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In other words, the nurse needs to become the patient's mentor and confidant all at the same time. This requires excellent communication skills and listening skills on the part of the nurse.
Applicable Psychological Theory:
Cognitive Behavioral Therapy (CBT)
The Cognitive Behavioral model is an amalgamation of three major psychology disciplines: behavior therapy, cognitive therapy and social psychology (Cooper & Lesser, 2008). There are a series of steps that need to be undertaken to assess or intervene using Cognitive Behavioral Therapy. These are: 1) Specifying the problematic behaviors; 2) Data collection (monitoring and recording); 3) Goal setting; 4) Intervention; 5) Homework; 6) Reinforcement for Change; 7) Helping the client take credit for change; 8) Relapse prevention (Cooper & Lesser, 2008, pp. 167-168).
According to Scott (2001) "There is increasing support for the use of cognitive behaviour therapy as an adjunct to medication for patients with bipolar disorder" (p. 164). The primary goal of the use of CBT with bipolar clients is to create a feeling of acceptance of the disorder on the part of the patient. Essentially, the aim is to help the patient stop fighting against the disorder and start working with it. Scott (2001) reports that CBT has been shown to help bipolar patients get the treatment they need, both medically and therapeutically. It also helps with the self-management of symptoms and the ability to recognize signs of relapse.
The Mood Disorder Questionnaire
The Mood Disorder Questionnaire (MDQ) is a valid and reliable instrument for assessing Bipolar Disorder Type I. According to Hirschfeld (2002) this is an excellent and easy to use instrument for diagnosing bipolar disorder in a clinical setting. He states that "The MDQ has both good sensitivity and very good specificity" (p. 10). The screening ability of the MDQ works well both in diagnosing those who have bipolar disorder and weeding out those who do not. Hirschfeld (2002) reports that 7 out...
In order for someone to be diagnosed positively for bipolar disorder, they must answer "yes" to at least seven of the thirteen questions (Hirschfeld et al., 2003).
The validity and reliability of the MDQ has been tested at great length. In one study, Hirschfeld et al. (2003) tested 711 randomly selected adults with the MDQ to determine if it measured what it was designed to measure, and if it did so consistently. They found that the instrument returned results of a sensitivity of 0.281 and a specificity of 0.972, which indicates very high reliability and validity.
References
Cooper, M.G. & Lesser, J.G. (2008) Clinical social work practice, Pearson Education.
Doran, C.M. (2007) The Hypomania Handbook: The Challenge of Elevated Mood, Lippincott Williams & Wilkins
Diagnostic and Statistical Manual for Mental Disorders (DSM IV) (1994) American Psychiatric Association, American Psychiatric Press
Hirschfeld, R.M.A. (2002) The Mood Disorder Questionnaire: a simple, patient-related screening instrument for bipolar disorder. Journal of Clinical Psychiatry 4(1), 9-11.
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