APNA 27th Annual Conference Session 4034: October 12, 2013

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1 Innovative Educational Strategies for Keeping the 4th P Relevant: Psychotherapy Skills in PMHNP Graduate Programs Susie Adams, PhD, PMHNP/CNS, FAANP Dawn Vanderhoef, PhD, DNP, PMHNP/CNS Tari Dilks, DNP, PMHNP, FNP, FAANP Susie Adams, PhD, PMHNP/CNS, FAANP Dawn Vanderhoef, PhD, DNP, PMHNP/CNS Vanderbilt University School of Nursing Tari Dilks, DNP, PMHNP, FNP, FAANP McNeese State University and the Intercollegiate Consortium for MSN: Southeast Louisiana University, Nicholls State University, University of Louisiana Lafayette The speakers have no conflicts of interest to disclose. Objectives 1. Discuss the relevance of psychotherapy skills for PMHNPs in treating patients across the lifespan within contemporary practice settings. 2. Evaluate a variety of educational strategies from different PMHNP programs that develop counseling and psychotherapy skills from low tech, low cost to more resource intensive approaches. 3. Discuss applications to competency based evaluations of psychotherapy and counseling skills in PMHNP programs. Adams, Dilks, Vanderhoef 1

the Intercollegiate Consortium for MSN: Southeast Louisiana University, Nicholls State University, University of Louisiana Lafayette The speakers have no conflicts of interest to disclose.

2 Role of Psychotherapy in PMHNP Education ANA Scope and Standards ANCC Certification NONPF PMHNP Competencies QSEN Graduate Level Competencies Current PMHNP Practice Trends Emphasis on diagnostic assessments and medication management Emphasis on productivity units rather than patient outcomes for performance evaluation Community Mental Health Centers hiring majority of new PMHNP graduates Challenges to Teaching Psychotherapy Shift to NP role focused on diagnostic and medication management skills Obtaining practicum sites and psychotherapy opportunities Need for lifespan clinical experiences Individualize clinical learning experiences based on student needs Adams, Dilks, Vanderhoef 2

Centers hiring majority of new PMHNP graduates Challenges to Teaching Psychotherapy Shift to NP role focused on diagnostic and medication management skills Obtaining

3 Low Tech, Low Cost Simulations: Diagnostic Interviewing Case Based Interview Analysis Individual or as group Online Unfolding Case Study Student Role Play Students prepare and role play Role play video taped Evaluated by student and faculty as low fidelity simulation Low Tech, Low Cost Simulations: Counseling and Psychotherapy Skills Analysis of Video Vignette Evaluation of communication and therapy Techniques Student role play with focus on communication skills and evidence based therapy techniques Motivational Interviewing Dialectical Behavioral Therapy Techniques Cognitive Behavioral Therapy Techniques Interpersonal Therapy Techniques Resource Intensive Simulations: Diagnostic Interviewing Use of Simulation Center Standardized Case Vignettes Use of Standardized Patients Recording of Session Debriefing Adams, Dilks, Vanderhoef 3

therapy Techniques Student role play with focus on communication skills and evidence based therapy techniques Motivational Interviewing Dialectical Behavioral Therapy Techniques Cognitive Behavioral

4 Resource Intensive Simulations: Counseling and Psychotherapy Skills Use of Simulation Center Standardized Case Vignettes Use of Standardized Patient Recording of Session Debriefing Limited Resource Considerations Integration of simulation into programs who do not have access to standardized patients Use of no cost or low cost audio/visual recording options Partnering with other colleges/departments Interprofessional Eductation (IPE) Using reflective practice with self help books that promote a particular approach Clinical Supervision Education on process of / roles in supervision Individual or group supervision Format of Supervision Face to Face Telephone FaceTime Skype or Web Conferencing Software (single or multipoint) Reflective practice exercises Lifelong learning process Adams, Dilks, Vanderhoef 4

colleges/departments Interprofessional Eductation (IPE) Using reflective practice with self help books that promote a particular approach Clinical Supervision Education on process of / roles in

5 Formative Competency Based Evaluations Role Play Feedback Debriefing Feedback on Clinical Assignments Written assignments Audio recordings Summative Competency Based Evaluations Use of Check List Developed using competencies Faculty Education Standardization of grading rubrics Inter rater reliability concerns Multiple Faculty Grading Assignments Consistency Faculty Debriefing Quality control References American Association of Colleges of Nursing. (2012). Graduate Level QSEN Competencies KSA. Retrieved 8/8/13 at QSEN website: American Nurses Association. (2013). Scope and Standards of Psychiatric Mental Health Nursing. Silver Spring, MD. (in press) Decker, S., Sportsman, S., Puetz, L., & Billings, L. (2008). The Evolution of Simulation and Its Contribution to Competency. J Contin Educ Nurs, 39(2), Delaney, K.R. & Handrup, C.T. (2011). Psychiatric mental health nursing s psychotherapy role: are we letting It slip away. Archives of Psychiatric Nursing, 25(4): GUISE, V., CHAMBERS, M. & VÄLIMÄKI, M. (2011). What can virtual patient simulation offer mental health nursing education? Journal of Psychiatric and Mental Health Nursing, 19(5), National Task Force Nurse Practitioner Competencies. (2013). Psychiatric Nurse Practitioner Competencies. Retrieved 8/8/13 at NTF NONPF website: Adams, Dilks, Vanderhoef 5

References American Association of Colleges of Nursing. (2012). Graduate Level QSEN Competencies KSA. Retrieved 8/8/13 at QSEN website: http://qsen.org/ American Nurses Association. (2013).

6 References Olfson, M., et al. (2002). National trends in the outpatient treatment of depression. Journal of the American Medical Association, 287(2), Peplau, H. (1952). Interpersonal Relations in Nursing: A Conceptual Frame of Reference for Psychodynamic Nursing. New York, NY: Springer Publishing Co. Plakun, E., Sudak, D. M., & Goldberg, D. (2009). The Y model: an integrated, evidencebased approach to teaching psychotherapy competencies. Journal of Psychiatric Practice, 15(1): Redfren, S., Norman, I., Calman, L., Watson, R., Murrells, T. (2002). Assessing competence to practice in nursing: a review of the literature. Research Papers in Education, 17(1), Thase, M.E., et al. (1997). Treatment of major depression with psychotherapy or psychotherapy pharmacotherapy combinations. Archives of General Psychiatry, 54: Wheeler, K. (2008). Psychotherapy for the Advanced Practice Psychiatric Nurse. St. Louis, MO: Mosby Elsevier. Adams, Dilks, Vanderhoef 6

The Y model: an integrated, evidencebased approach to teaching psychotherapy competencies. Journal of Psychiatric Practice, 15(1): 5 11. Redfren, S., Norman, I., Calman, L., Watson, R., Murrells, T.

CYNTHIA TAYLOR HANDRUP. UIC Office: 845 S. Damen Ave., M/C 802 Office: 2800 North Sheridan Rm. 1052 Suite 502 Chicago, IL 60612 Chicago, IL 60657

CYNTHIA TAYLOR HANDRUP. UIC Office: 845 S. Damen Ave., M/C 802 Office: 2800 North Sheridan Rm. 1052 Suite 502 Chicago, IL 60612 Chicago, IL 60657 CYNTHIA TAYLOR HANDRUP UIC Office: 845 S. Damen Ave., M/C 802 Office: 2800 North Sheridan Rm. 1052 Suite 502 Chicago, IL 60612 Chicago, IL 60657 FAX: (773) 929-3105 TEL: (773) 472-2720 (312) 355-5098 E-Mail: