NRNP6650 Psychotherapy With Groups and Families
Week 1 Discussion
Legal and Ethical Considerations for Group and Family Therapy
Considering the Health Insurance Portability and Accountability Act (HIPPA), the idea of discussing confidential information with a patient in front of an audience is probably quite foreign to you. However, in group and family therapy, this is precisely what the psychiatric mental health nurse practitioner does. In your role, learning how to provide this type of therapy within the limits of confidentiality is essential. For this Discussion, consider how limited confidentiality and other legal and ethical considerations might impact therapeutic approaches for clients in group and family therapy.
Learning Objectives
Students will:
Compare legal and ethical considerations for group and family therapy to legal and ethical considerations for individual therapy
Analyze the impact of legal and ethical considerations on therapeutic approaches for clients in group and family therapy
Recommend strategies to address legal and ethical considerations for group and family therapy
To prepare:
Review this week’s Learning Resources and consider the insights they provide on group and family therapy.
View the media, Legal and Ethical Issues for Mental Health Professions, Volume I, and reflect on legal and ethical considerations for group and family therapy and individual therapy.
Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the Post to Discussion Question link and then select Create Thread to complete your initial post. Remember, once you click submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking Submit!
By Day 3
Post an explanation of how legal and ethical considerations for group and family therapy differ from those for individual therapy. Then, explain how these differences might impact your therapeutic approaches for clients in group and family therapy. Support your rationale with evidence-based literature.
By Day 6
Respond to at least two of your colleagues by suggesting strategies to address the legal and ethical considerations your colleagues discussed. Support your responses with evidence-based literature.
NRNP6650 Psychotherapy With Groups and Families
Week 5 Discussion
Cognitive Behavioral Therapy: Family Settings Versus Individual Settings
Whether used with individuals or families, the goal of cognitive behavioral therapy (CBT) is to modify client behavior. Although CBT for families is similar to CBT for individuals, there are significant differences in their applications. As you develop treatment plans, it is important that you recognize these differences and how they may impact your therapeutic approach with families. For this Discussion, as you compare the use of CBT for families and individuals, consider challenges of applying this therapeutic approach to your own client families.
Learning Objectives
Students will:
Compare the use of cognitive behavioral therapy for families to cognitive behavioral therapy for individuals
Analyze challenges of using cognitive behavioral therapy for families
Recommend effective cognitive behavioral therapy strategies for families
To prepare:
Review the media, Johnson Family Session 3, in this week’s Learning Resources and consider the insights provided on CBT in family therapy.
Reflect on your practicum experiences with CBT in family and individual settings.
Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the Post to Discussion Question link and then select Create Thread to complete your initial post. Remember, once you click submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking Submit!
By Day 3
Post an explanation of how the use of CBT in families compares to CBT in individual settings. Provide specific examples from your own practicum experiences. Then, explain challenges counselors might encounter when using CBT in the family setting. Support your position with specific examples from this week’s media.
Read a selection of your colleagues' responses.
By Day 6
Respond to at least two of your colleagues by recommending CBT strategies to overcome the challenges your colleagues have identified. Support your recommendations with evidence-based literature and/or your own experiences with clients.
NRNP6650 Psychotherapy With Groups and Families
Week 8 Discussion
Cognitive Behavioral Therapy: Group Settings Versus Family Settings
As you might recall from Week 5, there are significant differences in the applications of cognitive behavior therapy (CBT) for families and individuals. The same is true for CBT in group settings and CBT in family settings. In your role, it is essential to understand these differences to appropriately apply this therapeutic approach across multiple settings. For this Discussion, as you compare the use of CBT in group settings and family settings, consider challenges of using this approach with your own groups.
Learning Objectives
Students will:
Compare the use of cognitive behavioral therapy for groups to cognitive behavioral therapy for families
Analyze challenges of using cognitive behavioral therapy for groups
Recommend effective strategies in cognitive behavioral therapy for groups
To prepare:
Reflect on your practicum experiences with CBT in group and family settings.
Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the Post to Discussion Question link and then select Create Thread to complete your initial post. Remember, once you click submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking Submit!
By Day 3
Post an explanation of how the use of CBT in groups compares to its use in family settings. Provide specific examples from your own practicum experiences. Then, explain at least two challenges counselors might encounter when using CBT in the group setting. Support your response with specific examples from this week’s media.
Read a selection of your colleagues' responses.
By Day 6
Respond to at least two of your colleagues by recommending strategies to overcome the challenges your colleagues have identified. Support your recommendation with evidence-based literature and/or your own experiences with clients.
NRNP6650 Psychotherapy With Groups and Families
Week 10 Discussion
Psychotherapeutic Approaches to Group Therapy with Children and Adolescents
Group therapy may be beneficial for children and adolescents, because it often provides an environment that normalizes clients’ thoughts, feelings, and behaviors. However, as with any therapeutic approach, group therapy might not be appropriate for every client, every setting, or even every therapist. When selecting therapies, you must always consider the psychodynamics of the client and your own skill set.
This week, as you assess and develop diagnoses for clients presenting for child and adolescent group psychotherapy, you examine the effectiveness of this therapeutic approach. You also consider legal and ethical implications of counseling children and adolescent clients with psychiatric disorders.
Learning Objectives
Students will:
Assess clients presenting with disruptive behavior
Analyze group therapeutic approaches for treating clients presenting with disruptive behavior
Evaluate outcomes for clients presenting with disruptive behavior
To prepare:
Review this week’s Learning Resources and reflect on the insights they provide.
Read the case study I am Feeling Like I’m Going Crazy
For guidance on assessing the client, refer to pages 137-142 of the Wheeler text in this week’s Learning Resources.
Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the Post to Discussion Question link and then select Create Thread to complete your initial post. Remember, once you click submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking Submit!
By Day 3
Post an explanation of the most likely DSM-5 diagnosis for the client in the case study. Be sure to link those behaviors to the criteria in the DSM-5. Then, explain group therapeutic approaches you might use with this client. Explain expected outcomes for the client based on these therapeutic approaches. Finally consider legal and ethical implications of counseling children and adolescent clients with psychiatric disorders. Support your approach with evidence-based literature.
Read a selection of your colleagues' responses.
By Day 6
Respond to at least two of your colleagues by providing one alternative therapeutic approach. Explain why you suggest this alternative and support your suggestion with evidence-based literature and/or your own experiences with clients.
NRNP6650 Psychotherapy With Groups and Families
Week 2 Assignment
Hernandez Family Assessment
Assessment is as essential to family therapy as it is to individual therapy. Although families often present with one person identified as the “problem,” the assessment process will help you better understand family roles and determine whether the identified problem client is in fact the root of the family’s issues. As you examine the Hernandez Family: Sessions 1-6 videos in this week’s Learning Resources, consider how you might assess and treat the client family.
Learning Objectives
Students will:
Assess client families presenting for psychotherapy
To prepare:
Review this week’s Learning Resources and reflect on the insights they provide on family assessment.
View the Hernandez Family: Sessions 1-6 videos, and consider how you might assess the family in the case study.
Note: For guidance on writing a comprehensive client assessment, refer to pages 137–142 of Wheeler (2014) in this week’s Learning Resources.
The Assignment
Address in a comprehensive client assessment of the Hernandez family the following:
Demographic information
Presenting problem
History or present illness
Past psychiatric history
Medical history
Substance use history
Developmental history
Family psychiatric history
Psychosocial history
History of abuse and/or trauma
Review of systems
Physical assessment
Mental status exam
Differential diagnosis
Case formulation
Treatment plan
Note: Any item you are unable to address from the video should be marked “needs to be added to” as you would in an actual comprehensive client assessment
NRNP6650 Psychotherapy With Groups and Families
Week 3 Assignment
Experiential Versus Narrative Family Therapies
Although experiential therapy and narrative therapy are both used in family therapy, these therapeutic approaches have many differences in theory and application. As you assess families and develop treatment plans, you must consider these differences and their potential impact on clients. For this Assignment, you compare Experiential and Narrative Family Therapy.
Learning Objectives
Students will:
Compare experiential family therapy to narrative family therapy
Justify recommendations for family therapy
To prepare:
Review this week's Learning Resources and reflect on the insights they provide on experiential and family therapies.
The Assignment
In a 2- to 3-page paper, address the following:
Summarize the key points of both experiential family therapy and narrative family therapy.
Compare experiential family therapy to narrative family therapy, noting the strengths and weakness of each.
Provide a description of a family that you think experiential family therapy would be appropriate, explain why, and justify your response using the Learning Resources.
Note: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The sample paper provided by the Walden Writing Center provides examples of those required elements (available at http://writingcenter.waldenu.edu/57.htm). All papers submitted must use this formatting.
Part 2: Family Genogram
Develop a genogram for the client family you selected. The genogram should extend back at least three generations (parents, grandparents, and great grandparents).
NRNP6650 Psychotherapy With Groups and Families
Week 4 Assignment
Structural Versus Strategic Family Therapies
Although structural therapy and strategic therapy are both used in family therapy, these therapeutic approaches have many differences in theory and application. As you assess families and develop treatment plans, you must consider these differences and their potential impact on clients. For this Assignment, as you compare structural and strategic family therapy, consider which therapeutic approach you might use with your own client families.
Learning Objectives
Students will:
Compare structural family therapy to strategic family therapy
Create structural family maps
Justify recommendations for family therapy
To prepare:
Review this week’s Learning Resources and reflect on the insights they provide on structural and strategic family therapies.
Refer to TherapistAid (2020) in this week’s Learning Resources for guidance on creating a structural family map.
The Assignment
In a 2- to 3-page paper, address the following:
Summarize the key points of both structural family therapy and strategic family therapy.
Compare structural family therapy to strategic family therapy, noting the strengths and weaknesses of each.
Provide an example of a family in your practicum using a structural family map. Note: Be sure to maintain HIPAA regulations.
Recommend a specific therapy for the family, and justify your choice using the Learning Resources.
NRNP6650 Psychotherapy With Groups and Families
Week 6 Assignment
Applying Current Literature to Clinical Practice
Psychiatric mental health nursing practice is one of the newest disciplines to be licensed to provide psychotherapy As such, the majority of psychotherapy research is centered on other disciplines such as psychology, social work, marriage/family therapy, art therapy, psychiatry, and mental health counseling. This makes it essential for you to be able to translate current literature from other disciplines into your own clinical practice. For this Assignment, you practice this skill by examining literature on group work and group therapy and considering its applicability to your own clients.
Learning Objectives
Students will:
Evaluate the application of current literature to clinical practice
To prepare:
Review this week’s Learning Resources and reflect on the insights they provide on group work and group therapy.
Select one of the articles from the Learning Resources to evaluate for this Assignment.
Note: In nursing practice, it is not uncommon to review current literature and share findings with your colleagues. Approach this Assignment as though you were presenting the information to your colleagues.
The Assignment
In a 5- to 10-slide PowerPoint presentation, address the following:
Provide an overview of the article you selected, including answers to the following questions:
What type of group was discussed?
Who were the participants in the group? Why were they selected?
What was the setting of the group?
How often did the group meet?
What was the duration of the group therapy?
What curative factors might be important for this group and why?
What “exclusion criteria” did the authors mention?
Explain the findings/outcomes of the study in the article. Include whether this will translate into practice with your own client groups. If so, how? If not, why?
Explain whether the limitations of the study might impact your ability to use the findings/outcomes presented in the article.
Note: The presentation should be 5–10 slides, not including the title and reference slides. Include presenter notes (no more than a half page per slide) and use tables and/or diagrams where appropriate. Be sure to support your work with specific citations from the article you selected. Support your presentation with evidence-based literature.
NRNP6650 Psychotherapy With Groups and Families
Week 7 Assignment
Group Processes and Stages of Formation
In your role, you must understand group processes and stages of formation, as this will help you develop groups and determine an individual’s appropriateness for group therapy. Whether you are at the beginning stages of group formation or facilitating a session for a developed group, it is important to consider factors that may influence individual client progress. For this Assignment, as you examine the video Group Therapy: A Live Demonstration in this week’s Learning Resources, consider the group’s processes, stages of formation, and other factors that might impact the effectiveness of group therapy for clients.
Learning Objectives
Students will:
Analyze group processes and stages of formation
Analyze curative factors of groups
Analyze the impact of curative factors on client progress
Recommend strategies for managing intragroup conflict
To prepare:
Review this week’s Learning Resources and reflect on the insights they provide on group processes.
View the media, Group Therapy: A Live Demonstration, and consider the group dynamics.
The Assignment
In a 2- to 3-page paper, address the following:
Explain the group’s processes and stage of formation.
Explain curative factors that occurred in the group. Include how these factors might impact client progress.
Explain intragroup conflict that occurred and recommend strategies for managing the conflict. Support your recommendations with evidence-based literature.
NRNP6650 Psychotherapy With Groups and Families
Week 9 Assignment
Psychotherapeutic Approaches to Group Therapy for Addiction
When selecting a psychotherapeutic approach for a client, you must consider the unique needs and characteristics of that particular client. The same is true when selecting a psychotherapeutic approach for groups. Not every approach is appropriate for every group, and the group’s unique needs and characteristics must be considered. For this Assignment, you examine psychotherapeutic approaches to group therapy for addiction.
Learning Objectives
Students will:
Evaluate psychotherapeutic approaches to group therapy for addiction
To prepare:
Review this week’s Learning Resources and reflect on the insights they provide on group therapy for addiction.
View the media, Levy Family: Sessions 1-7, and consider the psychotherapeutic approaches being used.
The Assignment
In a 2- to 3-page paper, address the following:
Identify the psychotherapeutic approach that the group facilitator is using and explain why she might be using this approach.
Determine whether or not you would use the same psychotherapeutic approach if you were the counselor facilitating this group and justify your decision.
Identify an alternative approach to group therapy for addiction and explain why it is an appropriate option.
Support your position with evidence-based literature.
NRNP6650 Psychotherapy With Groups and Families
Week 6 Midterm Exam
• Question 1 When completing this exam, did you comply with Walden University’s Code of Conduct including the expectations for academic integrity?
• Question 2 A client in group therapy has been suffering from anxiety and is worried that she will have a panic attack again. Which of the following interventions demonstrates use of the principle of imparting knowledge?
• Question 3A man calls a PMHNP to set up an initial appointment for family therapy. He explains, “My wife lost her job several months ago. She has been angry and less patient with the kids. All of the stress is taking a toll on me. I can’t focus at the office and I’m mentally exhausted at home.” Based on this phone contact, who would the PMHNP most likely choose to see for the first session?
• Question 4 The PMHNP is meeting with a single mother and her 19-year-old son who lives with her. The son complains that his mother is always nagging him. What is the PMHNP’s interpretation of this scenario according to a complementarity approach?
• Question 5 The PMHNP is meeting with a mother and father for the first time in a family session. As soon as the session begins, the mother says, “I don’t know what to do anymore. Our son is flunking math. I think we should pull him out of football, but I don’t get any support in that decision. What would you do if you were us?” The PMHNP recognizes this as what?
Question 6 A family is in therapy because they have been unable to resolve conflicts and are arguing frequently. When using a strategic family therapy approach, which of the following directives might the PMHNP suggest to create a sense of togetherness?
• Question 7 The PMHNP is working with a family consisting of a father, a mother, and a daughter who is a sophomore in high school. The issue being discussed has to do with the daughter’s emotional outbursts about wanting to spend more time with her friends. Recently, the daughter blew up at the parents over the fact that they wouldn’t let her go to a party, since older kids from the school were throwing it. This outburst led to arguments in the household, which led to the daughter getting grounded for 2 weeks. Which theory does the PMHNP recognize as the most applicable?
Question 8 The PMHNP wants to identify the unique outcomes of a married couple who are having arguments about finances. In particular, the wife is concerned about her husband splurging without consulting her. What question will the PMHNP ask to arrive at the unique outcomes?
• Question 9 The PMHNP is working with a family during their first therapy session. According to the Gestalt school of perception, what must the PMHNP do to change the group behavior?
• Question 10A PMHNP learns that the family has been experiencing dysfunction because a mother and her teenage son have been getting easily annoyed and yelling at each other. When using a strategic family therapy approach, which directive should the PMHNP suggest to solve the problem?
• Question 11 The PMHNP is meeting with two women, ages 35 and 42, who are concerned about their mother’s use of alcohol. During the meeting, what question(s) should the PMHNP ask the mother to help uncover the potential drinking problem?
NRNP6650 Psychotherapy With Groups and Families
Week 11 Final Exam
• Question 1 A patient has had a problem with substance use and has been receiving treatment for addiction. Which additional step might the PMHMP suggest to help the patient maintain abstinence from drugs during and after treatment?
• Question 2 A PMHNP is meeting with the mother of a 10-year-old boy named Malik, who has been depressed since his parents’ divorce. The mother explains that her goal for treatment is to help Malik feel better so he can become his “usual outgoing self.” She insists that she does not want him on medication. Which is the best response by the PMHNP?
• Question 3 The anticipation of the first meeting among psychotherapy group attendees may cause feelings of dread and uneasiness among clients. How does the PMHNP demonstrate awareness and promote the success of this first psychotherapy meeting?
• Question 4 The homogenous mode of composition involves a theory that relates to group composition. When applying this theory, the PMHNP is aware that the group will most likely consist of which of the following?
• Question 5 A PMHNP has been holding group therapy sessions for several weeks and notices that a patient is timid and predictable in his or her responses. When the patient does speak, he or she avoids saying anything to contradict anyone in the group. Based on this information, what is an appropriate question the PMHNP should ask herself?
• Question 6 A member in group therapy named Tom asked others for suggestions to a problem he was having. He did not think a suggestion by a member named Steve would work, and for the rest of session, the group took sides arguing why the idea would work or would not work. The session ended with Tom agreeing to try the suggestion and report back to the group the following week. Based on this session, what is an appropriate step by the PMHNP?
• Question 7 A group member who suffers from depression and anxiety says during the session, “I don’t see how any of this is going to help. I am still too anxious to leave the house and do the things I want to do.” What is an appropriate response by the PMHNP?
• Question 8 When forming a group for therapy, which action would the PMHNP likely take as a predictor for group behavior?
• Question 9 A PMHNP is meeting with parents and their 10-year-old child. The child is having trouble paying attention at school and has been getting easily frustrated at home when doing homework, which often results in everyone arguing. What step might the PMHNP take as part of a family-centered, solution-oriented approach?
• Question 10 The social microcosm theory is a theory that relates to group composition. In accordance with this theory, the PMHNP is aware that the group must consist of which of the following?
• Question 11 Following the PMHNP’s cancellation of a group session, he or she notices a decrease in compliance and attendance within the group. What does the PMHNP identify as the group’s reason for noncompliance?
