Modeling and Role Modeling theory:
The nursing profession is a unique discipline that is shaped by its concepts and practices. The defining distinctions of nursing discipline are framed by what is commonly known as nursing theories. Nursing theories are organized and knowledge-based concepts that define the scope of nursing practice. Based on the level of abstraction, nursing theories fall into three categories: grand theory, middle-range theory and practice level theory (Smith, 2019). This practicum journal discusses one nursing and one counselling theory that best guides practice in psychotherapy, supported by an explanation on why the two theories were selected. Also, it analyzes the goals and objectives held through the practicum experience as well as the practicum activities.
The Nursing Theory
The nursing theory that guides my psychotherapy practice is the Modeling and Role Modeling theory. The Modeling and Role Modeling Theory was developed by Helen Erickson and first published in the book “Modeling and Role Modeling: A Theory and Paradigm for Nursing” in the year 1983. This theory enables nurses to care and nurture different patients with awareness and respect for individual patient’s uniqueness. Modelling and Role Modeling theory draws concepts from sources such as Maslow’s Theory of Hierarchy of Needs, Piaget’s Theory of Cognitive Development, Seyle and Lazarus’s General Adaptation Syndrome, and Erikson’s Theory of Psychosocial Stages. It addresses commonalities and differences among people that must be considered when providing care for patients. Some of the commonalities include holism, the basic needs that drive behavior, affiliated individualization, attachment and loss, psychological stages and cognitive stages (Erickson, 2017). The differences include inherent endowment, stress, self-care resources, self-care actions, adaptation potential.
According to Modeling and Role Modeling theory, modelling is the process by which a nurse attempts to understand the patient’s world to appreciate its value and significance. On the other hand, role modelling is the process by which a nurse facilitates and nurtures the patient to attain, maintain and promote health by accepting him/her unconditionally and allowing the planning of unique interventions (Erickson, 2017).
Modelling and Role Modeling theory appeals to me because takes a holistic approach to patient care by providing a framework that enables nurses to recognize the uniqueness of different patients to enable them to focus on their individual needs when caring and nurturing them. Modelling and Role Modeling theory encourages individuality in inpatient care, a concept that is crucial in psychiatry where patients have different adaptation levels, self-care knowledge and stress management capabilities (Erickson, 2017). The concept of individuality in this theory promotes self-care based on clinical evidence that relies on the perception of clients and adaptation to common stressors. Additionally, Modeling and Role Modeling theory acknowledges the fact that different clients have different needs that can only be met within the circumstantial framework of the client.
Counselling Theory
The counselling theory that best guides my psychotherapy practice is the cognitive theory, proposed by Aaron Beck and Albert Ellis. The cognitive theory considers cognitive processes such as attention, perception and sensation to be the center of behaviors, emotions and thoughts. It emphasizes people’s thoughts rather than actions to help explain and resolve abnormal behaviors (Qiao et al., 2014). Cognitive therapy helps people overcome problems by developing new and more functional ways of thinking. Based on this theory, therapists can help clients recognize errors in logic, biased interpretations and negative thoughts that dominate thinking and make them feel depressed.
Cognitive therapy was ideal for my psychotherapeutic practicum because it’s among the counselling theories best suited to deal with short-term disorders and help client’s overcome specific problems. As a short term treatment approach, it’s also affordable compared to long term approaches. Just like the Modeling and Role Modeling theory that encourages individuality inpatient care, a concept that is crucial in psychiatry, Cognitive therapy applies a similar principle by helping clients understand thoughts and feelings that control individual behavior (Beck & Haigh, 2014). Therefore, the theory was chosen based on its individuality aspect. Using this theory, patients can understand the different dynamics of their thought processes and how they affect their character, psychological perceptions and emotions. The theory enables clients to understand that they can control their perceptions when going through different situations. As a result, clients can identify and change destructive cognition to reduce distress.
Practicum Goals and Objectives
Going into practicum, I had several goals and objectives to achieve when dealing with psychiatric patients and their families. The first goal was to learn how to diagnose and manage different mental illnesses that are encountered in psychiatry clinical settings. The second goal was to acquire the interview skills that are necessary to successfully engage patients concerning mood symptoms, suicidality, psychosis and others. The third goal was to learn how to orally present comprehensive biopsychosocial mental health assessments. The fourth goal was to demonstrate the ability to assess my decisional capacity and develop an appreciation of how capacity issues affect decision making in psychiatry. Based on these goals, objectives were to diagnose and manage a range of psychiatric illnesses, engage patients in discussions about their mental health needs, conduct a biopsychosocial assessment, describe major indications and side effects of different therapies in psychiatry settings, describe how to assess decisional capacity and its impacts in mental health, and work effectively as part of a multidisciplinary team.
Timeline of Practicum Activities
| Week | Dates | Times | Total Hrs. | Activities | Objectives (s) |
| 1 | 1st-5th March 2021 | 9am-3pm | 20hrs | Collecting medical and family history of newly admitted patients | Building trust with patients to be able to extract information about their condition |
| 2 | 8th-12th March 2021 | 9am-3pm | 20hrs | Collecting medical and family history of newly admitted patients Communicating with patients | Building trust with patients to be able to extract information about their condition |
| 3 | 15th-19th March 2021 | 9am-3pm | 20hrs | Reviewing and recording both the psychological and physical status of different patients | Concentrating on the uniqueness of different patients |
| 4 | 22nd-26th March 2021 | 9am-3pm | 20hrs | Scheduling patient appointments Researching and conducting nursing care plans | Concentrating on patient’s strengths and individuality |
| 5 | 29th-2nd April 2021 | 9am-3pm | 20hrs | Patient evaluation, Follow-ups and medications management | Utilization of DSM-5 for accurate diagnosis and Motivational Behavioral Theory |
| 6 | 5th-9th April 2021 | 9am-3pm | 20hrs | Patient Follow-ups, evaluations, medication management and Discharge instructions | Application of Contingency management (CM) and CBT |
| 7 | 12th-16th April 2021 | 9am-3pm | 20hrs | Patient evaluation, Follow-ups and medications management | Mental examination using Motivational Enhancement Therapy |
| 8 | 19th-23rd April 2021 | 9am-3pm | 20hrs | Patient evaluation, Follow-ups and medications management | Mental state examination using Beck Depression Inventory |
| 9 | 26th-30th April 2021 | 9am-3pm | 20hrs | Patient evaluation, Follow-ups and medications management | Mental state examination and counselling |
| 10 | 3rd-7th May 2021 | 9am-3pm | 20hrs | Interpretation of patient’s response to treatment and medication management | Seeking nuggets of wisdom, counselling |
| 11 | 10th-14th May 2021 | 9am-3pm | 20hrs | Patient Follow-ups, interpretation of patient response to treatments, medication management | Promoting positive orientation, patient control |
| 12 | 17th-21st May 2021 | 9am-3pm | 20hrs | Interpretation of patient response to treatment, medication management | Promoting positive orientation, patient control |
Total Hours Completed: 240Hrs.
References
Beck, A. T., & Haigh, E. A. (2014). Advances in cognitive theory and therapy: The generic cognitive model. Annual review of clinical psychology, 10, 1-24.
Erickson, M. E. (2017). Modeling and role-modeling. Nursing Theorists and Their Work-E- Book, 398.
Qiao, Y. Q., Shen, J., Liang, X., Ding, S., Chen, F. Y., Shao, L., … & Ran, Z. H. (2014). Using cognitive theory to facilitate medical education. BMC medical education, 14(1), 1-7.
Smith, M. C. (2019). Nursing theories and nursing practice. FA Davis.