Category: Therapy

Introduction

Medical students constantly need to practice their professional skills in real-life cases to ensure that they develop their professional skills. In the era of COVID-19, many students were forced to study online, and this type of learner has become one of the most popular in the medical sphere.

Discussion

The education of young experts in physical therapy requires knowing a lot about the body composition of a human (Mitra et al., 2021). Consequently, it became possible for students studying in this department to continue their studies during uncertain coronavirus times. However, this change in life has caused many breakdowns, as many students experienced a lack of motivation (Mitra et al., 2021). One of the greatest motivators that were popular at the beginning of the process of transferring to e-learning was that students have to spend less money on traveling (Mitra et al., 2021). Moreover, some people living in distant locations could commute less.

Every student can define a specific factor that motivated them toward online learning. For example, when students are surrounded by an atmosphere where they feel comfortable, the online materials regarding anatomical structures decrease the amount of cognitive load (Mitra et al., 2021). Nevertheless, a student might need more communication with peers, and misunderstandings can appear (Lee & Martin, 2017). Online interaction does not allow making eye contact which is important while thinking, answering questions, and proposing ideas.

Conclusion

This issue may make medical students more scared to ask a question regarding anatomic facts causing a poor ability to keep up with the content (Kool et al., 2016). Consequently, students should try both types of education to make the right choice and start their professional pathway.

References

Kool, A., Mainhard, T., & Brekelmans, M. (2016). Goal orientations of health profession students throughout the undergraduate program: A multilevel study. BMC Medical Education, 16(100), 1-9.

Lee, J., & Martin, L. (2017). Investigating students perceptions of motivation factors of online class discussions. International Review of Research in Open and Distributed Learning, 18(5), 148-172. Web.

Mitra, N. K., Aung, H. H., & Kumari, M. (2021). Improving the learning process in anatomy practical sessions of chiropractic program using e-learning tool. Translational Research in Anatomy, 23. Web.

Compare and contrast the effectiveness of group therapy. What elements are particularly helpful for the group? What elements are potentially detrimental to group dynamics?

The type of addicts best suited for the Self-Evaluation Group are learners who have to abuse drugs to perform an array of tasks as individuals or as a group inside and outside the societal setting. Such addicts have consented to the therapy sessions because of their addiction. In general, SEG is an exceptional approach for motivating students to appreciate and evaluate their successes and potential impediments to accomplishing such progress (Brebender 2004). However, addicts in a Self-Evaluation Group are reluctant to abstain from drugs hence need motivation from the group setting. The Early Recovery Group (ERG) is best suited for organizations in which clients are drug addicts. Such addicts appreciate their repulsive situation and recognize the need to abstain and eventually attain stability. Such participants would only commit to the group for a certain period (usually some months) up to a year after which they withdraw membership. The counselor in conjunction with the Co-Leader holds group meetings in which they accord clients special considerations as per ERG guidelines. Relapse Prevention Group suits addicts who have successfully maintained abstinence. Addicts get a chance to share their ordeal with drugs and substances and keep off issues, which may lead to relapse. In particular, RPG (also known as Advanced Recovery Group) is critical for recuperation and steering clear of any possible relapse in the future (Brebender 2004). Responsible lifestyle and self-control top the agenda of a Relapse Prevention Group.

Group therapy has emerged as an effective tool for two main reasons:

1. the substance habit is typically maintained by the massive wall of denial of the drug and substance addict.
2. Addicts who are in the recovery process need strong social support. Group therapy is an effective tool in the provision of much-needed social support. Overall, group therapy encompasses a therapist or an assortment of therapists working concurrently with other inhabitants.

Group therapy is beneficial to the addicts as it facilitates individualized growth. Besides, it allows individuals to recognize and acknowledge the people who are willing and ready to provide support. Individuals in the group acquire counseling services on various aspects of life including social, cultural, and psychological problems (Bartels et al 2011). On the contrary, group therapy is always diverse. Psychologists who have acquired diverse training in theory employ group therapy to resolve a range of psychological problems (Brebender 2004).

The specific elements that are essential for the group include the dynamics of individuals in the group, the hopes, and expectations of new members, and the function of the head (counselor).

Group Dynamics

Typical group therapy should consist of 8-10 members. Besides, group therapy should also take into consideration a diverse mix of gender, social status, ethnicity, and drug of choice. Each group therapy should, however, be cautious about the existence of volatile members who in some instances fail to respond to the pre-established group dynamics. The group should consider its mission and the objectives it seeks to achieve. The group therapy principles are of immense importance as they determine the overall outcomes of any group therapy process.

Expectations of New Members

First, the counselor must meet each participant independently for a brief review of the rules as well as expectations. Under certain circumstances, the leader might ask participants to sign a contract as a way of confirming their willingness to adhere to the attendance policy, respectful interactions with colleagues, and sobriety expectations. Once the members have fully joined after meeting all the terms and conditions of the group, the counselor should allow them to give a brief introduction and history of addiction. This will allow group therapy to establish a common ground. Principles such as the installation of hope, universality, development of techniques for socialization, and imparting information are imperative for all group therapy sessions (Brebender 2004).

Role of the Leader (Counselor)

The primary role of the counselor is to enhance productive and unbiased interactions among members of the group. The counselor chooses topics for discussion on behalf of members. Such topics must be member-driven. The leader would also play a fundamental role in overcoming looming resistance resulting from absenteeism, complaints, lack of participation, and aggressive members. Unfortunately, certain elements are detrimental to group dynamics. Group dynamics refers to the forces which result from constant interactions of the members of the group. Negative ethnicity, racism, cohesion problems, lack of effective mode of communication, cultural stereotypes, and lack of social integration are harmful to the progress of group therapy. Segregation of members in terms of race or ethnic groups would affect integration and cohesion processes. Lack of universal communication channels and language would eventually create a feeling of alienation and neglect among certain members leading to boredom and apathy. Under extreme conditions, some members withdraw their membership and active participation in the affairs of the group therapy (Rutan et al 2007).

Evaluate the three types of group therapy sessions. For each type of session, speculate on the possible challenges you, as a counselor, would face in each of the settings. What concerns you from a counselors perspective when looking at a diverse group of addicts each requiring individualized attention?

The three types of therapy sessions are the Self-Evaluation Group session, Early Recovery Group session, and Advanced Recovery Group session. Every group session is distinct and depends on the intensity of addiction and the capacity of the group to find effective techniques for resting the addiction problem. Even though SEG has consented to the problem of drug addiction, the counselor may still face the enormous challenges of convincing them to abandon using drugs. Although ERGs acknowledge the need to abandon drugs, the counselor would still face the challenge of curbing the external pressure which might influence their habit of abusing drugs in the future. Similarly, the counselor would still face the enormous challenge of keeping the Advanced Group (Repulsive Group) from the abuser (addicts) who constantly interact with members who have stopped abusing those drugs and substances.

The members in each group belong to distinct stages of addiction. The demonstration is a presentation that provides awareness as well as an intellectual understanding of group therapy (Rutan et al 2007). An expert lecture is an official presentation by a single recognized professionally trained expert in that particular field. This professional would share the methodological along with theoretical innovations throughout the talk. Upon completion of the lecture, the professional pundit would then respond to a range of questions and comments from the audience. Questions as well as the comments emanating from the audience (group) must be relevant to the topic of the day. The panel is relatively proper with a thematic presentation focusing on various issues facing the assessment field (Bartels et al 2011). As a counselor, some of the challenges I am likely to face low or poor concentration on the part of the addict. In particular, the demonstration may not go down so well with a section of the audience who may eventually abscond from the session.

My primary concern of the counselor on the subject of addicts seeking individualized attention is the possibility of future integration of such individuals into group therapy. Finally, the unpredictability of the outcomes of individualized sessions is another matter of concern to an ordinary counselor unlike in group therapy where people share ideas and opinions as regards their problems more openly. Some of the challenges I am likely to face may also include low or poor concentration on the part of the addict. In particular, the demonstration may not go down so well with a section of the audience who may eventually abscond from the session.

References

Bartels, D. M., LeRoy, B., & Caplan, A. L. (2011). Genetic counseling: Ethical challenges and consequences. New Brunswick: Transaction Publishers.

Brabender, V., Smolar, A. I., & Fallon, A. E. (2004). Essentials of Group Therapy. Hoboken: John Wiley & Sons.

Rutan, J. S., Stone, W. N., & Shay, J. J. (2007). Psychodynamic group psychotherapy. New York: Guilford Press.

The medical field of psychiatry has several methods of treating difficult and debilitating disorders in people. One is cognitive behavioral therapy (CBT), which encompasses many treatment activities and procedures  cognitive reappraisal behavioral and motivation strategies, emotional regulation, and psychoeducation. CBT has been proven effective when treating mental illnesses such as anxiety and depression and certain disorders such as schizophrenia. This essay aims to explain how CBT works in theory and practice and why it shows great results for the patient in the long term.

In therapy, people with mental disorders, low self-esteem, and symptoms of being in a toxic relationship or household often confess to having negative cognitive thoughts. For example, they may think they are bad at everything they do, they will be alone for the rest of their lives, and nobody will love them. These thoughts stem from a deep sense of shame and cognitive distortions of reality (Psych Hub, 2019). Distorted thoughts influence people by making them develop a poor sense of self, self-loathing, and isolation tendencies. CBT can be delivered individually and in groups with parent or family involvement to combat these beliefs. One variant of CBT, called Coping Cat, consists of psychoeducation, modification of negative cognitions, exposure, social competence training, coping behavior, and self-reinforcement sessions (James et al., 2021, p. 12). The idea behind CBT is to strategically intervene by examining their cognition, explaining the irrationality of such thoughts, and providing the patient with positive affirmations and methods of changing their behavior.

CBT must be done with care and consideration for the patient, who must actively participate throughout the session. In theory, the client receiving CBT begins to recognize their anxious, depressing, and disordered thoughts after the therapist fully explains the negative ways their way of thinking impacts their life. For example, if the client is struggling with anxiety, they recognize anxious feelings and bodily or somatic reactions to anxiety, identify thoughts or cognitions in anxiety-provoking situations, and modify these anxiety-provoking cognitions (James et al., 2021, p. 12). The client starts changing their inner monologue from self-critical and mean-spirited to coping and affirming. After receiving care, the client can stop their escalation of negative thoughts and improve their mental state through positive self-talk, halting their effect on their life.

In practice, CBT is incredibly effective for the treatment of mental disorders. In comparison to waitlist/no treatment, this type of therapy leads to the remission of generalized anxiety, social anxiety, separation anxiety, panic disorder, agoraphobia, specific phobias, and selective mutism (James et al., 2020). Post-treatment patients and their families report reduced anxiety and depressive symptoms to a variable degree. However, due to limited research, there is no proven advantage that CBT is a more effective treatment method than treatment as usual, alternative treatment, or medication on most post-session outcomes. The client is much less likely to find CBT helpful if they do not actively welcome the change in their mindset.

In conclusion, CBT is a type of therapy used to treat mental disorders, such as anxiety and depression. It operates on the participation of the therapist, client, and sometimes any associated groups, such as family. The therapy process includes assessing the clients damaging thought processes and educating them on their effect. If the person receiving CBT learns to combat these thoughts, the long-term effects show reduced symptoms of mental illness.

References

James, A. C., Reardon, T., Soler, A., James, G., & Creswell, C. (2020). Cognitive behavioural therapy for anxiety disorders in children and adolescents. Cochrane Database of Systematic Reviews, 11. 

Psych Hub. (2019). What is Cognitive Behavioral Therapy [Video]? YouTube.

Counseling is one of the most comprehensive therapeutic techniques to save many lives. I have found counseling particularly fulfilling in my line of study, considering that it provides room for extensive research into what may be troubling a person. The application of counseling theories on various platforms must be carefully evaluated not to bring more harm to patients than benefits.

Some counseling theories may try to deviate from the moral goal of counseling, which primarily involves administering to the needs of the patients. Nevertheless, it has to be applied comprehensively to ensure that it works beyond acceptable limits. Engaging patients must be a cognitive process devoid of any manipulative techniques used these days by doctors from various sectors (Furukawa et al.). In cases where the therapeutic need for counseling goes beyond the appropriate solution required, it is essential to introduce other mechanisms.

My personal view supports cognitive behavioral therapy. Although widely applied, I find it personally appealing because it can be used to bring the solution to several problems that emanate from a wide range of sources not necessarily associated with one type of illness. At one point in my career, I used cognitive behavioral therapy to treat my clients. The patient was 55 years old and had failed memory, mostly during conversations. She would mostly forget or slip in many conversations; however, after using cognitive therapy, I stabilized her memory after a few counseling sessions. In most cases, cognitive behavioral therapy assists in handling cases of patients with Alzheimers.

Cognitive behavioral therapy is a therapeutic process applied to treat psychological problems. The method has been used to treat anxiety disorders, eating disorders, drug problems, severe mental illness, marital issues, depression, and many other problems (Wergeland et al.). Several studies indicate that this treatment method has received several successful cases over the years. Cognitive behavioral therapy is based on three frameworks; where the first suggests that psychological problems arise from how people think, some people believe abnormally and yet are unaware that they may have psychological issues.

I advocate for this treatment, especially for this category of people, because it tends to explore more about the human brain and how it operates, thus exposing patterns that might have been formed in the brain. Similarly, cognitive behavioral therapy is used in cases where the brain adopts unhelpful patterns. In such cases, the victims may not be aware that their brain system adopted a given pattern, but it is identified in their behavior and how they carry it out.

The final group deals with a particular group of individuals where the brain is subjected to abnormal cases and, over time, learns how to cope with such patterns. This is quite dangerous to the person who promotes how the brain operates and how it should perform. Thus, the brain operation system needs a comprehensive key to help it cope with the prevailing situation. These coping mechanisms are brought about through cognitive behavioral therapy.

The key concepts of my approach are to apply the therapy itself and communicate with patients during breaks between sessions for maximum effectiveness. It helps to consolidate the success achieved during the sessions and improve contact with patients. My role as a consul is essential to the patient as it performs basic client support tasks. Primarily, I help patients set the right goals before the session to spend time efficiently. Moreover, I provide support in case one is confused or does not understand what goals should be next. I inform clients on all issues of interest and discuss progress or regression with them.

Therapeutic goals are to make progress as soon as possible, and relationship issues are formulated by setting the proper contact with patients. Finally, the central techniques include active listening and participation and methods for recording thoughts and actions (Beck 27). These methods are important because they stimulate a response in the patient that generates interest and a high level of involvement. In other words, it encourages patients to be motivated to complete all the tasks scheduled for a certain period.

Cognitive behavioral therapy has long been used to treat various behavioral disorders brought about by substance abuse. Its success in this field is framed based on its three core principle (Furukawa et al.). It can be applied to remove learned unhelpful patterns, it can be used to draw ways that have been developed over time, and essentially, the brain creates a mechanism to help remove the challenges arising from such situations.

It can equally be used to remove unhealthy thought processes that have been induced through the abuse of the substance. This is the best technique proven to be effective in eliminating many psychological problems. Its solutions are based on a framework where a persons distorted thinking can be obliterated by exposing the person to reality (Wergeland et al.). The cogitative behavioral technique easily applies the mechanisms by helping the counselor better understand the problem faced by the individual. Hence, upon using these cognitive skills, the counselor can remove any problems from that person. It is equally important to note that introducing to use of problem-solving skills to cope with its problems is a concept that is widely applied in cognitive behavioral therapy. I helped my friend using cognitive behavioral therapy, who had suffered years of marital problems, thus leading to depression.

The application of cognitive behavioral therapy is quite fulfilling because, at the end of the clients counseling session, the client is expected to heal fully from the impending problem that might have been disturbing them. The counselor can open dark things within the individuals thinking process by applying role-playing as a critical technique for engaging with the patient. It is thus fulfilling to imagine situations where these clients can be relieved by assuming they occupy the best moment of their lives through the therapeutic moment. Having seen the number of patients that recover from depression due to cognitive behavioral therapy, I feel that it is the best therapeutic approach to a number of patients psychological problems.

The main reason for choosing this therapy is because it greatly appeals to my counseling orientation which is quite direct and precise. One advantage of cognitive behavioral therapy is that it helps the patient overcome problems independently. At times they instill capabilities within the patient that transforms their life for the better. Patients can exercise their minds abilities and strengths without involving the counselor. These are some of the strengths of this technique and why the reason instrumental in overcoming societal problems (Wergeland et al.). It is equally important to note that these therapeutic sessions tend to explore more what is going on with the patients life rather than what made them in such a position. I find this particularly fulfilling under all dimensions because of a case in which a drug addict was brought in at our hospital and after a number of cognitive behavioral therapy sessions, one demonstrated significant progress.

As a future counselor, I feel that this is the method that doctors should use and widely apply because it offers a lot of healing and, significantly, fulfillment. It is, therefore important to note that these processes are essential to the whole system. Although doctors can use other therapies to treat various illnesses, especially those emanating from psychological operations, I suppose that applying this method comprehensively will help reduce the impending problems that have seen many people commit suicide. I will continually advocate for this method since, at one time I used it to overcome my own emotional fears.

I support a comprehensive system where the patients whole life is reviewed to ensure they are fully healed. Introducing the patients to self-therapy is a win for me in any treatment. They usually think if they can employ their psychological processes to overcome challenges. CBT has a direct recovery rate, especially concerning its application to patients progress. It helps remove various difficulties, mainly when complex theories cannot be applied to solve the problem. Conclusively, cognitive behavioral therapy is among the best counseling approaches that any practitioner can use to treat patients with memory relapses.

Works Cited

Beck, Judith. Cognitive Behavior Therapy, Third Edition: Basics and Beyond. Guilford Publications, 2020.

Furukawa, Toshi A. et al. Dismantling, Personalising and Optimising Internet CognitiveBehavioural Therapy for Depression: A Study Protocol for Individual Participant Data Component Network Meta-Analysis. BMJ Open, vol. 8, no. 11, 2018.

Wergeland, Gro J. et al. Cognitive Behavior Therapy for Internalizing Disorders in Children and Adolescents in Routine Clinical Care: A Systematic Review and Meta-Analysis. Clinical Psychology Review, vol. 83, 2021.

Introduction

Total Knee Arthroplasty (TKA) is among the most affordable and generally successful procedures done in orthopaedics. Patient-reported results indicate a significant improvement in pain alleviation, functional restoration, and overall quality of life. The rationale for choosing Trauma-induced TKA as the clinical issue is its wide prevalence and a major cause of health burden to patients and the health care system. Trauma-induced injury to the knees occurs as a result of intra- or extra-articular injuries of the patella, proximal tibia, and distal femur. According to the research, the incidence of this injury ranges from 21% to 44% (Lie et al., 2019). Moreover, patients who have undergone TKA need close monitoring as well as prompt patient education that will help alleviate pain and restore the functionality of the knee.

Mr Neil, a 45-year-old roof tiler, underwent the TKA procedure after falling from the roof of a single-story building. He was transported to the hospital, where he underwent bilateral knee replacements as a result of the trauma from the fall. Mr Neil has a vertical incision covered by an occlusive dressing to both knees. Following a successful surgery and positive prognosis, he is discharged but with many routine self-care that he needs to cope with. Since he is not able to perform all normal daily life functions without assistance, it is crucial to demonstrate and draw to him an appropriate plan of care to assist him while at home.

Reference to Relevant Learning Theory

Cognitive Behavioral Therapy (CBT) is a successful psychological intervention method used by hundreds of therapists worldwide. The concept of CBT can be applied to Mr Neil in helping him to full recovery and functionality of his knees. Traditionally, psychologists have administered CBT therapies, and the use of physiotherapists to offer psychological therapy is a relatively new concept (Peters et al., 2021). On the other hand, physiotherapists have a long history of educating patients on pain and pain management. Recent research indicates that both physiotherapists and nurses are capable of providing high-quality pain coping skills training. According to CBT theory, thoughts, emotions, and behavior are interconnected, and ones ideas and actions determine how one feels (Peters et al., 2021). The state of a persons cognition has an effect on their emotions and moods, as well as their physiological responses and behavior. CBT involves the client developing and practising new techniques, with one goal being to reduce maladaptive pain responses (Peters et al., 2021). CBTs objective is to recognize maladaptive ideas and then replace them with more genuine and constructive ones to alter emotions and behavior, hence the perception of pain.

The Rationale for the Selected Teaching-Learning Setting

The teaching-learning setting for Mr Neil is hospital-based and will incorporate his wife as well in the process. Since Mr Neil needs assistance with movement, involving his next of kin in health education is important. Hospital-based education is critical since the patient has a greater chance of obtaining further care. Additionally, it is cost-effective since it minimizes the expense of transporting the health care practitioner to the patients house (Werner et al., 2019). Another rationale for choosing patient education and learning in the hospital environment is that nurses, doctors, and pharmacists can all contribute to ensuring that the patient knows the type of medication they are getting and the necessity of taking it therapeutically at suitable intervals. Thus, it is critical to inform Mr Neil and his wife that they should stick to the drugs prescribed the following discharge.

Following Mr Neils surgery, it will take him a lot of time to recover fully, which will render him jobless or the coming months. Being a family man with two children and a wife, this proves to be a challenge for him as he needs to provide for them the basic needs. It is evident that this state of immobility due to surgery exposes Mr Neil to a stressful experience. Mr Neil can benefit from the use of the CBT concept in reducing psychological distress as well as alleviating the pain.

The core tenet of cognitive-behavioural therapy is that maladaptive cognitions perpetuate psychological distress and behavioural disorders. Thus, CBT employs a variety of strategies to foster the development of more adaptive thoughts and behaviours, such as psychoeducation, relaxation therapy, cognitive restructuring and guided imagery, problem-solving, and coping with stress (Peters, 2021). CBT focuses on lowering pain and suffering, particularly in the setting of pain, through changing bodily sensations, tragic and meditative thinking, maladaptive behaviours, and boosting self-efficacy (Peters, 2021). Thus, the interventions objective is to heighten Mr Neils knowledge of his thoughts and behaviours, as well as to teach and practice new ones in order for him to commence, maintain, or resume his regular physical and social tasks. Additional learning objectives include increasing patients confidence in establishing their evaluations and teaching them suitable ways to cope with pain.

Identification of Learning Readiness

Through self-assessment, Mr Neil can demonstrate appropriate readiness to learn new coping skills during the learning session. This entails maintaining a record of learning requirements that arise throughout a typical workday. Mr Neil can detect knowledge gaps by reviewing his diary. Notably, people who maintain a diary develop more defined learning goals than people who do not. Additionally, feedback evaluation may be used to indicate preparedness for learning. For example, Mr Neil may get comments from his wife, Lisa, about his strengths and weaknesses.

Furthermore, it is vital to evaluate the performance and provide comments on areas that may be improved throughout the learning session. Observing ones practice and documenting consultations on film is a strong tool that may aid in understanding ones learning requirements. It is especially useful for seeing how people interact with one another during consultations and how patient-centred they are. Mr Neil may also benefit from the use of questionnaires to aid in the comprehension of the teaching session. The formal patient participation questionnaire should as well be given to Mr Neils wife to demonstrate that she also understands the goals of CBT in achieving recovery.

Strategies for Minimising Learning Challenges

It is critical to incorporate family members in the administration of health care in order to reduce the likelihood of any difficulties arising during patient education. Family involvement in patient education increases the likelihood that patients will follow the advice (Dineen-Griffin et al., 2019). In many circumstances, nurses are the one that provides the majority of the training to family members. Families have an important role in the administration of healthcare resources. It is one of the most difficult but ultimately gratifying aspects of delivering nursing care to educate patients and their families. It is important to include Mr Neils wife in the training session; for example, she may be able to assist him in making sure he takes his antibiotic prescriptions at the appropriate times.

Additionally, stimulating the clients interest is crucial to lowering the number of challenges they face throughout the learning procedure. Patients must comprehend why this is so vital to their health. As a nurse or other healthcare professional, one should create rapport with patients, respond to questions, and take into consideration individual patient problems. It is possible that some individuals want thorough information on every element of their health condition, while others may be satisfied with just the basics and would benefit from a basic checklist. In the end, technological advancements have made patient education resources more accessible (Dineen-Griffin et al., 2019). By just pressing a button, patients may have their educational materials tailored and printed out. Education technology has made learning processes easier to understand, reducing the number of obstacles to efficient learning. Going through the patients particular requirements with them can guarantee that they comprehend the instructions and can address questions that occur.

The Rationale for the Teaching Aids

A questionnaire is a frequently used health assessment device that assists in determining a patients progress toward achieving set objectives, or lack thereof. The utilization of questionnaires as a data-gathering tool in health research has risen in recent years, both nationally and internationally (Werner et al., 2019). It offers benefits over other data gathering techniques in that it is generally fast to complete, affordable, and often straightforward to analyze. Well-designed questionnaires may assess cognition, knowledge, attitudes, intention, emotion, and behaviour. They collect the persons self-reported observations and are often used to assess patient views of a variety of areas of health treatment. Effective health education materials and assessment questionnaires may assist the medical team in designing a patient-centred care plan that is easy to execute and maintain. These technologies aid in the improvement of patient outcomes related to adherence to medical guidance.

Statement and Justification of Learning Outcomes

By the end of the teaching process with Mr Neil, he will have a clear understanding of adaptive cognitive behaviours such as relaxation techniques and cognitive restructuring that will assist him in managing chronic pain. Behavioural patterns vary over time as a person develops, societal constructions change, personal beliefs evolve, and others expectations alter. Patients with chronic pain have been shown to benefit from relaxation strategies such as deep breathing and music therapy.

By the end of Mr Neils learning session, he will be able to define his emotions and differentiate between unhealthy and good feelings. Mr Neil is subjected to stress as a result of his inability to return to work after surgery since he has a family to support. It is critical that he be able to distinguish between positive and negative emotions after the learning session. Mr Neil must pay close attention to his body for warning signs of stress, such as increasing discomfort, anxiety, or difficulties keeping a healthy sleep pattern.

Evaluation and Feedback

Behavioural theory is crucial for assessing the patient outcome after the scheduled teaching session. In order to offer the continuous repetition required for efficient reinforcement of response patterns, behaviourist teaching approaches often depend on the repetition of specific activities. Other techniques include question and response frameworks with progressively more demanding questions, guided practice, and periodic content reviews (Dineen-Griffin et al., 2019). Additionally, behaviourist approaches often emphasize the need for positive incentives such as compliments, excellent grades, and awards. Behaviourists determine the extent of learning by observable behaviour measures such as test performance. Behaviourist teaching strategies have been most effective in areas with a proper answer or content that is readily remembered. While behaviourist approaches have been shown to be effective in teaching organized content such as facts and equations and scientific ideas, their usefulness in teaching understanding, composition, and analytical ability is debatable.

It is critical to assess Neils responses throughout the training session by questioning him questions on previously taught outcomes. A favourable answer demonstrates Neils capacity to adapt to new coping mechanisms. A questionnaire may be used since it enables the collection of a vast quantity of data from a minimal sample size. Summative evaluations may be performed to determine a patients competency (Dineen-Griffin et al., 2019). Following training and effort, patients might be assessed to determine their level of mastery of a skill. These evaluations may serve as a roadmap for future endeavours. Furthermore, formative evaluation may be used to examine Neils competency. These contribute to competency-based education by ensuring that health personnel understands patients requirements, allowing for real-time lesson modification and feedback.

Evaluation is the process of passing judgment about an individual or something with little or no purpose in altering any of its characteristics or actions. It is meant to be summative. On the other hand, feedback provides formative information to help learners improve their competence regardless of their present performance, and it is participative (Dineen-Griffin et al., 2019). It is critical to construct a survey focused on patient learning that prompts the patient to reply to the lesson planning in their own words. The patients response can help assist in improving future patient education.

Conclusion

CBT may be administered to Mr Neil in order to assist him in achieving complete recovery and functioning of his knees. CBT entails the client creating and practising new skills, one of which is to decrease maladaptive pain reactions. Mr Neils teaching and learning environment is a hospital setting. Hospital-based teaching is crucial since it increases the patients chances of receiving more treatment. CBT incorporates a number of treatments, including psychoeducation and relaxation therapy, to promote the development of more adaptive beliefs and behaviours. Thus, the goal of CBT is to increase Mr Neils awareness of his thoughts and actions and educate and practice novel ones for him to begin, maintain, or resume his usual physical and social activities.

Through self-assessment, Mr Neil may show suitable preparedness to acquire new coping strategies throughout the learning session. This requires keeping track of learning needs that emerge during a regular workday. It is vital to engage family and friends in delivering health care to lessen the chance of any complications occurring during patient learning. Family engagement in patient education enhances the possibility that patients will implement the advice. For teaching aids, excellent health education resources and evaluation questionnaires may support the medical team in establishing a patient-centred plan of care that is simple to implement and maintain.

Lesson Plan

Learning outcomes

On completion of this teaching session, Neil will be able to:

1. Demonstrate various skills necessary in managing chronic pain.
2. Describe his emotions and distinguish healthy from unhealthy feelings.
3. Demonstrate understanding of various signs of asthma attacks and effective use of inhalers.

References

Dineen-Griffin, S., Garcia-Cardenas, V., Williams, K., & Benrimoj, S. I. (2019). Helping patients help themselves: A systematic review of self-management support strategies in primary health care practice. PloS one, 14(8), e0220116. Web.

Lie, M. M., Risberg, M. A., Storheim, K., Engebretsen, L., & Øiestad, B. E. (2019). Whats the rate of knee osteoarthritis 10 years after anterior cruciate ligament injury? An updated systematic review. British Journal of Sports Medicine, 53(18), 1162-1167. Web.

Peters, W., Rice, S., Cohen, J., Murray, L., Schley, C., Alvarez-Jimenez, M., & Bendall, S. (2021). Trauma-focused cognitivebehavioral therapy (TF-CBT) for interpersonal trauma in transitional-aged youth. Psychological Trauma: Theory, Research, Practice, and Policy, 13(3), 313. Web.

Werner, R. M., Coe, N. B., Qi, M., & Konetzka, R. T. (2019). Patient outcomes after hospital discharge to home with home health care vs to a skilled nursing facility. JAMA Internal Medicine, 179(5), 617-623. Web.

Introduction

Gestalt therapy is a form of psychotherapy that maximizes a persons freedom, awareness, and self-direction. It is a form of therapy that focuses on the present moments rather than the events of the experience (Bowman, 2019). It is based on the idea that individuals are influenced by their current environment and work to achieve personal balance and growth. Moreover, it focuses on unconditional acceptance as this form enables individuals to get rid of distress by embracing what they feel and trusting people. Through Gestalt therapy, people can innovate new perspectives and bring positive changes into their lives. The paper focuses on group therapy on adolescents through the Gestalt form of therapy. My interest surfaced in graduate school due to the fact there more open than other groups. Hence, I propose using this methodology to prove effective in group therapy and adolescents.

Disorders That Can Be Treated Using Gestalt Therapy

Gestalt therapy is a practical therapeutic approach to treating and addressing mental health conditions, including anxiety. As gestalt therapy deals with present occurrences, it allows individuals to explore the factors that make them feel anxious. The second condition is behavioral health issues, such as drug use; gestalt therapy helps individuals view life differently and develop new lifestyles. The third condition is depression, whereby as gestalt therapy focuses on self-awareness, it can help individuals discover their stressful situations. Moreover, gestalt therapy can enable couples to recognize destructive behaviors that could have adverse effects. Lastly, gestalt therapy also deals with self-esteem issues; individuals can find factors that contribute to their low self-confidence.

Gestalt Therapy Techniques

There are various therapy modes involving a series of exercises and experiments. Therapy can take place in a group or individual setting. However, in our case were to focus on a group therapy setting. Activities and experiments enable people to increase their awareness and understanding of now and here (Bowman, 2019). Different techniques work for other people since each person has distinct past occurrences. In this specific case of group therapy in adolescents, we will use the here-and-now technique. This kind of technique is where an individual opens up about how they feel at that particular moment. This specific model aims to forget past experiences and focus on the present issues. The model is most applicable to adolescents as it presents behavioral issues. The platform creates an environment where adolescents can express themselves, building the healing process.

Background on the Formation of the Group Therapy

When group formation started, it was composed of adult groups, and at times it dealt with childrens therapies. The storytelling in these particular two groups was boring to the author; hence rethought the idea and decided to focus on the here-and-now interactive group that concentrated mainly on adolescents. The influence of using this particular model was to reverse the individuals norm. The group structuration was that each member was required to abide by the rule that attention was directed to the groups issues. There was no discussion of family, job, or health issues in the platform, only if they were concerned with the group experiences. The group therapy had 16 members, as many individuals preferred to be in an interactive session.

Initial Stage

An interactive group can be quite demanding and intense; hence, it requires extra keenness when selecting members. The caution is to avoid having two or more volatile members in the same group; otherwise, having violent participants can lead to fighting and unnecessary drama. A group can only handle one, such as with time; the person will adapt to the other participants behavior as they do not have individuals to challenge. The essence of ensuring this is that if conflicts occur in the group that may be abusive, they may lead to some members quitting. It is also essential to avoid having more than half of the groups have passive members, as the group should be interactive and not monotonous interactive. The preferred group size in this study is a two-hour group composed of eight members, and it involves both genders. The formation of this particular group allows opportunities for crucial issues to evolve and enhance fixed patterns for members to attend the session.

Before initially forming the group, most members were practicing individual therapy; hence when a potential member is identified, preparations are made to refer the individual to the group. When the client responds effectively to the recommendation to join the group, the individual is given a handout describing the group and its benefits (Cole & Reese, 2017). Once the person reads the rules and decides to join the group, the individual must sign a contract. The group is founded on four ground rules: the individuals are only expected to focus on issues that pertain to the group. The rationale for using this model is that individuals will become aware of self-interruption and other hindrances to good living. The second ground rule is that group members are neither encouraged nor discouraged from contacting outside the group. The third rule states that members of the group are responsible for keeping matters related to other members of the group. They have legitimate rights to discuss their issues with outsiders but no other members. The fourth rule is that a member should state if there to miss a session, and lastly, no physical violence is apprehended in the group.

Transition Stage

The transition stage is one of the most challenging stages to get through. The scene comes after the initial step of selecting and preparations of members to join the group. This stage is quite tricky for members are yet to know neither nor understand each hence they all fear talking about their issues. Some members are fearful and shy, while others become defensive as they feel it is too much to share their problems in a group. Thus, as a group leader, one is expected to gain the members trust to trust other individuals. The leader should open an open view and platform to ease the tension and anxiety of being around one individual. A platform should be laid where the counselor outlines similar ties between all the members issues.

Working Stage

The working stage occurs after the members talk about their issues after the transition stage. Several approaches can be applied in this stage, such as gossiping. Clients know minimal information about other members; hence, the participants can talk about anything in the first ten minutes (Greenberg, 2019). The schmoozing can be caught up hastily; therefore, it is difficult to shift from chatting to working. After ten minutes of speaking, the group members are asked to close their eyes and meditate on their lives, and it is for the members to decide what task is to be carried out in the session. Before the session ends, the counselor asks the members to fill in logs where they expound on what they have learned in this particular and how far the progress is.

The leader is expected to comment on their records and provide feedback in the next session. The counselor can also give out handouts to the members to move along during the session. Stillstand as they are not allowed to talk of the past or the future even when the counselor gives examples of the works that have fared okay rule of members still paying attention to the particular session, the events in this session are brief. In contrast, others take time to conclude. Moreover, the counselor emphasizes the importance of practicing skills they have acquired during the session as they can only outgrow through examination.

Termination Stage

The stage involves the counselor dispersing the group after the sessions are done, and individuals are to continue enrolling in their everyday lives. At this stage, the members are used to each other, making it problematic. Moreover, they have adapted to speak of their issues; therefore, they fear leaving as they are unsure how to explain their problems. Hence it is the role of the counselor to assure them that everything will be set to normal and the session they participated in has grown them.

Conclusion

In conclusion, the work described above is not easy as one has to keep members on the course. The temptation to tell narratives about other experiences is powerful for many. Usually, three to four members of the group succumb to it. Even when everyone else is faithful to the law, violation of it can get the group off track. Hence it becomes difficult for the counselor to bring people back on track. Although the work can be intense, the rewards are plentiful in the end.

References

Bowman, C. (2019). New directions in gestalt group therapy: Relational ground, authentic self. Gestalt Review, 23(2), 187-190. Web.

Cole, P., & Reese, D. (2017). An introduction to contemporary Gestalt therapy for group therapists. Group, 41(2), 95. Web.

Greenberg, E. (2019). Group therapy with borderline, narcissistic, and schizoid adaptations. Gestalt Review, 23(2), 129-150. Web.

Introduction

When individuals lose someone close to them, either spouse, friend, or family member, they tend to experience grief. When facing a loss, people manage this traumatic experience in different ways. Some enter into depression, especially children who have not experienced such events. There are two approaches that a therapist can use to help a patient, for example, group or individual sessions. The former is categorized into an open or closed group whereby individuals can be allowed to join the program after it has progressed or are denied permission to do that.

It is important to note that group therapy is appropriate for the selected group of patients in this case. It allows one person to learn from others which can ensure that the healing process is fast. Additionally, the chosen collection of individuals consists of children as well. This means that the adults can offer more support to them and help them cope better since the experiences might be novel to them. The major challenge presented by the use of this technique is the issue of confidentiality. Even though a psychologist is legally and ethically bound to not share information about the clients with a third party, the group members are not. This paper looks at cognitive-behavioral group therapy for bereaved patients.

Needs of the Clients

The cognitive-behavioral group therapy in this discussion is offered to bereaved patients. These are individuals who are in deep sorrow at a loss of a close relative or friend. The number of clients is ten as the group consists of five children and five adults. They can be reassured that their feelings, emotions as well as pain are normal and that all experience loss and grief differently (Berardelli et al., 2018). This group of clients shows various behaviors and emotions, and it can be comforting to them to be guaranteed that the intensity of their sentiments will diminish over time. Some of their needs include a balance between privacy and companionship.

Bereaved patients need a chance to express their grief without feeling embarrassed. Comfortable surroundings are required where the patient can speak about their emotions. Thirdly, they need acknowledgment of the various symptoms that may happen due to intense grieving. These indicators usually resemble physical alterations that happen after or during a severe condition and may consist of loss of appetite, sleep, motivation, and strength and behavioral inconsistencies (Berardelli et al., 2018). The fourth need is support or assistance in becoming socially reactivated. Someone who is dependable and trustworthy has to be close to assist them in social circumstances. Additionally, the active listener would be beneficial in terms of healing since the clients need a chance to re-narrate their encounters.

As hard as grief counseling can be, the level of difficulty increases when handling children and their family members. Special care has to be given when doing this to aid them in grieving in a healthy way. However, there are tips on how to conduct this procedure and make it easier. For instance, answering any question asked by a patient, even the tough ones concerning the issue of death. A therapist ought to offer them honest answers that are proper for both their development and age. It is preferred to use terms such as killed or died rather than passed away or lost.

The other tip is to provide children with choices when possible. They should be allowed to decide how they wish to say goodbye to the individual, permit them to join in the funeral arrangements and the service, as well encouraged to work through grief. Thirdly, the professional needs to speak about and recall the deceased (Butler et al., 2018). This helps them to view grief as a normal part of life and empowers them to focus on good recollections they had with the dead. Someone in the profession of counseling ought to show respect to the variances in grieving styles. A child within the same family may have dissimilar coping methods. It is best or appropriate to allow them to work through it. Lastly, listening without judging them would ensure they heal faster from the situation. The key is to avoid communicating how they need to behave or feel.

Type of Group

Many individuals find it great to be part of both group and personal therapy. Doing this boosts the chances of making valuable and lasting changes for someone. In the event that a person who has been engaging in individual psychotherapy and is not experiencing any progress, joining others may lead to a level of growth. There are two types of groups, including open and closed, and, in this case, whereby there are bereaved patients, the chosen approach is the latter (Ardehali et al., 2020). In this one, every member starts the process toward recovery simultaneously (Ardehali et al., 2020). For instance, they may participate in a twelve-week session together. The format offers varying types of surroundings allowing deeper therapeutic work to happen in contrast to conventional bereavement support groups. It is client-led as well as cost-effective and can be replicated. It is easy to adapt to fit other services needs.

A closed group is the most usual type whereby psychoeducational programs are implemented and have been proven to possess particular benefits for implementation. They offer an organized scheme with a set amount of time and sessions, enabling patients to have one experience from start to finish (Do et al., 2021). Such encounter has been discovered to give secure and consistent surroundings for individuals to associate with and feel the support from others. They as well are thought to provide the clients with a greater sense of safety as a result of the stability of the social environment of the group.

The approach allows facilitators to build upon prior weeks and establish trust with members without the disturbance of one entering or leaving on a constant basis. The only disadvantage of this format is being unable to instantly address community needs for intervention and probable retention matters that threaten the process (Do et al., 2021). Accountability is one of the benefits of a closed group intervention. Participants are empowered to share setbacks and successes, and they provide support as well as encouragement.

The closed group format allows an individual to be a part of something greater. While trying to help the bereaved, the person who engages in an intervention can feel as if they are associated with a mission bigger than them (Do et al., 2021). It makes it easy for one client to learn from another since they hear and are able to understand what others underwent in their life. They look objectively at the faults and successes of people within the program.

There are professionals who claim that for bereaved patients, it is important for a therapist to consider advising them to embrace the open group format. This approach is whereby a new member can join regardless of how far the program has reached, and there will be a period of adjustment while familiarizing oneself with the other participants. However, there is a section of researchers who argue that it is not the right path to follow (Do et al., 2021). For instance, it can be a source of instability and unpredictability, lacks intimacy and depth, and it is difficult to balance the instant needs of members.

Inclusion Criteria

To be included in the group therapy aimed at enabling the ten patients to heal, there are certain conditions that someone had to achieve. For instance, the selected individuals were supposed to be between the age of 10 years old and thirty-five years old. Additionally, they had to have a loved one who had recently died. For example, a spouse, child, brother, sister, parent, relative, or friend (Wolgensinger, 2022). Exceptions were made for those who claimed to have lost colleagues at work with whom they had bonded prior to demise. Above all, one was required to have shown symptoms such as loss of appetite, sleep, motivation, and strength, and behavioral inconsistencies mentioned earlier.

For the intensive outpatient program, it would be a single 3-hour session from 9 to 12 noon, Monday through Friday, for five weeks. Regarding the transition part, a two-hour session would be required, between 9 and 11 am, twice weekly for twelve weeks (Wolgensinger, 2022). In the weekly recovery initiative, one would need a 2-hour session, from 9 to 11 am, once every week for 12 weeks. Lastly, for monthly recovery intervention, it would be once a month from 6 to 8 pm for five months.

Confidentiality Issues/Contracts

As the group approach in treatment is gaining popularity, awareness of some ethical dilemmas usually seem to be a risk factor in this format than in individual therapy. Confidentiality refers to an issue that warrants much-needed attention in groups (Ewuoso, 2021). Even though a therapist is ethically and legally bound, no rules exist for a member engaging in therapeutic dialogue (Naidu, 2018). To dispel the fear around the matter, it is assumed that promoting cohesion and trust amongst participants will put them at ease.

Principles of ethics that psychologists adhere to have a responsibility to respect a piece of informations confidentiality. This notion is based on someones right to privacy, whereby it allows a client to establish the level to which data about them and their condition are shared and how that is accomplished. Someone being able to communicate such intimate insight about themselves, they expect that the professional will ensure it remains confidential and used to assure progress in treatment (Ewuoso, 2021). Organizations put in place limits to this to guarantee that the public is secure. Therefore, a person ought to learn about the restrictions before committing to a program.

Even though there are limitations on the data that can be legally and ethically maintained between a clinician and a client, the latter is encouraged to not fear communicating how they feel with a therapist. Generally, unless the professional is mandated by law or given permission by the patient, they cannot disclose any knowledge of the situation learned during any of the sessions. When third parties are available during treatment, they are not held to similar legal and ethical standards. Hence, the capacity to put one at ease regarding ensuring confidentiality presents a bigger problem than in individual treatment.

Although it is assumed that anything shared between a therapist and his or her client should remain confidential, doubts emerge when the patients undergo the process within a group. Complications arise when self-disclosures are heard by multiple participants instead of only the clinician. In the event the members become dependent on one another and are able to form connections, it is impossible to guarantee that the obtained information will remain undisclosed to outer parties. When it is emphasized that people need to convey their experiences, emotions, or feelings, it usually exerts pressure on participants. On the one hand, they are greatly encouraged to share with others in the group. This does not mean that they are sure as to if the listeners will keep the data to themselves. In the early phases of group work, seeming forced to do that can result in a lack of trust. To correct this, it is essential to comprehend the issue of confidentiality, know the restriction, and respect shared information.

Many facilities ensure that members participating in group therapy know and understand the importance of confidentiality in such settings and will dismiss anyone who tries to go against the guideline. Nevertheless, enforcement has been discovered to be hard, as suggested by Ewuoso (2021). The research found that individuals who underwent mental distress due to breaches of this policy felt that the leaders failed to strongly hold accountable those in violation. There exists an uncoded rule that anything discussed in a therapeutic environment will remain confidential and that those in charge will address the matter before the treatment begins.

Nonetheless, participants are not held to similar legal and ethical standards as the therapists. There are possible implications for a clinician who breaches confidentiality when unwarranted. There is no common statute upholding the rights of privacy when another person apart from the client and professional is available even when they are actively engaged in the process. Whereas a psychologist usually reminds the members of the group regularly of the significance of maintaining confidentiality, they are not legally or ethically bound to such conduct. It is viewed often with respect to following that route, as suggested by Koocher (2020). It is necessary when involved in group therapy to have a clear sense of the meaning of discretion and the need to respect disclosures. Having a group leader or psychologist define privacy and explain its implications is proper and necessary but is often enough to guarantee that people assume confidentiality in a group function can be a norm. To address the matter, it has been suggested that members engage in a debate concerning the topic, review the contracts, or use examples to illustrate intentional or unintentional violations.

Cognitive-Behavioral Group Therapy Approach

Cognitive-behavioral group therapy is an approach in counseling whereby behavioral, relational, cognitive, as well as group processes are used to improve the coping capabilities of the clients. It has been concluded by most systematic reviews that this method is effective in helping individuals in situations that may lead to depression. For example, in this case, there are bereaved patients who, if not assisted, might become depressed. The aim or objective of applying this technique is to prevent the negative effects of depression. In many areas, it is recommended that a clinician opts to apply it first.

Delivering the method for depression in the format used in this case is cost-effective as compared to individual treatment. Group therapy sessions may offer more benefits as clients may profit from cohesion as well as normalization impacts. They may as well utilize the group as a platform to engage in behavioral trials, learn from other people, and work as co-psychologists. Some clients do not accept or approve of this type of approach as there is less time dedicated to the healing of one person. There have emerged concerns on whether it is possible to generalize the discoveries from studies.

Using this context, it is easier to differentiate between the effectiveness and efficacy of a treatment method. The latter means the outcome attained in experiments, while the former refers to the results in regular practice. The main objective of the research is to establish an association between a particular technique and results. The participant is usually chosen patient and is treated by a qualified therapist who strictly follows manuals for therapy, receives routine overseeing, and whose adherence is closely supervised. Consistent practice can be characterized by unselected clients, flexible utilization of treatment protocols, and high therapist caseloads. It has been recommended that as a result of harsh exclusion standards, those participating in clinical experiments are not a depiction of people seen in practice which compromises the generalizability of randomized controlled trials. Recent research shows only minor variations in the characteristics between those in RCTs and others in clinical practice, which may be representative of more liberal inclusion criteria in more current RCTs (Ewuoso, 2021). Ethically, it is not feasible to randomize individuals to either active or non-active control conditions.

Multiple researchers have attempted to explore the effectiveness of cognitive-behavioral group therapy for adult depression in regular practice. To define a studys clinical representatives, Morrison et al. (2019) recommended some standards, including non-university surroundings and referred patients. Others include psychologists with routine caseloads, flexible structure, no training of a therapist for study purposes, or monitoring of the implementation of treatment. In the studies, there were one thousand, eight hundred and eighty patients included in the evaluations. It was found that an average effect magnitude of 1.13 for treatment completers as well as 1.06 for intent-to-treat examination in decreasing depression seriousness (Lazarov et al., 2018). Understanding all this information about the selected approach, it is important to develop sessions or stages a patient will undergo.

There will be five stages as shown below:

• Stage 1

  • Session 1  opening;

    • introduction of aims;
    • clients introduce themselves;
    • forming (i.e., participants look up to the group leader to offer them direction).
• Stage 2

  • Session 2  developing a connection between the therapist and clients;

    • storming (i.e., conflict and competition in the relationship between therapist and members begin to develop).
• Stage 3 is defined by cohesion, as suggested by Lazarov et al. (2018).

  • Session 3  the therapist utilizes conflict management strategies to work with the client;

    • interventions are implemented to establish connections among participants and between them and the therapist;
    • norming (i.e., individuals reach a consensus concerning respect and dynamics and embrace the uniqueness of every one of them).
• Stage 4

  • Session 4  implementing cognitive-behavioral therapy;

    • clients make individual contributions to group activities;
    • useful examples (one person said&) are introduced to foster communication.
  • Session 5  collecting feedback from the clients;

    • addressing the issues;
    • providing the clients with comments on how they should address their challenges.
• Stage 5

  • Session 6  adjourning;

    • making conclusions;
    • commenting on whether the aims have been achieved;
    • disengaging from the group.

Conclusion

The paper has looked at cognitive-behavioral group therapy for bereaved patients. The needs of such a group have been explained, for instance, a chance to express their grief without experiencing embarrassment. Most of the time, after an individual loses a loved one, they may feel as if no one is trying to understand them. The pain and the manner in which they may grieve might appear different to another who deals with similar encounters in a varying way. In therapy, the professional attempt to be a great listener and non-judgmental to ensure that the client is willing to express themselves without fear. This is important, particularly for children who do not understand how to behave or how to feel but show signs of grief.

The paper has introduced the concept of group therapy, whereby individuals experiencing similar issues undergo treatment together. In such settings, they can opt for either an open or closed group whereby a new person is allowed or not permitted to join after the method has progressed. In the case of bereaved patients, the latter is better since adding another client not present at the start might lead to distrust or discomfort in the current participants.

Lastly, it is important to note that cognitive-behavioral group therapy refers to an approach in psychotherapy whereby behavioral, relational as well as cognitive processes are used to better the coping capability of a client. Through systematic reviews, experts have concluded that it is effective in assisting people in circumstances that may result in depression. For instance, in the case of bereaved patients, if treatment is not provided early, the symptoms might persist and lead to more severe mental conditions.

References

Ardehali, S. H., Fatemi, A., Rezaei, S. F., Forouzanfar, M. M., & Zolghadr, Z. (2020). The effects of open and closed suction methods on occurrence of ventilator-associated pneumonia; A comparative study. Archives of Academic Emergency Medicine, 8(1). Web.

Berardelli, I., Bloise, M. C., Bologna, M., Conte, A., Pompili, M., Lamis, D. A.,& & Fabbrini, G. (2018). Cognitive-behavioral group therapy versus psychoeducational intervention in Parkinsons disease. Neuropsychiatric Disease and Treatment, 14, 399. Web.

Butler, R. M., Boden, M. T., Olino, T. M., Morrison, A. S., Goldin, P. R., Gross, J. J., & Heimberg, R. G. (2018). Emotional clarity and attention to emotions in cognitive-behavioral group therapy and mindfulness-based stress reduction for social anxiety disorder. Journal of Anxiety Disorders, 55, 31-38. Web.

Do, A., McGlumphy, E., Shukla, A., Dangda, S., Schuman, J. S., Boland, M. V.,& & Craven, E. R. (2021). Comparison of clinical outcomes with open versus closed conjunctiva implantation of the XEN45 Gel Stent. Ophthalmology Glaucoma, 4(4), 343-349. Web.

Ewuoso, C. (2021). Patient confidentiality, the duty to protect, and psychotherapeutic care: Perspectives from the philosophy of ubuntu. Theoretical Medicine and Bioethics, 42(1), 41-59. Web.

Koocher, G. P. (2020). Privacy, confidentiality, and privilege of health records and psychotherapy notes in custody cases. American Journal of Family Law, 41-50. Web.

Lazarov, A., Marom, S., Yahalom, N., Pine, D. S., Hermesh, H., & Bar-Haim, Y. (2018). Attention bias modification augments cognitive-behavioral group therapy for a social anxiety disorder: A randomized controlled trial. Psychological Medicine, 48(13), 2177-2185.

Morrison, A. S., Mateen, M. A., Brozovich, F. A., Zaki, J., Goldin, P. R., Heimberg, R. G., & Gross, J. J. (2019). Changes in empathy mediate the effects of cognitive-behavioral group therapy but not mindfulness-based stress reduction for social anxiety disorder. Behavior Therapy, 50(6), 1098-1111.

Naidu, T. (2018). To Be or Not to Be&Revealing questions of anonymity and confidentiality. The Palgrave Handbook of Ethics in Critical Research, 241256.

Wolgensinger, L. (2022). Cognitive-behavioral group therapy for anxiety: Recent developments. Dialogues in Clinical Neuroscience, 17(3), 347-351.

Current cognitivebehavioral therapy is a general concept for scientifically validated treatment for well-diagnosed psychopathologies with particular therapeutic approaches. According to David et al. (2018), CBT is the most investigated kind of psychotherapy, and no other type of cognitive therapy can be deemed substantially stronger than CBT. Cognitive behavioral therapy has several advantages that might significantly influence a patients well-being.

CBT, for instance, can be as successful as medicine in treating various psychological disorders and beneficial when medication alone has failed. Furthermore, as opposed to other treatments, CBT may be finished in a short amount of time. This approach concentrates on re-training patients thinking and changing their behaviors in order to improve their mood (David et al., 2018). As a result, the techniques a patient develops during sessions become valuable, practical, and beneficial tactics that can be adopted into daily life to support them and help them learn to deal with future pressures and challenges, even after therapy is over.

Nonetheless, there are several weaknesses of CBT that may prevent this approach from being effective. In order to benefit from the therapy, for example, a patient must commit to the procedure. In this respect, a psychotherapist can assist and support the patient but cannot help the patient without their involvement. Moreover, there is a need to establish a therapeutic alliance before implementing CBT (David et al., 2018). Otherwise, this therapy might not yield any results and be beneficial. Another shortcoming of CBT is that cognitivebehavioral therapy may not be effective for those with more severe mental health conditions or learning disabilities because of its organized character.

Culturally-Adapted CognitiveBehavioral Therapy

All cultures have their own views and beliefs on dealing with unpleasant emotions and negative experiences, which can vary from ethnopsychology expressed in proverbs to organized religious practices and rituals. These concepts might be used to help teach cognitivebehavioral therapy concepts and contribute to CBT cultural adaption. For example, Cambodian Buddhism frequently equates aggression and other destructive emotions to fire (Hinton, 2017). This metaphor can be used in therapies to help patients draw a parallel between their feelings and cultural idiosyncrasies.

Another noteworthy fact is that many traditional therapies incorporate some form of a cooling system, such as anointing a person with cold water. In this situation, a therapist can tell the patient that feeling aggressive or angry reminds them of a case when someone brings fire into their house (Hinton, 2017). Moreover, a person can find an analogy that, when frustrated, there are often two fires. One fire is caused by what the person did, such as a child misbehaving, which can later be added to the fire of similar incidents, such as the childs father mistreating them (Hinton, 2017). Therefore, CBT approaches should be tailored to these populations to improve therapy tolerance, commitment, and general effectiveness.

Additionally, in order to increase acceptance, trauma memory processing might have to be combined with emotion management. As a result, visualization might have to be altered to contribute to the therapys efficacy. For instance, it is more effective in CBT therapy to utilize imagery that develops cognitive flexibility and to do so with specific Asian groups by combining the idea of a wind-moved lotus with physical flexibility (Hinton, 2017). For example, in Latino communities, meditation imagery with an allocentric (the belief that one identifies oneself via social interactions) orientation is more successful than individualistic (the concept that one defines oneself by personal qualities) orientation.

References

David, D., Cristea, I., & Hofmann, S. G. (2018). Why cognitive behavioral therapy is the current gold standard of psychotherapy. Frontiers in Psychiatry, 9(4), 1-3.

Hinton, D. E., & Patel, A. (2017). Cultural adaptations of cognitive behavioral therapy. Psychiatric Clinics, 40(4), 701-714.

Both SFT and NT are postmodernist approaches to therapy, which means that their techniques are built on the idea that reality is relative and peoples experiences are influenced by everything around them. Therefore, the role of the therapist is in assisting the client and helping them understand more about themselves and their views on the world, as opposed to being an expert with all the answers. SFT is rooted in the idea that a therapist can help the client see the gaps in their goal setting and achievement practices to enhance their wellbeing. The notion of NT was developed by Michael White and David Epston and is based on the story metaphor (Metcalf, 2018). This paper will discuss the two differences between NT and SFT, the pragmatism, and mental health issues that each approach can address.

The goals of the two therapies are different, as SFT uses a more pragmatic approach and emphasis finding a solution to pressing issues immediately. SFTs tools are helpful for people from pragmatic cultures because this therapy is focused on finding solutions over the curse of quick sessions (Metcalf, 2018). Through these sessions, the client can better understand the gap between their goal and the current citation and set objectives that will help them achieve this goal. However, unlike the NT, the SFT approach is focused on the immediate problems and is not suitable for the exploration of deep personality issues (Metcalf, 2018). Hence, the briefness of the SFT makes it useless when applying for the treatment of deep-rooted issues, such as substance abuse and personality disorders. Moreover, the pragmatic of SFT also results in the fact that with this approach, the client is in charge of the therapy process, and they are the ones finding solutions to their immediate concerns. With the NT, the therapist asks the client questions to understand their construct of reality and the stories they develop around their lives. Hence, there is no need to set immediate goals with the NT and find solutions at each of the sessions.

As opposed to the pragmatic approach that is the basis of SFT, NT is focused on allowing the client to build their own narratives that are rich and meaningful. Hence, the main difference between NT and SFT is their orientation on the pragmatic and non-pragmatic objectives. With NT, the client can create rich and meaningful stories, which will help them address some of the deep-rooted issues and concerns, while SFT is helpful for addressing immediate problems that a client is struggling with. Therefore, this method can be helpful when working not only with some immediate problems but also with deep-rooted mental health issues and concerns.

Although SFT and NT are drastically different, these approaches offer a unique set of benefits for the client. Metcalf (2018) describes a combination of SFT and NT that allows the client to take responsibility for telling their own story and, therefore, empowers them to find solutions to the pressing issues. This shows that the differences between these therapies discussed above, in fact, can be very helpful when combining SFT and NT and can allow the therapist to help the client reach better results. In summary, the main differences between SFT and NT are the pragmatic orientation and mental health issues that can be addressed by each of these therapies.

Reference

Metcalf, L. (2018). Marriage and family therapy (2nd ed.). Springer Publishing Compan.

The question of whether clinical reasoning expertise should be perceived as a skill, or a state is a complex issue that has reverberations on medical expert education. The phenomenon of context specificity (CS) and the situativity theory (ST) represent theoretical perspectives that oppose the viewpoint of professional expertise as a transferable and static trait, and both find reflections in the physical therapy field. Physical therapy practice involves active collaboration with the patient, and the clients preferences for the use of imaging or treatment options that minimize unwanted physical contact with the provider exemplify the fields connection to CS/ST.

One example of CS and ST in physical therapy is that patients perspectives of diagnostic procedures might interfere with physical therapists knowledge. There are interpersonal differences in learning styles and abilities; sometimes, patients misconceptions might cause the ordering of additional tests or necessitate additional patient education that delays decision-making and treatment plan realization (Grasha, 1995). CS has emerged from Elsteins theoretical discussions and means that factors influencing diagnostic and therapeutic processes extend beyond the clinical content of a case, and ST further anatomizes it (Rencic et al., 2016, p. 215). For instance, patients with low back pain may take time to request unnecessary imaging tests, assuming that their physical therapist cannot recommend effective treatments without scans (Hoffmann et al., 2022). Such suggestions hinder the physical therapists ability to prioritize guideline knowledge, such as the absence of imaging as a routine diagnostic recommendation for low back pain (Crowell et al., 2022; Hoffmann et al., 2022). Instead of relying on their knowledge, professionals might have to dedicate time to client education or investigate the clinical case further to assess such requests or argue that imaging will bring no benefit.

Physical therapy patients inability to proceed with some treatments for psychological reasons also illustrates the connection between CS/ST and physical therapy. Specifically, as recent qualitative research suggests, female patients might give preference to exercise-based treatments rather than manual therapy due to the fear of getting naked (Bastemeijer et al., 2021). The situativity theory (ST) seeks to explain CS and argues that direct clinician-related factors, such as knowledge, do not solely predict clinical reasoning outcomes (Rencic et al., 2016). The distributed cognition concept within the ST theory emphasizes that interactions between the physician and other professionals, environments, and patients interfere with the clinicians own expertise (Rencic et al., 2016). The aforementioned example illustrates both concepts; physical therapists knowledge regarding manual treatments being more effective in relieving certain symptoms encounters barriers in the form of the clients preferences. In certain cases, manual therapy could be a better choice, such as pain that is strong enough and needs to be reduced quickly. Due to psychological constraints, patients might still prefer exercise-based treatments, so clients preferences become another factor besides the clinicians knowledge to affect the chances of positive outcomes.

To sum up, as a discipline, physical therapy involves some manifestations of the CS concept and the ST theory when it comes to patients participation in decision-making. Physical therapy clients frequent desire to undergo imaging procedures prior to receiving treatment for lumbago exemplifies how patients knowledge levels interact with the clinicians expertise in decision-making processes. In a similar manner, some patients preference for therapies that account for their psychological barriers to physical interaction with treatment providers is indicative of the interplay of factors in treatment decisions.

References

Bastemeijer, C. M., Van Ewijk, J. P., Hazelzet, J. A., & Voogt, L. P. (2021). Patient values in physiotherapy practice, a qualitative study. Physiotherapy Research International, 26(1), 1-10. Web.

Crowell, M. S., Mason, J. S., & McGinniss, J. H. (2022). Musculoskeletal imaging for low back pain in direct access physical therapy compared to primary care: An observational study. International Journal of Sports Physical Therapy, 17(2), 237-246. Web.

Grasha, A. F. (1995). Teaching with style: The integration of teaching and learning styles in the classroom. Essays on Teaching Excellence: Toward the Best in the Academy, 7(5), 1-6. Web.

Hoffmann, T., Bakhit, M., & Michaleff, Z. (2022). Shared decision making and physical therapy: What, when, how, and why? Brazilian Journal of Physical Therapy, 26(1), 1-10. Web.

Rencic, J., Durning, S. J., Holmboe, E., & Gruppen, L. D. (2016). Understanding the assessment of clinical reasoning. In P.F. Wimmers & M. Mentkowski (Eds.), Assessing competence in professional performance across disciplines and professions: Innovation and change in professional education (pp. 209-235). Springer.