
  • empathy
  • compassion -respect of client autonomy -acknowledgment of the client's strengths & efforts -Spirit of MI
  • Partnership, compassion, acceptance, evocation
  1. MI Role of the Psychotherapist: represented by the mnemonic RULE: Resist the righting reflex Understand the patient's motivation Listen to the patient Empower the patient
  2. OARS: Communication skills for MI: -Open questions
  • cannot be answered with a yes or no, require elaboration
  • Affirming
  • provide encouragement, are (+) comments on a client's strengths or efforts

7 / 50 opportunities for the client to elaborate on their concerns

  • empower clients to take control of the conversation
  • recommended to use at least two reflections for every question
  • Summarizing
  • links together what has been stated to help the client organize their experiences
  1. MI Phases of the Change Process: - engagement
  • establishment of trust & a helping relationship between the therapist & client
  • uses reflections that communicate understanding
  • focusing
  • identification of the direction or target of the change
  • uses open-ended questions
  • evoking
  • identifying the client's motivation for change and evoking hope
  • uses reflections and summaries
  • planning

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  • creating a plan for change
  1. acceptance and commitment therapy (ACT): -helps individuals accept life's challenges while focusing on their values and goals
  • learning how to relate to thoughts & feelings which impact life rather than changing those thoughts & feelings -referred to as a "third wave" CBT therapy -Accepting reactions and being present -Choosing a valued direction -Taking action -Used for:
  • depression, anxiety, substance use, chronic pain, transdiagnostic combinations of conditions
  1. solution-focused therapy (SFT): -future-oriented approach -helps client ID problems & construct solutions that will result in change -postmodern thinking
  • reality is shaped by multiple and conflicting "truths" & constructed through human interaction
  • there are as many stories of meaning as there are people involved -fourth force of psychotherapy

10 /

  • postpartum depression
  • depression
  • eating disorders
  • severe mental illness
  1. how SFT is used to alleviate anxiety: 4-Step Approach for Overcoming Anxiety -Identify the meaningful parts of life that the anxiety is blocking. -Shift the focus away from the anxiety itself toward the meaningful goal. -Create a list of positive messages that would motivate you toward that goal. -Be gentle with yourself - you're not alone. Many of the people you meet may be working through something similar.
  2. Behavioral theory: -Personality is a result of the interaction between an ind. and their environment. -focus on observable and measurable behavior
  • Skinner
  • associated with the concept of operant conditioning, using rewards and punish- ments to increase or decrease a behavior

11 /

  • Pavlov
    • Russian Physiologist, father of behaviorism, associated with classical conditioning, Pavlov dog,
    1. Cognitive theory: -Study of mental processes and complex behaviors -Albert Bandura combines concepts of observing, thinking, and behaving. -Tying external behaviors in with internal mental processes that facilitate them
    • learning, memory, language development, mental problem solving.
    1. Cognitive Distortions: -faulty, exaggerated, or irrational thinking patterns
    • cause ind's to inaccurately perceive reality
    • lead to (-) emotions & psychopathological states, including depression & anxiety
    1. common cognitive distortions: -Should statement
    • "I shouldn't yell at my kids. I should always be able to keep my temper. I'm the adult here." -All-or-nothing thinking
    • "I got an A- on the biology exam! I never get below an A. I am such a complete failure!"
  • Catastrophizing
    • "I know my relationship is in trouble. If my girlfriend leaves, I know I'll never find someone else and will be alone forever."
  • Filtering

13 /

  1. Cognitive Techniques for Stabilization: -Socratic dialogue (SD)
  • Decatastrophizing
  1. Socratic dialogue (SD): -hallmark of CBT -helps facilitate guided discovery -therapist guides the client through a series of questions & answers to draw out the client's automatic thoughts & assumptions
  • collaboratively examine the logic underlying the assumptions
  • ID thought processes that may be creating problems -can be used to:
  • facilitate cognitive reappraisal
  • information processing
  • emotional regulation
  • support tx processes
  1. Socratic questions: -Socratic questions
  • What is the evidence your belief is true?
  • What is the evidence your belief is not true? -Alternative Explanation Socratic Questions
  • Is there another point of view?

14 /

  • Are you paying attention to only one aspect of the situation?
  • Are you misinterpreting the evidence?
  • Are you making assumptions? -Impact of the automatic thought Socratic Question
  • What is the effect of believing "If I'm not perfect then I'm a failure?" -Distancing Socratic Question
  • What would you advise a friend who told you something similar? -Problem solving Socratic Question
  • What would be good to do now?
  • What would you like to do about this situation?
  1. Decatastrophizing: -Catastrophic thinking
  • common for clients with anxiety
  • focusing on most (-) outcome of a situation
  • Decatastrophizing
  • cognitive restructuring technique
  • used to explore fears

16 / -examining the outcome the client considers to be the "worst possible"

  • developing a plan of action to address that outcome to decrease anxiety
  1. Valerie is a 34-year-old who presents for therapy with symptoms of anxiety and depressive disorder. She has been in a relationship with her partner for the past 12 years. She feels like her partner makes all the decisions in the relationship, and when Valerie's opinions differ, she does not feel comfortable sharing her thoughts. She states, "If my partner can't figure out what my needs are after so many years, I don't know how we can save this relationship." What can you use to assist the client? Assertiveness training Bibliotherapy Contingency management Behavioral rehearsal: Assertiveness training Rationale: Assertiveness training can assist clients who are experiencing symptoms of depression, anxiety, and low self-worth. It may help clients learn how to express their point of view in a respectful manner. The client and therapist may use role-play to practice verbal and nonverbal behaviors and improve assertiveness.

17 /

  1. Dustin is a 24-year-old who presents for therapy with symptoms of anx- iety. He

19 / What can you use to assist the client? Assertiveness training Bibliotherapy Contingency management Behavioral rehearsal: Bibliotherapy Rationale: CBT therapists may prescribe specific readings or self-help books related to the client's condition as an adjunct to in-session work.

  1. Tina is a 52-year-old who presents with depression and obesity. She has struggled with her weight for the last several years. The therapist implements a series of rewards when Tina adheres to treatment goals. What can you use to assist the client? Assertiveness training Bibliotherapy Contingency management Behavioral rehearsal: Contingency management Rationale: Contingency management reinforces or rewards positive behavioral changes. The

20 / client and therapist can work together to identify appropriate rewards; for instance, Tina may choose to reward herself for maintaining an exercise regimen by scheduling a relaxation massage.

  1. Amina is a 40-year-old who presents for therapy. She reports that she has felt "depressed" most of her life but never sought mental health services. She discloses that she was a victim of childhood incest and neither reported the abuse nor discussed it with anyone before this time. She feels that the time is right to do therapy. The psychiatric mental health nurse practitioner (PMH- NP) selects solution-focused therapy (SFT) to create a warm and supportive climate in which the client can identify her resources to create a shift from the past to the present, integrate her memories, and empower herself beyond her victimization. Which of the following provider statements or question prompts are congruent with SFT? Select all that apply. "What needs to happen today so that when you leave, you'll think this was a good session?" "I can see that things have been difficult for you. How have you managed to