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NR605 FINAL EXAM
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NR605 FINAL EXAM
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NR605 FINALEXAM
cognitive-behavioral therapy - Answers --focus on how well individuals can adapt
cognitively 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
CBT Relationship to Nursing Theory - Answers --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.
MI Guiding Principles - Answers --acceptance
,-empathy
-compassion
-respect of client autonomy
-acknowledgment of the client's strengths & efforts
-Spirit of MI
• Partnership, compassion, acceptance, evocation
MI Role of the Psychotherapist - Answers -represented by the mnemonic RULE:
Resist the righting reflex
Understand the patient's motivation
Listen to the patient
Empower the patient
OARS - Answers -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
-Reflecting
• mirror the content or feelings explicitly or implicitly stated by the client
• convey empathy, demonstrate listening, highlight emotions & beliefs, • provide
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
MI Phases of the Change Process - Answers --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
• creating a plan for change
,acceptance and commitment therapy (ACT) - Answers --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
solution-focused therapy (SFT) - Answers --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
• transpersonal, going beyond the ideas of humanness, identity, and self-actualization
-client is considered to be the expert of their lives
-focus from the problem to the solution
-grew out of the work at the Brief Family Therapy Center in Milwaukee in the 1970s
• influenced by many psychotherapists, work at the Mental Research Institute in
California, and the philosophies of Buddhism and Taoism
solution-focused therapy Key Concepts and the Role of the Psychotherapist - Answers
--Solutions talk
• Shift talk from problems to solutions
-Positive orientation
• Shift focus from problems to new possibilities
-Looking for what is working
• Focus on the exceptions within problem patterns
Indications for CBT - Answers --treatment of a wide range of diagnoses
• depression
• anxiety disorders
• substance use disorders
• eating disorders
• severe mental illness
• PTSD
, Principles of CBT include: - Answers --way an ind cognitively structures thoughts about
self & the world determines how the ind feels & behaves
-Dysfunctional thoughts are rooted in irrational assumptions
-Dysfunctional thinking and learned patterns of maladaptive behavior contribute to
psychological problems
-Ind's can learn more adaptive behaviors which can relieve symptoms & improve quality
of life
-CBT is (+) & stresses collaboration & active participation
-CBT includes action plans in the form of therapy homework
Role of the Psychotherapist in CBT - Answers --using a structured, collaborative
approach to help clients recognize and reevaluate cognitive distortions
-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
motivational interviewing (MI) - Answers --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
Indications for MI - Answers --reduction of substance use and health promotion
-improving medication adherence in clients with schizophrenia
Indications for SFT - Answers --used for individual or group therapy across settings
• marriage, family, and child therapies
• trauma
• postpartum depression
• depression
• eating disorders
• severe mental illness
how SFT is used to alleviate anxiety - Answers -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.
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