NURS2118 Therapeutic Initiatives In Mental Health


This essay will be demonstrating the case study of 20 years old John who is diagnosed from psychosis. According to john’s Parents he is being angry, resentful, and having difficulty in establishing relationship with others. He was being aggressive towards family and hallucinating. The essay will be demonstrating the significance and advantages of utilising psychotherapeutic approaches in mental health and delivery of trauma. It will be analysing the use of motivational interviewing with the patient suffering with mental illness. It will be identifying several psychotherapeutic approaches with the patient suffering from mental health problems and their families as well.

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Utilisation of the principles of trauma informed care and trans theoretical model of change and motivational interviewing to support John

There are five guiding principles of trauma informed care that are safety, choice, collaboration, trustworthiness, and empowerment.

Safety – Safety of patient is most important and significant aspect of nursing; hence John is aggressive and being angry there are chances of self-harm and harming others which is required to provide some therapies such as open-end questions to John (Hamberger, Barry, & Franco, 2019).

Choice – The choice of patient is an essential aspect of treatment, as John have gone through a lot of traumas and is victimized in the past it is important to involve John in the decision making related to his treatment and seeking his choice and consent before providing any kind of treatment or therapies (Berger, 2019).

Collaboration – Collaborating with inter professional team and family of patient suffering from mental illness. It is important to involve several intra professional people such as social worker, psychiatrist, and nurses in cases like John’s. John’s family have provided several insight and information regarding his past which can be very helpful in his treatment and recovery.

Trustworthiness – It is important to build trustworthy relationship with patient, as it is mentioned that john have mistrust regarding mental health services and authority after his first contact with them. It is essential to make him believe and trust his care takers in order to improve his condition and better mental health (Rance & Treloar, 2015).

Empowerment – Empowering patient by supporting and respecting patient related to his decision related to health and life. It helps the patient to gain confidence and show interest and contribution towards the decision making related to their mental health (Bailey, et al., 2019).

The trans theoretical model of change the patient go through sic stages including precontemplation, contemplation, preparation, action, maintenance, and termination.

Precontemplation – At this stage patient is generally unaware that their behavior impacts negatively and leads to adverse consequences.

Contemplation – At this stage the patient realize that their behavior is problematic and produce negativity for others and they consider their pros and cons and taking measures to change their behavior (Kleis, Hoch, Hogg-Graham, & Hoch, 2020).

Preparation – It is stage of making action plans related to behavior change and start taking steps regarding that (Romain, Caudroit, Hokayem, & Bernard, 2018).

Action – At this stage people have started taking actions regarding the change in behavior. People make efforts towards the change they want to make in their behavior.

Maintenance – At this stage, patient try to maintain the changes they have bought to their behavior. People also try to prevent relapse at the earlier stage.

Termination – At this stage people left with no desire to go back to their old behavior and condition (Ginwright, 2018).

Motivational Interviewing

Motivational interviewing is related to communicating with patient related to the importance and advantages of taking medication in within time and in proper manner. In this it is required to communicate John why it is important to take medications in time and advantages of taking medication such as informing him about the benefits and improvements. One on one conversation and telling John taking medications can impact his health as well as impact (Frost, et al., 2018).

Link between motivational interviewing and trauma in informed care

Motivational interviewing with trauma informed care is interrelated as the patient in trauma is required to provide motivational interview in order to make them understand about the benefits and advantages of the treatment.

Trauma informed care refers to the care given in relation to any trauma that patient may have experienced in their past life, the major aim of trauma informed care is to preventing that traumatized experience that can stop patient from continuing the treatment of mental illness (Unick, Bassuk, Richard, & Paquette, 2019). The major principles of trauma informed care are

 Safety – taking care of the safety of the patient while providing treatment to them.

Trustworthiness and transparency – building trust and transparency between nurse and patient which encourage and motivate patient to complete their treatment

 Peer support – providing support to patient by listening and understanding their perspective and communicating with them.

 Collaboration and mutuality – involving and collaborating with the patient in the decision making related to the mental health of patient. Making decisions and mutually with consent and knowledge of the patient (Gagneur, Respiratory syncytial virus: Motivational interviewing: A powerful tool to address vaccine hesitancy., 2020).

 Empowerment – empowering the patient by showing support and showing that you understand the traumas the patient gone through and grief of the patient.

 Voice and choice – it is important to keeping the choice and voice of the patient on priority by seeking and knowing the patients and choice and listening to their concern and choices.

 Casual issues – supporting the casual choices of the patient including habits and choices related to food, clothing, and type of treatment (Gagneur, et al., 2018).

Trauma informed care is important because it provide the opportunity to the nurses and other healthcare staff to develop the sense of empathy towards the patients who is gone through a past trauma as they have started to identify and understand the trauma and how it adversely impacted the health and well being of the patient and their family. It is also helpful in identifying the personal trauma of their lives and by identifying own traumas they are closely capable of identifying the same for a patient and effectively providing treatment to them (Levenson, 2020).

The interrelation between informed trauma care and motivational interviewing is that after identifying the trauma of the patient it is important to prevent them from getting re- traumatized by their past incident and stop taking and seeking care. Motivational interviewing help in interacting with patient regarding how they are still getting impacted by their past traumas and communicating and informing them about the benefits of taking their medication in time and how completing their treatment can be beneficial for them and their family. Motivational interviewing help in motivating and encouraging the patient to complete their treatment, build some sort of confidence and trust in them towards their care takers (Onlinenursing, 2020).

Strategies Of Mental Health For John And Their Family

The strategy that will be beneficial while working for mental health of john and his family would be family based strategy. This strategy emphasizes on the involving and including john and his family in the mental illness treatment of john and other decision making process related to his mental health. Family based approach help in several ways as john’s family will be helpful and contribute in the treatment of john by adding close and minor information about his past experiences and traumas. It also provide wide array of problems such as family communication, aggression on family (Jiménez, Hidalgo, Baena, León, & Lorence, 2019).

Family based approach refers to involving and informing the family in every point of decision making related to the John’s health (Betancourt, et al., 2020).


This essay concludes the information and problems related to mental illness suffered by john and his family, it is discussing the principles of trauma informed care that are safety, choice, collaboration, trustworthiness, and empowerment. It is discussing the principle of Trans theoretical model including pre contemplation, contemplation, preparation, action, maintenance, and termination. It is discussing about the motivational interviewing intervention used in mental illness treatment. The essay then discussing about the interrelation between traumas informed care and motivational interviewing. The major principles of trauma informed care are Safety, Trustworthiness and transparency, Peer support, Collaboration and mutuality, Empowerment, Voice and choice Casual issues. In the end the essay is discussing the strategies which can be employed in order to mental health treatment of John while working with his family for recovery.


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