NURS 6650 Week 2 practicum journal entry

NURS 6650 Week 2 practicum journal entry


Clients with mental health illness use group therapy as one of the psychotherapy techniques to deal with different ideas. This paper will talk about different therapy that the family can benefit such as structural family therapy, cognitive behavioral therapy, problem solving that will involve the family and the client, and solutions that are needed. “All of this leads to the obvious fact that expectations from patient to patient were different, as was perception of relevance, depending on the task” (Roman, 2018). The therapist will use experimental therapy to focus on family relationship which will help the family to develop an insight in their relationship. This will also help the family to communicate openly and sincere with each other during therapy. In the context of a group therapy setting, patients that participate develop a bond that allows them to share ideas, experiences, and set-backs. “They teach each other self-advocacy skills, link them to other members in the community and provide a canvas that each patient can use to comfortably discuss their situation that a clinician alone may not be able to provide” (Roman, 2018).  In solving family problem, it is important to educate the family about mental health illness and supporting the client with the illness which will bring hope to the families and the client. “In any group therapy setting, the clinician is exposed to a variety of patient personalities with diverse backgrounds” (Roman, 2018). In this paper, I will about two of the clients that attended the group therapy PW and MJ. NURS 6650 Week 2 practicum journal entry


Pertinent and Medical History

PW is a 26 years Caucasian female who has illicit drug abuse and was recently diagnosed with chronic liver disease because of her drinking too since she was 15 years old. Because of her drinking and taking illicit drugs her children were taken away from her to her grandmother who is now in custody of her children. She has been taken to the emergency room several times where she was referred to a rehabilitation center that helped her in counseling and was given medication to get rid of the marijuana addiction in her system. She grew in a family that her mother was using illicit drugs and she was abused by her step father which contributed to her mental illness. She has diagnosis of Cannabis use, Generalized Anxiety Disorder (GAD), Panic disorder, Adjustment disorder with mixed anxiety and depressed mood, and bipolar disorder.  She is taking Buspirone and Wellbutrin. “It is accompanied by symptoms such as restlessness, fatigue, muscle tension, irritability, sleep disturbance, and difficulty concentrating; trembling, sweating, headache, or gastrointestinal symptoms may also be present” (Gilmour, 2016).

On the other hand, MJ is a 30-year-old Caucasian female who has diagnosis of Post Stress Traumatic Disorder (PSTD), Major Depression Disorder (MDD), and Generalized Anxiety Disorder (GAD). She was recently diagnosed with blood clot and was started on anticoagulant due to her birth control patch that has not changed for months. Her depression affects her sleep and eating habits. She was abused by her step-father and her mother does not care about her that much. She is on Guanfacine, Prozosin, Ambien, Zoloft, and Buspar. She lives with her boyfriend who sometimes does not help her in dealing with her mental illness. NURS 6650 Week 2 practicum journal entry.

Diagnostic and Statistical Manual of Mental Health Disorder (DSM-5)

PW has diagnosis of alcohol abuse disorder which according to DSM-5 client with symptoms of alcohol craving, not able to control self, and physically depending on others falls on alcohol category. MJ suffers from Generalized Anxiety Disorder (GAD), Post Stress Traumatic Disorder (PSTD), and Major Depression Disorder (MDD) which were outlined through DSM-5. “Generalized Anxiety Disorder (GAD) is characterized by excessive, often irrational, worry about events and situations such as work, school, health, relationships, finances or routine activities and the anxiety persists for at least six months, is difficult to control, and interferes with occupational, social or other areas of functioning” (Gilmour, 2016). “According to DSM-5, client experiencing symptoms such as depressed mood, having difficult time sleeping, losing weight, not eating well, and having fatigue for several weeks qualifies that client as having diagnosis of depression. Also, clients who have these significant symptoms without been caused by alcohol use or substance abuse or any other psychological disorder are categorized is been having depression disorder. “Diagnostic criteria in the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) include the following: Excessive anxiety and worry for at least six months, difficulty controlling the worrying. Anxiety and worry associated with at least three of the following: Restlessness or feeling keyed up or on edge, being easily fatigued, difficulty in concentrating or mind going blank, irritability, muscle tension, and sleep disturbance” (Munir, & Hughes, 2018). The best intervention for the clients is cognitive behavioral therapy which will help them to overcome their problems by changing how they think will help them to avoid having any harmful behavior, stay off stress emotions, and help them in practicing and recognizing the healthy ways of thinking. NURS 6650 Week 2 practicum journal entry.

Legal and Ethical Implications

It is important for the therapist to inform the client that she will be tested for substance abuse. Making sure that they get consent from the client who and what information will be shared. Informing the clients what medications will be prescribed and the side effects. It is very important for the therapist to keep that information received from the client confidential and shared whatever that client wants the therapist to share. “In working with certain population, each clinician may be working with an immigrant client(s) from specific cultural background, socioeconomic status or mental health care system, for places where it exists, that have a unique perspective of what a visit to a mental health clinician really means and informed consent defines the roles of the clinician and the client(s) during the therapeutic interaction” (Lewis, Paik, & Tseng, 2017). It is very important for the mental health professional has to refer to the facility’s ethical policy when caring for the needs of the client that are outside the professional scope of practice. NURS 6650 Week 2 practicum journal entry.


“To address the individuality of the patient, it might be necessary to provide extra “homework” to individuals within the group and this homework may be informational in nature, such as doing additional research on the diagnosis, interventions, and the implementing the interventions” (Roman, 2018). The outcome of the group therapy will benefit the clients in a clinical setting and the implementing the client to attend the group therapy will provide benefits to those clients with mental illness and addictions. CBT has been helpful to the clients when the therapist use it to deal with different difficulties and mental illness. CBT have been used in a crucial situation and have been effective and resulted to positive outcomes. “The core value of confidentiality is one of the factors of therapy that promote the comfortability to be vulnerable that clients need and facilitate healing. Transparency could be utilized in discussing the times when confidentiality will need to be broken in order to promote safety” (Lewis, Paik, & Tseng, 2017). NURS 6650 Week 2 practicum journal entry.



Cho, J. M., & Lee, K. (2018). Effects of motivation interviewing using a group art therapy program on negative symptoms of schizophrenia. Archives Of Psychiatric Nursing, 32(6), 878–884.


Gilmour, H. (2016). Threshold and subthreshold Generalized Anxiety Disorder (GAD) and suicide ideation. Health Reports, 27(11), 13–21. Retrieved from


Lewis, F., Paik, S., & Tseng, C.-F. (2017). Deconstructing the Legal Process for the Immigrant Population in the United States: Ethical Implications for Mental Health Professionals. Contemporary Family Therapy: An International Journal, 39(3), 141–149. NURS 6650 Week 2 practicum journal entry


Munir, S., & Hughes, J. (2018). Anxiety, Generalized Anxiety Disorder (GAD). Retrieved from


Roman, A. M. (2018). It Takes a Village: Lessons in Group Aural Rehabilitation Therapy. Audiology Today, 30(2), 12–14. Retrieved from NURS 6650 Week 2 practicum journal entry