Cognitive Behavior Therapy (CBT) is a therapy used to treat patients with mental illness. This therapy deals with the interaction between the experience and behavior of patients suffering mental health. CBT focus on 5 major points, behavior, thoughts, attitude, physical response, and atmosphere. These all points somewhere are correlated to each other and one can influence the actions of others. Evidence-based practice (EBP) in the provision of patient care requires correct information and the existing effective treatments. Nurses being an important part of healthcare services are also engaged in CBT. They help to improve the thoughts of patients and satisfy them by performing their duties (Kellett et al., 2019). The purpose of this assignment is to study the improvement in therapeutic relationship between patient and nurse by help of cognitive behavior theory. The structure includes the potential clinical nursing problems and a PICOT framework clinical question.
The patients with mental health care are the target role of nursing staff. Non-compliance of a patient is a major clinical problem or challenge for mental health of nurses. Moreover, the patient also starts feeling burnt-out without any emotional relationships (Berry et al., 2015). To overcome these situations and give better outcomes, several therapies are provided by the clinical government on efficiency and practice standards. These therapies include cognitive behavior theory, canine-assisted therapy, animal-assisted therapy, and natural sunlight. These therapies were help creating interactions between the nursing staff and patients, while maintain the therapeutic relationships and quality care (Coffey et al., 2019).
Moreover, by maintaining emotional and physical understanding and well treating the patients, positive feelings of patients and other service users are enhanced. In mental health, therapeutic role of nursing staff is to control the inpatient wards. In these wards, the nurses interacts with the patients and maintain their relationship for therapeutic progression and better results (McAllister et al., 2019).
Nursing profession needs care, skills, positive attitude, knowledge, and interactions. The clinical nurses deal with the care of patient such as feel them comfort, supportive, prevention of trauma, elevation of recovery, routinely health screening, appraisal, provide health education, and coordination of health care. Cognitive behaviour theory helps to improve the healthcare. It enhances the critical thinking of nurses and patient by increasing their communication and understanding. Nurses while performing their duties build up a mental image about the requirements or approaches, and the past experience related to that incident. They remind their past work to avoid same issues and proceed with safer technique. It is clear from this prospective that along with physical actions of healthcare workers, mental health is also involved. Healthcare providers like nurses are involved in CBT in clinical professions, and work together with other healthcare providers. This will enhance their critical thinking, skills, thoughts, actions and beliefs by addressing the problems of decision making. CBT approach is useful for nurses for performing their duties, as it helps to satisfy the patients and improve their physical and mental health (Ameel et al., 2019).
Considering the enhancement of evidence-based practice in healthcare sector, it will be more appropriate that future nurses will give knowledge about principles of CBT. According to a recent study, CBT provides high satisfaction rates among patients which is worth acceptable. Although it is not compulsory to train all the nurses about CBT, the only thing that is important is to develop non-traditional interventions among healthcare individuals (Moreno-Poyato et al., 2018). Along with the analgesics given to the patients, it is important to provide psychological help and mental support to the patient. These kind of mental support and interactions between the nurses and patient can help maintaining therapeutic relationships among them and produces better outcomes (Fitzpatrick et al., 2017). Another challenge faced by the nurses is the lack of skills and knowledge to implement CBT principles while ensuring the necessities of evidence-based practice. To overcome this issue and improve the knowledge of nurses about EBT, post-registration training must be provided.
P- Population- Nurses; I- Intervention- Cognitive behaviour therapy; C- Comparator- Therapeutic relationship; O-Outcome- Improved compliance to treatment.
Research Question: “Does Cognitive Behaviour Theory improve the therapeutic relationship of patients and nurses?” Or “Does cognitive Behaviour Theory reduce the mental illness of patient and improve compliance to treatment?”
The elements included in PICO framework, such as nurses, cognitive behaviour theory, therapeutic relationship, improved compliance to treatment are all corelated with each other. As mentioned above, the therapeutic relationship of nursing staff in mental health can be maintained by CBT. The study is conducted by the view of nurses, so the population will be nurse. Intervention is the therapies used to treat the mental health of a patient, which includes cognitive behavior theory (CBT), canine-assisted therapy, animal-assisted therapy, and natural sunlight. Among them the major focus of this assessment is on CBT. Comparative study is conducted on the therapeutic relationships between patient and nurses (McAllister et al., 2019). Outcome or results of this study suggest about the improved compliance to the treatment and mental health of the individual. This research question clearly aimed to support nursing staff to maintain therapeutic relationships with mental health patients. This question is selected for development of clinical practices like CBT and other therapies mentioned earlier. Moreover, it would help to enhance the professional knowledge among nurses for establishing better relationship with the patients (Hartley et al., 2020).
Overall, the clinical problems faced by the nursing staff is the non-compliance of the patient, their aggressive nature and reframing from the treatment. The solution to this problem is the therapies like CBT provided by the healthcare, which would help in maintaining the mental health. Moreover, there is broad scope of CBT and is proved to be beneficial for nursing staff. Along with the physical and mental health improvement, CBT is also useful for patients in other surroundings. Nurses by developing a bond and building the trust of patients, can improve their mental health. These therapies will help to produce better outcomes and improved compliance to treatment.
Ameel, M., Kontio, R., & Välimäki, M. (2019). Interventions delivered by nurses in adult outpatient psychiatric care: An integrative review. Journal of Psychiatric and Mental Health Nursing,26(9-10), 301-322. DOI:10.1111/jpm.12543
Berry, K., Haddock, G., Kellett, S., Roberts, C., Drake, R., & Barrowclough, C. (2015). Feasibility of a ward-based psychological intervention to improve staff and patient relationships in psychiatric rehabilitation settings. British Journal of Clinical Psychology,55(3), 236-252. DOI:10.1111/bjc.12082
Coffey, M., Hannigan, B., Barlow, S., Cartwright, M., Cohen, R., Faulkner, A., . . . Simpson, A. (2019). Recovery-focused mental health care planning and co-ordination in acute inpatient mental health settings: A cross national comparative mixed methods study. BMC Psychiatry,19(1), 115. DOI:10.1186/s12888-019-2094-7
Fitzpatrick, K.K., Darcy, A., & Vierhile, M. (2017). Delivering cognitive behaviour therapy to young adults with symptoms of depression and anxiety using a fully automated conversational agent (woebot): A randomized controlled trial. JMIR Mental Health,4(2), e19. DOI:10.2196/mental.7785
Hartley, S., Raphael, J., Lovell, K., & Berry, K. (2020). Effective nurse–patient relationships in mental health care: A systematic review of interventions to improve the therapeutic alliance. International Journal of Nursing Studies,102, 103490. DOI: 10.1016/j.ijnurstu.2019.103490
Kellett, S., Ghag, J., Ackroyd, K., Freshwater, K., Finch, J., Freear, A., . . . Simmonds‐Buckley, M. (2019). Delivering cognitive analytic consultancy to community mental health teams: Initial practice‐based evidence from a multi‐site evaluation. Psychology and Psychotherapy: Theory, Research and Practice. DOI:10.1111/papt.12221
Mc Allister, S., Robert, G., Tsianakas, V., & Mccrae, N. (2019). Conceptualising nurse-patient therapeutic engagement on acute mental health wards: An integrative review. International Journal of Nursing Studies,93, 106-118. DOI: 10.1016/j.ijnurstu.2019.02.013
Moreno-Poyato, A. R., Delgado-Hito, P., Suárez-Pérez, R., Lluch-Canut, T., Roldán-Merino, J. F., & Montesó-Curto, P. (2017). Improving the therapeutic relationship in inpatient psychiatric care: Assessment of the therapeutic alliance and empathy after implementing evidence-based practices resulting from participatory action research. Perspectives in Psychiatric Care,54(2), 300-308. DOI:10.1111/ppc.12238
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