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Journal Entry

Attainment of Goals and Objectives

The objective I was mostly focused on customizing was psychotherapeutic

modalities to patient needs. I have developed my interview skills with clients by

gathering information that helped me with the treatment plan and completing

comprehensive mental health histories of individual, family, and group participants,

which was my significant accomplishment during my clinical rotation. Building a

therapeutic rapport with each client was a critical goal that was achieved by identifying

and recognizing individual issues, empowering support, encouraging participation,

listening attentively, and addressing any worries or concerns with a good outcome. I can

diagnose patients appropriately using the DSM-5 criteria and develop effective

treatment planning.

Challenges with Patients

During my practicum experience, one of the challenging patients I encountered

was a client going through grief. According to the patient, therapy homework was

ineffective because she could not distract her thoughts from the past to cope with grief.

Adherence to the treatment plan and doing therapy homework is related to further

developed treatment results and builds inspiration and anticipation of progress (Jensen

et al. 2020). The second challenging client I encountered was a teenager with conduct

disorder who constantly ran away from home and engaged in violent acts towards her

siblings. She was non-compliant and refused to participate in initial sessions. After a few

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sessions and building therapeutic rapport, she could complete her assignment and

show full participation. My third challenging patient was a client with depression who

complained of complete darkness in her mind and could not channel her thoughts for

something positive. The patient was unable to complete multiple homework

assignments because, according to her, she was too tired to complete the tasks. Tasks

performance are designed methods to decrease symptoms and improve adapting skills.

Lessons Learned

Psychotherapists must have good interpersonal and communication skills with

their clients to develop relationships and rapport with their patients. Developing a

therapeutic relationship encourages patients to express their feelings and thoughts,

making it easier for the practitioner to assess a patient, investigate various treatment

options, evaluate current best evidence, and inspire patient desire or need. (Areán,

Renn, & Ratzliff, 2021).

Available Resources

The healthcare setting was fully equipped with the necessary resources to

facilitate the effective assessment of patients and treatment plan development, including

preceptor support, educational material on psychotherapeutic modalities, structured

interview guidelines, and serene surroundings for quiet and comfortable therapy

sessions. Also, the Walden University library provided information on cognitive

behavioral therapy, dialectical behavioral therapy, and trauma-focus therapy with

evidence-based practice research articles.

What I would do differently

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What I would do differently is to improve the flow of patients and the amount of

time I spend with each client during the therapy sessions. I would also help underserved

communities by providing them with information on healthcare options so they could get

the care they require.

Evidence-Based Practice (EBP)

With the patients I engaged with during my Practicum, I applied evidence-based

therapy by exploring behavioral and cognitive therapies with Melnyk and Fineout-

Overhold (2022), citing their effectiveness in enhancing the quality of treatment and

increasing accountability. In the future, I will explore more EBP treatment options that

incorporate wholesome options beyond the simple ones of meditation and exercise to

explore more active participation in healing.

Management of Patient Flow and Volume

I was able to handle the patient flow and volume without any problems. I realized that

the volume and flow of patients extensively relied on my ability to assess each patient

within the allotted time for the patient’s treatment. During intake, a treatment plan and

projected release date were made, and revisions were done as the patient progressed.

Communicating and Feedback

With this practicum experience, my communication abilities with clients

experiencing mental health disorders have improved significantly. I am also able to

improve my critical thinking skills and gain awareness of how to lead a therapy session.

I will continue to acquire more knowledge that will help me understand the challenges

among those living with mental illnesses or dysfunctional behavior, for which I am

thankful, and be available to provide care in the community.

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References

Areán, P. A., Renn, B. N., & Ratzliff, A. (2021). Making Psychotherapy Available in the

United States: Implementation Challenges and Solutions. Psychiatric Services

(Washington, D.C.), 72(2), 222–224. https://doi-

org.ezp.waldenulibrary.org/10.1176/appi.ps.202000220.

Jensen, F. M. A. C. A. L., Beckner, V. L., Owen, D., & Persons, J. B. (2020).

Congruence of Patient Takeaways and Homework Assignment Content Predicts

Homework Compliance in Psychotherapy. Behavior therapy, 51(3), 424–433.

https://doiorg.ezp.waldenulibrary.org/10.1016/j.beth.2019.07.005

Melnyk, B. M., & Fineout-Overhold, E. (2022). Evidence-based practice in nursing &

healthcare: A guide to best practice (5th ed.). Lippincott Williams & Wilkins.

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