Summary Psychotherapy For The Advanced Practice Psychiatric Nurse

Appendices, Figures, and Tables



Provided to Supplement



Psychotherapy for the Advanced Practice
Psychiatric Nurse
Second Edition




Kathleen Wheeler, PhD, PMHCNS-BC, PMHNP-BC, APRN, FAAN




ISBN: 978-0-8261-3625-1
Digital Product

,Contents




1. The Nurse Psychotherapist and a Framework for Practice
Table 1.1 Basic Education, Orientation, and Setting of Psychotherapy Practitioners   6
Table 1.2 Comparison of Benner’s Model and the Stages of Learning   7
Table 1.3 Timeline of the History of the Nurse Psychotherapist   8
Figure 1.1 Paradigms of care   9
Figure 1.2 Cyclical psychodynamics of a person with borderline personality disorder   10
Figure 1.3 Therapeutic window of arousal   11
Figure 1.4 Maslow’s hierarchy of needs   12
Table 1.4 Cultural Competence: Have You Asked the Right Questions?   13
Figure 1.5 Adaptive information processing model   14
Figure 1.6 Treatment hierarchy framework for practice   15
Figure 1.7 Trauma and resource balance   16
Figure 1.8 Spiral of treatment process   17
Figure 1.9 Ms. A’s psychotherapy outcomes   18
Appendix 1.1 Suggestions for Presenting a Case   19
Appendix 1.2 Weekly Plan for Increasing Resources   21
Appendix 1.3 Weekly Plan   23
Appendix 1.4 Treatment and Case Management   24
Appendix 1.5 Stage I   29
Appendix 1.6 Stage II   30
Appendix 1.7 Safe-Place Exercise   31
Appendix 1.8 Container Exercise   32

2. The Neurophysiology of Trauma and Psychotherapy
Figure 2.1 Continuum of stress/trauma   33
Figure 2.2 Neuron and receptor site   34
Figure 2.3 Stages of brain development, regulation, and memory   35
Table 2.1 Attachment Schemas   36
Figure 2.4 Therapeutic window of arousal    37
Figure 2.5 Structures of the brain   38
Figure 2.6 Cerebral cortex and brainstem   39
Figure 2.7 Right- and left-hemisphere functions   40
Figure 2.8 Trauma response pathway   41

3. Assessment and Diagnosis
Table 3.1 Assessment Questions: Continuum of Openness   42
Table 3.2 Ego Functions for Assessment   43
Table 3.3 Observer-Rated Ego Function Assessment Tool   44
Table 3.4 A Fragment of the Inventory of Interpersonal Problems   45
Table 3.5 A Portion of the World Health Organization’s Spirituality, Religiousness, and Personal
Beliefs Field-Test Instrument   46



From Psychotherapy for the Advanced Practice Psychiatric Nurse © Springer Publishing Company, LLC

,   Contents 3

Table 3.6 Commonly Used Clinical Rating Scales   47
Figure 3.1 An elaborated genogram with demographic, occupational, and major life event
­information    48
Appendix 3.1 Outline of the Comprehensive Psychiatric Database   49
Appendix 3.2 Sample Assessment Form   54
Appendix 3.3 Dissociative Experiences Scale (DES)   57
Appendix 3.4 The Impact of Event Scale (IES)   60
Appendix 3.5 Zung Self-Rating Depression Scale (ZSRDS)   61
Appendix 3.6 Geriatric Depression Scale (GDS) (Short Form)   62
Appendix 3.7 Patient Health Questionnaire-9 (PHQ-9)   63
Appendix 3.8 Young Mania Rating Scale (YMRS)   64
Appendix 3.9 Hamilton Anxiety Rating Scale (HAM-A)   66
Appendix 3.10 Generalized Anxiety Disorder Questionnaire (GAD-7)   67
Appendix 3.11 Yale-Brown Obsessive–Compulsive Scale (Y-BOCS)   68
Appendix 3.12 Quality-of-Life Scale (QOL)   70
Appendix 3.13 CAGE Questionnaire   72
Appendix 3.14 Michigan Alcohol Screening Test (MAST)–Revised   73
Appendix 3.15 Child Attachment Interview (CAI) Protocol   74
Appendix 3.16 Adverse Childhood Experiences Scale   75

4. The Initial Contact and Maintaining the Frame
Figure 4.1 Treatment hierarchy and continuum of therapeutic communication.   77
Table 4.1 Selected Therapeutic Communication Techniques   78
Appendix 4.1 Notice of Privacy Practices   79
Appendix 4.2 Contract   82
Appendix 4.3 Process Note   84
Appendix 4.4 Progress Note   85
Appendix 4.5 Process Recording   86
Appendix 4.6 Sample Termination Letter   89

5. Supportive and Psychodynamic Psychotherapy
Figure 5.1 Cyclical psychodynamics   90
Table 5.1 Freud’s Psychosexual Stages   91
Table 5.2 Mahler’s Stages of Separation–Individuation   92
Table 5.3 Erikson’s Psychosocial Stages   93
Table 5.4 Comparison of Classical Psychodynamic Therapy With Relational Psychodynamic
­Therapy   94
Table 5.5 Selected Meta-Analytic Studies of Psychodynamic Psychotherapy   95
Table 5.6 Practice Guidelines for Psychiatric Disorders   96
Figure 5.2 Psychodynamic case formulation   97
Table 5.7 Basic Strategies of Dynamic Supportive Therapy   98
Figure 5.3 Case formulation and psychodynamic therapy   99

6. Eye Movement Desensitization and Reprocessing Therapy
Table 6.1 EMDR Research: Selected Randomized Clinical Trials and Meta-Analyses   100
Table 6.2 EMDR Clinical Applications   103
Table 6.3 Eight-Phase Protocol for Eye Movement Desensitization and Reprocessing   105
Figure 6.1 Components of EMDR   106
Appendix 6.1 Lightstream Exercise   107
Appendix 6.2 Circle of Strength   108

7. Motivational Interviewing
Table 7.1 Meta-Analyses of Motivational Interviewing With Substance Use, Smoking, and
Health-Related Behaviors   109



From Psychotherapy for the Advanced Practice Psychiatric Nurse © Springer Publishing Company, LLC

, 4 Contents


8. Cognitive Behavioral Therapy
Table 8.1 Evidence-Based Research for CBT   110
Table 8.2 Socratic Dialogue   111
Table 8.3 Socratic Dialogue Basic Rules   112
Table 8.4 Cognitive Distortions   113
Table 8.5 Steps in Cognitive Restructuring   114
Table 8.6 Checklist of Patient Outcomes for Contingency Contract    115
Table 8.7 Maladaptive Schemas   116
Table 8.8 Hierarchy for Driving Fear of Bridges   117
Table 8.9 CBT Therapist Website Resources for Specific Populations    118
Appendix 8.1 Automatic Thought Record   119

9. Interpersonal Psychotherapy
Table 9.1 Interactive Dialogue: Evidence of Abnormal Grief Task   120

11. Group Therapy
Table 11.1 Examples of Theoretical Approaches and Focus of Approach   121
Table 11.2 Evidence-Based Research for Group Psychotherapy   123
Table 11.3 Phases of Group Formation/Development   124

12. Family Therapy
Table 12.1 Four Major Family Therapy Approaches   125

13. Stabilization for Trauma and Dissociation
Figure 13.1 The spectrum of traumatic response   126
Table 13.1 Diseases and Disorders of Trauma   127
Table 13.2 Assessment/Outcome Instruments for Dissociation   128
Table 13.3 Assessment/Outcome Instruments for Trauma   129
Appendix 13.1 SPRINT 05-30-13   130
Appendix 13.2 Progressive Muscle Relaxation   131

14. Dialectical Behavior Therapy for Complex Trauma
Figure 14.1 Characteristics of the DBT therapist   133
Figure 14.2 Behavioral chain analysis worksheet   134
Table 14.1 Skills Modules in DBT   135
Figure 14.3 Sample diary card for standard DBT treatment   136
Figure 14.4 Sample behavioral chain analysis for teen conflict with mother   137
Figure 14.5 Sample behavioral chain analysis for medication adherence   138
Figure 14.6 Behavioral chain analysis for Mr. M   139
Figure 14.7 Mr. M’s early diary card   140

15. Psychopharmacotherapy and Psychotherapy
Appendix 15.1 Collaborative Agreement   141
Appendix 15.2 Collaborative Agreement (Optional Language Added)   142
Appendix 15.3 Pharmacotherapy Consultation and Collaboration Request Form   143

16. Psychotherapeutic Approaches for Addictions and Related Disorders
Table 16.1 Worldwide Prevalence, Health Risks, and Economic Burden of Addictions   145
Table 16.2 U.S. Prevalence, Health Risks, and Economic Burden of Addictions   146
Figure 16.1 Current, binge, and heavy alcohol use among persons (age 12 years and older) by
age group  147
Table 16.3 Guiding Principles of Recovery   148
Table 16.4 Principles of Effective Treatment for Addictions   149


From Psychotherapy for the Advanced Practice Psychiatric Nurse © Springer Publishing Company, LLC