6503-4

Theory-Driven Advanced Practice

© 2023 Walden University, LLC 1

Theory-Driven Advanced Practice

WHO ARE YOU You are an advanced MSW student interning with Newcastle Behavioral Health Services (NBHS). NBHS is a structured outpatient program with five licensed social workers. The agency’s scope of practice includes adults and geriatric populations with DSM-5 diagnoses. You are responsible for follow-up services for patients discharged from inpatient care.

• CLICK HERE TO CONTINUE TO MEET YOUR CLIENT.

MEET YOUR CLIENT Molly Millhouse (21-year-old, Black and Native American, female, single, Protestant) was referred to you as part of her step-down discharge planning. She was inpatient at the local mental health facility, where she received intensive (daily) therapy for alcohol addiction and major depressive disorder. She was discharged in the care of her parents. Her intake includes admissions to your structured outpatient program for a period of no less than 8 weeks with individual and group therapy (as needed). She is highly motivated to engage and has participated fully in Alcoholics Anonymous meetings, medication management, and all follow-up appointments. Molly has 1 year of college left and is eager to return.

• CLICK HERE TO DECISION POINT 1 - THEORETICAL PERSPECTIVE.

Theory-Driven Advanced Practice

© 2023 Walden University, LLC 2

DECISION POINT 1 - THEORETICAL PERSPECTIVE Which of the following three theories would best help you engage and begin to intervene with the client? OPTION 1 Person-centered theory (also known as client-centered theory).

• RESPONSE OPTION 1 – CLICK HERE TO CHOOSE OPTION 1 FOR DECISION POINT 1.

OPTION 2 Psychodynamic theory.

• RESPONSE OPTION 2 – CLICK HERE TO CHOOSE OPTION 2 FOR DECISION POINT 1.

OPTION 3 Cognitive theory.

• RESPONSE OPTION 3 – CLICK HERE TO CHOOSE OPTION 3 FOR DECISION POINT 1.

Theory-Driven Advanced Practice

© 2023 Walden University, LLC 3

DECISION POINT 2 - PERSON-CENTERED THEORY This is Molly’s first session with you. It has been 3 weeks since her inpatient discharge. After brief introductions (including informed consent), and making sure the appropriate release of information forms are signed, you settle into the interview.

• CLICK HERE TO CONTINUE TO TODAY’S SESSION TODAY’S SESSION - PERSON-CENTERED THEORY Molly: I do not want to go back “there.”… I’ve been this way my whole life. I am never going to be “normal.” Which response best fits the theory you chose? OPTION 1 – PERSON-CENTERED THEORY Tell me what you think “normal” looks like.

• RESPONSE OPTION 1 – CLICK HERE TO CHOOSE OPTION 1 FOR DECISION POINT 2.

OPTION 2 – PERSON-CENTERED THEORY How long have you been feeling like you are not “normal”?

• RESPONSE OPTION 2 – CLICK HERE TO CHOOSE OPTION 2 FOR DECISION POINT 2.

OPTION 3 – PERSON-CENTERED THEORY I hear that you are concerned about going back to inpatient care. Tell me more about that.

• RESPONSE OPTION 3 – CLICK HERE TO CHOOSE OPTION 3 FOR DECISION POINT 2.

Theory-Driven Advanced Practice

© 2023 Walden University, LLC 4

DECISION POINT 2 FEEDBACK - PERSON-CENTERED THEORY OPTION 1 FEEDBACK – PERSON-CENTERED THEORY Molly: I don’t know, I’m not sure I will ever get there. I look at myself and think “that person is strange” and “that person does not have herself together.” The thoughts just stick with me. It might have started when I was adopted. Try again. This choice does not best align with the theory you chose.

• CLICK HERE TO TRY DECISION POINT 2 AGAIN. OPTION 2 FEEDBACK – PERSON-CENTERED THEORY Molly: Well, I was adopted, and I’ve always felt out of place and uncertain about whether I’m meeting everyone’s expectations. My family life wasn’t like my friends’ families. I couldn’t bring my friends over, because of my dad’s alcoholism. I had to hide it. So, my childhood was kind of isolating. Try again. This choice does not best align with the theory you chose.

• CLICK HERE TO TRY DECISION POINT 2 AGAIN. OPTION 3 FEEDBACK – PERSON-CENTERED THEORY Molly: I didn’t like being separated from my friends. I missed a semester of school while I was there. I just want to move forward with my degree—and my life. I think I can do this without having to be in the hospital. Being there felt like my life was on hold. It reminded me of foster care, before I was adopted. You say, “I hear what you’re saying. Tell me more about that.”

• CLICK HERE TO CONTINUE TO DECISION POINT 3.

Theory-Driven Advanced Practice

© 2023 Walden University, LLC 5

DECISION POINT 3 - PERSON-CENTERED THEORY Molly: I have been thinking a lot about my life and how it may have turned out differently, if my dad wasn’t an alcoholic. Which response best fits the theory you chose? OPTION 1 – PERSON-CENTERED THEORY Tell me more about your current situation from the lens of a past experience.

• RESPONSE OPTION 1 – CLICK HERE TO CHOOSE OPTION 1 FOR DECISION POINT 3.

OPTION 2 – PERSON-CENTERED THEORY Tell me how supported you feel by others around you (friends, family, others)?

• RESPONSE OPTION 2 – CLICK HERE TO CHOOSE OPTION 2 FOR DECISION POINT 3.

OPTION 3 – PERSON-CENTERED THEORY When you think about your life, how does your drinking parallel your dad’s drinking?

• RESPONSE OPTION 3 – CLICK HERE TO CHOOSE OPTION 3 FOR DECISION POINT 3.

Theory-Driven Advanced Practice

© 2023 Walden University, LLC 6

DECISION POINT 3 FEEDBACK - PERSON-CENTERED THEORY OPTION 1 FEEDBACK – PERSON-CENTERED THEORY Molly: I’ve never belonged anywhere, in any family. My birth parents didn’t know how to take care of me. I spent years in and out of foster care. I felt unimportant, unwanted. And I never had enough time to settle in and connect before I was off someplace else. Try again. This choice does not best align with the theory you chose.

• CLICK HERE TO TRY DECISION POINT 3 AGAIN. OPTION 2 FEEDBACK – PERSON-CENTERED THEORY Molly: My college friends have really been there for me. I can text them at any time. My mom is busy, but I can call her if I need to. You say, “It sounds to me like you have had a hard time. I am hearing that your friends have been an important support for you. And it sounds like they may worry about you when you drink, too.”

• CLICK HERE TO CONTINUE TO DECISION POINT 4. OPTION 3 FEEDBACK – PERSON-CENTERED THEORY Molly: When I drink, that’s the only time I do feel normal. I started drinking just at kids’ parties, to fit in. But then it turned into something else. My friends drink too, but it doesn’t seem to affect them the same way. It also connects me to my dad. As a kid, when my dad had a bad day at work, he drank to relax. I drink when I’m upset too. Try again. This choice does not best align with the theory you chose.

• CLICK HERE TO TRY DECISION POINT 3 AGAIN.

Theory-Driven Advanced Practice

© 2023 Walden University, LLC 7

DECISION POINT 4 - PERSON-CENTERED THEORY Molly: Yeah, my friends have been worried about me. … When I think about my life and all the mistakes I always make, it just makes me sad. And then I drink. Which response best fits the theory you chose? OPTION 1 – PERSON-CENTERED THEORY Have you shared your feelings with your friends?

• RESPONSE OPTION 1 – CLICK HERE TO CHOOSE OPTION 1 FOR DECISION POINT 4.

OPTION 2 – PERSON-CENTERED THEORY I see. Can you tell me about a time when you did not make a mistake – and instead made a wise decision (like coming here for instance)?

• RESPONSE OPTION 2 – CLICK HERE TO CHOOSE OPTION 2 FOR DECISION POINT 4.

OPTION 3 – PERSON-CENTERED THEORY How does your family typically react to crises like this?

• RESPONSE OPTION 3 – CLICK HERE TO CHOOSE OPTION 3 FOR DECISION POINT 4.

Theory-Driven Advanced Practice

© 2023 Walden University, LLC 8

DECISION POINT 4 FEEDBACK - PERSON-CENTERED THEORY OPTION 1 FEEDBACK – PERSON-CENTERED THEORY Molly: Mostly, I keep things to myself. I’m used to taking care of my own problems. I guess they all know now, since they found me in my room after taking all those pills. You say, “Thank you for sharing that with me. It seems like you have a lot on your mind. Would you like to tell me more?”

• CLICK HERE TO CONTINUE TO DECISION POINT 5. OPTION 2 FEEDBACK – PERSON-CENTERED THEORY Molly: Deciding to go to college. I’m proud of myself for getting accepted, going, and feeling independent after so much chaos at home. Try again. This choice does not best align with the theory you chose.

• CLICK HERE TO TRY DECISION POINT 4 AGAIN. OPTION 3 FEEDBACK – PERSON-CENTERED THEORY Molly: My mom tries to fix things—like right now making sure I have insurance coverage so I get the right treatment. My mom takes over. My dad doesn’t say much. He goes out with his friends to let off steam. Try again. This choice does not best align with the theory you chose.

• CLICK HERE TO TRY DECISION POINT 4 AGAIN.

Theory-Driven Advanced Practice

© 2023 Walden University, LLC 9

DECISION POINT 5 - PERSON-CENTERED THEORY Molly: My dad was my best fiend. We did everything together. I should have been a better daughter, and maybe he wouldn’t drink so much. Which response best fits the theory you chose? OPTION 1 – PERSON-CENTERED THEORY I noticed you said “fiend.” Did you mean “friend”? Tell me more about your relationship with your dad.

• RESPONSE OPTION 1 – CLICK HERE TO CHOOSE OPTION 1 FOR DECISION POINT 5.

OPTION 2 – PERSON-CENTERED THEORY If you were granted one wish, what would you wish that would change your life for the better?

• RESPONSE OPTION 2 – CLICK HERE TO CHOOSE OPTION 2 FOR DECISION POINT 5.

OPTION 3 – PERSON-CENTERED THEORY What do you think are the qualities that make a good daughter?

• RESPONSE OPTION 3 – CLICK HERE TO CHOOSE OPTION 3 FOR DECISION POINT 5.

Theory-Driven Advanced Practice

© 2023 Walden University, LLC 10

DECISION POINT 5 FEEDBACK - PERSON-CENTERED THEORY OPTION 1 FEEDBACK – PERSON-CENTERED THEORY Molly: No, I meant “fiend.” Because growing up I’d be his mischievous sidekick. We’d just go and have fun and not care about anything else, and I wanted to be like him. But the drinking kind of took over. Try again. This choice does not best align with the theory you chose.

• CLICK HERE TO TRY DECISION POINT 5 AGAIN. OPTION 2 FEEDBACK – PERSON-CENTERED THEORY Molly: There is so much I’d want to change, it’s overwhelming. That’s why I’m here. But I guess if it was just one thing I’d say my dad’s alcoholism. If I’d never seen him drinking, I doubt I would have started in the first place. You say, “I am noticing two things. Drinking seems to be a central force in your life and right now you appear down. Am I right, and can you tell me more about that?”

• CLICK HERE TO CONTINUE TO DECISION POINT 6. OPTION 3 FEEDBACK – PERSON-CENTERED THEORY Molly: A good daughter doesn’t drink, doesn’t get in trouble, helps her parents. I was an enabler to my dad’s drinking. Try again. This choice does not best align with the theory you chose.

• CLICK HERE TO TRY DECISION POINT 5 AGAIN.

Theory-Driven Advanced Practice

© 2023 Walden University, LLC 11

DECISION POINT 6 - PERSON-CENTERED THEORY Molly: Yes to both. I am sad and worried I’m going to be alone, once my friends find out the real me. I’ve never been good at keeping friends. I’ve always been the weird kid with the weird parents. Which response best fits the theory you chose? OPTION 1 – PERSON-CENTERED THEORY Can you give me an example of what supports the thought that you have “never been good at keeping friends”?

• RESPONSE OPTION 1 – CLICK HERE TO CHOOSE OPTION 1 FOR DECISION POINT 6.

OPTION 2 – PERSON-CENTERED THEORY What is the one "weird” thing that you would like to change about your family?

• RESPONSE OPTION 2 – CLICK HERE TO CHOOSE OPTION 2 FOR DECISION POINT 6.

OPTION 3 – PERSON-CENTERED THEORY Maintaining friendships can be difficult, especially as you enter adulthood. Can you give me one quality of a good friend that you possess?

• RESPONSE OPTION 3 – CLICK HERE TO CHOOSE OPTION 3 FOR DECISION POINT 6.

Theory-Driven Advanced Practice

© 2023 Walden University, LLC 12

DECISION POINT 6 FEEDBACK - PERSON-CENTERED THEORY OPTION 1 FEEDBACK – PERSON-CENTERED THEORY Molly: As a kid, I moved schools a lot because I was “acting up.” I couldn’t keep the friends from the old school, we just sort of lost touch. Or maybe they actively dropped me. With each one, I moved on to try to make new friends, then something else would mess it up. Now, I feel like my college friends are just freaked out by me. Try again. This choice does not best align with the theory you chose.

• CLICK HERE TO TRY DECISION POINT 6 AGAIN. OPTION 2 FEEDBACK – PERSON-CENTERED THEORY Molly: Well, the secrecy and silence about my dad’s drinking. Other people stayed away. They knew something was up. It didn’t help that I look different from my parents. Try again. This choice does not best align with the theory you chose.

• CLICK HERE TO TRY DECISION POINT 6 AGAIN. OPTION 3 FEEDBACK – PERSON-CENTERED THEORY Molly: Hmm… I would call myself a good listener. I’ve been through a lot so sometimes I can be helpful to friends if they are going through something similar. You say, “You’ve given us a lot to talk about. I am noticing themes of self-confidence and self-esteem, substance abuse, and relationship-building. I hope you feel we’ve already made great progress in this first session. Think about where you’d like to start next time.”

• CLICK HERE TO CONTINUE TO THE CONCLUSION.

Theory-Driven Advanced Practice

© 2023 Walden University, LLC 13

DECISION POINT 2 - PSYCHODYNAMIC THEORY This is Molly’s first session with you. It has been 3 weeks since her inpatient discharge. After brief introductions (including informed consent), and making sure the appropriate release of information forms are signed, you settle into the interview.

• CLICK HERE TO CONTINUE TO TODAY’S SESSION TODAY’S SESSION - PSYCHODYNAMIC THEORY Molly: I do not want to go back “there.”… I’ve been this way my whole life. I am never going to be “normal.” Which response best fits the theory you chose? OPTION 1 – PSYCHODYNAMIC THEORY Tell me what you think “normal” looks like.

• RESPONSE OPTION 1 – CLICK HERE TO CHOOSE OPTION 1 FOR DECISION POINT 2.

OPTION 2 – PSYCHODYNAMIC THEORY How long have you been feeling like you are not “normal”?

• RESPONSE OPTION 2 – CLICK HERE TO CHOOSE OPTION 2 FOR DECISION POINT 2.

OPTION 3 – PSYCHODYNAMIC THEORY I hear that you are concerned about going back to inpatient care. Tell me more about that.

• RESPONSE OPTION 3 – CLICK HERE TO CHOOSE OPTION 3 FOR DECISION POINT 2.

Theory-Driven Advanced Practice

© 2023 Walden University, LLC 14

DECISION POINT 2 FEEDBACK - PSYCHODYNAMIC THEORY OPTION 1 FEEDBACK – PSYCHODYNAMIC THEORY Molly: I don’t know, I’m not sure I will ever get there. I look at myself and think “that person is strange” and “that person does not have herself together.” The thoughts just stick with me. It might have started when I was adopted. Try again. This choice does not best align with the theory you chose.

• CLICK HERE TO TRY DECISION POINT 2 AGAIN. OPTION 2 FEEDBACK – PSYCHODYNAMIC THEORY Molly: Well, I was adopted, and I’ve always felt out of place and uncertain about whether I’m meeting everyone’s expectations. My family life wasn’t like my friends’ families. I couldn’t bring my friends over, because of my dad’s alcoholism. I had to hide it. So, my childhood was kind of isolating. You say, “I hear what you’re saying. Tell me more about that.”

• CLICK HERE TO CONTINUE TO DECISION POINT 3. OPTION 3 FEEDBACK – PSYCHODYNAMIC THEORY Molly: I didn’t like being separated from my friends. I missed a semester of school while I was there. I just want to move forward with my degree—and my life. I think I can do this without having to be in the hospital. Being there felt like my life was on hold. It reminded me of foster care, before I was adopted. Try again. This choice does not best align with the theory you chose.

• CLICK HERE TO TRY DECISION POINT 2 AGAIN.

Theory-Driven Advanced Practice

© 2023 Walden University, LLC 15

DECISION POINT 3 - PSYCHODYNAMIC THEORY Molly: I have been thinking a lot about my life and how it may have turned out differently, if my dad wasn’t an alcoholic. Which response best fits the theory you chose? OPTION 1 – PSYCHODYNAMIC THEORY Tell me more about your current situation from the lens of a past experience.

• RESPONSE OPTION 1 – CLICK HERE TO CHOOSE OPTION 1 FOR DECISION POINT 3.

OPTION 2 – PSYCHODYNAMIC THEORY Tell me how supported you feel by others around you (friends, family, others)?

• RESPONSE OPTION 2 – CLICK HERE TO CHOOSE OPTION 2 FOR DECISION POINT 3.

OPTION 3 – PSYCHODYNAMIC THEORY When you think about your life, how does your drinking parallel your dad’s drinking?

• RESPONSE OPTION 3 – CLICK HERE TO CHOOSE OPTION 3 FOR DECISION POINT 3.

Theory-Driven Advanced Practice

© 2023 Walden University, LLC 16

DECISION POINT 3 FEEDBACK - PSYCHODYNAMIC THEORY OPTION 1 FEEDBACK – PSYCHODYNAMIC THEORY Molly: I’ve never belonged anywhere, in any family. My birth parents didn’t know how to take care of me. I spent years in and out of foster care. I felt unimportant, unwanted. And I never had enough time to settle in and connect before I was off someplace else. You say, “It sounds to me like you have had a hard time. I am hearing that your friends have been an important support for you. And it sounds like they may worry about you when you drink, too.”

• CLICK HERE TO CONTINUE TO DECISION POINT 4. OPTION 2 FEEDBACK – PSYCHODYNAMIC THEORY Molly: My college friends have really been there for me. I can text them at any time. My mom is busy, but I can call her if I need to. Try again. This choice does not best align with the theory you chose.

• CLICK HERE TO TRY DECISION POINT 3 AGAIN.

OPTION 3 FEEDBACK – PSYCHODYNAMIC THEORY Molly: When I drink, that’s the only time I do feel normal. I started drinking just at kids’ parties, to fit in. But then it turned into something else. My friends drink too, but it doesn’t seem to affect them the same way. It also connects me to my dad. As a kid, when my dad had a bad day at work, he drank to relax. I drink when I’m upset too. Try again. This choice does not best align with the theory you chose.

• CLICK HERE TO TRY DECISION POINT 3 AGAIN.

Theory-Driven Advanced Practice

© 2023 Walden University, LLC 17

DECISION POINT 4 - PSYCHODYNAMIC THEORY Molly: Yeah, my friends have been worried about me. … When I think about my life and all the mistakes I always make, it just makes me sad. And then I drink. Which response best fits the theory you chose? OPTION 1 – PSYCHODYNAMIC THEORY Have you shared your feelings with your friends?

• RESPONSE OPTION 1 – CLICK HERE TO CHOOSE OPTION 1 FOR DECISION POINT 4.

OPTION 2 – PSYCHODYNAMIC THEORY I see. Can you tell me about a time when you did not make a mistake – and instead made a wise decision (like coming here for instance)?

• RESPONSE OPTION 2 – CLICK HERE TO CHOOSE OPTION 2 FOR DECISION POINT 4.

OPTION 3 – PSYCHODYNAMIC THEORY How does your family typically react to crises like this?

• RESPONSE OPTION 3 – CLICK HERE TO CHOOSE OPTION 3 FOR DECISION POINT 4.

Theory-Driven Advanced Practice

© 2023 Walden University, LLC 18

DECISION POINT 4 FEEDBACK - PSYCHODYNAMIC THEORY OPTION 1 FEEDBACK – PSYCHODYNAMIC THEORY Molly: Mostly, I keep things to myself. I’m used to taking care of my own problems. I guess they all know now, since they found me in my room after taking all those pills. Try again. This choice does not best align with the theory you chose.

• CLICK HERE TO TRY DECISION POINT 4 AGAIN. OPTION 2 FEEDBACK – PSYCHODYNAMIC THEORY Molly: Deciding to go to college. I’m proud of myself for getting accepted, going, and feeling independent after so much chaos at home. Try again. This choice does not best align with the theory you chose.

• CLICK HERE TO TRY DECISION POINT 4 AGAIN. OPTION 3 FEEDBACK – PSYCHODYNAMIC THEORY Molly: My mom tries to fix things—like right now making sure I have insurance coverage so I get the right treatment. My mom takes over. My dad doesn’t say much. He goes out with his friends to let off steam. You say, “Thank you for sharing that with me. It seems like you have a lot on your mind. Would you like to tell me more?”

• CLICK HERE TO CONTINUE TO DECISION POINT 5.

Theory-Driven Advanced Practice

© 2023 Walden University, LLC 19

DECISION POINT 5 - PSYCHODYNAMIC THEORY Molly: My dad was my best fiend. We did everything together. I should have been a better daughter, and maybe he wouldn’t drink so much. Which response best fits the theory you chose? OPTION 1 – PSYCHODYNAMIC THEORY I noticed you said “fiend.” Did you mean “friend”? Tell me more about your relationship with your dad.

• RESPONSE OPTION 1 – CLICK HERE TO CHOOSE OPTION 1 FOR DECISION POINT 5.

OPTION 2 – PSYCHODYNAMIC THEORY If you were granted one wish, what would you wish that would change your life for the better?

• RESPONSE OPTION 2 – CLICK HERE TO CHOOSE OPTION 2 FOR DECISION POINT 5.

OPTION 3 – PSYCHODYNAMIC THEORY What do you think are the qualities that make a good daughter?

• RESPONSE OPTION 3 – CLICK HERE TO CHOOSE OPTION 3 FOR DECISION POINT 5.

Theory-Driven Advanced Practice

© 2023 Walden University, LLC 20

DECISION POINT 5 FEEDBACK - PSYCHODYNAMIC THEORY OPTION 1 FEEDBACK – PSYCHODYNAMIC THEORY Molly: No, I meant “fiend.” Because growing up I’d be his mischievous sidekick. We’d just go and have fun and not care about anything else, and I wanted to be like him. But the drinking kind of took over. You say, “I am noticing two things. Drinking seems to be a central force in your life and right now you appear down. Am I right, and can you tell me more about that?”

• CLICK HERE TO CONTINUE TO DECISION POINT 6. OPTION 2 FEEDBACK – PSYCHODYNAMIC THEORY Molly: There is so much I’d want to change, it’s overwhelming. That’s why I’m here. But I guess if it was just one thing I’d say my dad’s alcoholism. If I’d never seen him drinking, I doubt I would have started in the first place. Try again. This choice does not best align with the theory you chose.

• CLICK HERE TO TRY DECISION POINT 5 AGAIN. OPTION 3 FEEDBACK – PSYCHODYNAMIC THEORY Molly: A good daughter doesn’t drink, doesn’t get in trouble, helps her parents. I was an enabler to my dad’s drinking. Try again. This choice does not best align with the theory you chose.

• CLICK HERE TO TRY DECISION POINT 5 AGAIN.

Theory-Driven Advanced Practice

© 2023 Walden University, LLC 21

DECISION POINT 6 - PSYCHODYNAMIC THEORY Molly: Yes to both. I am sad and worried I’m going to be alone, once my friends find out the real me. I’ve never been good at keeping friends. I’ve always been the weird kid with the weird parents. Which response best fits the theory you chose? OPTION 1 – PSYCHODYNAMIC THEORY Can you give me an example of what supports the thought that you have “never been good at keeping friends”?

• RESPONSE OPTION 1 – CLICK HERE TO CHOOSE OPTION 1 FOR DECISION POINT 6.

OPTION 2 – PSYCHODYNAMIC THEORY What is the one "weird” thing that you would like to change about your family?

• RESPONSE OPTION 2 – CLICK HERE TO CHOOSE OPTION 2 FOR DECISION POINT 6.

OPTION 3 – PSYCHODYNAMIC THEORY Maintaining friendships can be difficult, especially as you enter adulthood. Can you give me one quality of a good friend that you possess?

• RESPONSE OPTION 3 – CLICK HERE TO CHOOSE OPTION 3 FOR DECISION POINT 6.

Theory-Driven Advanced Practice

© 2023 Walden University, LLC 22

DECISION POINT 6 FEEDBACK - PSYCHODYNAMIC THEORY OPTION 1 FEEDBACK – PSYCHODYNAMIC THEORY Molly: As a kid, I moved schools a lot because I was “acting up.” I couldn’t keep the friends from the old school, we just sort of lost touch. Or maybe they actively dropped me. With each one, I moved on to try to make new friends, then something else would mess it up. Now, I feel like my college friends are just freaked out by me. Try again. This choice does not best align with the theory you chose.

• CLICK HERE TO TRY DECISION POINT 6 AGAIN. OPTION 2 FEEDBACK – PSYCHODYNAMIC THEORY Molly: Well, the secrecy and silence about my dad’s drinking. Other people stayed away. They knew something was up. It didn’t help that I look different from my parents. You say, “You’ve given us a lot to talk about. I am noticing themes of self-confidence and self-esteem, substance abuse, and relationship-building. I hope you feel we’ve already made great progress in this first session. Think about where you’d like to start next time.”

• CLICK HERE TO CONTINUE TO THE CONCLUSION. OPTION 3 FEEDBACK – PSYCHODYNAMIC THEORY Molly: Hmm… I would call myself a good listener. I’ve been through a lot so sometimes I can be helpful to friends if they are going through something similar. Try again. This choice does not best align with the theory you chose.

• CLICK HERE TO TRY DECISION POINT 6 AGAIN.

Theory-Driven Advanced Practice

© 2023 Walden University, LLC 23

DECISION POINT 2 - COGNITIVE THEORY This is Molly’s first session with you. It has been 3 weeks since her inpatient discharge. After brief introductions (including informed consent), and making sure the appropriate release of information forms are signed, you settle into the interview.

• CLICK HERE TO CONTINUE TO TODAY’S SESSION TODAY’S SESSION - COGNITIVE THEORY Molly: I do not want to go back “there.”… I’ve been this way my whole life. I am never going to be “normal.” Which response best fits the theory you chose? OPTION 1 – COGNITIVE THEORY Tell me what you think “normal” looks like.

• RESPONSE OPTION 1 – CLICK HERE TO CHOOSE OPTION 1 FOR DECISION POINT 2.

OPTION 2 – COGNITIVE THEORY How long have you been feeling like you are not “normal”?

• RESPONSE OPTION 2 – CLICK HERE TO CHOOSE OPTION 2 FOR DECISION POINT 2.

OPTION 3 – COGNITIVE THEORY I hear that you are concerned about going back to inpatient care. Tell me more about that.

• RESPONSE OPTION 3 – CLICK HERE TO CHOOSE OPTION 3 FOR DECISION POINT 2.

Theory-Driven Advanced Practice

© 2023 Walden University, LLC 24

DECISION POINT 2 FEEDBACK - COGNITIVE THEORY OPTION 1 FEEDBACK – COGNITIVE THEORY Molly: I don’t know, I’m not sure I will ever get there. I look at myself and think “that person is strange” and “that person does not have herself together.” The thoughts just stick with me. It might have started when I was adopted. You say, “I hear what you’re saying. Tell me more about that.”

• CLICK HERE TO CONTINUE TO DECISION POINT 3.

OPTION 2 FEEDBACK – COGNITIVE THEORY Molly: Well, I was adopted, and I’ve always felt out of place and uncertain about whether I’m meeting everyone’s expectations. My family life wasn’t like my friends’ families. I couldn’t bring my friends over, because of my dad’s alcoholism. I had to hide it. So, my childhood was kind of isolating. Try again. This choice does not best align with the theory you chose.

• CLICK HERE TO TRY DECISION POINT 2 AGAIN. OPTION 3 FEEDBACK – COGNITIVE THEORY Molly: I didn’t like being separated from my friends. I missed a semester of school while I was there. I just want to move forward with my degree—and my life. I think I can do this without having to be in the hospital. Being there felt like my life was on hold. It reminded me of foster care, before I was adopted. Try again. This choice does not best align with the theory you chose.

• CLICK HERE TO TRY DECISION POINT 2 AGAIN.

Theory-Driven Advanced Practice

© 2023 Walden University, LLC 25

DECISION POINT 3 - COGNITIVE THEORY Molly: I have been thinking a lot about my life and how it may have turned out differently, if my dad wasn’t an alcoholic. Which response best fits the theory you chose? OPTION 1 – COGNITIVE THEORY Tell me more about your current situation from the lens of a past experience.

• RESPONSE OPTION 1 – CLICK HERE TO CHOOSE OPTION 1 FOR DECISION POINT 3.

OPTION 2 – COGNITIVE THEORY Tell me how supported you feel by others around you (friends, family, others)?

• RESPONSE OPTION 2 – CLICK HERE TO CHOOSE OPTION 2 FOR DECISION POINT 3.

OPTION 3 – COGNITIVE THEORY When you think about your life, how does your drinking parallel your dad’s drinking?

• RESPONSE OPTION 3 – CLICK HERE TO CHOOSE OPTION 3 FOR DECISION POINT 3.

Theory-Driven Advanced Practice

© 2023 Walden University, LLC 26

DECISION POINT 3 FEEDBACK - COGNITIVE THEORY OPTION 1 FEEDBACK – COGNITIVE THEORY Molly: I’ve never belonged anywhere, in any family. My birth parents didn’t know how to take care of me. I spent years in and out of foster care. I felt unimportant, unwanted. And I never had enough time to settle in and connect before I was off someplace else. Try again. This choice does not best align with the theory you chose.

• CLICK HERE TO TRY DECISION POINT 3 AGAIN.

OPTION 2 FEEDBACK – COGNITIVE THEORY Molly: My college friends have really been there for me. I can text them at any time. My mom is busy, but I can call her if I need to. Try again. This choice does not best align with the theory you chose.

• CLICK HERE TO TRY DECISION POINT 3 AGAIN.

OPTION 3 FEEDBACK – COGNITIVE THEORY Molly: When I drink, that’s the only time I do feel normal. I started drinking just at kids’ parties, to fit in. But then it turned into something else. My friends drink too, but it doesn’t seem to affect them the same way. It also connects me to my dad. As a kid, when my dad had a bad day at work, he drank to relax. I drink when I’m upset too. You say, “It sounds to me like you have had a hard time. I am hearing that your friends have been an important support for you. And it sounds like they may worry about you when you drink, too.”

• CLICK HERE TO CONTINUE TO DECISION POINT 4.

Theory-Driven Advanced Practice

© 2023 Walden University, LLC 27

DECISION POINT 4 - COGNITIVE THEORY Molly: Yeah, my friends have been worried about me. … When I think about my life and all the mistakes I always make, it just makes me sad. And then I drink. Which response best fits the theory you chose? OPTION 1 – COGNITIVE THEORY Have you shared your feelings with your friends?

• RESPONSE OPTION 1 – CLICK HERE TO CHOOSE OPTION 1 FOR DECISION POINT 4.

OPTION 2 – COGNITIVE THEORY I see. Can you tell me about a time when you did not make a mistake – and instead made a wise decision (like coming here for instance)?

• RESPONSE OPTION 2 – CLICK HERE TO CHOOSE OPTION 2 FOR DECISION POINT 4.

OPTION 3 – COGNITIVE THEORY How does your family typically react to crises like this?

• RESPONSE OPTION 3 – CLICK HERE TO CHOOSE OPTION 3 FOR DECISION POINT 4.

Theory-Driven Advanced Practice

© 2023 Walden University, LLC 28

DECISION POINT 4 FEEDBACK - COGNITIVE THEORY OPTION 1 FEEDBACK – COGNITIVE THEORY Molly: Mostly, I keep things to myself. I’m used to taking care of my own problems. I guess they all know now, since they found me in my room after taking all those pills. Try again. This choice does not best align with the theory you chose.

• CLICK HERE TO TRY DECISION POINT 4 AGAIN. OPTION 2 FEEDBACK – COGNITIVE THEORY Molly: Deciding to go to college. I’m proud of myself for getting accepted, going, and feeling independent after so much chaos at home. You say, “Thank you for sharing that with me. It seems like you have a lot on your mind. Would you like to tell me more?”

• CLICK HERE TO CONTINUE TO DECISION POINT 5. OPTION 3 FEEDBACK – COGNITIVE THEORY Molly: My mom tries to fix things—like right now making sure I have insurance coverage so I get the right treatment. My mom takes over. My dad doesn’t say much. He goes out with his friends to let off steam. Try again. This choice does not best align with the theory you chose.

• CLICK HERE TO TRY DECISION POINT 4 AGAIN.

Theory-Driven Advanced Practice

© 2023 Walden University, LLC 29

DECISION POINT 5 - COGNITIVE THEORY Molly: My dad was my best fiend. We did everything together. I should have been a better daughter, and maybe he wouldn’t drink so much. Which response best fits the theory you chose? OPTION 1 – COGNITIVE THEORY I noticed you said “fiend.” Did you mean “friend”? Tell me more about your relationship with your dad.

• RESPONSE OPTION 1 – CLICK HERE TO CHOOSE OPTION 1 FOR DECISION POINT 5.

OPTION 2 – COGNITIVE THEORY If you were granted one wish, what would you wish that would change your life for the better?

• RESPONSE OPTION 2 – CLICK HERE TO CHOOSE OPTION 2 FOR DECISION POINT 5.

OPTION 3 – COGNITIVE THEORY What do you think are the qualities that make a good daughter?

• RESPONSE OPTION 3 – CLICK HERE TO CHOOSE OPTION 3 FOR DECISION POINT 5.

Theory-Driven Advanced Practice

© 2023 Walden University, LLC 30

DECISION POINT 5 FEEDBACK - COGNITIVE THEORY OPTION 1 FEEDBACK – COGNITIVE THEORY Molly: No, I meant “fiend.” Because growing up I’d be his mischievous sidekick. We’d just go and have fun and not care about anything else, and I wanted to be like him. But the drinking kind of took over. Try again. This choice does not best align with the theory you chose.

• CLICK HERE TO TRY DECISION POINT 5 AGAIN. OPTION 2 FEEDBACK – COGNITIVE THEORY Molly: There is so much I’d want to change, it’s overwhelming. That’s why I’m here. But I guess if it was just one thing I’d say my dad’s alcoholism. If I’d never seen him drinking, I doubt I would have started in the first place. Try again. This choice does not best align with the theory you chose.

• CLICK HERE TO TRY DECISION POINT 5 AGAIN. OPTION 3 FEEDBACK – COGNITIVE THEORY Molly: A good daughter doesn’t drink, doesn’t get in trouble, helps her parents. I was an enabler to my dad’s drinking. You say, “I am noticing two things. Drinking seems to be a central force in your life and right now you appear down. Am I right, and can you tell me more about that?”

• CLICK HERE TO CONTINUE TO DECISION POINT 6.

Theory-Driven Advanced Practice

© 2023 Walden University, LLC 31

DECISION POINT 6 - COGNITIVE THEORY Molly: Yes to both. I am sad and worried I’m going to be alone, once my friends find out the real me. I’ve never been good at keeping friends. I’ve always been the weird kid with the weird parents. Which response best fits the theory you chose? OPTION 1 – COGNITIVE THEORY Can you give me an example of what supports the thought that you have “never been good at keeping friends”?

• RESPONSE OPTION 1 – CLICK HERE TO CHOOSE OPTION 1 FOR DECISION POINT 6.

OPTION 2 – COGNITIVE THEORY What is the one "weird” thing that you would like to change about your family?

• RESPONSE OPTION 2 – CLICK HERE TO CHOOSE OPTION 2 FOR DECISION POINT 6.

OPTION 3 – COGNITIVE THEORY Maintaining friendships can be difficult, especially as you enter adulthood. Can you give me one quality of a good friend that you possess?

• RESPONSE OPTION 3 – CLICK HERE TO CHOOSE OPTION 3 FOR DECISION POINT 6.

Theory-Driven Advanced Practice

© 2023 Walden University, LLC 32

DECISION POINT 6 FEEDBACK - COGNITIVE THEORY OPTION 1 FEEDBACK – COGNITIVE THEORY Molly: As a kid, I moved schools a lot because I was “acting up.” I couldn’t keep the friends from the old school, we just sort of lost touch. Or maybe they actively dropped me. With each one, I moved on to try to make new friends, then something else would mess it up. Now, I feel like my college friends are just freaked out by me. You say, “You’ve given us a lot to talk about. I am noticing themes of self-confidence and self-esteem, substance abuse, and relationship-building. I hope you feel we’ve already made great progress in this first session. Think about where you’d like to start next time.”

• CLICK HERE TO CONTINUE TO THE CONCLUSION. OPTION 2 FEEDBACK – COGNITIVE THEORY Molly: Well, the secrecy and silence about my dad’s drinking. Other people stayed away. They knew something was up. It didn’t help that I look different from my parents. Try again. This choice does not best align with the theory you chose.

• CLICK HERE TO TRY DECISION POINT 6 AGAIN. OPTION 3 FEEDBACK – COGNITIVE THEORY Molly: Hmm… I would call myself a good listener. I’ve been through a lot so sometimes I can be helpful to friends if they are going through something similar. Try again. This choice does not best align with the theory you chose.

• CLICK HERE TO TRY DECISION POINT 6 AGAIN.

Theory-Driven Advanced Practice

© 2023 Walden University, LLC 33

CONCULSION

Pause and reflect: Do you think the original theory you chose worked best for the client's needs? Why or why not? How would you proceed with Molly in the next session?

Feel free to navigate the scenario again using a different theory to see how the client intervention would change.

• CLICK HERE TO START THIS ACTIVITY OVER.