Discussion: Legal and Ethical Considerations for Group and Family Therapy

Discussion: Legal and Ethical Considerations for Group and Family Therapy

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Considering the Health Insurance Portability and Accountability Act (HIPPA), the idea of discussing confidential information with a patient in front of an audience is probably quite foreign to you. However, in group and family therapy, this is precisely what the psychiatric mental health nurse practitioner does. In your role, learning how to provide this type of therapy within the limits of confidentiality is essential. For this Discussion, consider how limited confidentiality and other legal and ethical considerations might impact therapeutic approaches for clients in group and family therapy.

Learning Objectives

Students will:

  • Compare legal and ethical considerations for group and family therapy to legal and ethical considerations for individual therapy
  • Analyze the impact of legal and ethical considerations on therapeutic approaches for clients in group and family therapy
  • Recommend strategies to address legal and ethical considerations for group and family therapy

To prepare:

  • Review this week’s Learning Resources and consider the insights they provide on group and family therapy.
  • View the media, Legal and Ethical Issues for Mental Health Professions, Volume I, and reflect on legal and ethical considerations for group and family therapy and individual therapy.

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the Post to Discussion Question link and then select Create Thread to complete your initial post. Remember, once you click submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking Submit!

By Day 3

Post an explanation of how legal and ethical considerations for group and family therapy differ from those for individual therapy. Then, explain how these differences might impact your therapeutic approaches for clients in group and family therapy. Support your rationale with evidence-based literature.

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Revenue Sources

There are several advantages and disadvantages of various revenue sources as payment for services rendered in health care (e.g., managed care, prospective, retrospective).

  • What do you believe are the primary advantages and disadvantages of having multiple revenue sources for health care services offered by an organization for planning and reporting purposes?

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Marketing Proposal

You currently work for the development department of Sunny Manor Nursing and Rehab Center. Sunny Manor was once a privately owned small skilled nursing home in Sunny Beach, Florida until it was sold 6 years ago to a larger group of investors known for buying older nursing homes and developing them into larger more modern skilled nursing and rehab centers. Sunny Beach itself is a small retirement community close to larger beach towns. Most of the residents are 55 years or older, and there is a growing population of 70+ retired adults. However, the city is known for being technologically advanced for a retirement community. In fact, the city has a popular social media page followed by many residents and a very popular online newsletter that can be accessed through most social media programs. Also, 5 years ago, a brand new hospital opened just outside of Sunny Beach. This brought some the top physicians and surgeons in the state to the area.

Sunny Manor recently finished a major renovation, updating the previous long-term-care wings and adding a new wing with 20 new rooms. The new wing is solely dedicated to sub-acute rehab services, and the facility also added a new updated therapy room with an expanded therapy staff and modern high-tech equipment.

After working in care coordination and admissions for the past several years, you have been promoted to the development department and tasked with marketing the new facility. The goal is to build a stronger relationship with the discharge staff and physicians at the new hospital and expand a broader reach to the community.

The first step is for you to analyze and research the changing community and develop a marketing proposal for your boss, the director of development, on how to best connect with the community of Sunny Beach and increase referrals from the new hospital.

For this task, develop a summary marketing proposal on the above scenario that includes the following elements:

  • Evaluate the potential impact of the updated facility and new therapy services on potential improvements in patient satisfaction and developing new marketing share.
  • Assess possible methods to build rapport within Sunny Beach and surrounding communities.
  • Develop a plan for communicating with the community better through social media by connecting Sunny Manor to the residents of Sunny Beach through digital marketing.
  • Provide details on how ongoing research into the community will help Sunny Manor stay ahead of the competition and well connected with community. Consider concepts in monitoring the changing demographics of the community and growing health care sector.
  • Propose a research design model including all the key elements of the research design. Apply an assessment tool and implementation plan such as the Model for Improvement (Plan-Do-Study-Act [PDSA]).
  • Conclude with recommending models and/or tools that will be used to evaluate the effectiveness of the development teams’ efforts on an ongoing basis .

The body of the resultant report should  include at least 7 relevant peer-reviewed academic or professional references published within the past 5years.

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Journal Entry

Reflect on your overall practicum experience in this course. Then, address the following in your Practicum Journal:

  • Explain whether your therapeutic theory has changed as a result of your practicum experiences. Recall the theories you selected in Week 1.
  • Explain how you integrated the therapeutic approaches from this course in your clinical practice. Include how this helped you achieve the goals and objectives you developed in Week 1.
  • Explain how you might impact social change through your work with clients who have mental health issues.
  • Support your approach with evidence-based literature.

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Clinical Supervision

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This week, as you explore existential-humanistic therapy, you assess clients and consider the appropriateness of various therapeutic approaches. You also develop diagnoses for clients receiving psychotherapy and consider legal and ethical implications of counseling these clients.

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Existential-Humanistic Therapy Essay Assignments Discussion: Clinical Supervision

Clinical Supervision is an essential component of your development as a psychiatric mental health nurse practitioner. It provides an opportunity for professional collaboration as you share experiences with and gain insights from colleagues. For this Clinical Supervision, consider a client whom you do not think is adequately progressing according to expected clinical outcomes.

Existential-Humanistic Therapy Essay Assignments Learning Objectives

Students will:

  • Assess clients presenting for psychotherapy
  • Evaluate effectiveness of therapeutic approaches for clients receiving psychotherapy
  • Apply existential-humanistic therapy to clients with psychiatric disorders

To prepare:

  • Review this week’s media and consider the insights provided.
  • Reflect on the clients you are currently counseling at your practicum site.

By Day 3

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  • Describe a client you are counseling whom you do not think is adequately progressing according to expected clinical outcomes.

Note: Do not use the client’s actual name.

  • Explain your therapeutic approach with the client, including the perceived effectiveness of your approach.
  • Identify any additional information about this client that may potentially impact expected outcomes.

Note: Nurse practitioners must have strong oral communication skills. This Discussion is designed to help you hone these skills. When filming your Kaltura video, be sure to dress and speak in a professional manner.

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Adolescent Clients-Practicum Journal

Select a child or adolescent client whom you observed or counseled this week. Then, address the following in your Practicum Journal:

  • Describe the client (without violating HIPAA regulations) and identify any pertinent history or medical information, including prescribed medications.
  • Using the DSM-5, explain and justify your diagnosis for this client.
  • Explain any legal and/or ethical implications related to counseling this client.
  • Support your position with evidence-based literature.

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Practicum Journal

elect a client whom you observed or counseled this week. Then, address the following in your Practicum Journal:

  • Describe the client (without violating HIPAA regulations) and identify any pertinent history or medical information, including prescribed medications.
  • Using the DSM-5, explain and justify your diagnosis for this client.
  • Explain whether motivational interviewing would be effective with this client. Include expected outcomes based on this therapeutic approach. Support your approach with evidence-based literature.
  • Explain any legal and/or ethical implications related to counseling this client.

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U.S Health Care Nonprofit and For-Profit

Part 1:

Despite the documented challenges that the U.S. health care system faces, it also enjoys a number of advantages over other systems around the world.

  • Choose 2 other countries from around the world and discuss the strengths of the U.S. health care system as compared to these countries from an administrator’s and a third-party payer’s perspectives.
  • In your answer, be sure to not only discuss each strength, but provide an explanation as to why you believe the United States has this advantage over the other countries you chose.

Part 2:

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Identify a nonprofit health care organization and a for-profit health care organization of your choosing (not an organization mentioned in part 1). Answer the following:

  • Summarize the types of services provided, clientele served, and provider groups involved.
  • Compare and contrast the strengths and weaknesses of each organization from patient, provider, administrator, and third-party payer perspectives.
  • Provide at least 2 suggestions for each organization to minimize the identified weaknesses.
  • Summarize which organization you would rather be part of, using rationale.

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Assessing Client Progress

Part 1: Progress Note

Using the client from  your week 3 Assignment, address the following in a progress note (without violating HIPPA regulations):

Treatment modality used and efficacy of approach

Progress and/or lack of progress toward the mutually agreed upon client goals (reference the Treatment plan-progress towards goals)

Modifications of the treatment plan that were made based on progress/lack of progress

Clinical impressions regarding diagnosis and/or symptoms

Relevant psycho social information or changes from original assessment (i.e., marriage, separation/divorce, new relationships, move to a new house/apartment, change of job, etc.)

Safety issues

Clinical emergencies/action taken

Medications used by the patient (even if the nurse psychotherapist was not the on e prescribing them)

Treatment compliance/lack of compliance

Clinical consultations

Collaboration with other professionals (i.e., phone consultations with physicians, psychiatrists, marriage/family therapists, etc.)

Therapist’s recommendations, including whether the client agreed to the recommendations

Referrals made/reasons for making referrals

Termination/issues that are relevant to the termination process (i.e., client informed of loss of insurance company to pay for continued sessions)

Issues related to consent and/or informed consent for treatment

Information concerning child abuse, and/or elder or dependent adult abuse, including documentation as to where the abuse was reported

Information reflecting the therapist’s exercise of clinical judgement

NOTE: Be sure to exclude any information that should not be found in a discoverable progress note.

 

Part 2:Privileged Note

Prepare a Privileged psychotherapy note that you would use to document your impressions of therapeutic progress/therapy sessions for your client from the week 3 Practicum Assignment

The privileged note should include items that you would not typically include in a note as part of the clinical record.

Explain why the items you included in the privileged note would not be included in the client’s progress note.

 

 

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Hopsital Charitable Services

Which type of hospital do you believe provides more charitable health care services, and why?

Does the length of stay differ in for-profits versus non-profits? Why or why not?

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