Please see the attachment 

View the two videos linked below then answer the discussion question provided.

From the timeline, you are aware that in the 1960’s it was decided that the mentally ill should be provided care/ treat in their communities. This video will explain this process in greater detail.

Deinstitutionalization Movement

This is another segment of the same movie, explaining how communities in the different states were unable to meet client needs. As a result, many became homeless at that time, and many with a mental health disorder are homeless today.

The Homeless Mentally Ill

Initial Post

Do you think the mental health system in our country today functions well, or is it broken? Why or why not?

Purpose: To assist students in identifying areas to improve on in order to be academically successful, formulating strategies to implement and meet goals, and determining the effectiveness of the strategies (outcomes).

Student Learning Outcomes

• Describe her/himself as a learner.
• Demonstrate improvement of study skills through a variety of exercises.

Instructions:

1. Write a 4-8 page paper on the goals to improve, the outcomes, and the effectiveness of the strategies that you implemented this semester (use the chart below to guide you. Address each area.). Use the literature to provide the evidence to support your strategies.
2. Create two (2) strategies for each provided “Goals to Improve” that you plan to implement this semester.
3. Evaluate the effectiveness (Outcomes) of each strategy you implement in meeting the goal of improving academically.
4. Include a minimum of three (3) current (≤ 5 years), peer-reviewed, nursing journal articles.
5. Your paper should be 4-8 pages, excluding title and reference pages. No abstract is needed. Current APA formatting is required.
6. Upload each article in pdf form that is used in your paper to the Dropbox.
7. Please refer to the OWL at Purdue APA for questions. https://owl.english.purdue.edu/owl/resource/560/01/
8. Do not include any block quotes (direct quotes ≥ 40 words) or direct quotes in your paper.  Instead, paraphrase the information in your own words and cite appropriately.
9. Include a conclusion. Use headers in your paper.
10. No more than 25% Turnitin score. 

Submit your paper to the appropriate Dropbox, in a Word docx, by the specified date/time. If the document is uploaded in a format that will not open, meaning the faculty cannot grade it as it was uploaded, then the student will receive a grade of zero (0). It is the student’s responsibility to verify that their paper is in the correct format.

Only assignments that are uploaded to the correct location will be graded. It is the student’s responsibility to ensure they upload the correct assignment to the correct location and by the posted due date/time. It is also the student’s responsibility to ensure that they upload the correct version of their assignment. Only the version that is uploaded/posted will be graded. If a student inadvertently uploads the incorrect version of an assignment, it is the student’s responsibility to contact their instructor prior to the due date/time.

Evidence-Based Project, Part 5: Recommending an Evidence-Based Practice Change

The collection of evidence is an activity that occurs with an endgame in mind. For example, law enforcement professionals collect evidence to support a decision to charge those accused of criminal activity. Similarly, evidence-based healthcare practitioners collect evidence to support decisions in pursuit of specific healthcare outcomes.

In this Assignment, you will identify an issue or opportunity for change within your healthcare organization and propose an idea for a change in practice supported by an EBP approach.

To Prepare:

• Reflect on the four peer-reviewed articles you critically appraised in Module 4, related to your clinical topic of interest and PICOT.
• Reflect on your current healthcare organization and think about potential opportunities for evidence-based change, using your topic of interest and PICOT as the basis for your reflection.

The Assignment: (Evidence-Based Project)

Part 5: Recommending an Evidence-Based Practice Change

Create an 8- to 9-slide PowerPoint presentation in which you do the following:

• Briefly describe your healthcare organization, including its culture and readiness for change. (You may opt to keep various elements of this anonymous, such as your company name.)
• Describe the current problem or opportunity for change. Include in this description the circumstances surrounding the need for change, the scope of the issue, the stakeholders involved, and the risks associated with change implementation in general.
• Propose an evidence-based idea for a change in practice using an EBP approach to decision making. Note that you may find further research needs to be conducted if sufficient evidence is not discovered.
• Describe your plan for knowledge transfer of this change, including knowledge creation, dissemination, and organizational adoption and implementation.
• Describe the measurable outcomes you hope to achieve with the implementation of this evidence-based change.
• Be sure to provide APA citations of the supporting evidence-based peer reviewed articles you selected to support your thinking.
• Add a lessons learned section that includes the following:
  • A summary of the critical appraisal of the peer-reviewed articles you previously submitted
  • An explanation about what you learned from completing the Evaluation Table within the Critical Appraisal Tool Worksheet Template (1-3 slides)

cWhile the implementation plan prepares students to apply their research to the problem or issue they have identified for their capstone project change proposal, the literature review enables students to map out and move into the active planning and development stages of the project.

A literature review analyzes how current research supports the PICOT, as well as identifies what is known and what is not known in the evidence. Students will use the information from the earlier PICOT Question Paper and Literature Evaluation Table assignments to develop a 750-1,000 word review that includes the following sections:

1. Title page
2. Introduction section
3. A comparison of research questions
4. A comparison of sample populations
5. A comparison of the limitations of the study
6. A conclusion section, incorporating recommendations for further research

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

Minimum of 250 words with at least one peer review reference in 7th edition apa style.

 having a grasp of one’s emotional stability in a time of crisis is essential but it may not be something that comes naturally or can even be taught in a course. What are some strategies you believe might be effective in teaching this kind of self-awareness and self-regulation? If you were a mentor to a younger you, how might you guide yourself in these areas based on your own experiences? 

Case scenario to be completed (in file attached) 

–APA Format.

-Introduction or abstract page

-Summary or Conclusion page

–Four Pages Minimum, not included Introduction or abstract, Conclusion or Summary , and Bibliographic pages.

–Completely unacceptable Copy and Paste from Internet, or other resources.

– Bibliographic have to be in APA Format, minimum 3 references citations with 3 years old or less.

Reply prompt: Respond to threads posted by 2 classmates who analyzed a different area of practice than you did. Compare and contrast the legal and ethical issues of your area of practice with those explored by other students (I wrote on nursing and the law). Each reply must be supported by 4 scholarly sources, including the textbook chapter cited in current APA format. 450 words

Discussion Board: Responsibilities of advanced practice nursing staff

Define the responsibilities of an Advanced Practice Nurse. Identify the references used. For APA 3 pages – cover and reference pages not included. 

500 WORDS

I NEED A RES

ZERO PLAGIARISM

3 REFERENCES

Cognitive Behavioral Therapy: Group Settings Versus Family Settings

Cognitive Behavior Therapy (CBT) has proven to be an effective evidenced based psychotherapy for many individuals with psychological and emotional disorders in both family and group therapy settings as it is in individual settings (Landa, Mueser, Wyka, Shreck, Jespersen, Jacobs, … Walkup, 2016; Patterson, 2014). The paramount goal of CBT is to modify the maladaptive thinking of individual in the group so that they can better adjust in their perceptual, affective, and behavioral domains, interaction, and relationships (Wheeler, (Ed.), 2014). However, unlike in individual psychotherapy, where an individual’s thinking can be challenged directly, family and group sessions presents the dilemma of involvement of others whose definition of a problem may be at variance (Yalom and Leszcz, 2005). Furthermore, the issues of privacy, confidentiality, and honest exchange can present additional obstacles (Patterson, 2014; Wheeler, (Ed.), 2014).

In the light of this, determining if family or group CBT is appropriate for any individual or groups of individuals should be based on thorough assessment of the environment or contest in which communication take place (Wheeler, (Ed.), 2014; Yalom and Leszcz, 2005). The family provide the primary socializing environment for people of all cultures. Maladaptive behaviors in individuals can therefore be seen as a product of that family dysfunction (Gomes, Cordioli, Bortoncello, Braga, Gonçalves, Heldt, 2016). Family structure, hierarchy, alliances, boundaries, and communication patterns provide the context in which interaction that provide a feedback loop (negative or positive) take place (Selles, Belschner, Negreiros, Lin, Schuberth, McKenney, … Stewart, 2018; Gomes et al, 2016; Landa et al, 2016). Family CBT may be useful in families with multigenerational dysfunctional thinking patterns, feeling of a sense of guilt for the suffering of another, severe differentiation, triangulation of members, or role conflict, such as in post-traumatic stress disorder (PTSD), Obsessive compulsive disorders (OCD), and psychosis (Selles et al, 2018; Gomes et al, 2016; Landa et al, 2016).

A combination of cognitive and behavior approach is used to redirect the thinking of family members in more realistic way about the peculiar dysfunctions of the family, such as role differentiation, obsessions, entrenched behavioral responses, structures and subsystems, and communication patterns to produce second-order changes. Methods may include cybernetics, role reversal, acting out an escalation of dysfunction or the desired state, and exploiting the family feelings and reaction. When family members accept certain symptoms as normal, this may in effect reestablish dynamic family equilibrium in interaction (Sheehan and Friedlander, 2015),

Group CBT on the other hand can be used for therapeutic and preventive intervention in varying populations. Often shared symptomatology or diagnosis are the bases for group formation. At other times, groups may be formed around sociocultural identities. Whatever is the underlying reason for the group formation, proper assessment is necessary for setting, group membership, ground rules, development of goals and objectives (Selles, Belschner, Negreiros, Lin, Schuberth, McKenney, … Stewart, 2018). Psychoeducation of group members is done to introduce member to issues of rules, norms, gals, privacy, confidentiality and the limitation thereof (Mulia, Keliat, and Wardani, 2017). Unlike in family therapy, where embers have shared concerns and relative involvement in each others life, members of the group may not see how the group may be helpful to them.

It is therefore the responsibility of the leader or therapist to ensure that curative/therapeutic factors, such as, building hope, encouraging and guiding group interaction, emotional expression, real time awareness of the impact of interaction and communication patterns on individual in the session are addressed in a way that real but non-patronizing way (Patterson, 2014; Wheeler, (Ed.), 2014; Yalom and Leszcz, 2005).  During psychoeducation, integrative factors including group cohesion, universality of issues and cohesiveness should be emphasized.  Conflicts which may arise in groups should be considered as unique opportunity for social learning (Mulia, Keliat, and Wardani, 2017; Patterson, 2014; Yalom and Leszcz, 2005).

In a small-scale study conducted by Landa, Mueser, Wyka, Shreck, Jespersen, Jacobs, … Walkup, they found that group CBT did not only reduce psychotic symptoms in adolescents with predisposition to psychosis, but the “family members showed significant improvements in use of CBT skills, enhanced communication with their offspring, and greater confidence in their ability to help” (2016, p. 511). Another study by Mulia, Keliat, and Wardani (2017), showed significant improvement in anxiety in drug addicted inmates, using the Hamilton Anxiety Scale (HAM-A) post treatment with CBT compared to routine nursing intervention.

The media from Week 5 highlights some of the challenges of using cognitive behavioral therapy for groups. The clients (Ms. Johnson) who had been traumatized by sexual abuse could not at the time see the usefulness of therapy despite reassurance from peers. Self-blame was a central team for members of the group and that can be confronted with CBT.

I attended  a group therapy session where, a patient  was prematurely discharged from group therapy due to inability to follow rules. He has dysfunctional overcompensation for his internalized self-blame and maladaptive response to deal with his anger and feeling of inadequacy (Webb, Hirsch, Visser, and Brewer, 2013). His daughter was sexually abused by his younger brother while he was incarcerated, and he has not forgiven himself or his brother for what happened to his only daughter. Presently, he is overprotective of his daughter and excessively tax himself financially and otherwise to meet and exceed every irrationally perceived need of his daughter. Family CBT was recommended for him and his daughter before his premature discharge from the group therapy session.

In such situation a dyad type family CBT can be more beneficial than a group CBT therapy.

References:

Gomes, J. B., Cordioli, A. V., Bortoncello, C. F., Braga, D. T., Gonçalves, F., & Heldt, E. (2016). Impact of cognitive-behavioral group therapy for obsessive-compulsive disorder on family accommodation: A randomized clinical trial. Psychiatry Research, 246, 70–76. https://doi-org.ezp.waldenulibrary.org/10.1016/j.psychres.2016.09.019

Landa, Y., Mueser, K. T., Wyka, K. E., Shreck, E., Jespersen, R., Jacobs, M. A., … Walkup, J. T. (2016). Development of a group and family-based cognitive behavioural therapy program for youth at risk for psychosis. Early Intervention in Psychiatry, 10(6), 511–521. https://doi-org.ezp.waldenulibrary.org/10.1111/eip.12204

Laureate Education (Producer). (2013c). Johnson family session 3 [Video file]. Author: Baltimore, MD.

Mulia, M., Keliat, B. A., & Wardani, I. Y. (2017). Cognitive behavioral and family psychoeducational therapies for adolescent inmates experiencing anxiety in a narcotics correctional facility. Comprehensive Child & Adolescent Nursing, 40, 152–160. https://doi-org.ezp.waldenulibrary.org/10.1080/24694193.2017.1386984

Patterson, T. (2014). A Cognitive Behavioral Systems Approach to Family Therapy. Journal of Family Psychotherapy, 25(2), 132–144. https://doi-org.ezp.waldenulibrary.org/10.1080/08975353.2014.910023

Selles, R. R., Belschner, L., Negreiros, J., Lin, S., Schuberth, D., McKenney, K., … Stewart, S. E. (2018). Group family-based cognitive behavioral therapy for pediatric obsessive compulsive disorder: Global outcomes and predictors of improvement. Psychiatry Research, 260, 116–122. https://doi-org.ezp.waldenulibrary.org/10.1016/j.psychres.2017.11.04

Sheehan, A. H., & Friedlander, M. L. (2015). Therapeutic alliance and retention in brief strategic family therapy: A mixed-methods study. Journal of Marital and Family Therapy, 41(4), 415–427. doi:10.1111/jmft.12113