Assignment 1: Supportive Psychotherapy Versus Interpersonal Psychotherapy
Assignment Instructions. Please read carefully to the end before starting
Table of Contents
Assignment 1: Supportive Psychotherapy versus Interpersonal Psychotherapy
Amelia, a 16-year-old high school sophomore, presents with symptoms of weight loss and a very obvious concern for her weight. She has made several references to being “fat” and “pudgy” when, in fact, she is noticeably underweight. Her mother reports that she is quite regimented in her eating and that she insists on preparing her own meals as her mother “puts too many fattening things in the food” that she cooks. After discovering that during the past 3 months Amelia has lost 15 pounds and is well under body weight for someone of similar age/sex/developmental trajectory, the psychiatric mental health nurse practitioner diagnosed Amelia with anorexia nervosa.
Evidence-based research shows that clients like Amelia may respond well to supportive psychotherapy and interpersonal psychotherapy. So which approach might you select? Are both equally effective for all clients? In practice, you will find that many clients may be candidates for both of these therapeutic approaches, but factors such as a client’s psychodynamics and your own skill set as a therapist may impact their effectiveness.
This week, you continue exploring therapeutic approaches and their appropriateness for clients as you examine supportive psychotherapy and interpersonal psychotherapy. You also assess progress for a client receiving psychotherapy and develop progress and privileged psychotherapy notes for the client.
Dilemma of Psychotherapy Notes and HIPAA by Ruby Nicholson, RHIT
For HIM professionals in behavioral health settings, the HIPAA privacy regulations pose a downright dilemma. Here’s why.
The privacy rule defines psychotherapy notes as:
Notes recorded in any medium by a mental health professional documenting or analyzing the contents of conversation during a private counseling session or a group, joint, or family counseling session that are separate from the rest of the individual’s medical record. Psychotherapy notes exclude medication prescription and monitoring, counseling session start and stop times, the modalities and frequencies of treatment furnished, results of clinical tests, and any summary of the following items: diagnosis, functional status, the treatment plan, symptoms, prognosis, and progress to date.
The dilemma for many HIM professionals is determining what this means within the outpatient setting, particularly in free-standing outpatient behavioral health clinics.
Unlike an acute care hospital, where psychosocial documentation is maintained separately, records in behavioral health clinics are composed of screening assessments, psychosocial summaries, medication prescribing and monitoring, clinical tests, psychiatric evaluations, treatment planning, progress notes from multidisciplinary behavioral health teams, discharge summaries, and follow-up care. In a sense, the entire record could be considered a continuum of psychotherapy notes.
However, the privacy regulations are clear that only those psychotherapy notes kept separate from the rest of the individual’s record are afforded additional protection. All psychotherapy notes maintained with other documentation lose any special protection for confidentiality and are not required to be treated differently. (Remember, however, that special provisions to some information apply in regulations such as those related to drug and alcohol abuse treatment and in state laws related to mental health disorders.) Because there was no further definition of psychotherapy notes in the guidance released in July 2001, organizations are left to further define how to handle psychotherapy notes on their own.
The Law and Definition of Psychotherapy Notes
Clinical tests, assessments, treatment plans, case management notes, and other documentation found in a behavioral health record are just as confidential as counseling or therapy notes, and they often contain even more sensitive material. As a result, HIPAA task forces within many organizations are currently engaging in discussions around their definitions of psychotherapy notes. It may be possible to define some, if not all, of the documents in a behavioral health record as psychotherapy notes.
Included in these discussions is a review of individual state laws dealing with the release of information for mental health records. Some states have adequate language within existing state law that provides the protection not
Copyright © 2002 by The American Health Information Management Association. All Rights Reserved.http://www.ahima.org/copyright
available through federal privacy regulations. In states where laws involving release of mental health records are ambiguous, HIM professionals need to initiate language with their state legislators now.
Because the privacy regulations do not preempt 42 CFR Part II (the federal law relating to the confidentiality of alcohol and drug abuse patient records) substance abuse providers will not lose the existing additional protection, but they will need to ensure that other components of the privacy regulations are implemented. Behavioral health organizations that are federally assisted substance abuse providers and also provide mental health services may decide to cover the entire organization under 42 CFR Part II. This has both advantages and disadvantages depending on the structure of service delivery within the organizations, so professionals will want to review this closely before making any final decisions.
Regardless of the type of behavioral health services an organization delivers, it is imperative for HIM professionals to prepare well in advance of the April 2003 implementation date. Internal discussions, agency decisions, and passage of state laws all take time. Individuals working in behavioral health must be proactive in planning privacy implementation strategies.
Ruby Nicholson is director of QI/health information at Kent County Mental Health Center, Warwick, RI.
Article citation: Nicholson, Ruby. “The Dilemma of Psychotherapy Notes and HIPAA.” Journal of AHIMA 73, no.2 (2002): 38-39.
Copyright © 2002 by The American Health Information Management Association. All Rights Reserved.http://www.ahima.org/copyright
Photo Credit: Laureate Education
Although supportive psychotherapy and interpersonal psychotherapy share some similarities, these therapeutic approaches have many differences. When assessing clients and selecting therapies, it is important to recognize these differences and how they may impact your clients. For this Assignment, as you compare supportive and interpersonal psychotherapy, consider which therapeutic approach you might use with your clients.
To prepare:
· Review the media in this week’s Learning Resources.
· Reflect on supportive and interpersonal psychotherapeutic approaches.
The Assignment
In a 1- to 2-page paper, address the following:
Briefly describe how supportive and interpersonal psychotherapies are similar.
Explain which therapeutic approach you might use with clients and why. Support your approach with evidence-based literature.
References
Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (2nd ed.). New York, NY: Springer Publishing Company.
· Chapter 5, “Supportive and Psychodynamic Psychotherapy” (pp. 238–242)
· Chapter 9, “Interpersonal Psychotherapy” (pp. 347–368)
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
Note: You will access this text from the Walden Library databases.
Abeles, N., & Koocher, G. P. (2011). Ethics in psychotherapy. In J. C. Norcross, G. R. VandenBos, D. K. Freedheim, J. C. Norcross, G. R. VandenBos, & D. K. Freedheim (Eds.), History of psychotherapy: Continuity and change (pp. 723–740). Washington, DC: American Psychological Association. doi:10.1037/12353-048
Note: You will access this resource from the Walden Library databases.
Cameron, S., & Turtle-Song, I. (2002). Learning to write case notes using the SOAP format. Journal of Counseling and Development, 80(3), 286–292. Retrieved from the Academic Search Complete database. (Accession No. 7164780)
Note: You will access this article from the Walden Library databases.
Nicholson, R. (2002). The dilemma of psychotherapy notes and HIPAA. Journal of AHIMA, 73(2), 38–39. Retrieved from http://library.ahima.org/doc?oid=58162#.V5J0__krLZ4http://library.ahima.org/doc?oid=58162#.V5J0__krLZ4
U.S. Department of Health & Human Services. (n.d.). HIPAA privacy rule and sharing information related to mental health. Retrieved from http://www.hhs.gov/hipaa/for-professionals/special-topics/mental-health/
Sommers-Flanagan, J., & Sommers-Flanagan, R. (2013). Counseling and psychotherapy theories in context and practice [Video file]. Mill Valley, CA: Psychotherapy.net.
Note: For this week, view Reality Therapy, Feminist Therapy, and Solution-Focused Therapy only. You will access this media from the Walden Library databases.
Stuart, S. (2010). Interpersonal psychotherapy: A case of postpartum depression [Video file]. Mill Valley, CA: Psychotherapy.net.
Note: You will access this media from the Walden Library databases. The approximate length of this media piece is 110 minutes.
Note: The School of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the Walden Writing Center provides an example of those required elements (available at http://academicguides.waldenu.edu/writingcenter/templates ). All papers submitted must use this formatting.
Running head: PSYCHOTHERAPY APPROACHES 1
PSYCHOTHERAPY APPROACHES 2
Supportive and interpersonal psychotherapy approaches
Name
Institutions
Supportive and interpersonal psychotherapy approaches
With the prevalence of mental disorders, researchers and healthcare providers have studied the efficacy of different psychotherapy approaches to determine the most efficient strategies that can be used in assisting patients with particular psychiatric disorders. Supportive psychotherapy along with interpersonal psychotherapy are prevalently used in the treatment of mental disorders. These two approaches have various similarities as well as differences. Herein, I will discuss the two psychotherapy approaches, their similarities, differences, and situations in which each of the approaches would be effective in the treatment of patients with psychiatric disorders.
Similarities and Differences of Supportive and Interpersonal Psychotherapy Approaches
Supportive psychotherapy approach refers to a form of psychotherapeutic strategy that combines psychodynamic, cognitive-behavioral as well as interpersonal conceptual approaches of psychotherapy and techniques (Wheeler, 2014). With this psychotherapy approach, the major aim of the therapist is to improve the adaptive along with healthy patterns of the patient with the major objective being to reduce the prevailing intrapsychic conflicts contributing to the patient’s condition. On the other hand, the interpersonal approach refers to a brief, interpersonal focused strategy, which concentrates on identifying and resolving the prevailing interpersonal problems to alleviate the presenting symptoms (Wheeler, 2014). The therapist is essentially concerned with the interpersonal context and the associated factors that may predispose, propagate or precipitate the symptom of psychiatric disorders.
Both approaches are mainly aimed at bringing a therapeutic impact to patients presenting with the symptoms of psychiatric conditions. However, the two approaches have differences. Firstly, the interpersonal approach is an emphatically supported treatment model that mainly adheres to a highly structured and time-limited approach that often takes between 12 to 16 weeks (Cuijpers et al., 2016). Conversely, the supportive approach is not structured and utilizes a combination or either the psychodynamic, cognitive-behavioral and/or interpersonal conceptual approach. What is more, as highlighted in the above paragraph, the main aim of the supportive approach is to enhance the patient’s healthy as well as adaptive patterns in order lessen the prevailing intrapsychic conflicts contributing to the development of mental disorders. Conversely, the main aim of using the interpersonal approach is to identify and resolve any prevailing problematic interpersonal relationships. As such, therapist are necessitated to evaluate the relational aspects of patients that may be impacting the patient.
Application
According to Ashman et al. (2014), the supportive psychotherapy approach is mainly used in the treatment of patients with behavioral psychiatric problems such as alcoholism, addiction or eating disorders such as bulimia nervosa. With the use of this approach, the therapist assists the patients with behavioral problems to adopt and sustain healthy and efficient coping mechanisms to resolve their prevailing problems. On the other hand, the interpersonal psychotherapy approach is mainly used in the treatment of mental disorders that are related to the way people interact with family members or in other social organizations (Cuijpers et al., 2016). Essentially, by addressing the underlying relations problems, this approach can be used in lessening the symptoms of mental conditions such as depression, alcoholism, and other associated disorders.
As a nurse therapist, I prefer using the interpersonal approach in addressing problems presented by patients with mental conditions. Essentially, this is because the approach emphasizes the importance of interpersonal relationships. As highlighted by Cuijpers et al. (2016), poor interpersonal relationships contribute significantly to the development of the majority of psychiatric disorders including those related to the behavior and mood of individuals. These two aspects, mood, and behavior contribute significantly in the development of mental disorders. According to Gelo, Pritz, and Rieken (2014) who delves the efficacy of the psychotherapy approaches in the treatment of mental disorders, the interpersonal psychotherapy approach is more efficient in the treatment of the majority of psychiatric conditions compared to the supportive psychotherapy approach which is limited to behavioral problems.
References
Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (2nd ed.). New York, NY: Springer Publishing Company.
Ashman, T., Cantor, J. B., Tsaousides, T., Spielman, L., & Gordon, W. (2014). Comparison of cognitive behavioral therapy and supportive psychotherapy for the treatment of depression following traumatic brain injury: a randomized controlled trial. The Journal of head trauma rehabilitation, 29(6), 467-478.
Cuijpers, P., Donker, T., Weissman, M. M., Ravitz, P., & Cristea, I. A. (2016). Interpersonal psychotherapy for mental health problems: a comprehensive meta-analysis. American Journal of Psychiatry, 173(7), 680-687.
Gelo, O. C., Pritz, A., & Rieken, B. (Eds.). (2014). Psychotherapy research: Foundations, process, and outcome. Springer.
