Jessica, a 17-year-old girl who came with her family from Romania to the United States 10 years ago, is brought to the mental health clinic by her mother.

QUESTION

Case Study, Mohr

CHAPTER 4, Evidence-Based Practice

In completing the case study, students will be addressing the following learning objective:

Define evidence-based care.

1. Jessica, a 17-year-old girl who came with her family from Romania to the United States 10 years ago, is brought to the mental health clinic by her mother. At the admission psychiatric interview, the mother stated that Jessica has been saying for 6 months that aliens have been conducting experiments on her and will soon take her in a spaceship to their planet. Jessica is often awake at night and roams the house with a hammer and sharp knife, searching for aliens. Jessica’s mother says that she fears that some night Jessica will harm a family member whom she believes to be an alien. The mother then said that she did not bring Jessica for psychiatric care earlier because she had heard that much of mental health treatment was quackery and a waste of money. The psychiatric nurse explains to Jessica’s mother that all mental health treatment is based on scientific principles.

(Learning Objective: 3)

a. How would the nurse best explain that the care Jessica will receive at the psychiatric facility is based on evidence? Give two examples of psychiatric evidence-based care, and explain the scientific evidence that supports your examples.

ANSWER

Evidence-Based Care in Psychiatry: Ensuring Effective Treatment for Jessica

Introduction

Evidence-based care forms the cornerstone of modern psychiatric practice, ensuring that interventions are grounded in scientific research and proven effectiveness. In this essay, we will explore how the psychiatric nurse can explain to Jessica’s mother that the care her daughter will receive at the psychiatric facility is based on evidence. Additionally, we will provide two examples of evidence-based care in psychiatry, highlighting the scientific evidence that supports these interventions.

Body

Explanation of Evidence-Based Care

The psychiatric nurse can help Jessica’s mother understand that evidence-based care in psychiatry involves using treatments and interventions that have been extensively researched, rigorously tested, and proven effective through scientific studies (Titler, 2008b). It emphasizes the integration of the best available evidence with clinical expertise and the individual patient’s values and preferences.

Example 1: Cognitive-Behavioral Therapy (CBT)

Cognitive-Behavioral Therapy (CBT) is an example of evidence-based care widely used in psychiatric practice. CBT aims to help individuals identify and change negative thought patterns and behaviors that contribute to their distress (Chand, 2023). Several studies have demonstrated its efficacy in various mental health conditions, including psychosis-related symptoms like delusions, which Jessica is experiencing.

Scientific Evidence

A study by Garety et al. (2008) examined the effectiveness of CBT in reducing distressing psychotic symptoms and improving overall functioning in individuals with psychosis. The randomized controlled trial demonstrated that CBT significantly reduced the intensity and frequency of delusions, leading to enhanced well-being and improved quality of life. The study’s findings provided strong evidence for the effectiveness of CBT as an evidence-based intervention for psychosis-related symptoms.

Example 2: Antipsychotic Medication

Antipsychotic medication is another example of evidence-based care commonly prescribed in psychiatric settings, particularly for individuals experiencing symptoms of psychosis (Patel, 2014). These medications work by targeting neurotransmitter imbalances in the brain, reducing the severity of symptoms such as hallucinations and delusions.

Scientific Evidence

Numerous clinical trials have investigated the effectiveness of antipsychotic medications in treating psychotic symptoms. For instance, a meta-analysis conducted by Leucht et al. (2017) analyzed data from multiple randomized controlled trials involving antipsychotic medications. The results demonstrated that these medications were superior to placebo in reducing the severity of positive symptoms, including delusions and hallucinations, in individuals with psychosis. This meta-analysis provided robust evidence supporting the use of antipsychotic medication as an evidence-based approach for symptom management.

Conclusion

In conclusion, evidence-based care in psychiatry ensures that interventions are grounded in scientific research and proven effectiveness. By explaining this concept to Jessica’s mother, the psychiatric nurse can address her concerns about the legitimacy of mental health treatment. Two examples of evidence-based care in psychiatry, Cognitive-Behavioral Therapy (CBT) and antipsychotic medication, demonstrate their effectiveness in addressing symptoms like delusions in individuals with psychosis. The scientific evidence supporting these interventions helps validate their use and assures patients and their families that they are receiving care based on solid scientific principles.

References

Chand, S. P. (2023, May 23). Cognitive Behavior Therapy. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK470241/ 

Patel, K. R. (2014, September 1). Schizophrenia: Overview and Treatment Options. PubMed Central (PMC). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4159061/ 

Titler, M. G. (2008b, April 1). The Evidence for Evidence-Based Practice Implementation. Patient Safety and Quality – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK2659/