- Read Wheeler Chapters 2, 7, 11, 15, 17
- Read candice Knight and wheeler Chapters 10, 14, 15 Respond to the 2 discussion board post using APA 7 format and REFERENCES WITHIN THE PAST 5 YEARS
DB Post 1:
Prompt: THIS WEEK WE READ ABOUT TRM, EMDR, TRAUMA INFORMED MED MANAGEMENT, STABILIZATION FOR TRAUMA AND DISSOCIATION, DBT
- Discuss the Psychotherapeutic Approaches reviewed this week
- What do you like and dislike about them?
- Are they better for children or adults? Support your assertion with other scholarly sources.
- Do you feel you will use it in your practice? if yes why and if no why not?
DBT
Dialectical behavioral therapy (DBT) is an evident based form of therapy used in the treatment of complex trauma, personality disorder, post-traumatic stress disorder, substance abuse, depression, and chronic suicidal ideation (Wheeler, 2022). DBT should be completed by a trained therapist, who has gone through an intensive training program
The goal of DBT is to change behavior, helping the client to make better judgement with problem solving, and improve their engagement in life through regulating their emotions and teaching skills to help cope with their trauma (Knight & Wheeler, 2021). DBT would be better suited for young adults and older, due to the long intensive therapy, it does not appear to be suitable for children, since this type of therapy requires a long commitment for at least a year with many sessions (Wheeler, 2022).
DBT seems to be a very intense therapy involving a lot of different dynamics, requiring a great deal of time and commitment for the patient. Granted, dealing with complex trauma takes a lot of work, though I think a person trying to live a semi normal life with work, family, and other adult functions would have some trouble committing to such intensive therapy. The requirement of weekly sessions, weekly group sessions, phone coaching, and team consultation with the therapist just seems like too much to ask of a patient (Wheeler, 2022). Though DBT, may be a requirement for some patients I am not sure I would incorporate this into my practice unless absolutely necessary. I could see referring the client to someone who is trained in DBT, before actually learning it myself.
EMDR
Eye movement desensitization and reprocessing therapy (EMDR) is designed to help the client identify and reprocess memories, thereby processing disturbing events and weakening those experiences and strengthening the positive experiences (Knight & Wheeler, 2021). EMDR can be helpful for a assortment of populations, including children, couples, victims of sexual assault, those dealing with depression, anxiety, panic, addictions, phobias, just to name a few (Corey, 2021). EMDR requires specialized training and should not be used without an authorized instructor, due to the assortment of powerful reactions it can cause (Corey, 2021).
EMDR therapy is conducted under eight phases:
- Obtaining history and treatment planning
- Preparation- developing therapeutic rapport
- Assessment -identifying goals
- Desensitization-beginning bilateral stimulation with eye movements and sounds
- Installation- installation of PC with bilateral stimulation
- Body scan- notation of tension and sensation
- Closure- instruction on log journaling and education related to disturbances post session
- Reevaluation- reassess, review goals developed at the start of the sessions
(Knight & Wheeler, 2021)
TRM
Trauma resiliency model (TRM) is a type of therapy used to help and heal from trauma without the retelling of the traumatic event, deemed as the “kindest approach,” (Knight & Wheeler, 2021). TRM focuses on the body’s conscious awareness to stress through preventative and healing (Knight & Wheeler, 2021). This type of therapy can be helpful for clients dealing with mood or anxiety disorders, obsessive-compulsive disorder, eating disorders, and substance use disorders (Knight & Wheeler, 2021). The client has to be able to be aware of their body’s responses to trauma and stress and utilize skills learned through TRM to think clearly enough to make rational processes instead of acting on emotion and becoming behavioral (Knight & Wheeler, 2021). Goals of TRM include bringing healing to the patients through respect, their choices, and helping to identify their inner strengths; it is a type of self-care and self-soothing and allowing self to have compassion while becoming empowered about the future (Knight & Wheeler, 2021). I like this type of therapy for a few of the reasons already named. When a client is dealing with past trauma, it is difficult to retell the story of this trauma and could bring up so many painful feelings that it could destroy any progress the patient made previously. With TRM, they do not have to retell the story and can move toward learning to deal the emotions instead of reliving them.
There are nine skills learned through TRM:
- Tracking- awareness of the five senses thought conscious awareness
- Resourcing- utilizing a person, item, memory, place, etc which brings peace or a sense of calm or joy
- Grounding- somatic awareness of the support or security item in present moment
- Gesturing- spontaneous movements and involuntary movements of the body which are seen as comforting gestures to help with self-soothing.
- Help Now- are used when the client is in a distressed state, this can help them focus on an object to bring them back and avoid them from having an issue
- Shift and Stay- is a way of using one of the previously learned techniques and help them stay in a neutral state
- Titration-a way of becoming aware of how they feel when something reminds them of the trauma and the client being able to turn the attention to something that is easier to deal with
- Pendulation-basically swinging back and forth between distress and feeling of well-being with the help of the clinician to shift to a more pleasant state
- Completion of survival responses- after learning all of the skills, the client is able to return to a balanced state without experiencing fear. (Knight & Wheeler, 2021).
- How do they compare to the other therapeutic approaches covered in previous Modules? like CBT, MI, IPT ETC
While I it true that with any therapy, there needs to be training and experience for practitioners, EMDR, DBT, ETC, require specialized training and should not be utilized in inexperienced practitioners and counselors. I personally would like to start off with more talk therapies until I felt more comfortable and had the training needed for those with more extensive requirements. TRM has a lot of skills that need to be learning, though it reminds me somewhat of patient centered therapy, as the goals work toward helping patients work toward self-awareness and self care.
References
Corey, G. (2021). Theory and practice of counseling and psychotherapy (10th ed.). Cengage
Knight, C., & Wheeler, K. (2021). Case study approach to psychotherapy for advanced practice psychiatric nurses. Springer Publishing Company
Wheeler, K. (2022). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (3rd ed.). Springer Publishing Company.
DB Post 2:
TRM, EMDR, TRAUMA-INFORMED MED MANAGEMENT, STABILIZATION FOR TRAUMA AND DISSOCIATION,DBT
- What do you like and dislike about them?
TRM: The Trauma Resiliency Model is a therapeutic approach designed to help individuals manage the effects of trauma. TRM focuses on restoring and balancing the nervous system through body-centered techniques, mindfulness, practices, and education about the impact of trauma on the body and mind which help individuals have a sense of control. Some find the mindfulness practices unfamiliar and comfortable.
EMDR: Eye Movement Desensitization and Reprocessing is a type of psychotherapy that has gained popularity and is effective in treating trauma-related disorders and offers relatively quick results. This therapy provides a nonverbal approach to processing traumatic memories which is also highly favorable. Some find limitations in effectiveness for all individuals, as some methods work better for different people.
Trauma-Informed Med Management: Trauma-Informed Med Management refers to an approach to prescribing and managing medications for individuals who have experienced trauma as well as their response to medication. This therapy aims to minimize triggers while optimizing treatment outcomes. Limited understanding or acceptance of medication management in treating trauma among some individuals may cause drawbacks.
Stabilization for Trauma and Dissociation: Stabilization for Trauma and Dissociation involves techniques and strategies to help individuals manage and reduce stress. This therapy requires consistent grounding exercises and individuals find it hard to commit to as well as the ongoing management of trauma symptoms which are demanding and overwhelming for some. This type of therapy focuses on strategies that help create a sense of stability and control over traumatic experiences.
DBT: Dialectical Behavior Therapy is a type of cognitive behavioral therapy that was developed to treat individuals with borderline personality disorder. This therapy is favorable by focusing on helping individuals build skills in regulating emotions, distress tolerance, and acceptance-based strategies. This therapy is effective in treating various mental health conditions characterized by emotional dysregulation. The therapy is limited and variability in outcomes depends on the skill and experience of the therapist or practitioner.
- Discuss the Psychotherapeutic Approaches reviewed this week
- How do they compare to the other therapeutic approaches covered in previous Modules? like CBT, MI, IPT ETC
All approaches aim to empower individuals to make positive changes in their lives, whether it’s through processing trauma, changing negative thought patterns, or exploring personal growth and self-awareness. The focus may differ through each approach, all approaches promote growth and change in the individual. Trauma-related approaches promote healing in the aftermath of trauma, while behavioral therapies focus on identifying negative thoughts and behaviors and developing coping skills. Both therapies focus on reducing symptoms but are tailored to specific needs and the nature of their mental health concerns for each individual to provide comprehensive and effective treatment.
- Are they better for children or adults? Support your assertion with other scholarly sources.
TRM can effectively reduce symptoms of trauma and improve emotional regulation in both children and adults. When adapted, TRM can be beneficial for children and adults and this therapy aims to build a therapeutic relationship, providing them with healing (Nunez et al., 2022).
EMDR can be beneficial to both children and adults but will need to be adapted for the developmental stage and needs of children who have experienced trauma.
Trauma-informed medication management involves a personalized approach with a combination of medication management and psychotherapy that can be effective in treating trauma-related disorders in both children and adults.
Stabilization for Trauma and Dissociation contains grounding exercises, sensory-based interventions, and strategies to help increase a sense of safety, which can be tailored and adapted to meet the needs for both children and adults.
Dialectical Behavior Therapy (DBT) is known for treating a wide range of mental health disorders through the regulation of emotions, and interpersonal effectiveness can be beneficial for both children and adults coping with trauma-related challenges.
Therapeutic approaches have been shown to benefit individuals of all ages by providing them with effective tools and strategies to cope with symptoms, regulate their emotions, and promote mental health healing and recovery.
- Do you feel you will use it in your practice? if yes why and if no why not?
When providing care to individuals a wide range of approaches and therapeutic interventions address the specific needs of those facing challenges with all mental health disorders. As a Psych mental health nurse practitioner, I plan to incorporate all techniques such as mindful practices, self-soothing strategies, and helping individuals regulate emotions to cope with symptoms by using all techniques to improve overall mental health. Incorporating an approach to hidden trauma in primary care mental health has been long overdue and most individuals may not bring it to light until a trusting relationship is made (Dawson et al., 2021). Integrating trauma-focused approaches to my practice I can provide comprehensive and holistic care to patients with trauma-related symptoms while still managing and maintaining a primary focus on cognitive and patient-centered therapy. I plan to tailor treatment plans to meet the individual needs of each patient and provide effective care that addresses all mental health concerns.
References
Nuñez, L., Fernández, S., Alamo, N., Midgley, N., Capella, C., & Krause, M. (2022). The therapeutic relationship and change processes in child psychotherapy: a qualitative, longitudinal study of the views of children, parents and therapists. Research in psychotherapy (Milano), 25(1), 556. https://doi.org/10.4081/ripppo.2022.556Links to an external site.
Dawson, S., Bierce, A., Feder, G., Macleod, J., Turner, K. M., Zammit, S., & Lewis, N. V. (2021). Trauma-informed approaches to primary and community mental health care: protocol for a mixed-methods systematic review. BMJ open, 11(2), e042112. https://doi.org/10.1136/bmjopen-2020-042112Links to an external site.
References
Corey, G. (2021). Theory and practice of counseling and psychotherapy (10th ed.). Cengage
Knight, C., & Wheeler, K. (2021). Case study approach to psychotherapy for advanced practice psychiatric nurses. Springer Publishing Company
Wheeler, K. (2022). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (3rd ed.). Springer Publishing Company.