Title: Developing Therapeutic Relationships and Applying a Therapeutic Approach in Mental Health Nursing: A Case Study of John Short Title: Engaging and Building Rapport with a New Patient on a Mental Health Unit: A Person-Centered Approach “Exploring the Implications of the R Grade: An Analysis of ARU Academic Regulations, 3rd ed, 2020”

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Title: Developing Therapeutic Relationships and Applying a Therapeutic Approach in Mental Health Nursing: A Case Study of John Short Title: Engaging and Building Rapport with a New Patient on a Mental Health Unit: A Person-Centered Approach “Exploring the Implications of the R Grade: An Analysis of ARU Academic Regulations, 3rd ed, 2020”

ESSAY STRUCTURE
INTRODUCTION:
Your introduction needs to be demonstrate understanding of the essay guidelines by telling the reader/marker what you are going to do (focus) and how the essay will be constructed. Ensure that you acknowledge that both parts of the essay will be informed by your engagement with relevant literature, and wider evidence base.
Given the word count there is no need to offer an extended introduction, keep it clear and simple.
MAIN BODY
Part 1:
Therapeutic Relationships in Mental Health Nursing
Discuss how you create positive therapeutic relationships with service users. This discussion and analysis needs to consider the meaning of what therapeutic relationships are. It needs to explore how verbal and non-verbal communication skills are used and applied to develop the relationship.
You also need to consider the challenges of the different environments that mental health nurses work in when developing therapeutic relationships (e.g. working in in-patient hospital settings and working in people’s homes); and the challenges of developing therapeutic relationships based on different types of illness or difficulty a person is experiencing.
Contemporary mental health literature needs to be used to support the discussion and analysis.
Part 2:
Therapeutic Approach
Identify a specific therapeutic approach that you are going to apply the principles of, when working with John e.g. CBT, SFBT, MI, PCT etc…
You are required to introduce the approach and give a clear rationale for choosing this way of working. What are the key ideas and the overarching philosophy of the approach? Who developed the approach and what evidence is there for its application in mental health settings?
Please remember to keep this discussion simple, clear, and focused. If you over-complicate things, you run the risk of being too broad in your discussion and end up trying to cover too much.
Remember, you are not doing formal therapy, you are applying the principles of a particular therapy in your day to day 1-1 work with John.
Engaging with John (responding to questions)
In this section you need to respond to the statements/questions as they relate to your approach to working with John (see scenario below).
Question 1 asks you to outline how you will engage with John, taking into account the context of this 1-1 session.
Questions 2, 3, and 4 require you to offer a verbatim response to John’s statement. You must offer a rationale for your response as it links to your chosen approach. You must then explore how this will enable you to develop dialogue with John e.g. what are you trying to do and how will your approach enable you to do this. This again must be in keeping with your chosen approach. Please ensure that you take time to construct your answer to each statement/question by using the relevant literature to develop analysis.
Question 5 asks you how you will end this first 1-1 session with John, you need to be mindful of two things, First, this needs to be in keeping with your chosen approach to working with John; and second, it must take into account the context of this 1-1 session and the situation John finds himself in.
(Please refer to the Scenario below, and the 5 specific questions that you are required to answer)
CONCLUSION
Reflect on what you have learned and what you will take with you into clinical practice when sitting down to help a person begin to explore their experiences.
WORD COUNT
Insert the final word count for the essay after the conclusion (3500 words).
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SCENARIO: John Short
John Short is a 45 year old gentleman admitted to your assessment unit after he presented at A&E with cuts to his wrists and neck. He had cut himself with a kitchen knife following what he described as a “panic attack” where he “lost the plot”. He is settled, his wounds have been dressed and overall were not life threatening. Following assessment Joh was offered an informal admission to the local inpatient assessment unit. John has no previous contact with primary or secondary mental health services.
John works in the office of a delivery company and says that there has been asked to do more and more in the past few months as people have left or retired from their posts and he has not been coping well. John was also informed that the company were planning on outsourcing some of their work, and as a result there might be redundancies in the near future. John describes feeling increasingly stressed over this time, unable to concentrate, worrying that he might lose his job and ruminating on how this would affect the family.
John is married with two small children 10 and 5 years old. During his admission assessment he described his wife as loving and supportive and is worried that he “has put her through hell” and that he has “behaved stupidly”. He feels he has let his children down even though they did not see him harm himself or witness any of his distress and worry. John reflected on feeling increasingly anxious on heading out to work, worrying about his job security, so much so that he has not been sleeping well. John said that he feels he has been depressed for a short while but felt unable to talk to anyone about this. His wife is very worried about him, and he stated that she has told him many times that, “we can cope Janna, your job is not as important as your health”. John stated that he has been “stupid” and that he has “ruined everything”. He wishes he could turn the clock back to a time when he was “on top of things at work”. He worries that he might panic again and is scared of what he might do.
This is John’s first day on your unit, and this is his first 1-1 session with you since his admission. He is happy to talk to you.
QUESTIONS
How would you begin to engage with John and encourage him to talk about his issues and make him feel comfortable? How would you build rapport?
Think about how you are going to create a safe therapeutic milieu for John.
Remember that everything you are going to do with John, and the nature of the unit John has been admitted to is alien to John.
If John says, “I am a useless Father, I just panicked, how could I put my family through this?”
Offer a verbatim response to John’s statement, and your rationale for your response as it links to your chosen approach.
You must then explore how this will enable you to develop dialogue with John e.g. what are you trying to do and how will your response/approach enable you to do this.
When John states, “I haven’t been sleeping very well, I just keep thinking about work”.
Offer a verbatim response to John’s statement, and your rationale for your response as it links to your approach.
You might want to think about how sleep impacts on his mental health and how you can support this on the unit; or you may wish to consider the role of John’s negative thoughts about work, and how this might be affecting his sleep.
John has been admitted to the unit following an episode of self-harm.
How would you approach the issue of risk with John, and how can you use your chosen therapeutic approach to help support John in managing this?
Suggest a way to close or finish the 1-1 session with John e.g. you must relate this to the principles that underpin your chosen approach.
You need to be mindful of three things,
First, how you close the session needs to be in keeping with your chosen approach to working with John.
Second, it must take into account the context of this 1-1 session and the situation John finds himself
in.
Third, consider John’s needs, vulnerability, and emotions as he spends his first night on the unit.
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IMPORTANT SUBMISSION DETAIL
Ensure that your SID number is on the essay – (header or footer) (no names)
Insert Page Numbers – (header or footer)
Essay Line Spacing – 1.15 or 1.5
Essay Font Size – 11 or 12
Your essay must not exceed the maximum word limit for this essay. Exceeding word limits will be reflected in the academic judgement of the marker and will affect your grade (Page.101, ARU Academic Regulations, 3rd ed, 2020).
References (ARU Harvard – download the guide from the online University library)
Appendices (plafjkce John scenario as an appendix)

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