MENTAL HEALTH NURSING

Mental Health Nursing



Mental Health Nursing

Introduction

One of the most common and disabling psychological disorders encountered within mental health and general medical settings is that of an anxiety disorder (Dattilio & Kendall, 2000, pp 111). Professional literature suggests that cognitive-behaviour therapy (CBT) has been an efficient treatment against anxiety disorder (Beck, 1995, 199) though; this literature has predominately determined its focus to within the confines of mental health and general medical settings (Dattilio & Kendall 2000, 121). As a learning disability nurse wishing to ascertain the effectiveness of CBT as a practical intervention when presented with the dual-diagnosis of anxiety disorder and learning disability, is through the use of 'evidence-based practice'. One such framework as described by Sackett et al (1997) is a four- stage process, known by the acronym PICO: Patient or Population, Intervention or Indicator, Comparison or Control and Outcome. The construction of an answerable question is the basis of evidence-based practice and should guide the practitioner to how to find an answer (Ridsdale, 1998, 210). It is important that each variable under the PICO framework is clearly defined, being as detailed and explicit as possible in order to extend clarification to the question. Working through PICO methodically the practitioner would instigate the process by defining the 'Patient or Population'. Characteristics such age, gender and diagnosis would need to be deliberated and whilst the aforementioned were easily recognised in the practice area as adult male, identifying appropriate terminology for diagnosis can prove problematic. The term 'Learning Disability' is often used interchangeably in literature with terms such as, Mental Retardation and Intellectual Disabilities.

Literature Review

'Learning Disability' is a term with contemporary usage within the United Kingdom to describe a client group with significant development delays (Gates, 1996, 20). Whilst the idiom 'Learning Disability' is the preferred terminology for the question due to its contemporary usage it must be accepted that it's not a term not internationally recognised nor is it a term used for long in the United Kingdom (Gates, 1996, 24). Anxiety disorder comes in many facets and can be described as severe psychological disorders in which abnormal or chronic anxiety interferes with daily living (Adams & Bromley, 1998, 115). The client in the practice area had described psychological and physiological symptoms that were diagnosed as a social anxiety disorder through rating scales and self-report measures. It is crucial that the practitioner is aware that the term identified for the question as 'social anxiety' is often recognised by the synonyms, social phobia or panic disorder (Dattilio & Kendall 2000, 114).

The recognition of this inconsistent terminology will enable an evaluation to take place between the relationships of the chosen term to symptoms displayed by the client. The identification of existing clinical interventions is a valuable part of the process of developing evidenced-based interventions (Meijel, 2003, 87). Literature suggests that CBT is an effective treatment for a number of psychological disorders (Embling, 2002, 124). Central to the model of CBT is that distorted or dysfunctional thinking is prevalent ...