Psychosocial interventions are considered actions or therapies used to assist an individual in healthfully reintegrating into society when there is some disassociation with society due to emotional or psychological disruption or interference with homeostasis (McGovern et al. 2021). Individuals with psychological disorders including post-traumatic stress disorders (PTSD), depression, anxiety, and chronic stress often experience this condition when they require nurse-led therapeutic intervention or more specifically psychosocial intervention that specifically targets psychosocial determinants of health including social association, communication, fear, love, hostility, depression, job control, hopelessness and stress (Nosè et al., 2017). The study of Lyon & Koerner, (2016), suggests that different types of psychosocial interventions are driven or led by nurses in a mental healthcare setting to ensure wellbeing. For example, psychosocial interventions are classified into cognitive intervention, behavioral, systemic, humanistic, disease, and social and environmental intervention. Considering the availability of different psychosocial interventions, understanding patients’ requirements is considered essential to choosing the best-fit intervention. In the subsequent section of this study, a case study of a patient named Mr. X will be discussed.

REFLECTIVE ESSAY of Leo

Mr. X is a 46 years old Caucasian Chief Petty Officer. He lived with his wife Mrs. Y in the Secret Harbour. Mrs. Y comes from an Aboriginal background. Both Mr. Y and Mrs. X love making adventures, and short trips to rural villages and unknown places, and Mr. X has a hobby for taking photographs. Mr. X and Mrs. Y do not have any children and after having miscarriages two times at 15 and 22 weeks, Mr. X and Mrs. Y decided to not have any children. However, due to this reason, Mr. X blamed himself most of the time, as he could not be present at that time due to his deployment. Before two months, Mr. X returned from a deployment in South Asia. On their very last night before returning home, Mr. X and his team went out to enjoy a drink. Mr. X left before his other team members and went back to the ship. On his way back, he was attacked by a group of hooligans. Mr. X tried to manage this at that time however, he failed eventually and sustained fractures to the ribs, mandible, and head. Following this event, he was stabbed in the lower abdomen and went through a surgical event. Though no major organs were damaged at that time, however, the patient was found to have hepatic or liver cancer and this news was distressing for both Mr. X and Mrs. Y. Since that time Mr. X has started experiencing symptoms of post-traumatic stress disorder. His current symptoms are social withdrawal, sleeping disturbances, and poor communication with friends, colleagues, and peers. He was also found to be aggressive sometimes when his wife asked him about the said event. He has also increased his daily alcohol consumption and cigarette smoking which also hurt his physiological wellbeing. With complaints of chest pain and breathing trouble, Mr. X was presented to the emergency department three days before where he was diagnosed with PTSD and depression.

Emerging Technologies and Innovation Sample 1

A psychotherapy intervention has been chosen as the best fit psychosocial intervention for the chosen patient considering his psychological and emotional health status (Locher et al. 2019). Trauma-focused psychotherapy is considered appropriate for PTSD as well as depression. However, before, administering the said intervention, it seems very essential to develop an appropriate therapeutic relationship with the patient to aid the delivery of psychotherapy considering its principles (Watkins et al., 2018). Developing a therapeutic relationship within the mental health care unit depends on multiple factors including the client’s cultural background, ethnicity factor, current mental state, self-respect, dignity, and ego. Therefore, in the process of communication or interview sessions, it is considered very essential to provide opportunity and space for the client to open up without any doubt or confusion. Therefore, the processes, that were followed during that time include the utilization of both verbal and non-verbal communication methods according to the study of Del Giacco et al. (2020), during the therapeutic relationship-building process, the use of verbal and non-verbal language helps in developing trust in patients. Movement of hands, gestures, and eye contact was followed at the time of communication with the patient. Apart from that, while the patient was discussing his current problems, he was encouraged with some short phrases such as ‘hmm’, ‘yes’, ‘I understand’, and ‘Please continue. Active listening was another key that allowed the patient to feel comfortable to proceed more with his real-life experiences and troubles in terms of communicating with friends and colleagues (De Stefani & De Marco, 2019). Empathy was maintained throughout the conversation and it is also considered an important determinant of a professional therapeutic relationship (Tement et al., 2021). The body language cues of the patient were noticed during the conversation and the tone of voice was modified according to the alteration in the mood of the patient. Another essential determinant of therapeutic relationship development is emotional intelligence (Raghubir, 2018). During the communication process, emotional intelligence was used to ensure the comfort of the patient. In the subsequent section of this study, the process or strategy that was followed to implement the chosen intervention, psychotherapy will be discussed.

REGRESSION ANALYSIS

Psychotherapy is considered a talking therapeutic approach that helps participants or individuals who are suffering from a wide range of mental health illnesses including PTSD to manage their problems by altering the way they think and behave (Kredlow et al., 2018). In this specific aspect, during the process of the preliminary interview session, it was found that Mr. X has poor self-esteem and confidence that are significantly interfering with the process of communication, engagement, and socialization. Mr. X was also found to have excessive stress, worry, and consistent fear as he has been diagnosed with a life-threatening illness. However, the main objective of the psychotherapy was to focus on the strength-based approach to redirect the thinking patterns of the patient. In the subsequent section of this study, the implementation strategy will be discussed in this particular aspect. Five steps that were followed in the said context were initial disclosure or relationship building with the patient, in-depth exploration or problem assessment, commitment to action or goal setting, counseling intervention based on a strength-based approach, evaluation, termination, or referral. The health belief model was followed to break the current habits of the patient and to provide education regarding good practices to incline them into a regular habit (Jones et al., 2015). Considering the principle of the model, the modifying variables were identified including perceived susceptibility and perceived seriousness of the patient, and a decision was taken based on that. An open discussion was made regarding the risk factors and protective factors that were identified for the patient. For example, the risk factors that were identified during the time of the interview were cigarette smoking and alcohol consumption and on the other hand, the protective factors that were identified for the patient at that time were creative activities such as photography and a passion for traveling and exploring. Therefore, the main objective of the said therapy in the said context was to change his dependence on alcohol consumption and cigarette smoking to photography and traveling. To change the inclination of the patient, some motivational talk therapies were arranged where he was provided with education on the importance of photography, traveling, and staying adhered to other creative activities. One defense mechanism to cope with the stress that was followed at that time is considered sublimation (Vaillant, 2011). According to the principle of sublimation, it is considered a mature type of defense strategy, in which socially unacceptable idealizations or impulses are directly transformed into socially acceptable behavior or actions, possibly resulting in a long-acting transformation of the initial impulse of the participant (Vaillant, 2011). This was followed by focusing on the strength of the patient that was identified during the initial stage of the session. In this particular aspect, the study of Proyer et al., (2015), highlighted the advantages of using a strength-based approach while performing a psychosocial intervention and in this aspect, the process called sublimation is also beneficial to resolving the aggressive behavior of a patient who is suffering from moderate to a severe mental health condition. The overall process significantly helped in bringing positive outcomes to the patient’s emotional and psychological health and the compliance with the therapy was evaluated using a questionnaire and self-report of the patient. To evaluate the success of the said intervention a stress assessment score was used throughout the period where the main focus was given on the periodic decrease in the stress score of the patient. The study of Miner et al. (2015), has shown that using a stress score questionnaire is beneficial while performing psychotherapy based on trauma as a psychosocial intervention. Considering the ethical complication in the process called psychosocial intervention, at the very initial session of the study, ethical approval was taken from the patient in the form of a written consent where it was mentioned that none of the personal information of the patient would be published anywhere and the intervention will not increase risk of any harm to the patient (Kurpad, 2018). In the subsequent section of this study, I am going to reflect on how I have developed my skills in using the said intervention and how my practice will alter as a consequence of this experience.

BHS0003: International Business Group Project

While performing the psychotherapy and developing the implementation strategy, I experienced some challenges and perceived barriers from the end of the client. For example, the restrictive behavior of the patient was associated with his ego and internal locus of control. He had a self-blaming attitude and it was directly associated with the event of a miscarriage of his wife. While I found difficulties in addressing the said issue appropriately I tried to go through some peer-reviewed articles and journals on ego and its impact on self-blaming attitudes and also their association with an internal locus of control. At that time, I found the theory of psychosocial development of human beings that was proposed by Erik Erikson, and considering the intimacy vs isolation theorem I was able to draw a link between the restrictive behavior and inclination toward isolation. Before, this attempt I did not have a strong perception or idea of a strength-based approach. However, while handling this case scenario and experiencing difficulties due to the restrictive behavior of the client, I found the importance and validity of a strength-based approach while performing psychotherapy or any other psychosocial interventions for patients who are suffering from social withdrawal or other clinical symptoms of mental health diseases. A comprehensive understanding of the strength-based approach and concept of sublimation will help me further when I take care of a similar patient. To overcome the resistance of patients due to restrictive behaviour or internal control of locus instead of forcing them to follow the prescriptions or suggestions, I will rather try to focus on the strength of them which will eventually guide them to follow the right path. However, as chances of relapses are there, thorough monitoring will be made at that time and this could have been made by focusing on the importance of involvement of multidisciplinary team members. I also have learned the utilization of different tools and checklists including stress score, depression score, and GCS score which will further help in increasing my skills and understanding of the said intervention.

INVESTMENT AND PORTFOLIO MANAGEMENT SAMPLE

Reference

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