Week 4: Advocacy Letter

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Purpose:

The purpose of this assignment is to provide an opportunity for students to apply and disseminate information based on the status of public health policies and practices designed to address important public health problems, concerns, and implications for nursing practice.

Requirements:

Through this assignment, the student will write a letter to their legislator (House of Representatives or Senator) on a public health topic. The student will state relevant statistics in the area, indicate how this issue is affecting nursing practice, and describe the action the student would like the legislator to take in regards to a current bill, or in support of the issue. Please see the attached document for full instructions.  See the sample letter for a template to use. 

NR442_Faculty Assignment_Advocacy Letter (1).docx

sampleletter (1).pdf

Rubric

Advocacy Letter RubricAdvocacy Letter RubricCriteriaRatingsPtsThis criterion is linked to a Learning OutcomePurpose and IdentityPurpose and Identify (includes correct identification of the legislator based on address)15.0 pts
This criterion is linked to a Learning OutcomeBackgroundIncludes:
Two statistics
Affected population20.0 pts
This criterion is linked to a Learning OutcomeRequest of legislator:• Solution identified and is realistic10.0 pts
This criterion is linked to a Learning OutcomeGrammar and Construction• Proper grammar and mechanics
• Correct spelling
• Websites or resources for statistics
• Word count5.0 pts
Total Points: 50.0PreviousNext

This week’s first discussion forum will focus on the population of abused individuals. Abuse is a pervasive problem in our society. Although the forms of abuse, as well as the intensity and duration can vary from case to case, each abused person is tasked with dealing with the scars left from the abuse.  As you can imagine, this task can be very challenging to say the least. Using research to help you form an opinion, which form of capital (social or human capital) do you feel will have a greater influence over resources accessible to the abused?  Discuss which form of capital you would rely on for emotional support and help through difficult times if abused.  Explain your rationale. Chapter 3 of the course text defines these terms in more detail.

Your initial contribution should be 250 to 300 words in length. Your research and claims must be supported by your course text and at least one other scholarly source.  Use proper APA formatting for in-text citations and references as outlined in the Ashford Writing Center.

The first of your two written assignments for the course will provide a beginning framework that you will utilize in the development of your
Final Project: a proposal for a community-based program in your area. For this first written assignment, you will select one of the vulnerable groups identified in the text that will serve as your target population of interest throughout the duration of your next written assignment and Final Project.

Select one among the following groups from Chapter 1:

• Vulnerable mothers and children
• Abused individuals
• Chronically ill and disabled people  
• People diagnosed with HIV/AIDS
• People diagnosed with mental conditions
• Suicide- and homicide-liable people
• People affected by alcohol and substance abuse
• Indigent and homeless people
• Immigrants and refugees
• Groups for special consideration (you may propose a different vulnerable population at the consent of the instructor)

Once you have selected a group of interest, write a three page paper that covers the following:

• Discuss the impact that at least two of the factors below have on the vulnerability of your chosen group:
  • Age
  • Gender
  • Culture/Ethnicity
  • Income
• Analyze the intersection of social, political, and economic factors affecting vulnerability (must address all three factors).
• Draft the design of a new model program, not currently existent within your community. Provide a two- to- three paragraph statement that introduces your proposed community program. This section is tentative and might change as you conduct more research. At a minimum, however, items to address should include:
• An explanation of the issues and risk factors experienced by the selected population.  
• An evaluation of the health needs of the group and a proposed continuum of care level (preventive, treatment, or long-term care) based on the group’s issues, risk factors, and needs.  Justify the proposed level with supportive research/evidence.
• A description of one to two proposed services your program will include. 

Your assignment should be a minimum of three pages in length (excluding title and reference pages), and should include a minimum of three scholarly sources cited according to APA guidelines as outlined in the Ashford Writing Center.

 I NEED A RESPONSE FOR THIS ASSIGNMENT

2 REFERENCES

Group Therapy with Older Adults

Psychotherapy, according to Wheeler (2014), can be used to treat varying psychological disorders throughout the lifespan of an individual. In general, psychotherapy must be adapted to address and fit the specific needs of the age groups. Researches have indicated in older group therapy that one can socialize with peers who share similar symptoms. It also creates an opportunity to increase one’s altruism and empathy and feel useful by helping others (Tavares & Barbosa, 2018). However, the elderly often may have neurological deficits and comorbidities that may affect their ability to fully participate and benefit from psychotherapy (Wheeler, 2014). Studies indicated that some of these older adults live in isolation and have lost their relationships, occupation, and capacity. Group therapy allows them to connect to people and be useful while receiving help (Wheeler, 2014). The discussion will include a description of a group therapy session with older adults, the group’s stage, any issues or resistances present, therapeutic modalities utilized, and challenges resulting from working with the group.

Group Description

This group includes ten members whose ages range from 64 to 80, including females and males, each with different diagnoses such as depression, sleep disorders, anxiety disorders, personality disorders, alcohol, drug use disorders, and neurocognitive disorders. Some of the patients were hyperactive, while some were depressed. Currently, the group comprises patients in different stages, such as forming, storming, norming, performing, and adjourning. The orientation stage still ongoing as new members joins the group while some are in their terminal adjourning phase. This group did not follow the predictable pattern of the average group staging. However, the patients introduce their names, ages, professions, and family backgrounds. The group went back and forth, elaborating on more background aspects of individual lives. Individuals were encouraged to share as much as they feel comfortable sharing. The group ran for 60 minutes, from 1030 to 1130 in the morning. It is modified to bring the best out of the patients. The therapy session time was divided and organized to allow note-taking, summarization, memory aids, and mnemonics devices to help in their recovery (Tavares & Barbosa, 2018).

Resistance or Issues Present

The cohesiveness of the group met a few resistances. One group member, a 70-years-old male, did comment on the newness of therapy. His comment was: “back in the day; people did not meet with each other to talk about everyday life hurdles; we dealt with it, that is what is expected of us as men.” I had a 65-year-old female who said she is not crazy and should not be in the group; this was her second day. She laughs, smiles, and shakes her head when others are speaking. She moved her chair further away from how the chairs were spaced-out due to the coronavirus pandemic. 

The compilation of both hyperactive and depressed patients made it often difficult for every patient to participate and achieve their expected goal at the same time. Some patients were hyperactive, intrusive, and monopolizing. They tried to control everything and respond to every question asked, which sometimes increased anxiety and tension to other group patients. While depressed and quiet, patients feel irritated, intimidating, and sad. 

Therapeutic Techniques

Cognitive-behavioral therapy (CBT) is a practical approach for a wide range of problems affecting older adults (Secker et al., 2020). As a therapeutic approach in group therapy sessions, CBT has proven to be beneficial to the elderly. It helps them build an interpersonal relationship with others, improve socializing skills, improve the symptoms of depression, and help manage stressful life events (Tavares & Barbosa, 2018). CBT aims to have the patients and the counselor in agreement on markers of progress in therapy. Domhardt and Baumeister (2018) stated that the CBT coping strategy helps the patient identify negative thoughts and replace more functional views. CBT equips the patients with internal resources and enhances their coping skills (Wheeler, 2014). In this manner, the individual’s symptoms reduce, and behaviors change as they learn to control their feelings.

Challenges

I encountered different challenges in conducting therapy with the age group. There was an issue with the seat arrangement; because of COVID-19, the patients were spaced six fits apart to maintain social distance. With some of the patients being intrusive and exhibiting poor boundary behavior, it became difficult to keep the space. Some patients had physical declines that affected therapy, some with cognitive impairment, hearing impairment, and decreased eyesight. Thus, requiring the facilitator to speak more slowly, louder and to explain more clearly. To accommodate those with low vision, I had to provide large print worksheets for the patients. Some patients remained in the forming and storming stages for a prolonged period due to their cognitive state. The group dynamic also affected this group outcome due to new admissions and discharges, which hinder the group’s progress.

No matter what population of people being counseled, it is necessary to recognize the challenges they face and change practices accordingly. CBT is feasible and highly effective in geriatric patients. Early diagnosis, good access to psychotherapy, and early intervention could improve care for older patients.

References

Domhardt, M., & Baumeister, H. (2018). Psychotherapy of adjustment disorders: current state and future directions. The World Journal of Biological Psychiatry, 19(sup1), S21-S35.

Hummel, J., Weisbrod, C., Boesch, L., Himpler, K., Hauer, K., Hautzinger, M., … & Dutzi, I. (2017). AIDE–acute illness and depression in elderly patients. Cognitive-behavioral group psychotherapy in geriatric patients with comorbid depression: A randomized, controlled trial. Journal of the American Medical Directors Association, 18(4), 341-349.

Secker, D. L., Kazantzis, N., & Pachana, N. A. (2020). Cognitive behavior therapy for older adults: Practical guidelines for adapting therapy structure. Journal of rational-emotive and cognitive-behavior therapy, 22(2), 93-109.

Tavares, L. R., & Barbosa, M. R. (2018). Efficacy of group psychotherapy for geriatric depression: A systematic review. Archives of gerontology and geriatrics, 78, 71-80.

Wheeler, K. (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice. New York, NY: Springer.

How has the U.S.A risen to the top internationally to decrease abuse amongst pregnant women?

NOTE: Assignment must be 1 page long.