NURS 2118: Therapeutic Initiatives in Mental Health
Assessment Assessment Task 2
Assessment Title and type Case Study-Application of trauma informed care and motivational interviewing in mental health
Word Count 1,500 words (+/- 10%)
Weighting 40%
Due Date 2nd April 2023 @ 2359hrs
Associated Learning Outcomes 1. Explore the significance and advantages of utilising psychotherapeutic approaches within mental health as well as delivery of trauma informed care.
2. Critically examine the use of motivational interviewing when working with people experiencing a mental illness.
3. Examine the use of various psychotherapeutic approaches when working with people and their families experiencing a mental illness.
4. Evaluate the application of psychotherapy within mental health settings.
Background Information:
Emma Smith is a 33-year-old female with a diagnosis of schizoaffective disorder. Emma was born in Queensland and is an only child and moved to Melbourne at age 20 to pursue a career in finance. Emma was diagnosed with depression at age 14 however at age 21 she was diagnosed with first episode psychosis after experiencing her first psychotic episode resulting in an admission to a public mental health unit. During this admission she reports that she was sexually assaulted by a co consumer and had multiple episodes of seclusion. Emma engaged with a private psychiatrist and psychologist on discharge and remained stable and compliant with medication management.
Emma subsequently married her current husband at age 25 and has experienced a significant relapse at age 29 in the context of self ceasing medications and disengaging with private supports after being concerned of the impacts her medication was having on her unborn child at approx. 8months pregnancy. During this prolonged admission to a public mental health inpatient unit then to a mother baby unit She was diagnoses with schizoaffective disorder and was discharged on Olanzapine 15mg nocte and Fluoxetine 40mg mane. She re engaged with her private supports.
Emma is now 33 years of age and has been brought to the emergency department by her husband John who has concerns regarding early warning signs of relapse after noticing Emma has been talking to herself, poor sleep and appetite and anhedonia. John also reports that two months ago they commenced IVF treatment. Whilst in the emergency department she is placed under an Assessment Order and then a Temporary Treatment Order and admitted to the public mental health inpatient unit.
Assessment Task:
You are Emma’s contact nurse for the afternoon at day 3 (Sunday) of her admission. Emma has been recommenced on her medication regime of Olanzapine 15mg nocte and Fluoxetine 40mg mane since arriving on the ward.
Emma has been isolating in her room since being admitted and at times has been heard responding to internal stimuli in a distressed manner. She is presenting as guarded and difficult to engage with regarding her mental state. You have gone to administer her nocte medication and she is refusing this stating “I don’t want it; I just want to go home and see my family. I don’t feel safe here.” She further states she has concerns regarding the safety of the medication but won’t disclose exactly what the concerns are. You also note that she refused the previous nights dose and has been refusing to engage with her treating team and nursing staff.
Details of the Task/Instructions:
– Your introduction should set the scene for the essay, provide context and the scope of what areas your essay would be discussing.
– Discuss how you would utilise the principles of trauma informed care and trans theoretical model of change and motivational interviewing to support Emma when it comes to her taking her medications as prescribed and engaging with services. Your discussion should be embedded within the available evidence-based literature around the concepts.
– You will need to demonstrate a good understanding of how to link/incorporate MI while providing trauma informed care.
– What strategies would you employ as a mental health nurse when it comes to working with Emma and her family to promote recovery?
Please note that this case scenario would also be used for your second written assignment so make sure you limit your discussion to only the relevant parts of the current assignment due to word limitations
______________________________________
Emma Smith is a 33-year-old female with a diagnosis of schizoaffective disorder. She has a history of trauma, including sexual assault, and has experienced multiple relapses of her mental illness. She is currently refusing to take her medications and is isolating herself from her family and friends.
Trauma Informed Care
Trauma informed care is an approach to providing services that takes into account the impact of trauma on individuals and communities. It is based on the understanding that trauma can have a profound impact on a person’s physical, emotional, and psychological health. Trauma informed care can help to improve the quality of care for people with mental illness by providing a safe and supportive environment, and by helping to address the underlying causes of trauma.
Trans Theoretical Model of Change
The trans theoretical model of change (TTM) is a stage-based model that describes the process of change. The TTM has five stages: precontemplation, contemplation, preparation, action, and maintenance. Each stage has its own unique characteristics and challenges.
Motivational Interviewing
Motivational interviewing (MI) is a client-centered, goal-oriented approach to helping people change their behavior. MI is based on the principle of self-determination, and it uses a variety of techniques to help people explore their own motivations for change.
Strategies for Promoting Recovery
There are a number of strategies that can be used to promote recovery for people with mental illness. These strategies include:
Providing trauma informed care
Using the trans theoretical model of change
Employing motivational interviewing
Working with families and friends
Providing access to evidence-based treatments
Promoting social inclusion
Conclusion
By using the principles of trauma informed care, the trans theoretical model of change, and motivational interviewing, mental health nurses can help people with mental illness to recover and live fulfilling lives.
Discussion
Emma’s case is a complex one, and there is no single approach that will be effective in helping her. However, by using the principles of trauma informed care, the trans theoretical model of change, and motivational interviewing, mental health nurses can help Emma to start the journey towards recovery.
Trauma Informed Care
One of the first things that Emma needs is a safe and supportive environment. Trauma informed care can help to create this environment by providing staff with training on how to identify and respond to the needs of people who have experienced trauma. It can also help to create a culture of respect and understanding, which can be essential for people who are struggling to cope with the effects of trauma.
Trans Theoretical Model of Change
Emma is currently in the precontemplation stage of change. This means that she is not yet ready to make a change. However, she is aware that her mental health is not good, and she is open to talking about it. The trans theoretical model of change can help Emma to move from the precontemplation stage to the contemplation stage. This can be done by helping her to explore her reasons for wanting to change, and by helping her to develop a plan for how she will make the change.
Motivational Interviewing
Motivational interviewing is a powerful tool that can be used to help people move from the contemplation stage to the action stage. MI is based on the principle of self-determination, and it uses a variety of techniques to help people explore their own motivations for change. MI can be used to help Emma to identify her reasons for wanting to take her medications, and to develop a plan for how she will do so.
Working with Families and Friends
Emma’s family and friends can play a vital role in her recovery. They can provide her with support, encouragement, and practical help. They can also help her to stay on track with her treatment plan.
Providing Access to Evidence-Based Treatments
Emma needs access to evidence-based treatments. These treatments have been shown to be effective in helping people with mental illness. Emma’s treatment team should work with her to identify the most appropriate treatments for her needs.
Promoting Social Inclusion
Emma needs to feel like she is part of a community. She needs to have opportunities to connect with others and to participate in activities that she enjoys. Social inclusion can help Emma to feel more connected to the world around her, and it can help her to build a sense of purpose.
The principles of trauma informed care, the trans theoretical model of change, and motivational interviewing, mental health nurses can help people with mental illness to recover and live fulfilling lives.
References
Millard, David, Peter Agulnik, Neil Armstrong, Craig Fees, John Hall, David Kennard, and Jonathan Leach. “Innovation in mental health care: Bertram Mandelbrote, the Phoenix Unit and the therapeutic community approach.” History of Psychiatry (2023): 0957154X221142416.
Sreeram, A., Cross, W. M., & Townsin, L. (2022). Anti‐stigma initiatives for mental health professionals—A systematic literature review. Journal of Psychiatric and Mental Health Nursing, 29(4), 512-528.
Millard, David, Peter Agulnik, Neil Armstrong, Craig Fees, John Hall, David Kennard, and Jonathan Leach. “Innovation in mental health care: Bertram Mandelbrote, the Phoenix Unit and the therapeutic community approach.” History of Psychiatry (2023): 0957154X221142416.
