Unit 14 Assignment – Psychotherapy Modality of Choice for PMHNP Clinical Practice Paper

Interpersonal Therapy as the Psychotherapy Modality of Choice for PMHNP Clinical Practice Paper

Healthcare providers, particularly those specializing in the provision of mental health services, recognize the critical role that psychiatric mental health nurse practitioners play in bridging the gap in the availability of mental healthcare. According to Wesemann (2019), PMHNPs have an essential role in transforming how people view mental health care and decrease the stigmas linked to mental health treatment. As specialist nurse practitioners, the PMHNPs serve as educators of communities, medical peers, families and individual patients who emphasize that mental health is a primary component of health care in general. Advances in treating mental health disorders categorize the two main approaches as either somatic (where drugs, electroconvulsive therapy amongst other strategies are used to stimulate the brain) or psychotherapeutic (where psychotherapy or behavior therapy and other types of therapies are used. Additionally, one can opt to use a combination of the two. There is a need for a PMHNP to be conversant with the six main types of psychotherapy, namely behavior therapy, psychoanalysis, cognitive therapy, psychodynamic therapy, supportive therapy or interpersonal therapy. The responsibilities and duties of PMHNPs include but are not limited to conducting patient intake screening, diagnosis and treating mental illness and overseeing case management, making referrals and coordinating care. These duties mean these professionals have a critical role in psychotherapy, considering all 50 contiguous states of the US allow PMHNPs some level of prescribing authority. Consequently, the purpose of this practice paper is to examine interpersonal therapy as the choice therapy to implement in clinical practice. (Interpersonal Therapy as the Psychotherapy Modality of Choice for PMHNP Clinical Practice Paper)

Choice of ITP as the Therapy to Implement in Clinical Practice

ITP was developed as a brief psychological treatment for depression, and the essence of its design is to enhance the quality of relationships for people diagnosed with depression (Rajhans et al., 2020). The IPT structure is acute, time-limited and maintenance. This therapy focuses on four interpersonal problem areas of grief, interpersonal role disputes, role transitions, and interpersonal benefits. The ITP design ensures enhancement of the quality of relationships among depressed people, ease the sick people suffering while enhancing interpersonal purpose and cure a depressive episode instead of increasing insight only. Subsequently, interpersonal therapy concentrates on problems that come up when individuals have to fill duties different from their expectations, unresolved grief, challenges while communicating with other parties and transitions in social duties.(Interpersonal Therapy as the Psychotherapy Modality of Choice for PMHNP Clinical Practice Paper)

Furthermore, interpersonal therapy has several theoretical foundations. These theoretical foundations include social theory in which social factors are significant in the progression of depression, communication theory where unsuitable communication with other people can avoid attachment wants against being fulfilled, and interpersonal theory in which relations with more people matters a lot than intrapsychic processes. Moreover, the goals of interpersonal therapy are to lower depression symptoms, enhance interpersonal connections, construct a more efficient social support network, and assist depressed people in handling others and life situations linked with depressive symptoms. Through educating new skills and lastly to enhance sick people’s capabilities to communicate attachment wants.(Interpersonal Therapy as the Psychotherapy Modality of Choice for PMHNP Clinical Practice Paper)

Along with that, interpersonal therapy has three phases of intervention. They are the Initial (early) phase, middle (intermediate) phase, termination (END) phase. Ideally, ITP therapy should last 12-16 weekly sessions. At the early phase, a Psychiatric-Mental Health Nurse Practitioner (PMHNP) seeks data where he reviews the patient’s depression indications, links depressive indications to the interpersonal context, undertakes an interpersonal inventory and distinguishes a key challenge area. At the middle or intermediate phase, the PMHNP concentrates on the interpersonal focus area. The sick person explains feelings, expectations, behaviors, and incidents from life relationships and experiences, links the patient’s events and depressive indications, and explores additional options. Lastly, at the termination phase, PMHNP reviews what the sick person has accomplished, explain to the patients what to do in case they feel depressed, train depressed patients how to deal with potential future life situations that seem to be challenging and encourages patients to continue using or practicing new skills to enhance interpersonal connections and communication strategies. In summary, the techniques applied in ITP are communication analysis, interpersonal incidents, use of content and process effect and role-playing. Other techniques entail clarification, use of the effect, problem-solving and effective optimization of the therapeutic relationship.(Interpersonal Therapy as the Psychotherapy Modality of Choice for PMHNP Clinical Practice Paper)

Why This Modality for One’s Clinical Practice and the Ideal Clientele a PHMNP Would Want to Work with to Implement Psychotherapy

The selection of ITP as the modality of choice arises from this therapy’s effectiveness. Interpersonal therapy is evidence-based psychotherapy which in the past health professional has analyzed in research studies. Precisely, it is a part of Unipolar Depressive Disorder practice guidelines treatment. (Interpersonal Therapy as the Psychotherapy Modality of Choice for PMHNP Clinical Practice Paper) At the same time, young adults were picked as the ideal clientele for the PMHNP to work with during the implementation of this therapy because individuals between the ages of 18 and 29 were found to be the adult population with the highest incidence of symptoms of depression (Villarrolel & Terlizzi, 2020). Additionally, people have found interpersonal therapy as efficient, nationally and internationally, for depression treatment.(Interpersonal Therapy as the Psychotherapy Modality of Choice for PMHNP Clinical Practice Paper)

Along with that, interpersonal therapy is effective when combined with pharmacotherapy and as a single or independent treatment. Compared to other forms of psychotherapy, ITP has several benefits. Be that as it may, the limited scope of this essay necessitates that only a few of the benefits are highlighted. To begin with, ITP has the advantage in that it focuses on improving the patient’s interpersonal communication with others, unlike cognitive behavioral therapy that focuses on how the patient’s internal cognitions impact their feelings and behaviors instead of the external factors like people, situations and events. Similarly, CBT contends that thoughts can positively or negatively affect the patient’s mood. At the same time, IPT posits that interpersonal relationships and external factors can positively or negatively impact the patient’s mood. (Interpersonal Therapy as the Psychotherapy Modality of Choice for PMHNP Clinical Practice Paper)

Apart from this, in interpersonal therapy, patients are given a chance to monitor their well-being by paying close attention to their relationships with other people and recognizing mood changes to help identify a connection between their interpersonal events and depression. Moreover, the affected people will learn to elucidate their interpersonal challenges and efficient ways to solve their problems. ITP offers both the therapist and the patient in that in the four problem areas that the young adults face achieving the goals of IPT is comparatively easy. For example, unresolved grief among depressed people leads to either delayed grief, distorted grief. In resolving grief, the goal of ITP is to help the patient assess the significance of the loss realistically and therefore emancipate themselves. In the event of interpersonal role disputes where disputes have stalled, are repetitious, or show little hope of improving, the goal of ITP is to help the patient identify the dispute, make appropriate choices on their plan of action and finally, modify maladaptive communication patterns or reassess expectations.(Interpersonal Therapy as the Psychotherapy Modality of Choice for PMHNP Clinical Practice Paper) A client regards role changes as a loss, and the ITP goal comes in handy to help the person give up the old role, express their guilt, anger or loss and embrace the skills that become instrumental in developing new attachments (Finley et al., 2020). The fourth and last problem areas are dealing with interpersonal deficits and facing extreme social isolation. The primary goal of ITP in such a scenario is to help the client learn how to form new relationships. (Interpersonal Therapy as the Psychotherapy Modality of Choice for PMHNP Clinical Practice Paper)

Why the PMHNP Can Improve Patient Outcomes and Access by Providing both Medication Management and Psychotherapy Treatment

The PMHNP is bound to improve patient outcomes and access to mental health care and psychiatric services. (Interpersonal Therapy as the Psychotherapy Modality of Choice for PMHNP Clinical Practice Paper)By applying interpersonal therapy, a PMHNP can review a sick person depression symptoms, new interpersonal challenges, and a patient’s chance of creating personal goals, explaining their symptoms linked with depression, and explaining significant individuals in their life (Birch et al., 2021). Drug therapy using the various classes of antidepressants significantly improves patient outcomes.(Interpersonal Therapy as the Psychotherapy Modality of Choice for PMHNP Clinical Practice Paper) However, the PMHNP should know when to use selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), norepinephrine –dopamine reuptake inhibitors, tricyclic antidepressants (TACs) and monoamine oxidase inhibitors. Most importantly, the efficacy of psychotherapy is enhanced if the PMHNP can choose the most appropriate therapy from behavioral to supportive therapy to use depending on the symptoms the patient in context presents with.(Interpersonal Therapy as the Psychotherapy Modality of Choice for PMHNP Clinical Practice Paper)

Conclusion

In conclusion, this essay has established that PMHNPs have a central role in utilizing psychotherapy to meet the growing demand for mental and psychiatric care services. One must also acknowledge that PMHNPs are ready to offer independent and autonomous mental healthcare services and treatment. Of interest are individuals aged between 18 and 29 years who are at a high risk of experiencing depression. The use of ITP is recommended as this form of therapy can adapt in several ways. The PMHNP can plan the ITP as a short-term, time-limited therapy, maintenance therapy, or long-term therapeutic intervention.(Interpersonal Therapy as the Psychotherapy Modality of Choice for PMHNP Clinical Practice Paper)

References

Birch, K., Ling, A., & Phoenix, B. (2021). Psychiatric nurse practitioners as leaders in behavioral health integration. The Journal for Nurse Practitioners, 17(1), 112-115.(Interpersonal Therapy as the Psychotherapy Modality of Choice for PMHNP Clinical Practice Paper)

Finley, B. A. (2020). Psychiatric mental health nurse practitioners meeting rural mental health challenges. Journal of the American Psychiatric Nurses Association, 26(1), 97-101.(Interpersonal Therapy as the Psychotherapy Modality of Choice for PMHNP Clinical Practice Paper)

Rajhans, P., Hans, G., Kumar, V., & Chadda, R. K. (2020). Interpersonal Psychotherapy for Patients with Mental Disorders. Indian journal of psychiatry, 62(Suppl 2), S201.(Interpersonal Therapy as the Psychotherapy Modality of Choice for PMHNP Clinical Practice Paper)

Villarroel, M. A., & Terlizzi, E. P. (2020). Symptoms of Depression Among Adults: the United States, 2019. US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics.(Interpersonal Therapy as the Psychotherapy Modality of Choice for PMHNP Clinical Practice Paper)

Wesemann, D. (2019). Maximizing the Use of Psychotherapy With PMHNP:: A Call to Action for Nurse Leaders. Nurse Leader, 17(6), 537-541.(Interpersonal Therapy as the Psychotherapy Modality of Choice for PMHNP Clinical Practice Paper)

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