Therapeutic relationship in mental health nursing

Therapeutic Relationship in Mental Health Nursing Code #10443400000166

Introduction Nurses play a vital role in the health department of any country as they develop a strong bond with the patient that might also help the patient to get out of the physical and mental problem faster. No matter if the disease is physical or mental, the nurse­patient relationship is always so strong, and bonding that its significance is not easy to deny. Analysts believe that with the help of better and improved therapeutic relationships between the nurse and the patient, the patient can be helped to feel better by the good vibes created and the sense of safety; the more reliable the relation, the higher the chances of recovery (OHSU, 2015).

This essay is focused to study the therapeutic relationship of nurse and the patients of anxiety and depression over the age of 65. The main aim is to study the significance of the therapeutic relationships between a nurse and a patient of depression or anxiety who is over the age of 65 and how it might help the patient to lead a better life.

The essay contains four sections. The first section includes the details of a therapy and what are therapeutic relationships between the patient and the nurse. The second section of the essay explains what is anxiety and depression and why a patient might need a therapeutic treatment to get out of the mental problem. The third section discusses the significance of the therapeutic

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relationship between the anxiety and depression patients who are over the age of 65. The last section concludes the essay and provides some recommendations.

What is Therapy and Therapeutic Relationship?

A therapy is a way of treating a patient that has a mental or a physical problem. Therapy mainly involves physical and active involvement of the patient rather than a passive one like only taking the medicine and waiting for it to do the magic. For instance, a person who has arthritis might need a physical therapy and exercise to feel better and get relief from the pain. In the same way, mental patients also need therapy along with the medicine that helps them get rid of the mental disorder in a faster and more effective way (CNO, 2006).

The therapy can be done by a specialist, a doctor, physician, or a nurse and during the process of the therapy, as the relationship between the patient and the nurse starts to develop, they become complementary for each other that helps the patient towards getting better. The conditions for this relation is to stay within the professional boundaries, healthy, active, cooperative, supportive, honest, effective, safe, and ethical. If these codes of conduct are not followed, the importance of this therapeutic relationship might reduce and even diminish to a major extent (College of Physical Therapists of Alberta, 2015).

Anxiety, Depression, and Need for Therapeutic Relationship – Brief Overview It was not long ago when psychological disorders were only treated with the help of psychological sessions and therapies, and no medicine had been developed. As the technology

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gained extensive growth, so did the field of medicine and along with many physical problems, psychological disorders also started getting pharmacological treatment. But the introduction of medicine for psychological problems worked as a complement to the therapies rather than replacing them (Richelson, 1991).

Depression and anxiety are one of the most common psychological problems in the world. They are mainly associated with sadness, lack of interest in life, pessimism, hopelessness, and frustration. According to 2013 statistics, only in the United States, about 6.7% people suffer from depression and this rate is 5.1% among the people above the age of 50 (NIH, 2015). This rate is rising at an increasing rate that also increases the need for therapeutic treatments by medical experts and nurses. Along with frustration, sadness, lack of sleep and appetite, agitation, recklessness and mood swings, a major effects and risk of depression is the risk is committing suicide. The patient of depression and anxiety is more likely to attempt suicide than a normal person. That is the reason depression, and anxiety patient should seek therapeutic treatment right away (HG, 2015).

Significance of Therapeutic Relationship between Nurse and the Patient Depression makes a person vulnerable in many ways, and when this depression is over the age of 65, it makes a person psychological weaker than anyone can imagine. In that hard time, a good therapeutic relationship can be very helpful for the patient to feel better. (Arnow, et al., 2013), mentioned in their study that the therapeutic relations have a significant impact on the reversal of symptoms of depression in patients over the age of 65. For the study, they kept 395 patients

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under observation; 57% being females, and 46.91 being male and the effects were as high as 8%, and was also statistically highly significant. The study reports that the effects of the therapeutic relation increase as the quality and strength of the relationship enhances, and the results start to unveil in just a couple of days.

A relation between a nurse and a patient of depression and anxiety over the age of 65 is always based on affection, trust, respect, professional intimacy and power. The relation can only last if these codes are followed in a certain professional and strategic manner and if not, the significance of the therapeutic relationship can reduce to a major extent even eliminating the need for the relationship. It is also important that the relationship is developed by keeping in view the current situation of both the patient and the nurse. During the relationship, the depressed patient and the nurse communicate verbally or non­verbally and proper development of the communication tool can help strengthen the bond and generate better results. To maintain the code of the therapeutic relationship, the nurse can do a couple of things including keeping a proper check on the daily routine of the patient and his nature as well. Older patients suffering from depression are usually stubborn and do not seem to cooperate. In such circumstances, keeping in view the severity of depression, the patient, and the nurse can collaborate on the rules of their therapeutic relationship and develop a contact to follow as the relationship grows (CNO, 2006).

According to (Bensen, 2015), the percentage of people over the age of 65 with mental disease including depression and anxiety is as high as 20%, and right now, about 7 million adults over

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the age of 65 suffer from this disease. The higher rate of depression does not only reduce the life expectancy rate, but also invites many other mental and physical diseases. It has been reported that the depressed patient over the age of 65 have 16% higher rate of committing suicide. Under these astonishing drastic circumstances, the need for a strong and well therapeutic relationship increases even more. Not only the patients of depression need this relation, but it is also very important for the family of the patient.

In the old age like 65, the level of motivation for the depression patient is very low, and not every patient tries to get out of the phase of depression and anxiety. In that situation, it is believed that the therapeutic relationship is as much helpful as a blood relation and can even be more important than any other relationship. The nurse can help the patient in developing a healthy outlook and keep up with the positive vibes of life that can help him get out of the mental problem. Analysts also argue that sometimes, therapeutic relationship can help the patient get out of the depression when the familial relations can’t. It is true because of the professional and constantly growing bond the patient and the nurse develop over time under a specific framework.

As far as the nurse keeps a proper check on the framework of the relationship, makes sure that the needs of the relationship are being met, and health schedule is being properly followed, the therapeutic relationship can go a long way, and transform the 65­year­old depressed patient into a mentally healthy and optimistic person (Bensen, 2015).

Some people do not favor the fact that the role of nurses in the therapeutic relationship is significant. But while studying the therapeutic treatment of a depression victim over the age of

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65 closely, it can be easily noticed that their role is angelic in this entire process. In this therapeutic relationship, the role of the nurse is to make sure that the therapy is going into the right direction, and the challenges of the treatment are properly handled. The nurse also makes sure to keep the care mechanism going no matter what the level of motivation and cooperation the patient has. On the other hand, the job of the patient is to be as cooperative as possible so that he/she can get out of depression as soon as possible (Bullen, 2013).

(Elisabet & Fisher, 2011), reported that the role of the nurses the therapies of elderly depression patients can be enhanced and the therapeutic relationship can be improved if the care for both the patient and the nurse is better and the nurse is also given a broader capacity for applying the therapeutic modules. Moreover, it is also reported that although the pharmacological treatments of depression among the patients over the age of 65 are very important, the need and importance to focus on other therapeutic measures that involve nurses cannot be ignored. This therapeutic relation can provide the scope of a breakthrough in the mental health of the elderly patients.

Concluding Remarks and Recommendations In psychological problems like depression and anxiety, therapeutic treatment is a way of treating a patient that also invites the involvement of the patient rather than just being passive. These therapeutic treatments mainly involve both pharmacological and psychological sessions between

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the patient and the nurse to help the patient especially when the disorder is as sensitive as depression at the age of over 65 when the patient is the most vulnerable.

During the therapeutic treatment, the patient, and the nurse develop a special bond; a therapeutic relationship. This therapeutic relationship plays a vital role in improving the recovery of the patient. As far as the relationship remain professional, healthy, effective, compassionate and safe, the effects of the therapeutic relationships remain positive and can significantly help in bringing the patient back to normal life.

To make the relationship healthy and more effective for the patient, it is suggested that the nurse collects sufficient and necessary information about the patient beforehand so that she knows well how to treat the patient. The therapeutic relationship also requires a reflective practice that means that the nurse has to develop the feelings of empathy, compassion, self­awareness and acknowledgment of professional boundaries before starting the job to make sure that the therapeutic relationship remains healthy.

Moreover, the nurse should do a detailed general to specific learning of the problem before starting the job and should give keen focus to the therapeutic process. The therapeutic organization or body can also help in strengthening the patient­nurse therapeutic relationships while making sure that they keep the well­being of the nurse and the patient in mind.

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Bibliography Arnow, B. et al., 2013. The Relationship between the Therapeutic Alliance and Treatment Outcome in Two Distinct Psychoterapies for Chronic Depression. ​ American Psychological Association, ​ 81(4), pp. 627­638.

Bensen, W., 2015. ​ CDC Promotes Public Health Approach To Address Depression among Older Adults. ​ [Online] Available at ​ http://www.cdc.gov/aging/pdf/CIB_mental_health.pdf [Accessed 17 November 2015].

Bullen, D., 2013. ​ Nurse Role in Treating Depression. ​ [Online] Available at http://nursing.advanceweb.com/Features/Articles/Nurse­Role­in­Treating­Depression.aspx [Accessed 17 November 2015].

CNO, 2006. ​ Therapeutic Nurse­Client Relationship. ​ [Online] Available at ​ https://www.cno.org/Global/docs/prac/41033_Therapeutic.pdf [Accessed 17 November 2015].

College of Physical Therapists of Alberta, 2015. ​ Therapeutic Relationships. ​ [Online] Available at ​ https://www.physiotherapyalberta.ca/files/guide_therapeutic_relations.pdf [Accessed 17 November 2015].

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Elisabet, J. & Fisher, M., 2011. ​ The Therpeutic Role of the Mental Health Nurse: Implications for the Practice of Psychological Therapies. ​ 2 ed. New South Wales: Research and Scholarly Publications of Southern Cross University.

HG, 2015. ​ Depression Symptoms and Warning Signs. ​ [Online] Available at ​ http://www.helpguide.org/articles/depression/depression­signs­and­symptoms.htm [Accessed 17 November 2015].

NIH, 2015. ​ Major Depression among Adults. ​ [Online] Available at http://www.nimh.nih.gov/health/statistics/prevalence/major­depression­among­adults.shtml [Accessed 17 November 2015].

OHSU, 2015. ​ Developing Therapeutic Relationships. ​ [Online] Available at http://www.ohsu.edu/xd/outreach/occyshn/training­education/upload/DevelopingTheraputicRelat ionships_Ch10.pdf [Accessed 18 November 2015].

Richelson, E., 1991. Biological Basis of Depression and Therapeutic Relevance. ​ The Journal of Clinical Psychiatry, ​ 52(6), pp. 4­10.

Virani, T. et al., 2002. ​ Establishing Therapeutic Relationships. ​ [Online] Available at

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http://www.spitjudms.ro/_files/protocoale_terapeutice/nursing/936_bpg_tr_rev06.pdf [Accessed 17 November 2015].

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