NURS 6650 Week 10 Journal Entry

Week 10 Journal Entry

NURS 6650: Group and Family

Walden University

Emotionally Focused Family Therapy is often used to help change negative interaction patterns between family members and improve their accessibility and responsiveness, (Wheeler, 2014). EFT has been known to be helpful in parent-child relationships. “Secure attachment is defined as the degree of confidence a family member has that other family members will provide support, comfort, and protection and will remain emotionally available,” (Stavrianopoulos et al, 2014). The purpose of this journal entry is to document the observations of two clients who are currently in family therapy. The effectiveness of Emotionally-Focused Family will be discussed and, legal and ethical implications will be reviewed.

Demographics of Client #10

WL is a 19-year old, white male who is currently living with his mother and father after recently returning from a wilderness program in Utah for adolescent boys. The Client reports medically withdrew from college because of his anxiety and depression. WL is unemployed and he has decided not to go back to college.

Presenting Problem of Client #1

CC: Depression, Anxiety, Conversion Disorder. The client states, “I was too suicidal to continue taking college courses and I am doing everything I can to avoid stress in my life right now. I see how stressed out my older sister trying to get her PHD in epidemiology and I see how much stress my parent have from work and I don’t want to live like that.”

History of Present Illness of Client #1

WL was referred to group therapy by his psychiatrist after he was seen for an initial assessment last week. The Client is now being treated for depression, anxiety and conversion disorder. Client denies having any suicidal or homicidal ideations at this time and he reports his brother committed suicide last year and after seeing how this impacted his family and, he has decided against doing the same thing. Client reports with fewer stressors he is now coping better and, he has full support from his mother but not from his father. Client reports his symptoms have improved after completing a wilderness course in Utah last Fall and since starting Group Therapy this week. WL was started on a new antidepressant this week. Client reports he no longer attends church and he does not believe what the Baptist church is teaching.

DSM-V Diagnosis of Client #1

WL was diagnosed with Anxiety Disorder Unspecified (300.00) due to inadequate information to determine if his anxiety is being caused by another medical condition. WL was also diagnosed with Major Depression that is recurrent/severe (296.33/F33.2) since his symptoms has been present every day and there was little or no interest in his educational activities and he reported sleep disturbance and fatigue. WL was also diagnosed with Conversion Disorder (F44.4), (APA, 2013).

Past Psychiatric History of Client #1

WL reports he was diagnosed depression in high school but denies any psychiatric hospitalization.

Medical History of Client #1

WL denies having any chronic medical conditions and denies taking any prescriptions meds except for anti-depressants and Clonidine. A physical assessment was not completed during this visit.

Substance Abuse of Client #1

WL denies drinking alcohol and he claims he has never smoked cigarettes and he does not use illegal drugs.

Demographics of Client #2

Client BL is a 49-year old, white male, who is employed as a Vice President at a tech company. He lives with his spouse, daughter and son in a single-family home in McKinney, Texas. BL reports that he is supportive and loving to his wife and children but, he has inflexible with matters that involved church. Client reports he is Southern Baptist and he feels strongly about his faith and works very closely with the church.

Presenting Problem Client #2

CC: “I’m just here to support my son in any way possible since his brother committed suicide.”

History of Present Illness of Client #2

BL states he has not been diagnosed with any mental illness.

Past Psychiatric History of Client #2

BL denies being diagnosed with mental illness and she did not seek psychiatric care in the past or have any psychiatric hospitalization.

Medical History of Client #2

BL reports he was hospitalized for gallbladder surgery in 2014 and he takes prescription meds for high cholesterol and high blood pressure. His immunizations are current, and he does not have any known food or drug allergis.no known allergies. A physical assessment was not completed during this visit.

Substance Abuse of Client #2

BL denies using illegal drugs, and she is not taking any prescribed medication. Client denies drinking alcohol and he does not smoke cigarettes or cannabis.

Emotionally Focused Family Therapy

Emotionally Focused Family therapy (EFT) was selected for the clients WL and his father BL to address WL’s feelings of his father’s unrealistic expectations for his future and his decision to leave the church. Restructuring their interactions could help WL and his father form a more therapeutic relationship. A key concept of EFT is to encourage acceptance and help families be more open, supportive and receptive, (Wheeler, 2014). Family cohesion requires resolving conflict and changing emotional responses.

Legal and Ethical Implications of Counseling Families

Psychiatric Mental Nurse Practitioners (PMHNP) are required to deliver medical care in a manner that promotes ethical care, (ANA, 2014). The PMHNP should protect the rights and confidentiality of their clients and use the Code of Ethics for Nurses in their practice, (ANA, 2014). PMHNP’s are required to act in a responsible legal manner and follow all laws, regulations and standards. Before prescribing or administering medication to clients they should have informed consent about any planned treatment or intervention.

References

American Nurses Association. (2014). Psychiatric-mental health nursing: Scope and standards of practice (2nd ed.). Washington, DC: Author.

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders. Washington, DC: Author.

Stavrianopoulos, K., Faller, G., & Furrow, J. L. (2014). Emotionally Focused Family Therapy: Facilitating Change Within a Family System. Journal of Couple & Relationship Therapy, 13(1), 25–43. https://doi-org.ezp.waldenulibrary.org/10.1080/15332691.2014.865976

Wheeler, (Ed.), (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice. (2nd ed.). New York, NY: Springer Publishing Company