Efficacy Of Meditation In The Management Of Anxiety

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Efficacy of Meditation in the Management of Anxiety Disorders Danny Burr, RN, BSN University of Central Florida College of Nursing NGR 6813

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According to NIH data, Chronic Pain Clinic affects more than 24 million Americans. Pain is often untreated in mental health settings due to a lack of clinical skills. The combination of opiate use disorder and chronic pain have reduced the life expectancy nationwide. The 2016 national pain strategy has indicated that integrated behavioral psychology into pain management is a central goal, but current plans have shown no changes in access. Developing chronic pain and opiate risk clinical rotation provides ways to reduce the training to treatment pipeline issues. Pain management is needed both in health and mental health settings. Leaders with pain psychology skills can provide a high level of care and address public health needs. Most psychologists are trained in a single professional siloed context. This training rotation is a collaborative care approach to treatment that supports work with medical professionals at a high level of embedded clinical skills growing interprofessional skills in internship year that can be foundational in the development of clinical professionals. This training rotation was established to develop skills in assessment, treatment, and interdisciplinary treatment of chronic pain. Interns in this rotation will be assigned to a weekly chronic pain clinic paired with a medical provider who is a specialist in chronic pain management and develop integrated treatment plans to address patient care needs. There are four components to the training rotation in chronic pain; these are a. precepted clinic rotation with monthly or more direct supervision of clinical consultation and intervention in a high-risk pain management clinic, b. Weekly group supervision and didactic training, c. Supervised individual pain treatment post-mid-year, d. Orientation training on the clinic and chronic pain.

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In clinical practice, there are times when it is especially wise to explicitly formulate a detailed understanding of a patient and his or her disorders. Such times would include the beginning evaluation at the start of treatment; a time of transfer of care to another professional; and those occasions when progress in treatment has plateau’d, yet the patient’s current status remains sufficiently psychopathological that it is unacceptable as a treatment endpoint. Such a formulation, or reformulation, is useful to insure that all important aspects of a patient are considered in further treatment, so that nothing in particular is overlooked. It is particularly important to recall that psychiatry recognizes multiple dimensions in psychopathology, indicating various foci, for example, on mind, or brain, or behavior, or interactions. This entails considering the different groups of factors that can be impacting the patient. We can say that psychiatry is a “biospsychosocial” [1] discipline, or one that calls for a “systems theory” [2] model. But in the case of a full formulation, one from differing perspectives, what is involved? What dimensions need to be looked at? From a very general point of view, we can recall the interplay of mind and body, of environment and behavior, but what might be considered more specifically?

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Assignment: Read a selection of your colleagues' responses. Respond to at least two of your colleagues by comparing your assessment tool to theirs. APA Format with at least two references in each responses no more than five years old Response Post #1 Main Post - Brief Psychiatric Rating Scale Week 2 Discussion - Assessment and Diagnosis in Psychotherapy Main Post Assessment Tools It is paramount as health care professionals to be skillful in assessing clients to be able to diagnose, plan, and produce optimal care yielding full or partial recovery of the clients. Various assessment and measuring tools are available for mental health providers to help measure illness, diagnose clients, and measure a client’s response to treatment that will help supplement data obtained from the clinical interview. Though assessments usually span the entire treatment cycle, a thoughtfully constructed initial intake meeting can be a great tool to establish and reinforce the required therapeutic alliances between client and therapist, provide reassurance, ease anxiety, and enhance information gathering process required for an accurate diagnosis and suitable treatment plan (Wheeler, 2014). Brief Psychiatric Rating Scale The Brief Psychiatric Rating Scale (BPRS) was developed in the sixties. It is still one of the most popular behavioral rating scales/instruments use today by clinicians to quickly gather information about the possible presence and severity of various psychiatric symptoms and to assess changes in symptoms in response to medications (Zanello et al., 2013). Originally, the BPRS was a 16-item scale, it was later extended to the standard 18-item version and currently expanded to a 24-item scale to measure additional aspects of schizophrenia symptoms thereby increasing its sensitivity to psychotic and affective disorders and to be used for patients living in the community (Shafer et al., 2017). The 18-item BPRS assess the following symptoms: somatic concern, anxiety, emotional withdrawal, conceptual disorganization, guilt feelings, tension, mannerisms and posturing, grandiosity, depressive mood, hostility, suspiciousness, hallucinatory behavior, motor retardation, uncooperativeness, unusual thought content, blunted affect, excitement, and disorientation (Yee et al., 2017). The manual of administration of the 24-item BPRS offers a more detailed semi-structured interview with more probe questions for each symptom, and providing supplementary rules for the rating (e.g., delusions) including a well-defined anchor point (Zanello et al., 2013). The recent analysis of the 24-item BPRS produced a four-factor solution: Negative Symptoms, Positive Symptoms, Manic-hostility, and Anxiety–Depression (Zanello et al., 2013). The current BPRS is rated on a seven-point Likert-type scale. A rating of “1” indicates the absence of symptoms, ratings of “2–3” indicate “very mild” to “mild” symptoms that are considered to have nonpathological inte.

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CONCEPT ANALYSIS Mindfulness in nursing: an evolutionary concept analysis Lacie White Accepted for publication 15 May 2013 Correspondence to L. White: e-mail: [email protected] Lacie White BScN RN PhD Student School of Nursing, Faculty of Health Sciences, University of Ottawa, Ontario, Canada W H I T E L . ( 2 0 1 4 ) Mindfulness in nursing: an evolutionary concept analysis. Journal of Advanced Nursing 70(2), 282–294. doi: 10.1111/jan.12182 Abstract Aim. To report an analysis of the concept of mindfulness. Background. Mindfulness is an emerging concept in health care that has significant implications for a variety of clinical populations. Nursing uses this concept in limited ways, and subsequently requires conceptual clarity to further identify its significance, use and applications in nursing. Design. Mindfulness was explored using Rodgers evolutionary method of concept analysis. Data Sources. For this analysis, a sample of 59 English theoretical and research- based articles from the Cumulative Index to Nursing and Allied Health Literature database were obtained. The search was conducted between all-inclusive years of the database, 1981–2012. Review Methods. Data were analysed with particular focus on the attributes, antecedents, consequences, references and related terms that arose in relation to mindfulness in the nursing literature. Results. The analysis found five intricately connected attributes: mindfulness is a transformative process where one develops an increasing ability to ‘experience being present’, with ‘acceptance’, ‘attention’ and ‘awareness’. Antecedents, attributes and consequences appeared to inform and strengthen one another over time. Mindfulness is a significant concept for the discipline of nursing with practical applications for nurse well-being, the development and sustainability of therapeutic nursing qualities and holistic health promotion. Conclusion. It is imperative that nurse well-being and self-care become a more prominent focus in nursing research and education. Further development of the concept of mindfulness could support this focus, particularly through rigorous qualitative methodologies. Keywords: concept analysis, evolutionary method, holistic, mindfulness, nursing, presence, self-care 282 © 2013 John Wiley & Sons Ltd Introduction Mindfulness is an emerging concept in health care that has gained substantial interest in research communities in the last two decades (Mindfulness Research Guide 2011). Situated in 2,600-year-old Eastern Buddhist philosophy, mindfulness was taught as a means to alleviate human suffering (Matchim et al. 2011b) and cultivate compassion (Ludwig & Kabat-Zinn 2008). The alleviation of suffering is a universal concern, particularly relevant in the field of health care where there is extensive contact with suffering, and additionally healthcare providers themselves struggle to maintain their own health and well-being in the midst o ...

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1 PAGE 2 1. What is the question the authors are asking? They asked about a reduction in judgmental biases regarding the cost and probability associated with adverse social events as they are presumed as being mechanisms for the treatment of Social Anxiety Disorder (SAD). Also, the authors poised on the changes in judgmental biases as mechanisms to explain cognitive-behavioral therapy for social anxiety disorder. On top of that, they stated that methodological limitations extant studies highlight the possibility that rather than causing symptom relief, a significant reduction in judgmental biases tends to be consequences of it or correlate. Considerably, they expected cost bias at mid-treatment to be a predictor of the treatment outcome. 2. Why do the authors believe this question is important? According to the authors, this question was relevant as methodological limitations of present studies reflect on the possibility that instead of causing symptom belief, a significant reduction in judgmental biases can be consequences or correlated to it. Additionally, they ought to ascertain the judgment bias between treated and non-treated participants. Significantly, this was important as they had to determine the impact of pre and post changes in cost and probability of the treatment outcomes. But, probability bias at mid-treatment was a predictor of the treatment outcome contrary to the cost bias at mid-treatment that could not be identified as a significant predictor of the treatment outcome. 3. How do they try to answer this question? They conducted a study to evaluate the significant changes in judgmental bias as aspects of cognitive-behavioral therapy for social anxiety disorders. To do this, they conducted a study using information from two treatment studies; an uncontrolled trial observing amygdala activity as a response to VRE (Virtual Reality Exposure Therapy) with the use of functional magnetic resonance imaging and a randomized control trial that compared Virtual Reality Exposure Therapy with Exposure Group Therapy for SAD. A total of 86 individuals who met the DSM-IV-TR criteria for the diagnosis of non-generalized (n=46) and generalized (n=40) SAD participated. After completing eight weeks of the treatment protocol, the participants who identified public speaking as their most fearsome social situation were included. The SCID (Structured clinical interview for the DSM-IV) was used to ascertain diagnostic and eligibility status on Axis 1 conditions within substance abuse, mood and anxiety disorder modules. The social anxiety measures were measured with the use of BFNE (Brief Fear of Negative Evaluation), a self-reporting questioner that examined the degree to which persons fear to be assessed by other across different social settings. Additionally, the OPQ (Outcome Probability Questionnaire) self-reporting questionnaire was used to evaluate individual’s estimate on the probability that adverse, threatening events will occur at t ...

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