NUR 650
Miss Cookie
3 months ago
20
files (2)NUR650Diss1-7.pdf
NUR650W1respose.pdf
NUR650Diss1-7.pdf
NUR650 Discussions
Submission Instructions:
Your initial post should be at least 500 words, formatted and cited in the current APA style
Provide support for your work from at least 2 academic sources less than 5 years old.
Wk1 Tom’s Parents are Fighting
After studying Module 1: Lecture Materials & Resources, discuss the following:
Tom is a 16-year-old who comes to you to evaluate his lack of attention because his grades are progressively getting worse. When you ask about stress in his life, he notes that his parents are always fighting, and this upsets him. He believes that they fight more when they have been drinking, and he believes that his father is the heavier drinker of the two, but he cannot quantify either parent's use.
• What information would be most critical for the group leader to collect in the first visit? • What is the primary goal for group treatment of this patient’s family problem based on
US group therapy best practices? • Which harm reduction strategies would you recommend? • Identify your city. Then refer this patient to three support groups near you that promote
positive health outcomes for this patient. What was your rationale for choosing these three agencies?
W2 Harriet Needs Surgery
After studying Module 2: Lecture Materials & Resources, discuss the following:
Harriet is a 51-year-old married woman with a past history of alcohol and cocaine abuse. She has been attending AA and NA meetings regularly and does not report urges to drink or use drugs during the 4 years you have been her psychiatric mental health nurse practitioner. She needs carpal tunnel surgery and the typical regimen during recovery is oxycodone 15 mg per day.
• What information would be most critical for the group leader to collect in the first visit? • What is the primary goal for the treatment of this patient’s family problem, based on the
US clinical guidelines?
• Discuss one curative factor the group would observe during the initial, middle and termination phases in group therapy?
• Identify your city. Then refer this patient to three agencies near you that would support positive health outcomes for this patient. (These agencies must not have been used in past discussion posts). What was your rationale for choosing these three agencies?
W3 Motivational Interview with Mary
After studying Module 3: Lecture Materials & Resources, discuss the following:
Mary is 27 years old and has had a history of alcohol dependence for several years. Mary has a daughter Kylie, aged 3 years, who displays signs of fetal alcohol syndrome. Social work services have been involved with Mary and Kylie since her birth, culminating in Kylie being looked after by the local authority as a result of Mary arriving to collect Kylie from the local nursery while significantly under the influence of alcohol. Mary has demonstrated ambivalence regarding her ability to control her alcohol use. Mary has referred herself to a local counseling agency as suggested by the social worker and her PCP.
• Discuss how you might use the principles of motivational interviewing with Mary. • Provide a detailed overview of how the interview may progress. Include each step of
motivational interviewing in your discussion. • Describe how a provider would recognize this patient is ready to change. Use principles
of motivational interviewing to support your answer.
W4 Richard is Motivated
After studying Module 4: Lecture Materials & Resources, discuss the following:
Richard is a 62-year-old single man who says that his substance dependence and his bipolar disorder both emerged in his late teens. He says that he started to drink to “feel better” when his episodes of depression made it hard for him to interact with his peers. He also states that alcohol and cocaine are a natural part of his manic episodes. He also notes that coming off the cocaine and binge drinking contribute to low mood, but he has not responded well to referrals to AA and past inpatient stays have led to only temporary abstinence. Yet, Richard is now trying to forge a closer relationship with his adult children, and he says he is especially motivated to get a better handle on both his bipolar disorder and his substance use. He has been more compliant with his mood stabilizing and antidepressant medication, and his psychiatric provider would like his dual diagnoses addressed with psychotherapy.
• What diagnostic information would be most critical to collect in the first visit?
• Which diagnostic measures are recommended by the US clinical guidelines for the treatment of this patient’s family problem?
• Which evidence based harm reduction strategies would you recommend to treat this patient?
• Identify your city. Then refer this patient to three agencies near you that would support positive health outcomes for this patient. (These agencies must not have been used in past discussion posts). What was your rationale for choosing these three agencies?
W5 Pretty Serious Partying
After studying Module 5: Lecture Materials & Resources, discuss the following:
Jackie is a 31-year-old pregnant patient (2nd child, two different fathers) single mother of a 6- year-old who is coming for prenatal care since she suspects she is pregnant. She is no longer with the father of Robby, her firstborn. She indicates "pretty serious partying" with the likely father of the baby. By pretty serious partying she means 10-12 drinks per occasion, one to two times per week, plus intermittent methamphetamine use.
• Which clinical information would be most critical for you to collect in the first visit? • What are the greatest risk factors for substance use disorder for this patient? • Which harm reduction strategies would you recommend? • Identify your city. Then refer this patient to three agencies near you that would support
positive health outcomes for this patient. (These agencies must not have been used in past discussion posts). What was your rationale for choosing these three agencies?
W6 Toneika
After studying Module 6: Lecture Materials & Resources, discuss the following:
Tomeika is a three-year-old girl. She was recently diagnosed with autism spectrum disorder (ASD). Tomeika is able to make many vocalizations and is able to say one recognizable word. Tomeika will say “juice”, which she pronounces as “oos.” Throughout the day, Tomeika cries and falls to the floor to gain access to food, obtain a favorite toy, or when she wants to be picked up. Her parents, Mr. and Mrs. Williams, would like for Tomeika to communicate her desires with words, but do not know how to help her. Tomeika recently began attending an early childhood special education classroom for learners with ASD in the County Public School System for six hours a day, four days a week. On Wednesdays, Tomeika and her peers do not go to school. Instead, on this day, Tomeika’s interventionist, Mrs. Dell, has parent conferences in her students’ homes.
During the conferences, Mrs. Dell discusses educational programming, learner progress, areas of concern, and also provides training to parents.
• Which diagnostic information would be most critical for you to collect in the first visit? • What is the primary goal for the treatment of this patient’s family problem based on
current US clinical practice guidelines? • Which complementary and alternative medication treatments would you recommend? • Identify your city. Then refer this patient to three agencies near you that would support
positive health outcomes for this patient. (These agencies must not have been used in past discussion posts). What was your rationale for choosing these three agencies?
W7 Hip Fracture
After studying Module 7: Lecture Materials & Resources, discuss the following:
The patient is a 71-year-old widowed man who is seen regularly in the clinic for health maintenance and follow-up of his chronic insomnia and anxiety. He has regular prescriptions for triazolam (Halcion) and clonazepam (Klonopin) for these problems. Recently he has been reporting frequent episodes of losing his balance and falling, and eight weeks ago was hospitalized for a hip fracture sustained during one of these falls resulting in hip surgery. On this visit, he also complains of becoming increasingly confused.
• What information would be most critical for you to collect in the first visit? • What is the primary goal for the treatment of this patient? • Identify potential obstacles for change. Which educational approach would the PMHNP
provide to overcome these obstacles? • How would you teach the patient about the Beers list and Halcion? • Discuss a medication in detail that could be safely substituted to treat insomnia in
geriatric patients.
NUR650W1respose.pdf
Dailys Prado Bravo
St. Thomas University
NUR 650
Dr PetitHomme
March 2026
Adolescents who present with declining academic performance and lack of attention require a comprehensive psychosocial evaluation. In Tom’s case, his report of parental conflict and suspected alcohol misuse suggests that family stressors may be contributing to his symptoms. Family substance use and interpersonal conflict are well-documented risk factors for emotional distress, impaired concentration, and academic difficulties in adolescents (Substance Abuse and Mental Health Services Administration [SAMHSA], 2023).
Critical Information to Collect During the First Visit
During the initial visit, the group leader should prioritize gathering several categories of information. First, a comprehensive psychosocial assessment is essential. This should include Tom’s academic history, attention and concentration symptoms, mood, sleep patterns, and any history of anxiety or depression. Screening for attention-deficit/hyperactivity disorder (ADHD) and trauma-related symptoms may also be necessary.
The clinician should assess family functioning and parental alcohol use. Important information includes the frequency and intensity of parental conflicts, whether alcohol is involved in arguments, the quantity and frequency of each parent’s alcohol consumption, and whether Tom has experienced emotional or physical harm related to these conflicts. Adolescents exposed to parental alcohol misuse are at higher risk for psychological distress and behavioral problems (Windle et al., 2021).
Safety and coping mechanisms must be evaluated. The clinician should assess whether Tom feels safe at home, whether domestic violence is present, and what coping strategies he currently uses to deal with stress. Screening for suicidal ideation or self-harm behaviors is also critical. Finally, identifying protective factors, such as supportive relatives, school counselors, mentors, or extracurricular activities, can guide intervention planning.
Primary Goal of Group Treatment
Based on U.S. group therapy best practices, the primary goal of treatment would be to improve family functioning and reduce the negative impact of parental substance use on the adolescent. Group therapy can help families develop healthier communication patterns, improve emotional regulation, and increase awareness of the impact of alcohol misuse on family
relationships. Psychoeducational family groups and support groups have been shown to improve coping skills among adolescents affected by parental substance use (SAMHSA, 2023). Ultimately, the goal is to strengthen resilience, promote healthy family interactions, and reduce psychological stress for the adolescent.
Harm Reduction Strategies
Harm reduction strategies focus on minimizing the negative consequences of substance use rather than requiring immediate abstinence. For Tom’s family, several strategies may be beneficial. First, encouraging parents to monitor and reduce alcohol consumption, particularly during times when conflict is likely to occur, can decrease family tension. Second, implementing conflict-management strategies, such as avoiding arguments while drinking and setting family communication guidelines, may reduce emotional harm to Tom.
Connecting the parents with alcohol education programs or counseling services can increase their awareness of how their behavior affects their child. Finally, teaching Tom coping strategies such as stress management, emotional expression, and seeking support from trusted adults can reduce the psychological impact of family conflict.
Local Support Groups
Because I am located in Miramar, Miami, Florida, the following support groups in the area would be appropriate referrals:
1. Al-Anon Family Groups – Fort Lauderdale Area Al-Anon provides peer support for individuals affected by someone else’s drinking. Teen- focused groups such as Alateen can help adolescents share experiences, develop coping skills, and reduce feelings of isolation.
2. Alcoholics Anonymous (AA) – Broward County Intergroup AA meetings provide structured peer support for individuals struggling with alcohol use. Referring Tom’s parents to AA may help them address problematic drinking behaviors and reduce alcohol-related conflict within the home.
3. NAMI Broward County Family Support Groups The National Alliance on Mental Illness (NAMI) offers family education and support groups that help families manage mental health stressors and improve communication. These programs can support both Tom and his parents by promoting healthier family dynamics.
The rationale for selecting these organizations is that they are evidence-based, widely accessible, free or low-cost, and provide both family-focused and substance-use-specific support. Access to community support networks can significantly improve outcomes for adolescents living in households affected by substance use.
Tom’s declining academic performance may be closely related to the stress associated with parental conflict and possible alcohol misuse. A thorough assessment, family-centered group therapy, and harm reduction strategies can help address the underlying issues affecting his attention and emotional well-being. Connecting the family with community support groups may further strengthen coping skills and promote healthier family relationships.
Arlette Del Pino Vento
Discussion 1 NUR 650 Psychiatric Management IV
Dr. PetitHomme PMHNP-BC 03/15/2026
The process of assessing adolescents who show reduced school achievement and problems with focusing needs to include both possible neurodevelopmental conditions and environmental stressor effects. Tom's family situation includes parental alcohol-related fights which he describes as a common occurrence that leads to family stress which impacts his school performance and focus. The group leader needs to gather essential information about Tom's complete family situation and his current emotional state and the alcohol consumption habits present in his home. The clinician should investigate how frequently parents engage in conflicts which escalate into dangerous confrontations and analyze how Tom behaves or reacts during these situations. The alcohol consumption patterns at home need to be established through an assessment which includes the drinking frequency of both parents and their drinking behavior during conflicts and any situations where Tom has experienced danger due to their actions. The clinician needs to evaluate anxiety symptoms along with depression and sleep problems and concentration difficulties because adolescents who experience ongoing familial disputes will develop emotional health issues. The process of identifying Tom's academic decline needs to establish its starting point while tracking teacher observations of his attention issues to evaluate whether school stress drives his academic challenges or whether assessment for attention-deficit/ hyperactivity disorder is needed. The clinician needs to identify specific protective factors which include supportive peers and trusted adults and extracurricular activities as stress management resources for Tom to handle his stress. The primary goal of group treatment in this situation would be to address the family dynamics that are contributing to Tom's distress while the group establishes better ways for family members to communicate and decreases the harmful effects of alcohol use on their family relationships. Family-focused group therapy approaches in the United States often aim to help family members recognize how their interactions affect one another and to develop more constructive ways of managing conflict. In this case, the goal would not only be to support Tom emotionally but also to help the parents recognize how their alcohol use and arguments may be
affecting their child. Improving communication, increasing emotional awareness, and encouraging accountability related to drinking behaviors are all important aspects of treatment. Research suggests that family-based interventions can significantly improve outcomes for adolescents experiencing stress related to parental substance use or family conflict because they address the relational environment rather than focusing solely on the individual adolescent (Hogue et al., 2021). Because immediate abstinence from alcohol may not always be realistic, harm reduction strategies may be a practical starting point for this family. The goal of harm reduction is to decrease the harmful effects of substance use while supporting users in their progressive development of better habits. The parents require training about alcohol's ability to escalate conflicts and cause emotional instability when parents argue with children present. The recommendation to parents is that they should refrain from drinking alcohol whenever their family members are present or when disputes arise because this will decrease the severity of arguments that Tom sees. Parents should be encouraged to become conscious of their drinking habits because this awareness will help them decide whether to cut back on alcohol or undergo alcohol screening. The availability of resources which help people develop healthier methods to cope with stress will decrease their tendency to use alcohol as their main stress relief method. Harm reduction approaches are widely supported in substance use treatment because they prioritize safety and incremental improvements rather than requiring immediate complete abstinence (Collins et al., 2021). This case is being considered in Miami, Florida, where several support groups are available that could promote positive health outcomes for Tom and his family.Al-Anon Family Groups functions as an essential support system for people who need help because their loved ones suffer from alcohol addiction. Al-Anon meetings enable adolescents and their family members to learn about addiction while also teaching them how to establish proper boundaries and handle situations with their family member who consumes alcohol. Alcoholics Anonymous serves as another essential resource because it provides a broad support network that helps people dealing with alcohol addiction. If Tom's parents join the meetings then they will learn to identify his drinking issues while starting their path to recovery. SMART Recovery provides a third choice which enables people to use cognitive behavioral and motivational strategies for controlling their addiction problems. The program attracts people who want to use structured methods based on scientific evidence instead of following the standard twelve-step program. These three agencies were selected because they offer different types of support that address both the family’s emotional needs and the parents’ potential substance use concerns. By connecting the family with community resources that encourage healthier coping, improved communication, and support for recovery, the overall goal is to reduce the stress in Tom’s home environment and help restore his ability to focus on school and personal development.
