Question:
The initial examination or meeting with a client sets the “frame” which is considered the “whole” of the therapeutic alliance and work with a client.
Describe or define (don’t just state) some of the important aspects of the initial meeting and why you have chosen theses s some of the most important aspects. In other words, how influential and why are they influential as you work with a patient. Keep in mind part of the response focuses on the implications for the PMH-NP

Grading Rubric
The Paper
1. Length of Paper/Format for typing
The paper should be no more than 7 pages, a minimum of 5, use 12 point font and 1 inch margins, double-spaced. Title page and reference page do not count in the required total number of pages. Do not use lengthy direct quotes, please paraphrase important information from your references.
2. Format of Content
A. Introduction
State in a few sentences how you plan to answer the question. What will follow?
B. Body of Paper
Answer the question and include at least three different references to support your answer. Who said what? What has been reported? How do we know? From which resources do your answers come? Please provide one analysis of a study (research you describe that supports your response) and one or two references you use as “synthesis.”
C. Implications for the Psychiatric Mental Health Nurse Practitioner (PMH NP)
What 3-4 conclusions can you draw from your answer that will assist the PMH-NP in practice? How can he/she use the information you provided? How significant is the information and why?
D. Summary
Include a section that sums up what you presented – this should help you review if you kept to your introduction as stated – did you present what you said you would present in your introduction? Two or three sentences.  The Initial Examination Essay Paper

Rubric for Grading Essay Exam / Response

Total: 100 points
Introduction (10 points)
Clearly states how the student plans to answer the question. This lets the reader know the main points that will be covered in the body of the paper.

Body of Paper (40 points)
Presents information from the literature to support the response to the question. Statements should be supported and not just be ideas you might know or have concluded. The statements that support your response must all relate to the question you are answering. Be exact with statements. References should be included that support your answer. What research has been done? What has it shown? What experts have “weighed in” on your topic and what are their claims? Use synthesis statements or analysis of a research study to make your point or support your claims.

Implications for the PMH-NP (20 points)
Present at least three implications for the importance of your response for the PMH-NP in practice. Be specific regarding how the information you presented will assist with practice, improve practice, provide quality care, etc. Be sure not to give specific examples.

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Summary (5 points)
Provide a review of what you planned to cover and what you did cover. Three to four sentences,

Logical Flow of Paper (5 points)
Does your response flow? Do the ideas fit together into a whole response? Are the ideas you present disjointed? Do paragraphs have topic sentences so that ideas within a paragraph fit together?

Grammar / APA / Spelling (15 points)
Please proof your paper. Do not submit a paper with typos, spelling errors, poor grammar (such as incomplete sentences). APA format should be used

References (5 points). These must relate to the topic and be 3 different references. Only use Wheeler (text) as one reference: (Wheeler, K. (2014). Psychotherapy for the advanced practice psychiatric nurse, (2nd ed), New York: Springer Publishing Company.)

The Initial Examination or Meeting with a Client

Introduction

The ultimate aim of psychotherapy is to assist clients address and recover from the mental health issue that brought them into treatment. The treatment process starts during the initial interactions and therefore therapists are supposed to be acclimatized to exchanges with the client the instant the treatment starts (American Nurses Association, 2014). The initial meeting with the client is very valuable time during therapy because it is the time when the therapist and the therapist meet and decide if they are able to work together. Therefore, the initial assessment or meeting with the client forms the basis of a therapeutic alliance and the entire course of therapy as well. This paper will describe the most important aspects during the initial contact between the therapist and the client and provide a rationale for why these aspects are fundamental.

Creating a safe, private and trustful environment where the initial examination or the first meeting takes place is very important. The safe environment also involves the need for visual and hearing confidentiality in order to encourage trust (Apodaca et al, 2016).  According to Sadock et al (2014), a lack of trust can reduce the client’s participation in the therapy process, or might even threaten or scare the client. Therefore, during the initial meeting, it is important to create an environment of trust and confidentiality especially for distressed people, sexually abused clients as well as adolescents. For example, the therapist should assure the client that the therapy will take place in a private and separate environment. Easterbrook & Meeha (2017) further adds that the therapy environment also includes how the therapist welcomes the client, talks to them as well as other elements of non-verbal communication like body language. How the client treats the client during the initial contact is part of establishing a good therapy environment and the therapist is illustrating their use of respect and empathy, which a key guiding principle during therapy. Preparing a good therapy environment forms the basis to form an alliance and built trust (World Health Organization, 2013).  The Initial Examination Essay Paper

During the initial contact with the client, the therapist should avoid using judgmental words as this can make the client open up freely. It is also important for the therapist to show empathy and understanding to the client. Sadock et al (2014) provide that being nonjudgmental and showing empathy to the client during the initial contact assures them that the therapist will be understanding throughout the session and hence this is an important basis to forming a good client-therapist relationship.

Another important aspect during the initial contact with the client is to establish a good therapy environment by welcoming and greeting the client. According to Easterbrook & Meeha (2017), the therapist sets the tone for the therapeutic relationship by greeting the client. The warmth and the tone of the words used during the exchange can encourage connectedness between the therapist and the client. After the greetings, the nurse should then do introductions; the introduction is not only an important part of establishing a therapeutic relationship but it also creates trust and contributes to the client having confidence in the therapist (World Health Organization, 2013).

Seeking informed consent is another important aspect during the initial meeting with the client. Informed consent involves explaining to the client what the therapy involves so that the client can make an informed decision before accepting the therapy. Informed consent is vital because this gives the client a chance to consent to the treatment and at the same time the client understands what the treatment involves, including the risks and benefits associated with the treatment (Krieg & Tracey, 2016). Thomas-Anttila (2015) further adds that informed consent further improves the client’s confidence in the treatment because he/she is aware of what the treatment involves. Seeking informed consent also influences the therapeutic relationship because the client gains trust in the treatment and in the therapist, and also it makes the client more collaborative (Krieg & Tracey, 2016).

Another important aspect during the initial meeting with the client is to establish an understanding in the client that the therapist is entering into an alliance with the client that is safe, trustworthy, reliable and consistent with suitable and clear boundaries. This is because this helps in establishing a positive therapist-client relationship. Many clients with mental health and emotional problems tend to have issues like low self-esteem and this can be significantly improved through a good therapist-client relationship.  A randomized trial established that developing a positive therapeutic relationship is among the most important aspects of therapy outcomes (Krieg & Tracey, 2016).

Assuring the client of confidentiality and privacy is of equal importance during the initial assessment or the first meeting. This means that the therapist should explain to the client that their confidentiality and privacy would be respected and it would not be disclosed to a third party without their consent. Easterbrook & Meeha (2017) explain that healthcare providers have the duty of protecting their client’s information. In addition, assuring clients that their privacy and confidentiality would be respected facilitates a trustful therapist-client relationship. The client is able to open up and freely express him/herself without fearing that their confidentiality and privacy would be violated.

Finally, during the initial contact, the therapist should try to learn about the client and allow the client to talk openly while working to reduce the anxiety for the client. According to Marais & Merw (2016) during the initial examination or initial contact, the therapist should aim to demonstrate to the client that she will listen to the client and has a sense of the client’s suffering.  The therapist should also invite the client to ask any questions regarding the therapeutic process or the therapist. All these aspects relay a sense of hope to the client regarding the treatment process.

Implications for the Psychiatric Mental Health Nurse Practitioner (PMHNP)

PMHNP should be aware that the initial contact with the client sets the tone for the treatment, and it can influence the outcome as well as the duration of the treatment. Therefore, during the initial contact therapists should put effort to establish a strong alliance with the client in order to facilitate the probability of a successful treatment (Krieg & Tracey, 2016). During the initial contact, the PMHNP needs to be welcoming and warm to the client as this significantly contributes to a good therapeutic relationship. The PMHNP should introduce her/himself in order to give the client confidence regarding her/his competency as a therapist. The therapist should also prepare a trustful and a therapeutic environment; this assures the client that the therapy will take place in a safe environment (Easterbrook & Meeha, 2017).

The PMHNP also needs to make the client feel safe, listened to and understood during the first contact as this will reduce the probability of the client not returning for further treatment (World Health Organization, 2013). The therapist should actively listen to the client, pay attention and be empathic as this is likely to foster a good therapeutic relationship and also assure the client that the therapist is understanding (Apodaca et al, 2016). The Initial Examination Essay Paper

The PMHNP should utilize supportive and engaging techniques during the initial contact in order to be attuned to the experience of the client. The PMHNP should generate curiosity during the initial contact by being open and honest, being empathic and establishing trust. One way to establish trust is to assure the client of their privacy and confidentiality and seeking informed consent from the client before treatment begins. The therapist should also avoid being judgmental as this can make the client not to open up during the entire treatment process (Sadock et al, 2014).

Summary

During the initial contact, it is important to create a safe, private and trustful environment in order to promote the client’s participation in the treatment process. It is also important to assure clients of privacy and confidentiality during the initial contact in order foster trust and allow them to confide during the treatment process and at the same time foster a trustful therapist-client relationship. It is also important for the therapist to try to learn regarding the client during the initial contact and at the same time allow the client to talk freely and openly. It is also during the initial contact when the therapist should actively listen to the client in order to assure the client that the active listening will continue throughout the treatment process. as aforementioned, seeking informed consent from clients also influences the therapeutic relationship and fosters trust in the treatment process, in addition to making the client more collaborative in the therapy.

Basically, the initial contact with the client is very important in treatment. Evidence shows that how therapists conduct themselves during the initial contact significantly impacts the formation of a therapeutic relationship as well as the client’s engagement during the treatment process. Therefore, it is important for the PMHNP to put into consideration all the discussed aspects during the initial meeting with the clients in order to be effective in forming a positive relationship with the client and to give the client hope and confidence in the treatment.

References

American Nurses Association. (2014). Psychiatric-mental health nursing: Scope and standards of practice (2nd ed.). Washington, DC: Author.

Apodaca T, Jackson K, Borsari B, Magill M, Richard L, Nadine M & Barnett N. (2016). Which individual therapist behaviors elicit client change talk and sustain talk in motivational interviewing? J Subst Abuse Treat. 61(1), 60–65

Easterbrook C & Meeha T. (2017). The Therapeutic Relationship and Cognitive Behavioral Therapy: A Case Study of an Adolescent Girl with Depression.  The European Journal of Counselling Psychology. 6(1).

Krieg C & Tracey T. (2016). Client Interpersonal Problems and the Initial Working Alliance. The European Journal of Counseling Psychology. 24(2).

Marais C & Merw M. (2016). Relationship building during the initial phase of social work intervention with child clients in a rural area. Social work. 52(2).

Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer.

Thomas-Anttila, K. (2015). Confidentiality and consent issues in psychotherapy case

reports: The Wolf Man, Gloria and Jeremy. British Journal of Psychotherapy.31 (3), 360-375.

World Health Organization (2013). Counseling for Maternal and Newborn Health Care: A Handbook for Building Skills. Geneva: World Health Organization.  The Initial Examination Essay Paper

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Question:

The initial examination or meeting with a client sets the “frame” which is considered the “whole” of the therapeutic alliance and work with a client.

Describe or define (don’t just state) some of the important aspects of the initial meeting and why you have chosen theses s some of the most important aspects. In other words, how influential and why are they influential as you work with a patient. Keep in mind part of the response focuses on the implications for the PMH-NP

Grading Rubric

The Paper

1. Length of Paper/Format for typing

The paper should be no more than 7 pages, a minimum of 5, use 12 point font and 1 inch margins, double-spaced. Title page and reference page do not count in the required total number of pages. Do not use lengthy direct quotes, please paraphrase important information from your references.

2. Format of Content
3. Introduction

State in a few sentences how you plan to answer the question. What will follow?

1. Body of Paper

Answer the question and include at least three different references to support your answer. Who said what? What has been reported? How do we know? From which resources do your answers come? Please provide one analysis of a study (research you describe that supports your response) and one or two references you use as “synthesis.”

1. Implications for the Psychiatric Mental Health Nurse Practitioner (PMH NP)

What 3-4 conclusions can you draw from your answer that will assist the PMH-NP in practice? How can he/she use the information you provided? How significant is the information and why?

1. Summary

Include a section that sums up what you presented – this should help you review if you kept to your introduction as stated – did you present what you said you would present in your introduction? Two or three sentences.

Rubric for Grading Essay Exam / Response

Total: 100 points

Introduction (10 points)

Clearly states how the student plans to answer the question. This lets the reader know the main points that will be covered in the body of the paper.

Body of Paper (40 points)

Presents information from the literature to support the response to the question. Statements should be supported and not just be ideas you might know or have concluded. The statements that support your response must all relate to the question you are answering. Be exact with statements. References should be included that support your answer. What research has been done? What has it shown? What experts have “weighed in” on your topic and what are their claims? Use synthesis statements or analysis of a research study to make your point or support your claims.

Implications for the PMH-NP (20 points)

Present at least three implications for the importance of your response for the PMH-NP in practice. Be specific regarding how the information you presented will assist with practice, improve practice, provide quality care, etc. Be sure not to give specific examples.

Summary (5 points)

Provide a review of what you planned to cover and what you did cover. Three to four sentences,

Logical Flow of Paper (5 points)

Does your response flow? Do the ideas fit together into a whole response? Are the ideas you present disjointed? Do paragraphs have topic sentences so that ideas within a paragraph fit together?

Grammar / APA / Spelling (15 points)

Please proof your paper. Do not submit a paper with typos, spelling errors, poor grammar (such as incomplete sentences). APA format should be used

References (5 points). These must relate to the topic and be 3 different references. Only use Wheeler (text) as one reference:   (Wheeler, K. (2014).  Psychotherapy for the advanced practice psychiatric nurse, (2^nd ed), New York: Springer Publishing Company.)  The Initial Examination Essay Paper