Module Code: MOD007221

Module Title: Therapeutic Engagement in Mental Health Nursing

Length: 3500 Words

Case Presentation Structure:

Your Summative Case Presentation with relate to the ‘Claire Smith’ scenario

See scenario below…

1. Overview and Background

• • Provide a brief overview of the Case Scenario (Claire)
  • Explore how you can utilise different approaches to nursing handover (models/structures e.g. ISBAR) to present a succinct overview of Claire.
  • Summarise Claires’ strengths, goals, and current support needs

2. Making Interactions Person-Centred

• • Consider the evidence-base around communication, and how you will develop a therapeutic relationship with Claire
  • Summarise Claires’ strengths, goals, and current support needs
  • Explore how you will engage Claire in therapeutic interactions

3. Therapeutic model

• • Using appropriate literature, evaluate the contribution therapeutic approaches can make in relation to engagement and recovery.
  • Identify your chosen therapy and consider how you can utilise principles of your chosen therapy to prioritise the problems that Claire is presenting with.
  • Present a brief rationale for why you have chosen the therapeutic approach you have selected 

4. Treatment

• • Explore your next steps for treatment, using the evidence-base for your chosen therapeutic framework to explain and justify your treatment choices
  • Think critically about the evidence, explore the barriers and facilitators to delivering treatment in this way
  • Link back to your identified goals (see ‘Making Interactions Person Centred’) – how is what you are proposing to do going to support Claire to achieve their treatment goals?
  • Consider how you can use other therapeutic interventions to support Claire e.g., psychopharmacological interventions, psychosocial interventions etc…
  • Think critically about the evidence, explore the barriers and facilitators to delivering care and treatment in this way
  • Link back to your identified goals (see ‘Making Interactions Person Centred’) – how is what you are proposing to do going to support Claire to achieve their treatment goals?
  • Consider where you think additional psychoeducation can be used to support Claires’ recovery
  • How will you engage other clinical professionals in treatment and why?

5. Risk management

What evidence-base strategies can you use to manage risk with Claire

Consider risk management approaches in your chosen therapeutic model

How can you promote positive risk-taking with Claire?

 

6. Questions

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Summative Assessment (Module 4a)

Scenario – Claire Smith

Claire Smith is a 33-year-old female with a diagnosis of emotionally unstable personality disorder. Claire is currently being cared for by your team in the community, although she is well known to both community and inpatient mental health services. Claire has an extensive history of admissions to inpatient mental health units and has had both informal and formal admissions between the ages of 16-29 years. Claire has not had an inpatient admission in the last 4 years but has remained under community mental health services.

Claire has a history of non-suicidal self-injury, most notably through making cuts to her arms and legs with a blade, swallowing batteries, and using an aerosol or lighters to burn her skin. Claire reports that the function of non-suicidal self-injury for her is to alleviate emotional distress and feelings of “emptiness”. Claire also has a history of taking overdoses of both prescribed and non-prescribed medications and tying ligatures to cut off her airway. Claire reports that the intention with these behaviours is to end her life.

Claire struggles to manage her emotions and reports that she experiences emotions very intensely, but that her emotional experiences can also change very rapidly with little warning. These intense emotional experiences have resulted in difficulties for Claire in maintaining her relationships with others, and she describes patterns of falling out with friends and family, and then making up with them again. Claire reports that ‘fallings out’ often result in low self-esteem and feelings of worthlessness that lead to feelings of suicidality.

Claire grew up in a household that she described as ‘volatile’ and reports witnessing emotional and physical abuse between her parents. Claire also reports that she has experienced sexual abuse from a family member at a young age. Claire does not have a relationship with either of her parents but is very close to her younger sister who also has a history of contact with mental health services. Claire lives with her younger sister and their pet cat in a rented flat in the city centre.

Although your team have been supporting Claire in the community for the last 4 years. Claire’s engagement with your service has been inconsistent over this time. Claire often misses appointments and does not reschedule or cancels last minute. When Claire does miss an appointment, she often does not return phone calls that day. Claire has recently split up with her partner and this has resulted in an increase in self-harming, and Claire has been to A&E three times in the last week following episodes of self-harm. Most recently Claire was treated at hospital following taking an overdose of paracetamol, and in her most recent appointment with the team she has spoken about thoughts of ending her life.

 

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