Part 1: Therapeutic Relationships in Mental Health Nursing
Discuss how you create positive therapeutic relationships with the service users. This discussion and analysis needs to consider the meaning of what therapeutic relationships are. It needs to explore how verbal and non-verbal communication skills are used and applied to develop the relationship.
You also need to consider the challenges of the different environments that mental health nurses work in when developing therapeutic relationships, and the nature of their mental health (illness) e.g. people living in inpatient and community (home) settings; a person who is admitted in a crisis and acutely psychotic, hypomanic, or depressed; or a person living at home, not acutely unwell but vulnerable; or a person with serious long-term illness who are symptomatic most of the time with very limited remission.
Contemporary mental health literature needs to be used to support the discussion and develop analysis on differing perspectives. This discussion and analysis should be supported by relevant contemporary literature and evidence.
Developing analysis around descriptive writing is essential in this section
Part 2: Engaging with Janna (responding to questions)
Read the scenario relating to Janna (see below; place the scenario as an Appendix in your essay)
Identify a specific therapeutic approach that you are going to apply the principles of, when working with Janna e.g. CBT, SFBT, MI, C/PCT etc… You are required to introduce the approach and give a clear rationale for choosing this way of working. What are the key ideas and the overarching philosophy of the approach? Who developed the approach and what evidence base is there for its application in mental health settings? Please remember to keep this discussion simple, clear and focused. If you over-complicate things, you run the risk of being too broad in your discussion and end up trying to cover too much.
Following this discussion you need to respond to the statements/questions as they relate to your approach to working with Janna (see scenario below). Some of the questions you are asked to address are broad issues, while some of the questions you asked to respond to are very specific. For each question you need to offer an answer/response, a rationale, and consider what you would hope to be the outcome of you approach/response. You should include relevant supporting references for your rationale.
Reflect on what you have learned and what you will take with you into clinical practice when sitting down to help a person begin to explore their experiences.
Insert the final word count for the essay after the conclusion (3000 words).
SCENARIO: Jana Timera
Janna Timera is a 45 year old gentleman admitted to your assessment unit after he presented at A&E with cuts to his wrists and neck.
He had cut himself with a kitchen knife following what he described as a “panic attack” where he “lost the plot”. He is settled, his wounds have been dressed and overall were not life threatening.
He describes feeling depressed for some months after he was told there may be redundancies at work. He works in the office of a delivery company and says that there has been more and more work recently as people have left or retired from their posts and he has not been coping well.
Janna is married with two small children 10 and 5 years old. He describes his wife as loving and supportive and is worried that he “has put her through hell” and that he has “behaved stupidly”. He feels he has let his children down even though they did not see him harm himself or witness any of his distress and worry.
He reflected on feeling increasingly anxious on heading out to work, worrying about his job security, so much so that he has not been sleeping well. Janna said that he feels he has been depressed for a short while, but felt unable to talk to anyone about this. His wife is very worried about him and he stated that she has told him many times that, “we can cope Janna, your job is not as important as your health”.
This is Janna’s first 1-1 with you since his admission and he is happy to talk to you. During the session he states that he has been “stupid” and that he has “ruined everything”. He wishes he could turn the clock back to a time when he was “on top of things at work”. He worries that he might panic again and self- harm, although he does say that he would not do this to the family again.
How would you begin to engage with Janna and build his trust in you as a health professional?
How would you make him feel comfortable and encourage him to talk about his issues? How would you build rapport with Janna?
If Janna says “I am a useless Father, I just panicked, how could I put my family through this?” How would you respond? What would you say and how does this fit with your therapeutic approach?
If Janna says “I can’t cope at work I’m failing everyone“. How would you respond?
If Janna says “I used to be such a strong person now I am the opposite”. How would you respond?
Suggest a way to close or finish the session using appropriate homework tasks, statements or questions based on the Janna’s statements in the scenario.