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Week #11: Journal Entry
College of Nursing-PMHNP, Walden University
NRNP 6645: Psychopathology and Diagnostic Reasoning
Dr. Enzor
November 10, 2024
During this practicum, I established certain goals: to perform individual and group
psychotherapy sessions, as well as to incorporate CBT into my practice. I accomplished
a lot of my goals, but not without some challenges and growth opportunities. Individual
sessions felt more manageable because I could focus on unique client needs. However,
group therapy created unforeseen obstacles in generating a balanced, inclusive
environment in which all members felt heard and supported. These sessions put my
facilitation and intervention skills to the test, and while they were difficult, they gave vital
experience in dealing with complicated group dynamics and personalities.
Clients with personality problems, those diagnosed with Avoidant/Restrictive
Food Intake Disorder (ARFID), and those demonstrating severe emotional dysregulation
were the most difficult to work with. Personality disorders required great work to
establish therapy rapport and boundaries, especially when clients exhibited distrust or
impulsivity. For ARFID clients, it was particularly hard to navigate their resistance to
discussing food and eating habits without triggering anxiety. Additionally, clients who
had intense mood swings required careful grounding techniques and a strong
Week #11: Journal Entry
College of Nursing-PMHNP, Walden University
NRNP 6645: Psychopathology and Diagnostic Reasoning
Dr. Enzor
November 10, 2024
During this practicum, I established certain goals: to perform individual and group
psychotherapy sessions, as well as to incorporate CBT into my practice. I accomplished
a lot of my goals, but not without some challenges and growth opportunities. Individual
sessions felt more manageable because I could focus on unique client needs. However,
group therapy created unforeseen obstacles in generating a balanced, inclusive
environment in which all members felt heard and supported. These sessions put my
facilitation and intervention skills to the test, and while they were difficult, they gave vital
experience in dealing with complicated group dynamics and personalities.
Clients with personality problems, those diagnosed with Avoidant/Restrictive
Food Intake Disorder (ARFID), and those demonstrating severe emotional dysregulation
were the most difficult to work with. Personality disorders required great work to
establish therapy rapport and boundaries, especially when clients exhibited distrust or
impulsivity. For ARFID clients, it was particularly hard to navigate their resistance to
discussing food and eating habits without triggering anxiety. Additionally, clients who
had intense mood swings required careful grounding techniques and a strong
