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Complex Mental Health, Trauma and Recovery

CHIME Recovery Process 1:

Connectedness- This is one of the main process that can be useful in patients who might reflect upon a potential in themselves to recover. The process is also based on respect as well as emotional availability of the person for ramifications. This method can be applied for the patient on a one-on-one basis, getting to know his limitations as his impairments on a personal level (Kverme, 2019). The process makes use of mutual support of the patient and the care giver. Thus, it can be deemed as quite fruitful in pacing the recovery process and helping the patient to attain his self-esteem and confidence.

MH Nursing Interventions for the Consumer:

Intervention 1: Exploring the meaningful losses beared by the client. Patient can be provided with safe portal or platform to express his anger or remorse for any familial or personal loss he might have experienced in his life. Personal losses can impact gravely on the sound functionality of the cognitive and emotional aspect of the person’s behavior (Watson, 2020). By letting things out, the patient might feel a bot relieved of his stresses and discomfort her might be experiencing. This can also be helpful for developing fruitful stress management skills for the patient and thus, helping in reducing the overall impact of the same on the patient’s daily routine.

Intervention 2: The intervention can also be applied to reduce the incidences of suicidal thoughts in the patient (Grover, 2018). The patient can be encouraged to not make decision, in times he is going through emotional crisis. The patient can be encouraged to spend more time with family and friends. Reliving the isolation scenarios, can be helpful providing safety and comfort to the patient. Presence of family and friends during counselling sessions can also provide a good medium to vent out the emotions and thus, reliving the added stress and anxiety of the patient. This will be helpful for the patient to ponder upon things before having suicidal thoughts.

Intervention 3: The negative pattern and though processes can be identified for the patient to concentrate more upon. For enabling so a good rapport with the patient should be established (McKenzie, 2018). There is a dire need of accepting approach for the patient to do so. Analyzing these symptoms will help in making sense for the interventions to be implemented for the patient, that might be beneficial in eliminating these barriers. The patient should also be made aware of his current status, to keep him constantly engaged in the process of recovery. This intervention will also be fruitful in maintaining and promoting a safe environment, with minimal possible stimulation to trigger components.

Critical Discussion Linking Interventions back to the CHIME Recovery Process 1:

The patient in the given case study started having his symptoms aggravation, after loosing his mother. The method of connectedness is the best possible option in the given case scenario. By providing the patient with a secure and safe niche, the nurse can help in patient’s transformation on a bigger scale. The process of connectedness involves being constantly engaged with the patient (Hagen, 2017). This method can thus, be very helpful in providing the nurse, a deeper insight about the triggers that might cause an onset of depression, stress or anxiety in the patient. The process also helps in defining newer approaches of customized care, in accordance with the healthcare needs of the patient. the collaborative approach of involvement of family and support group, can also be very fruitful in the process. Despite having a diagnosis of major depressive disorder, patient reflects upon the positive attitude towards abstaining himself from alcohol intake. This can be observed as a positive factor, that can be worked upon to bring about positive reinforcement and behavioral changes in the patient. The process of connectedness also ensures that the patient has safe surroundings to express himself. This method can thus, prove to be quite effective for Alexander, as he has little trust in people around him.

CHIME Recovery Process 2:

Meaning in life- This method helps in developing coping and self-management strategies for the patients. The process aims at developing and enhancing the problem-solving nature for the patient. the main key is to have a better understanding of the stress points and possible crisis events, that can deter the recovery process of the patient. The nurse also helps the patient to understand the overall role of sustaining the recovery process and the benefits it may give to the patient, upon implementation (Glaw, 2017) The idea is to develop a sense of meaning and purpose in the process and its direct impact on the developing a progressive narrative for the patient.

MH Nursing Interventions for the Consumer:

Intervention 1: The primary intervention in this process can be psychotherapy. Evidence-based studies have proven that psychotherapeutic treatment provide an overall and composite support to patients suffering from major depressive disorders (Dunlop, 2016). This intervention can be rendered through multiple ways. Some of the common methods include behavioral therapy, cognitive therapy, cognitive behavioral therapy, interpersonal psychotherapy, problem-solving therapy and self-control of self- management therapy. 

Intervention 2: The nurses can also help the patient, by assuming active role in initiating the communication. The patient might not feel secure in expressing himself to another person, due underlying fear, stress and uncertainty. It is therefore, imperative to set up a supporting and free environment to the patient, to allow them freedom of expression. The nurse can allow the patient with ample amount of time to respond to the questions he might be subjected to. Patient can also be encouraged to write down his feelings, in case he is not comfortable with speaking out for his concerns (Czekierda, 2017). This will help the nurses to have an insight into the non-competitive activities which might hinder with the recovery process. By doing so the grey areas of concerns can be acknowledged and rectified effectively.

Intervention 3: Educating the patient about depression can also be an effective management strategy. The stigma associated with the disease is found to add misery to the patient’s stress and anxiety. Nurse can help in facilitating the barrier to these thoughts and help patient with easing up in expressing his concerns and feelings. This can also be helpful to engage the patient in pleasurable activities and thus, inducing a positive reinforcement in his behavioral and personal approach. This method can also be effective for helping the patients realize on the distorted perceptions (Hopwood, 2018) and thus, liking the same with their depressive state of mind. It can be good source of self-reflection for the patient, instigating him positively to make behavioral changes.

Critical Discussion Linking Interventions back to the CHIME Recovery Process 2:

Meaning of life can prove to be quite a reliable method in the given case study. The patient Alexander, can be observed to have a loss of interest in life. However, he can still be observed to ponder upon the impact of his condition on his family, for whom he cares a lot. This point can be used for the benefit of the patient, by helping him realizing what all he is missing on and the future prospects he might have post recovery. Meaning of life can help the patient with analyzing his condition from a positive aspect. The stress and anxiety of the patient, might be shadowing the patient judgement to ponder upon the possibilities and the positive factors associated with his life. This method can be apt for the given case scenario as it will help in positive reinforcement and will also help in reducing the suicidal ideation of the patient (Heisel, 2016). This method can help with reducing the overall impact of the associated risk factors for the patient.

Reference for Recovery Focused Nursing Care Plan

Czekierda, K., Banik, A., Park, C. L., & Luszczynska, A. (2017). Meaning in life and physical health: Systematic review and meta-analysis. Health Psychology Review11(4), 387-418. https://doi.org/10.1080/17437199.2017.1327325

Dunlop, B. W. (2016). Evidence-based applications of combination psychotherapy and pharmacotherapy for depression. Focus14(2), 156-173. https://doi.org/10.1176/appi.focus.20150042

Glaw, X., Kable, A., Hazelton, M., & Inder, K. (2017). Meaning in life and meaning of life in mental health care: An integrative literature review. Issues in Mental Health Nursing38(3), 243-252. https://doi.org/10.1080/01612840.2016.1253804

Grover, S., Avasthi, A., Sahoo, S., Lakdawala, B., Dan, A., Nebhinani, N., ... & Suthar, N. (2018). Relationship of loneliness and social connectedness with depression in elderly: A multicentric study under the aegis of Indian Association for Geriatric Mental Health. Journal of Geriatric Mental Health5(2), 99. 10.4103/jgmh.jgmh_26_18

Hagen, J., Knizek, B. L., & Hjelmeland, H. (2017). Mental health nurses' experiences of caring for suicidal patients in psychiatric wards: an emotional endeavor. Archives of Psychiatric Nursing31(1), 31-37. https://doi.org/10.1016/j.apnu.2016.07.018

Heisel, M. J., Neufeld, E., & Flett, G. L. (2016). Reasons for living, meaning in life, and suicide ideation: investigating the roles of key positive psychological factors in reducing suicide risk in community-residing older adults. Aging & Mental Health20(2), 195-207. https://doi.org/10.1080/13607863.2015.1078279

Hopwood, C. J. (2018). A framework for treating DSM‐5 alternative model for personality disorder features. Personality and Mental Health12(2), 107-125. https://doi.org/10.1002/pmh.1414

Kverme, B., Natvik, E., Veseth, M., & Moltu, C. (2019). Moving toward connectedness–a qualitative study of recovery processes for people with borderline personality disorder. Frontiers in psychology10, 430. https://doi.org/10.3389/fpsyg.2019.00430

McKenzie, S. K., Collings, S., Jenkin, G., & River, J. (2018). Masculinity, social connectedness, and mental health: Men’s diverse patterns of practice. American Journal of Men's Health12(5), 1247-1261. https://doi.org/10.1177%2F1557988318772732

Watson, R., Harvey, K., McCabe, C., & Reynolds, S. (2020). Understanding anhedonia: A qualitative study exploring loss of interest and pleasure in adolescent depression. European Child & Adolescent Psychiatry29(4), 489-499. https://doi.org/10.1007/s00787-019-01364-y.

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