Psychotherapist? Using Nursing Skills in Therapeutic Relationships and Psychotherapies

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Learning Point Summary • CYP-IAPT has significantly increased access to psychological therapies over the last few years. • CYP-IAPT aims to upskill clinicians in specialist CAMH services and tho... se professionals that have significant contact with CYP in wider community services. • The Department of Health and Social Care and the Department of Education are piloting mental health support teams using evidence-based therapeutic interventions to support education providers in embedding their mental health and well-being strategies. • There are different levels of training in evidence-based therapy. • Evidence-based interventions can be offered by a nurse without any formal therapeutic training as long as it is informed by the evidence base and is supervised appropriately. 9.2 How Has Therapy Evolved? Learning Point Summary • Psychotherapy or helping people deal with psychological difficulties can be traced back to the ancient Greeks. • There are many different models of therapy. • Therapy is always developing. • It is really important to ensure the therapy is the right fit for the CYP and not the CYP be fitted for the therapy. • NICE (2019) offers guidance about what therapies are demonstrated to be effective for specific diagnoses. • Trained therapists can help you choose an appropriate therapy or intervention for a patient. 9.3 An Overview of Some of the Therapies 9.3.1 Cognitive Behavioural Therapy Learning Point Summary • CBT is a structured approach to therapy; the model will not suit CYPs who do not want to work in between sessions and do not want to challenge their difficulties. • CBT is very collaborative and holds the collaboration as central to its philosophy, the therapist and CYP are equal in the therapeutic relationship. • CBT is not just about changing thoughts and CYPs should not be referred for this alone. • It is a short-term evidence-based treatment for a range of mental health difficulties. • CBT works to an agenda and goal-based outcomes and uses ROMS throughout its process. 9.3.2 Psychodynamic Therapy Learning Point Summary • Psychodynamic therapy is a medium-term intervention that focuses on relationships. • It is evidence-based for depression and eating disorders. • Psychodynamic theory uses object relational theory to help understand relationships. • Two key structures within psychodynamic theory are transference and countertransference. • It is usually the CYP and the therapist that attend therapy and no other persons involved. 9.3.3 Systemic Family Therapy Learning Point Summary • SFT is a family-based therapy that involves all necessary members of the family. • It is a medium-term therapy. • SFT is evidence-based for a number of mental health disorders. • SFT is open to using ideas and theories from other models of psychotherapy. • At times reflecting teams are part of the therapy. • SFT holds the therapist in being neutral and valuing all family members as equal. • The therapist has to use self and reflexive use of self to maintain neutrality. 9.3.4 Other Therapies Used in CAMHS 9.4 Some Common Themes Across Therapies 9.4.1 Communication 9.4.2 The Therapeutic Relationship (TR) Supervision Routine Outcome Measures (ROMs) Learning Point Summary • There are many commonalities that cross all psychotherapies. • Being aware of personal values and assumptions are key in all aspects of therapy. • Supervision is a significant part of therapy that needs to be used effectively. • ROMs can be used across the spectrum of therapy and is expected as part of the CYP-IAPT strategy. • Fundamental verbal and non-verbal communication skills are paramount in developing the therapeutic relationship and maintaining therapy. • Nurses are equipped with many of the skills needed to develop and maintain therapy and the therapeutic relationship. 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