DOÑA REMEDIOS TRINIDAD ROMUALDEZ MEDICAL FOUNDATION

CALANIPAWAN ROAD, TACLOBAN CITY, LEYTE

COLLEGE OF NURSING
(2nd SEMESTER S.Y. 2023-2024)

NCM 117

PSYCHOSOCIAL THERAPIES

Submitted by: Clinical Group F - BSN UVAROVITE

MARJORIE D. IGLOPAS
LEAH JOYCE M. PACHECO
MHEL CHRISTELE P. PALMARES
JUDY ROSE C. PATALINGHUG
KERIELOU S. PEPITO
MARY CAMILLE A. PORE
JAZMIN R. PRESNILLA
XIORIETH YSHA L. PRETENCIO
CLAIRE JUSTINE N. QUIMINALES
SAMATHA JOYCE S. RELLIN
GWYNTH GIAN GAYLE J. RIPALDA
BABY JANINE B. RIVAS

Submitted to:
MR. JUDE MUASSAB, RN
APRIL 20, 2024
 DOÑA REMEDIOS TRINIDAD ROMUALDEZ MEDICAL FOUNDATION
CALANIPAWAN ROAD, TACLOBAN CITY, LEYTE
COLLEGE OF NURSING
(2nd SEMESTER S.Y. 2023-2024)

I. Nurse-Patient Relation therapy

OVERVIEW
Nurse-patient relationship therapy, sometimes referred to as therapeutic alliance or
therapeutic nurse-patient relationship, is a psychiatric therapeutic method that places a strong
emphasis on building a supportive and encouraging relationship between the nurse and the
patient. In order to aid the patient's mental health and general well-being, this therapy aims to
foster a cooperative and sympathetic relationship between the nurse and the patient.
In nurse-patient relationship therapy, the nurse serves as a facilitator for the patient's
emotional and psychological growth. The nurse creates a safe and non-judgmental environment
for the patient to share their thoughts, feelings, and experiences. By listening actively, providing
emotional support, and offering guidance, the nurse can help the patient to explore their thoughts
and feelings and gain insight into their mental health issues. Effective nurse-patient relationships
can lead to better patient satisfaction, enhanced compliance, and improved health outcomes

PURPOSE
The goals of a therapeutic relationship are directed toward promoting the patient’s growth and
well-being. The nurse identifies and maximizes the patient’s ego strengths and encourages
socialization and family relatedness. Together the patient and nurse correct communication
problems and modify maladaptive behavior patterns by testing new patterns of behavior and more
adaptive coping mechanisms:
● Enhanced self-realization, self-acceptance, and increased self-respect
● A clear sense of personal identity and an improved level of personal integration
● The ability to form intimate, interdependent, interpersonal relationships with a capacity to
give and receive love
● Improved functioning and increased ability to satisfy needs and achieve realistic personal
goals

PROCEDURE

3 Phases:
Orientation Phase
During the orientation phase, the nurse establishes roles, the purpose of meeting, and the
parameters of subsequent meetings The nurse identifies the client’s problems and clarifies
expectations. Also, during this phase, the nurse needs to listen closely to the client’s history,
perceptions, and misconceptions. He or she needs to convey empathy and understanding. It is
the nurse’s responsibility to establish a therapeutic environment that fosters trust and
understanding. The nurse should share appropriate information about him or herself at this time,
including name, reason for being on the unit, and level of schooling.
Here the nurse reads background materials available on the client, becomes familiar with
any medications the client is taking, gathers necessary paperwork, and arranges for a quiet,
private, and comfortable setting

Working Phase
The client identifies the issues or concerns causing problems and the nurse guides the client
to examine feelings and responses and to develop better coping skills and a more positive self-
image; this encourages behavior change and develops independence. The trust established
between the nurse and the client at this point allows them to examine the problem and to work on
them within the security of the relationship. Here there is specific tasks this include the following:
● Maintaining the relationship
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CALANIPAWAN ROAD, TACLOBAN CITY, LEYTE
COLLEGE OF NURSING
(2nd SEMESTER S.Y. 2023-2024)

● Gathering more data

● Exploring perceptions of reality
● Developing positive coping mechanisms
● Promoting a positive self-concept
● Encouraging verbalization of feelings
● Facilitating behavior change
● Working through resistance
● Evaluating progress and redefining goals as appropriate
● Providing opportunities for the client to practice new behaviors
● Promoting independence

Termination Phase
It is the final stage in the nurse–client relationship. It begins when the problems are resolved
and ends when the relationship is ended. The nurse terminates the relationship when the mutually
agreed goals are met, the patient is discharged or transferred or the rotation is finished. The focus
of this stage is the growth that has occurred in the client and the nurse helps the patient to
become independent and responsible in making his own decisions.

II. Art Therapy

OVERVIEW
Art therapy makes use of art and other visual mediums so patients can express their inner
emotions, and thoughts, and unprocessed trauma.
Art therapists work with patients one on one or in groups. The art therapist provides the
materials needed to make paintings, drawings, sculptures, and other types of artwork. This type of
therapy may help you express unspoken and unconscious feelings and emotions in a safe
environment under the guidance of a trained, experienced professional. The therapist or
professional can then help interpret the patient’s art, assess their mental and emotional state, and
help unpack them together with the patient.

PURPOSE
● To explore emotions
● To develop self-awareness and self-esteem
● To cope with stress
● To enhance communication skills

PROCEDURE
1. Pre-session
● Prepare any necessary client intake forms to record your client’s details.
● Review any notes taken about the client at the time the appointment was made so that you
are prepared for the purpose of your client’s session.
2. Start Session
● Discuss your role and your approach to therapy. Your client will feel at ease if you are able
to provide them with a basic guideline of the treatment process ahead.
● Ask your client about their primary reason for making an appointment and what they hope
to achieve in their time with you.
● Identify existing problems and discuss possible goals for your client to work towards in
relation to those problems.
3. Art Activity
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CALANIPAWAN ROAD, TACLOBAN CITY, LEYTE
COLLEGE OF NURSING
(2nd SEMESTER S.Y. 2023-2024)

● Determine how comfortable your client is with art supplies and discuss any possible
resistance to using art supplies.
● Address the issue of perfectionism and place the focus on the process of creating instead
of completing an artwork.
● Discuss possible art activities that you think your client may benefit from in this session.
4. Process Art
● Explain that processing the art activity is not about interpreting the meaning of any images
or outcomes but instead discussing the experience of the client during the activity. What
thoughts came to mind for the client? Did they experience any confronting emotions
throughout the process?
● Ask your client if the artwork that they created represents a memory or is a process of
storytelling about a life experience in the past.
● Keep your questions open-ended and avoid projecting your ideas on to the meaning of the
artwork.
5. Close Session
● Summarise any key points from the session and invite your client to offer their own
reflections on any insights they may have gained from the sessions.
● Discuss the option of any homework activities (not always necessary) and determine your
client’s confidence in being able to achieve that goal before your next session.
● Ask your client for feedback on the art activity from the session. This includes seeking
feedback on the art supplies used and any subsequent resistance or enthusiasm to
starting the activity.
6. Post-Session
● Write your client session notes and making a note in your schedule to prepare anything
you may need for future sessions.
III. Music therapy
OVERVIEW
Music therapy is a specialized form of therapy that utilizes the therapeutic properties of music
to address physical, emotional, cognitive, and social needs. It involves the intentional use of music
interventions within a therapeutic relationship to achieve specific therapeutic goals and improve
overall well-being. Music therapists, who are trained professionals with expertise in both music and
therapy, design and facilitate sessions tailored to each individual's unique needs and preferences.
Music therapy is utilized in a variety of settings, including hospitals, rehabilitation centers, schools,
mental health facilities, nursing homes, and community-based programs. It is used to address a
wide range of populations and conditions, including children with developmental disabilities, adults
recovering from trauma, individuals with neurological disorders, and older adults with dementia.

PURPOSE
The purpose of music therapy is diverse and far-reaching, extending beyond symptom
management to encompass holistic well-being and personal growth. Here's a more detailed
exploration of its multifaceted goals:
1. Complementary Therapy in Healthcare Settings: Music therapy serves as a valuable
adjunct to conventional medical treatments in healthcare settings. By integrating music into
treatment plans, it enhances the overall effectiveness of care and contributes to improved
patient outcomes. For instance, music therapy can complement pain management strategies
by helping individuals cope with discomfort, reduce perceived pain levels, and promote
relaxation. Similarly, it can be utilized alongside interventions for anxiety and depression,
offering additional support and addressing emotional distress.
 DOÑA REMEDIOS TRINIDAD ROMUALDEZ MEDICAL FOUNDATION
CALANIPAWAN ROAD, TACLOBAN CITY, LEYTE
COLLEGE OF NURSING
(2nd SEMESTER S.Y. 2023-2024)

2. Symptom Management: Music therapy targets a wide range of symptoms associated with
various physical and mental health conditions. For individuals with neurological disorders,
such as Parkinson's disease or traumatic brain injuries, music therapy can aid in improving
motor skills, coordination, and movement. It provides a therapeutic avenue for rehabilitation,
helping individuals regain mobility and functional independence. Moreover, for individuals
experiencing anxiety, depression, or trauma-related symptoms, music therapy offers
techniques for stress reduction, emotional regulation, and trauma processing, thereby
alleviating distress and enhancing overall psychological well-being.
3. Enhancement of Quality of Life: Beyond symptom management, music therapy aims to
enhance overall quality of life by addressing broader psychosocial and existential concerns.
Through musical engagement, individuals are provided with opportunities for emotional
expression, social connection, and self-discovery. Music serves as a universal medium for
communication, enabling individuals to convey and process complex emotions, experiences,
and narratives non-verbally. This is particularly beneficial for individuals who may struggle to
articulate their thoughts and feelings verbally, such as those with developmental disabilities or
communication disorders.
4. Fostering Emotional Expression and Self-Awareness: Music therapy provides a safe and
supportive environment for individuals to explore and express their emotions authentically.
Through musical improvisation, composition, or listening, individuals can access and process
deeply held emotions, gain insight into their internal experiences, and develop greater self-
awareness and emotional intelligence. This process of emotional exploration and self-
reflection can be empowering and transformative, facilitating personal growth and self-
actualization.
5. Promotion of Social Interaction and Connection: Music therapy promotes social
interaction, communication, and interpersonal connection through collaborative musical
activities. Group music-making experiences, such as singing in a choir or playing in an
ensemble, foster a sense of belonging, camaraderie, and mutual support among participants.
These shared musical experiences create opportunities for social engagement, cooperation,
and relationship-building.

PROCEDURE
Before Music Therapy:
1. Assessment of Needs and Strengths: The music therapist conducts an assessment to
gather information about the client's emotional well-being, physical health, social functioning,
perceptual/motor skills, communication abilities, cognitive skills, musical background, trauma
history, and trauma triggers. This assessment provides valuable insight into the client's unique
circumstances and informs the development of an individualized treatment plan.
2. Goal Identification: Working collaboratively with the client, the therapist identifies specific
therapeutic goals and objectives for the sessions. These goals may relate to emotional
expression, communication skills, motor coordination, relaxation, or other areas of focus. The
therapist considers the client's preferences, interests, age, developmental level, physical
abilities, cognitive abilities, and trauma triggers when establishing goals.
3. Treatment Plan Development: Based on the assessment findings and identified goals, the
therapist designs a personalized treatment plan that outlines the types of musical activities and
interventions to be used during sessions. The treatment plan is tailored to meet the client's
needs and preferences, incorporating a variety of techniques to promote therapeutic outcomes.

During Music Therapy:

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CALANIPAWAN ROAD, TACLOBAN CITY, LEYTE
COLLEGE OF NURSING
(2nd SEMESTER S.Y. 2023-2024)

1. Engagement in Musical Activities: In the therapy session, the client actively engages in a
variety of musical activities guided by the therapist. These activities may include:
○ Creating music: Clients compose music, write lyrics, or participate in collaborative music-
making exercises.
○ Singing: Clients use their voice to express themselves through singing, whether it's singing
along to familiar songs or improvising melodies.
○ Instrumental play: Clients play musical instruments such as guitar, drums, piano, or
percussion instruments to create music and express themselves.
○ Improvisation: Clients engage in spontaneous musical improvisation, exploring sounds
and melodies that reflect their emotions and experiences.
○ Movement to music: Clients engage in movement activities synchronized with music, such
as dancing, tapping, or swaying to the rhythm.
○ Listening to music: Clients listen to carefully selected music chosen by the therapist, either
recorded or performed live, and engage in directed listening exercises. The therapist may
guide discussions about the music's meaning and use it to facilitate emotional processing
and relaxation.
○ Lyric analysis: Clients explore the lyrics of songs, discussing their meanings and relevance
to their own experiences.
2. Therapist Facilitation: Throughout the session, the therapist provides guidance, support, and
encouragement to facilitate the client's engagement in musical activities. The therapist adapts
interventions based on the client's responses, ensuring a supportive and meaningful
therapeutic environment.
3. Reflection and Processing: At various points during the session, clients may reflect on their
experiences and process their emotions with the therapist. Discussions about the music, lyrics,
and personal insights help clients deepen their understanding of themselves and their
therapeutic journey.

IV. Dance therapy

OVERVIEW
Dance therapy is defined as a form of psychotherapy that uses movement to address
emotional, physical, and social needs. It integrates movement and dance with verbal
processing to enhance an individual's well-being. Dance therapy can be used in individual
or group settings, and the specific movements and techniques employed vary depending
on the client's needs and goals.

PURPOSE
Dance therapy serves several purposes in a mental health setting:
● Improve emotional expression: Movement can provide a safe and creative outlet for
expressing emotions that might be difficult to verbalize.
● Enhance body awareness: Dance therapy can help individuals build a better connection
with their bodies and gain insight into how their emotions manifest physically.
● Develop social skills: Group dance therapy sessions can foster communication,
collaboration, and trust among participants.
● Reduce stress and anxiety: The rhythmic and expressive nature of dance can promote
relaxation and reduce symptoms of anxiety and depression.
 DOÑA REMEDIOS TRINIDAD ROMUALDEZ MEDICAL FOUNDATION
CALANIPAWAN ROAD, TACLOBAN CITY, LEYTE
COLLEGE OF NURSING
(2nd SEMESTER S.Y. 2023-2024)

● Improve self-esteem: Dance therapy can empower individuals to feel confident in their
bodies and movement abilities, leading to increased self-esteem.

PROCEDURE
A typical dance therapy session might involve the following:
● Warm-up: Gentle movements prepare the body for more strenuous activity.
● Movement exploration: Clients are encouraged to explore different movements and
express themselves freely.
● Structured activities: The therapist may introduce specific tasks or themes to guide
movement exploration.
● Integration: Verbal processing helps clients reflect on their experience and connect their
movement to emotions or thoughts.
● Cool-down: Gentle stretching and relaxation techniques help participants wind down.

Reference:
American Psychiatric Association. (2014). Desk Reference to the Diagnostic Criteria from
DSM-5®. (5th ed.). American Psychiatric Pub.

V. Drama Therapy
OVERVIEW
Drama therapy is an embodied practice that is active and experiential. It involves using drama and
theatre techniques to help people resolve conflicts and problems. It may also allow individuals to
develop self-awareness, express emotions, and improve relationships.

PURPOSE
● To tell their stories
● To set goals and solve problems
● To express feelings
● To promote psychological growth, well-being, and self-discovery

PROCEDURE
Stages:
Renee Emunah (1994) has identified five stages through which most drama therapy groups progress.
Her five stage theory parallels established wisdom from group dynamics on how successful groups
form and grow.
1. The first stage is Dramatic Play where the group gets to know each other and the therapist
through playing together develop trust, group cohesion, and basic relationship skills.
2. The second stage is the Scene Work Stage where they continue playing. The focus remains on
developing dramatic skills which they will need as they continue in treatment. As they grow older
and begin school, they are encouraged to develop their abstract reasoning skills and use them in
their learning.
3. Stage Three focuses on Role Play, exploring issues through fictional means. Perhaps the group
acts out a generic family conflict or a familiar character from a fairy tale or legend that goes
through a crisis or challenge shared by group members. When the group is ready, they can move
on to the next stage.
4. Stage Four: Culminating Enactments, where personal issues are acted out directly through
psychodrama or autobiographical performance.
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CALANIPAWAN ROAD, TACLOBAN CITY, LEYTE
COLLEGE OF NURSING
(2nd SEMESTER S.Y. 2023-2024)

5. The final stage is Dramatic Ritual, which usually involves closure to the work of the group. This
might be the sharing of a public performance that has been created by the group or the sharing of
a private ritual within the group.

Techniques:
A drama therapist assesses a person’s individual needs and goals to create a treatment plan and
then considers approaches that might best meet those needs. They then use different drama
techniques, activities, and exercises to help the person explore their emotions and work through
challenging life experiences. These include:

1. Use of Metaphor: The first is the use of metaphor through action. Behaviours, problems, and
emotions can be represented metaphorically, allowing for symbolic understanding. An emotion
can be represented with a metaphorical image: anger displayed as a volcano, an exploding bomb,
or a smoldering fire. These images can be dramatised which allow the client to gain more insight
into the qualities of the emotion and how it functions positively or negatively in his/her life.
2. Concrete embodiment: This technique allows the abstract to become concrete through the client’s
body. Embodiment allows clients to “experience” or “reexperience” in order to learn, to practice
new behaviours, or to experiment with how to change old behaviours. Playing a role quite
different from oneself often feels more comfortable than playing oneself directly.
3. Dramatic Projection: This technique is akin to concrete embodiment and employs metaphor. It is
the ability to take an idea or an emotion that is within the client and project it outside to be shown
or acted out in the drama therapy session.
4. Creation of transitional space: The creation of Transitional Space is an important component in
many therapeutic and learning environments, but it is essential in drama therapy. Transitional
space is the imaginary world that is created when we play or imagine together in a safe, trusting
situation.
5. Incorporating other Arts: Drama therapy is like a crossroad, where all the arts come together and
are allowed to work together. Drama therapists use music, movement, song, dance, poetry,
writing, drawing, sculpture, mask making, puppetry, and other arts with their drama therapy
activities. Drama therapists are required to have training in the other creative arts therapies and
why many drama therapists have credentials in one of the other arts therapy modalities.

VI. Play therapy

OVERVIEW
Play therapy is a tool that originally comes from the field of psychotherapy, or talk therapy. It is a
child-centered therapy for children between the ages of 3 and 16 years who have mental or behavioral
conditions, such as autism and ADHD. It involves a trained therapist observing a client while they play
and following their lead as they do. The approach is based on the idea that children communicate
unconsciously through play. This means they reveal things about themselves without realizing they are
doing it. It is through play that children learn how to interact with the world and develop skills. As such, it
is a natural means of self-expression for them. During play, a child may either directly or symbolically act
out their feelings, allowing a therapist to gain insight into their emotional state. Playing together provides
a safe environment for this to happen, allowing people to express things they might otherwise find difficult.
Participating in a shared activity also fosters trust between the therapist and the client, creating a
therapeutic relationship. This can be especially useful for children, who may feel distrustful of strangers.

PURPOSE
● Reduces anxiety about traumatic events in the child’s life
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CALANIPAWAN ROAD, TACLOBAN CITY, LEYTE
COLLEGE OF NURSING
(2nd SEMESTER S.Y. 2023-2024)

● Facilitates a child’s expression of feelings

● Promotes self-confidence and a sense of competence
● Creates or enhances healthy bonding in relationships
● Enhances creativity and playfulness

PROCEDURE
Therapeutic Stages in Play Therapy:
● Intake interview: The therapist and client’s first meeting during which the client’s development,
current functioning, and presenting problems will be questioned. It is important to be honest and
open as possible.
● Introduction phase: The client will be getting used to the therapist , the playroom, and the play
therapy sessions. The more shy or anxious the client is, the more difficult this period may be.
● Tentative Acceptance: The stage after one to several sessions wherein the client is even more
eager to go to counseling. Positive changes are noticed, excitement in interacting with the
therapist, and looking forward to entering the room.
● Growth: The most important, and usually the longest part of the play therapy process. The client
will come to better understand his or her difficulties, how to best resolve these difficulties and how
to live a much happier and playful life.
● Termination Phase: The final stage of therapy wherein both the client and the therapist are
confident that behavioral and emotional functioning are stable enough to maintain what the client
has accomplished. This is also the end of the therapeutic relationship.
The client has the ability to choose what to do from a wide variety of materials and toys such as
balls, clay, dolls, puzzles, etc. The therapist encourages him to experiment and express himself freely.
The client is under observation, he gets attention, he is given the stimulus and he is helped to play. The
therapist facilitates the client's play, enables him to get into roles, develop standards and explore
alternatives.
Variety of play therapy techniques are put into practice around the world such as:
Toy and Object Play Techniques:
1. Ball Play - For example, in a group therapy session, a therapist might have a group take turns
throwing a ball around, and anytime someone catches the ball they have to say something that
makes them happy.
2. Plush Doll Play - For example, the therapist might present the client with a few stuffed animals
(or ask the client to bring their own) to help comfort the child during a therapy session.
3. Block Play - For example, the therapist might construct a wall of building blocks and allow the
client to throw a ball to knock the blocks down. This can help the client release anger.
4. Toy Telephone Play - For example, the client and the therapist might each have a toy phone,
and the therapist can ask therapy-related questions on the phone. The client might be more
comfortable indirectly answering questions like this, and if they feel uncomfortable they can just
hang up.

Game Playing Techniques:

1. Self-Control Games - For example, the therapist and client might play “Simon Says”, where the
client has to do what the therapist says (such as jumping on one foot), but only if the therapist
started their sentence with “Simon says…”. This can promote paying attention and self-control, as
the client has to pay attention to what the therapist is saying and only do what the therapist says
in certain situations.
2. Strategy Games - For example, the therapist might simply play a familiar strategy game with the
client, such as chess, checkers, or pick up sticks. This can help the client focus and feel happier,
as well as foster a bond between the client and therapist. These games can be especially useful
during early therapy sessions if the client is uncomfortable with the therapist or the idea of therapy
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CALANIPAWAN ROAD, TACLOBAN CITY, LEYTE
COLLEGE OF NURSING
(2nd SEMESTER S.Y. 2023-2024)

itself. These games may help a client feel a sense of control and mastery or strengthen impulse
control and self-regulation in their efforts to master the game. The chess pieces may also be seen
as embodying parental symbols and, therefore, help spark conversation regarding family
members.

Role Playing Techniques:

1. Superhero Play - For example, the therapist might ask the client to draw a superhero with
superpowers that the client would like to have. The therapist can then help the client figure out
how their personal strengths can be as useful as these superpowers.
2. Puppet Play - Puppets are frequently used tools in play therapy, which can be employed in a
variety of ways. One popular technique is called the Family Puppet Interview. When facilitating
this form of play, the therapist will present the client and the client’s family with dozens of puppets,
then ask the client and the client’s family to each choose a puppet to represent them. The client
and the client’s family then tell a story using the puppets, and the therapist interviews each family
member about the story then discusses the story with the whole group. This can reveal certain
family dynamics that the client is unable or unwilling to directly discuss with the therapist.

Creative Arts Techniques:

1. Color Your Life - For example, the therapist and client might work together to figure out which
colors represent which feelings (such as blue for sad, red for angry, yellow for happy, etc.) The
therapist can then ask the client to draw a timeline of their life, using the colors to represent
feelings.
2. Free Drawings - Free drawing is a widely used play therapy technique that serves a range of
functions. It can help therapists develop a rapport with new clients, encourage clients to express
their emotions, and reveal unconscious disturbances that spark discussion. For example, the
therapist might simply give the client paper and some crayons (or any drawing materials) and ask
them to draw a picture. The therapist can then ask open-ended questions about the picture once
it is complete.
3. Clay Play - For example, the therapist might give the client a ball of clay and let them do
whatever they want with it. Unstructured clay play has been shown to be effective for relieving
stress, but it can also be used to encourage clients to sculpt things that are important to them or
troubling them that they can talk about with the therapist.
4. Draw a Family - For example, the therapist might ask the client to draw a picture of their family.
Once the picture is drawn, the therapist can ask which drawing is which member of the client’s
family and discuss whatever the client wants to discuss about the drawing. The ways various
family members are drawn can be revealing and has particularly been shown to help elucidate
clients’ experiences of a blended family environment.

VII. Family Therapy

Overview
● Family therapy is a form of group therapy in which the client and his or her family
members participate. The goals include understanding how family dynamics contribute to
the client’s psychopathology, mobilizing the family’s inherent strengths and functional
resources, restructuring maladaptive family behavioral styles, and strengthening family
problem-solving behaviors (Spitz & Spitz, 2017). Family therapy can be used both to
assess and to treat various psychiatric disorders. Although one family member is usually
identified initially as the one who has problems and needs help, it often becomes evident
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CALANIPAWAN ROAD, TACLOBAN CITY, LEYTE
COLLEGE OF NURSING
(2nd SEMESTER S.Y. 2023-2024)

through the therapeutic process that other family members also have emotional problems
and difficulties.

Purpose:
● Improving communication in the family
● Solving family problems
● Understanding and handling special family situations
● Creating a better functioning home environment
● Exploring the interactional dynamics of the family

Procedure:
● Engagement and Rapport Building
○ The first stage lays the foundation for the therapeutic journey. Therapists establish
a safe and welcoming environment, allowing family members to open up about
their concerns. Building rapport and trust is crucial for effective therapy. Families in
distress find solace in sharing their experiences, while therapists listen attentively
to grasp the dynamics at play.
● Assessment and Understanding
○ During this stage, therapists dive deep into the family’s history, roles, and
communication patterns. By understanding the root causes of conflicts, therapists
gain insights that guide the therapeutic approach. Family members learn to see
beyond surface-level disagreements, recognizing deeper emotional triggers. This
understanding paves the way for addressing underlying issues.
● Restructuring and Communication Enhancement
○ Effective communication is the cornerstone of a healthy family dynamic. In this
stage, therapists teach families new ways to communicate and interact. The focus
is on active listening, respectful expression, and validation of each member’s
feelings. By replacing negative communication patterns with positive ones, family
members begin to understand each other better, fostering empathy and reducing
conflict.
● Resolution and Healing
○ As communication improves, the process moves toward resolving conflicts and
fostering healing. Family therapy provides a space to address pent-up emotions
and unresolved issues. Family members learn to manage conflicts constructively,
while therapists guide them through the process of forgiveness and letting go. This
stage encourages empathy, growth, and the emergence of stronger bonds.
● Integration and Maintenance
○ The final stage is about ensuring lasting change. Therapists help families integrate
the skills they’ve acquired into their daily lives. Families practice effective
communication, conflict resolution, and empathy outside the therapy sessions.
Therapists provide guidance on handling potential setbacks, ensuring the progress
made during therapy remains steady.
 DOÑA REMEDIOS TRINIDAD ROMUALDEZ MEDICAL FOUNDATION
CALANIPAWAN ROAD, TACLOBAN CITY, LEYTE
COLLEGE OF NURSING
(2nd SEMESTER S.Y. 2023-2024)

VIII. Self-enhancement Growth/therapeutic groups

A. OVERVIEW
- People engage in self-enhancement whenever they seek, interpret, or distort evidence
about themselves in a way designed to maintain, create, or amplify a positive self-image.
Self-enhancement is cognitive or interpersonal activity aimed at boosting beliefs that one
is a lovable and capable human being. People engage in self-protection when they strive
to deny undesirable aspects of themselves. Self-enhancement refers to claiming as much
good as one can about one’s strengths and achievements.
- Some examples of self enhancement include exaggerating one’s virtues, claiming that
one’s success is a reflection of ability, or preferentially remembering positive rather than
negative information of oneself.
- Mechanisms of Self enhancement are:
● Downward social comparison - comparing self to others worse off
● Self-serving bias - the tendency to perceive yourself favorably; take personal credit
for success, blame external factors for failure
● False uniqueness bias - underestimate the commonality of your abilities and
desirable characteristics
● False consensus bias - overestimate the commonality of your opinions or
undesirable characteristics.
● Strategic valuing - value traits you do have, devalue the traits you do not have
● Basking in reflected glory - associating yourself with people who are more
successful to boost our self-esteem
● Self-handicapping - create obstacles and excuses for yourself so that if you do
poorly on a task, you have a convenient excuse
- Overall, self-enhancement is believed to be a fundamental motive to increase the positivity
of one’s self-views (Alicke and Sedikides 2009). It can be conceptualized as a motive to
bring one’s self-views in line with a desired end state, one’s ideal self, or one’s aspirations
with respect to self-views.

B. PURPOSES
● To make people feel good about themselves.
● To maintain self-esteem.
● To emphasize their positive attributes.

C. PROCEDURE
● Compensatory Self Enhancement - acknowledging the negative feedback but then focusing on
the things that one is good at.
● Discounting - downplaying the importance or value of something.
● Downward Social Comparison - comparing oneself to someone who is worse off than you.
● External Attributions -Attributing failures to external factors rather than internal factors
● Basking in reflected glory - is a self-serving cognition whereby an individual associates
himself/herself with another successful individual such that another’s success becomes their own.

IX. Behavioral modification

 DOÑA REMEDIOS TRINIDAD ROMUALDEZ MEDICAL FOUNDATION
CALANIPAWAN ROAD, TACLOBAN CITY, LEYTE
COLLEGE OF NURSING
(2nd SEMESTER S.Y. 2023-2024)

OVERVIEW
Behavior modification is a psychotherapeutic intervention primarily used to eliminate or
reduce maladaptive behavior in children or adults. While some therapies focus on changing
thought processes that can affect behavior, behavior modification focuses on changing specific
behaviors with little consideration of a person’s thoughts or feelings. The progress and outcome
of the intervention can be measured and evaluated. First, a functional analysis of the
antecedents and consequences of the problem behavior(s) must be identified. This allows for
the determination of specific target behaviors that will become the focus of treatment. Then,
certain variables can be manipulated via reinforcers and punishments to change problem
behavior(s). The goal is to eliminate or reduce maladaptive behavior. This activity reviews the
indications and contraindications for behavior modification and highlights the role of the
interprofessional team in the management of patients with behavioral disorders.

PURPOSE
The indications for developing a behavior modification plan can be for any unwanted,
maladaptive, or aberrant behavior. It can also be used to teach and reinforce new, desired
behaviors. In clinical settings, the treatment team utilizes the concept of operant conditioning to
reinforce prosocial behaviors through positive consequences as seen in token economy,
shaping, differential reinforcement of desired behaviors, and extinguish the undesired behaviors
through negative consequences like an overcorrection, response costs, time outs.

PROCEDURE

A behavior modification chart is frequently used when implementing a behavior modification plan.
Behavior charts require specific, objective, quantifiable tasks that are rewarded in a previously
agreed upon way, be it points, stickers, or tally marks.
A “token economy” is synonymous with a behavior modification plan. A token (sticker, chip, point,
tally) is anything that can be earned by exhibiting the desired behavior that can then be
exchanged for reinforcers.
Reinforcers or rewards are a key part of a behavior plan but are unique to each child. The
reinforcement has to be of value to the child for the program to be effective. A child may be
motivated to make her bed every day if she gets a sucker every time she does it, but she may
not make her bed if she gets extra reading time. She has to value the reward for the reward to
be valued.
Reinforcers and punishments must happen at the time of the behavior to increase the likelihood
of success of a behavior modification plan. The more immediate to the behavior the better. For
example, praising a child for using the toilet while he is using it versus later that day. The
reinforcer must be appropriate, e.g., giving a child a sticker every time he says please, or giving
a teenager extra screen time for a good attitude. And lastly, the reinforcer must be consistent
where the behavior is rewarded by all caretakers as previously agreed upon and not to avoid
punishment due to caretaker guilt or inconvenience.

X. Cognitive Restructuring
 DOÑA REMEDIOS TRINIDAD ROMUALDEZ MEDICAL FOUNDATION
CALANIPAWAN ROAD, TACLOBAN CITY, LEYTE
COLLEGE OF NURSING
(2nd SEMESTER S.Y. 2023-2024)

OVERVIEW

Cognitive restructuring is a cognitive technique whereby distorted or negative thinking patterns

that lead to emotions such as anxiety and unhappiness are identified and examined for truth,
accuracy, and validity to replace them with alternative ones that are more realistic and helpful
(Leahy & Rego, 2012).

PURPOSE

● The purpose of cognitive restructuring is to help individuals recognize and change

unhelpful thought patterns that contribute to negative emotions and behaviors.
● By challenging and reframing these thoughts, individuals can develop more adaptive
ways of thinking, leading to improved emotional well-being and more effective coping
strategies.

PROCEDURE

Step 1: The Situation

● In this initial step, individuals identify and describe the specific situation or trigger that led
to the emergence of negative emotions. This could be any event, circumstance, or
interaction that elicits an emotional response. By pinpointing the triggering situation,
individuals gain clarity about the context in which their thoughts and feelings arise, laying
the foundation for subsequent analysis and intervention.

Step 2: The Feeling

● After identifying the triggering situation, individuals identify and acknowledge the
emotions they are experiencing in response to that situation. This step involves
accurately labeling and describing the emotional response, whether it's fear and anxiety,
sadness and depression, guilt and shame, or anger. Recognizing and validating emotions
is crucial for understanding their impact on cognition and behavior, setting the stage for
further exploration of underlying thoughts and beliefs.

Step 3: The Thought

● Once the emotional response is identified, individuals delve into the thoughts and beliefs
that accompany those feelings. They explore the content of their internal dialogue or self-
talk, examining the specific thoughts that contribute to the emotional experience. These
thoughts may be automatic and subconscious, yet they play a significant role in shaping
emotions and influencing behavior. By articulating and scrutinizing these thoughts,
individuals gain insight into the cognitive processes underlying their emotional reactions.
 DOÑA REMEDIOS TRINIDAD ROMUALDEZ MEDICAL FOUNDATION
CALANIPAWAN ROAD, TACLOBAN CITY, LEYTE
COLLEGE OF NURSING
(2nd SEMESTER S.Y. 2023-2024)

Step 4: Evaluate the Thought

● In this critical step, individuals engage in a process of cognitive appraisal, assessing the
accuracy, validity, and helpfulness of the identified thoughts. They challenge the
rationality of their cognitive appraisals, questioning the evidence supporting their beliefs
and considering alternative interpretations of the situation. This process involves applying
logical reasoning and empirical evidence to evaluate the truthfulness and realism of their
thoughts, enabling individuals to discern between realistic and distorted perceptions.

Step 5: Make a Decision

● Building on the insights gained from evaluating their thoughts, individuals are empowered
to make a conscious decision about how to respond to the situation and manage their
emotions effectively. They consider the implications of their cognitive appraisals for their
emotional well-being and behavioral choices, weighing the potential consequences of
different courses of action. This decision-making process is guided by a commitment to
promoting adaptive coping strategies and fostering resilience in the face of adversity.

XI. Milieu therapy

A. OVERVIEW
The concept of milieu therapy, originally developed by Sullivan, involved clients’ interactions with one
another, including practicing interpersonal relationship skills, giving one another feedback about behavior,
and working cooperatively as a group to solve day-to-day problems. Milieu therapy was one of the
primary modes of treatment in the acute hospital setting. Management of the milieu, or environment, is
still a primary role for the nurse in terms of providing safety and protection for all clients and promoting
social interaction.

B. PURPOSES
● Promoting social interaction and communication
● Developing coping mechanisms
● Enhancing self-esteem and self-confidence
● Promoting responsibility and independence

C. PROCEDURE

1. Assessment: Nurses conduct comprehensive assessments of patients' physical, psychological, and

social needs to tailor the therapeutic environment accordingly.

2. Environment establishment: Nurses create a structured and supportive milieu by establishing clear
routines, guidelines, and boundaries within the healthcare setting.

3. Patient engagement: Nurses encourage patients to participate in therapeutic activities, such as group
therapy sessions, recreational activities, and educational programs.
 DOÑA REMEDIOS TRINIDAD ROMUALDEZ MEDICAL FOUNDATION
CALANIPAWAN ROAD, TACLOBAN CITY, LEYTE
COLLEGE OF NURSING
(2nd SEMESTER S.Y. 2023-2024)

4. Communication: Nurses promote open communication among patients and healthcare team
members, fostering trust and collaboration.

5. Individualized care planning: Nurses collaborate with patients to develop individualized care plans
that address their unique needs and goals.

6. Monitoring and evaluation: Nurses continuously monitor patients' progress and adjust interventions
as needed, while also evaluating the effectiveness of milieu therapy in achieving desired outcomes.

By following these steps, nurses can effectively implement milieu therapy to create a therapeutic
environment that supports patients' overall well-being and promotes their recovery journey.

XII. Psychosocial Support Intervention

A. Overview:

Psychosocial support interventions play a vital role in promoting mental health and well-being by
addressing the psychological, emotional, and social needs of individuals experiencing distress or facing
challenging circumstances. These interventions encompass a range of therapeutic approaches aimed at
enhancing coping mechanisms, resilience, and social functioning. This report provides an overview of
psychosocial support interventions, their purpose, and procedural aspects, drawing upon current
research and evidence-based practices.

Types of Psychosocial Support Interventions for Mental Health:

1. Individual Counseling and Therapy: One-on-one sessions with a trained therapist or counselor
to explore thoughts, emotions, and behaviors, and develop coping strategies to address specific
mental health concerns.
2. Group Therapy: Therapeutic sessions conducted in a group setting, facilitated by a mental
health professional, where individuals share experiences, provide mutual support, and learn from
one another's perspectives.
3. Psychoeducation: Educational interventions aimed at providing individuals with information and
knowledge about mental health conditions, coping skills, and available resources to better
understand and manage their symptoms.
4. Cognitive-Behavioral Therapy (CBT): A structured, evidence-based therapeutic approach that
focuses on identifying and challenging negative thought patterns and behaviors, and replacing
them with healthier alternatives to alleviate distress.
5. Creative Therapies: Utilization of creative arts, such as art therapy, music therapy, drama
therapy, and dance/movement therapy, as expressive outlets to facilitate emotional expression,
self-discovery, and healing.
6. Peer Support Programs: Formal or informal networks of individuals with shared experiences of
mental health challenges who offer empathetic listening, encouragement, and practical advice to
one another based on their own lived experiences.
 DOÑA REMEDIOS TRINIDAD ROMUALDEZ MEDICAL FOUNDATION
CALANIPAWAN ROAD, TACLOBAN CITY, LEYTE
COLLEGE OF NURSING
(2nd SEMESTER S.Y. 2023-2024)

7. Family Therapy: Involvement of family members or significant others in therapy sessions to

address relational dynamics, communication patterns, and family systems issues that may
contribute to or exacerbate mental health symptoms.
8. Community-Based Interventions: Programs and initiatives implemented within local
communities to raise awareness, reduce stigma, promote mental health literacy, and provide
access to supportive services and resources.

B. Purpose:

The primary purpose of psychosocial support interventions is to alleviate psychological distress,

enhance coping skills, and improve overall mental well-being. These interventions are particularly
beneficial for individuals experiencing a wide range of mental health issues, including anxiety, depression,
trauma, grief, and adjustment difficulties. By addressing both the psychological and social dimensions of
distress, these interventions aim to empower individuals, strengthen social support networks, and foster
resilience in the face of adversity.

C. Procedure:
1. Assessment and Needs Identification: The first step involves conducting a comprehensive
assessment to understand the individual's or community's needs, strengths, and challenges. This
assessment may include interviews, standardized assessments, and observations to gather
relevant information.
2. Goal Setting: Based on the assessment findings, clear and achievable goals are established
collaboratively between the individual and the mental health professional. These goals serve as a
roadmap for the intervention and provide a framework for monitoring progress.
3. Selection of Intervention Strategies: Psychosocial support interventions encompass a range of
strategies, including individual counseling, group therapy, psychoeducation, cognitive-behavioral
techniques, mindfulness-based practices, and creative therapies (e.g., art therapy, music therapy).
The selection of intervention strategies depends on factors such as the nature of the presenting
issues, the individual's preferences, cultural considerations, and available resources.
4. Implementation: The selected intervention strategies are implemented in a structured and
systematic manner, with regular sessions scheduled according to the individual's needs and
progress. During these sessions, individuals are provided with opportunities to explore their
thoughts, emotions, and behaviors, learn new coping skills, and receive support from the therapist
or group members.
5. Evaluation and Monitoring: Throughout the intervention process, ongoing evaluation and
monitoring are essential to assess the effectiveness of the interventions, identify any emerging
needs or challenges, and make necessary adjustments to the treatment plan. This may involve
regular check-ins, feedback sessions, and the use of outcome measures to track progress over
time.
6. Integration and Follow-Up: As the intervention progresses, efforts are made to promote the
integration of newly acquired skills and insights into daily life. Additionally, follow-up sessions or
aftercare support may be provided to sustain gains made during the intervention and prevent
relapse.
 DOÑA REMEDIOS TRINIDAD ROMUALDEZ MEDICAL FOUNDATION
CALANIPAWAN ROAD, TACLOBAN CITY, LEYTE
COLLEGE OF NURSING
(2nd SEMESTER S.Y. 2023-2024)

Psychosocial support interventions represent a valuable approach to promoting mental health and
well-being by addressing the psychological, emotional, and social dimensions of distress. By providing
individuals with the support, skills, and resources they need to navigate challenges and build resilience,
these interventions contribute to enhancing the quality of life and fostering thriving communities.

XIII. Psychospiritual Support Intervention

A. OVERVIEW
○ It is commonly used to describe a wide range of therapeutic systems which embrace a
spiritual dimension of the human being as fundamental to psychic health and full human
development. Psychospiritual therapy utilizes both psychological and spiritual methods in
a holistic and integrated approach to healing and inner growth.This method involves
simultaneously engaging the soul, intellect, and spirit in healing mental health issues,
moving beyond problematic life patterns, and overcoming traumatic life experiences

B. PURPOSES
○ To restore harmony with our souls
○ To have strong acceptance of the unavoidable pain of one’s life
○ To train in communication and problem-solving techniques
○ To have an improvement of the ability to recognize and express feelings
○ To have an improvement of the image of self and self-esteem
○ To have an improvement of personal and professional relationships
○ To have an improvement or cure of the psychosomatic symptoms

C. PROCEDURE

Psycho-spiritual therapy is an approach to therapy that combines psychological and spiritual

principles to help individuals heal and grow. Here is a general procedure for psycho-spiritual
therapy:

1. Initial Assessment: The therapist conducts an initial assessment to gain an understanding of the
individual's psychological, emotional, and spiritual needs. This assessment includes an intake interview,
assessment of mental health history, and identification of any spiritual beliefs, practices, or experiences
that may be relevant.

2. Development of Treatment Plan: Based on the initial assessment, the therapist works with the
individual to develop a treatment plan that addresses their psychological and spiritual needs. This plan
may include a combination of traditional psychotherapy approaches, spiritual practices, and mindfulness
techniques.

3. Implementation of Therapy: The therapist works with the individual to implement the treatment
plan. This may include regular therapy sessions, homework assignments, and practicing mindfulness and
spiritual techniques.

4. Evaluation of Progress: Throughout the therapy process, the therapist evaluates the individual's
progress and adjusts the treatment plan as necessary. This may include modifying the therapy approach
or incorporating additional spiritual practices.
 DOÑA REMEDIOS TRINIDAD ROMUALDEZ MEDICAL FOUNDATION
CALANIPAWAN ROAD, TACLOBAN CITY, LEYTE
COLLEGE OF NURSING
(2nd SEMESTER S.Y. 2023-2024)

5. Termination and Follow-Up: Once the individual has achieved their therapy goals, the therapist
terminates therapy. However, some therapists may offer ongoing support or follow-up sessions to ensure
that the individual continues to maintain their progress and growth.

It's important to note that psycho-spiritual therapy is a highly individualized approach, and the procedure
may vary depending on the individual's needs and goals.

A. INITIAL ASSESSMENT

The initial assessment is a crucial step in psycho-spiritual therapy, as it helps the therapist to gain a
comprehensive understanding of the individual's psychological and spiritual needs. The assessment may
include the following components:

1. Intake Interview: The therapist conducts an intake interview to gather information about the
individual's current mental and emotional state. This may involve asking questions about their current
symptoms, stressors, and concerns.

2. Mental Health History: The therapist will also gather information about the individual's mental
health history, including any past diagnoses, treatments, hospitalizations, or medications.

3. Spiritual History: The therapist will inquire about the individual's spiritual background, beliefs,
practices, and experiences. This may include questions about their religious or spiritual affiliation,
spiritual practices, and any significant spiritual experiences they have had.

4. Assessment of Presenting Issues: The therapist will work with the individual to identify the
specific psychological and spiritual issues that they would like to address in therapy. This may include
symptoms of anxiety, depression, trauma, grief, or spiritual crisis.

5. Setting Treatment Goals: Based on the information gathered in the initial assessment, the
therapist and individual work together to set specific and achievable goals for therapy.

Overall, the initial assessment helps the therapist to establish a collaborative relationship with the
individual, gain insight into their unique psychological and spiritual needs, and develop a personalized
treatment plan.

B. DEVELOPMENT OF A TREATMENT PLAN

The development of a treatment plan is an important step in psycho-spiritual therapy, as it helps to guide
the therapeutic process and ensure that the individual's psychological and spiritual needs are being
effectively addressed. Here are some of the steps involved in the development of a treatment plan:

1. Review of Assessment: The therapist reviews the information gathered in the initial assessment,
including the individual's presenting issues, mental health history, and spiritual background.

2. Identification of Strengths and Challenges: The therapist works with the individual to identify
their strengths, resources, and challenges. This information is used to develop a treatment plan that is
tailored to the individual's unique needs.
 DOÑA REMEDIOS TRINIDAD ROMUALDEZ MEDICAL FOUNDATION
CALANIPAWAN ROAD, TACLOBAN CITY, LEYTE
COLLEGE OF NURSING
(2nd SEMESTER S.Y. 2023-2024)

3. Selection of Treatment Approaches: The therapist and individual work together to select the most
appropriate treatment approaches based on the individual's goals and needs. This may include a
combination of traditional psychotherapy approaches, spiritual practices, and mindfulness techniques.

4. Setting Treatment Goals: The therapist and individual work together to establish specific and
measurable goals for therapy. These goals should be achievable, realistic, and relevant to the individual's
needs.

5. Developing a Treatment Schedule: The therapist and individual work together to establish a
treatment schedule that works for the individual's needs and schedule. This may include the frequency
and duration of therapy sessions, as well as any spiritual practices or mindfulness techniques that are
incorporated into the treatment plan.

6. Establishing a Plan for Progress Evaluation: The therapist and individual establish a plan for
evaluating progress and adjusting the treatment plan as necessary. This may include regular progress
evaluations and modifications to the treatment plan based on the individual's changing needs.

The development of a treatment plan is a collaborative process that involves both the therapist and the
individual. It is designed to ensure that the individual's psychological and spiritual needs are being
effectively addressed and that progress is being made towards achieving their goals.

Moreover, the spiritual aspect of psycho-spiritual therapy is an important component of the treatment
plan, as it recognizes the role that spirituality can play in healing and growth. Here are some ways that
the spiritual aspect may be incorporated into the treatment plan:

1. Exploration of Spiritual Beliefs: The therapist and individual may explore the individual's spiritual
beliefs and how they relate to their psychological issues. This may involve discussing the individual's
religious or spiritual background, beliefs, and practices, and how these may impact their mental and
emotional well-being.

2. Integration of Mindfulness Practices: Many spiritual traditions emphasize the importance of

mindfulness practices, such as meditation, prayer, or breathing exercises, as a way to cultivate inner
peace and awareness. These practices can be incorporated into the treatment plan to help the individual
develop a greater sense of spiritual connection and calm.

3. Incorporation of Rituals and Ceremonies: Rituals and ceremonies can be powerful tools for
spiritual healing and growth. The therapist may work with the individual to develop personalized rituals or
ceremonies that can be incorporated into their daily life or therapy sessions.

4. Exploration of Transpersonal Experiences: Transpersonal experiences, such as mystical

experiences, near-death experiences, or spiritual crises, can be significant events that impact an
individual's spiritual and psychological well-being. The therapist may explore these experiences with the
individual to gain a deeper understanding of their impact on their life and to help the individual integrate
these experiences into their spiritual journey.

5. Use of Spiritual Symbols and Imagery: Symbols and imagery can be powerful tools for
connecting with the spiritual realm. The therapist may incorporate spiritual symbols or imagery into
therapy sessions to help the individual connect with their spiritual beliefs and values.
 DOÑA REMEDIOS TRINIDAD ROMUALDEZ MEDICAL FOUNDATION
CALANIPAWAN ROAD, TACLOBAN CITY, LEYTE
COLLEGE OF NURSING
(2nd SEMESTER S.Y. 2023-2024)

The spiritual aspect of psycho-spiritual therapy recognizes the importance of spirituality in healing and
growth. By incorporating spiritual practices and exploring spiritual beliefs, the individual can gain a
deeper sense of connection, purpose, and meaning in their life, which can have a positive impact on their
psychological well-being.

C. IMPLEMENTATION OF THERAPY/SUPPPORT

The implementation of therapy in psycho-spiritual therapy involves the actual process of working with the
therapist to address the individual's psychological and spiritual needs. Here are some of the key steps
involved in the implementation of therapy:

1. Building a Therapeutic Relationship: The therapist works to establish a positive and supportive
therapeutic relationship with the individual. This involves creating a safe and non-judgmental space
where the individual feels comfortable sharing their thoughts and feelings.

2. Utilizing Treatment Approaches: Based on the treatment plan developed in the earlier stages, the
therapist utilizes various treatment approaches to address the individual's psychological and spiritual
needs. This may include traditional psychotherapy approaches, such as cognitive-behavioral therapy,
psychodynamic therapy, or humanistic therapy, as well as spiritual practices and mindfulness techniques.

3. Practicing Mindfulness: The therapist may incorporate mindfulness practices into therapy
sessions, such as meditation, breathing exercises, or body scans. These practices can help the
individual develop greater awareness and acceptance of their thoughts and emotions, and can promote a
greater sense of calm and inner peace.

4. Encouraging Self-Exploration: The therapist may encourage the individual to explore their
thoughts, emotions, and beliefs in greater depth. This may involve asking open-ended questions,
exploring past experiences, and identifying patterns in thoughts and behaviors.

5. Promoting Personal Growth: The therapist works with the individual to promote personal growth
and development. This may involve setting goals for therapy, challenging negative thought patterns,
developing new coping skills, and exploring spiritual practices that can promote a greater sense of
purpose and meaning.

6. Evaluating Progress: Throughout the implementation of therapy, the therapist evaluates progress
and adjusts the treatment plan as necessary. This may involve assessing the individual's emotional and
spiritual well-being, identifying areas for improvement, and modifying the treatment plan to better meet
the individual's needs.

Overall, the implementation of therapy in psycho-spiritual therapy involves the application of treatment
approaches that address both the individual's psychological and spiritual needs. Through mindfulness
practices, self-exploration, personal growth, and progress evaluation, the individual can develop greater
awareness, inner peace, and personal growth.

In psycho-spiritual therapy, the spiritual aspect is an important component of the treatment process. Here
are some ways in which the spiritual aspect may be incorporated into the implementation of therapy:

1. Encouraging Spiritual Practices: The therapist may encourage the individual to engage in
spiritual practices, such as meditation, prayer, or journaling, as a way to connect with their spirituality and
promote inner peace.
 DOÑA REMEDIOS TRINIDAD ROMUALDEZ MEDICAL FOUNDATION
CALANIPAWAN ROAD, TACLOBAN CITY, LEYTE
COLLEGE OF NURSING
(2nd SEMESTER S.Y. 2023-2024)

2. Exploring Spiritual Experiences: The therapist may work with the individual to explore spiritual
experiences, such as mystical experiences or spiritual crises, and help them integrate these experiences
into their spiritual journey.

3. Identifying Spiritual Values: The therapist may work with the individual to identify their spiritual
values and how these values can inform their decision-making and sense of purpose in life.

4. Addressing Spiritual Struggles: The therapist may help the individual address spiritual struggles,
such as doubts, conflicts, or existential crises, and help them find meaning and hope in their spiritual
journey.

5. Promoting Spiritual Growth: The therapist may work with the individual to promote spiritual growth
and development, such as developing a deeper sense of compassion, forgiveness, or gratitude.

6. Utilizing Spiritual Resources: The therapist may encourage the individual to utilize spiritual
resources, such as support from a faith community or spiritual mentor, as a way to deepen their spiritual
connection and find support in their journey.

The spiritual aspect of psycho-spiritual therapy recognizes the important role that spirituality can play in
healing and growth. By incorporating spiritual practices, exploring spiritual experiences, addressing
spiritual struggles, promoting spiritual growth, and utilizing spiritual resources, the individual can develop
a deeper sense of connection, purpose, and meaning in their life, which can have a positive impact on
their psychological well-being.

Psycho-spiritual therapy can be incorporated with individuals who have mental health issues. In fact, for
some individuals, addressing their spiritual needs can be an important part of their overall treatment plan.
Here are some ways in which psycho-spiritual therapy can be incorporated with individuals who have
mental health issues:

1. Addressing Spiritual Distress: For individuals who experience spiritual distress, such as feeling
disconnected from their sense of purpose or feeling a sense of existential crisis, psycho-spiritual therapy
can be helpful in addressing these concerns and promoting spiritual growth.

2. Promoting Mindfulness: Mindfulness practices, which are often incorporated into psycho-spiritual
therapy, can be particularly helpful for individuals with mental health issues. Mindfulness can help
individuals develop greater awareness of their thoughts and feelings, reduce stress and anxiety, and
promote overall well-being

3. Integrating Beliefs and Values: For individuals whose religious or spiritual beliefs are important to
them, integrating these beliefs and values into therapy can be helpful in promoting a sense of meaning
and purpose. The therapist can work with the individual to identify how their beliefs and values can inform
their decision-making and promote a sense of connection.

4. Providing Support: For individuals who are part of a faith community, incorporating this support
network into therapy can be helpful in promoting overall well-being. The therapist can work with the
individual to identify supportive individuals or resources within their faith community and encourage them
to utilize these resources for support.
 DOÑA REMEDIOS TRINIDAD ROMUALDEZ MEDICAL FOUNDATION
CALANIPAWAN ROAD, TACLOBAN CITY, LEYTE
COLLEGE OF NURSING
(2nd SEMESTER S.Y. 2023-2024)

5. Promoting Self-Exploration: Psycho-spiritual therapy can be helpful in promoting self-exploration

and personal growth. The therapist can work with the individual to explore their thoughts, emotions, and
beliefs in greater depth, and identify patterns that may be contributing to their mental health issues.

Hence, the psycho-spiritual therapy can be a helpful approach for individuals with mental health issues.
By addressing both the psychological and spiritual aspects of their concerns, individuals can develop a
greater sense of connection, purpose, and well-being. It is important to note, however, that psycho-
spiritual therapy should not be used as a substitute for medical treatment or medication management for
mental health issues. It should be used in conjunction with these treatments as part of a comprehensive
treatment plan.

D. EVALUATION PROCESS

The evaluation process in psycho-spiritual therapy involves assessing the effectiveness of the treatment
plan and making any necessary adjustments. Here are the steps involved in the evaluation process:

1. Reviewing Progress: The therapist will review the progress made by the individual since the
treatment plan was developed. They will assess whether the individual has achieved their treatment
goals and whether they have experienced any significant improvements in their mental health and well-
being.

2. Gathering Feedback: The therapist will gather feedback from the individual about their experience
of the treatment process. They may ask questions about what has been helpful or challenging, and
whether there are any changes they would like to make to the treatment plan.

3. Revising Treatment Goals: Based on the review of progress and feedback from the individual, the
therapist may revise the treatment goals. This may involve adjusting the focus of therapy or setting new
goals that are more aligned with the individual's needs and preferences.

4. Adjusting Treatment Techniques: The therapist may also adjust the treatment techniques used in
therapy. For example, if a particular spiritual practice is not resonating with the individual, the therapist
may explore other practices that may be more effective for them.

5. Identifying New Challenges: As the individual progresses through therapy, new challenges may
arise. The therapist will work with the individual to identify these challenges and develop strategies to
address them.

6. Re-Evaluating Progress: The therapist will continue to monitor progress and evaluate the
effectiveness of the treatment plan. They will adjust the plan as necessary to ensure that it is meeting the
individual's needs and promoting their overall well-being

Overall, the evaluation process is an important component of psycho-spiritual therapy. It allows the
therapist and the individual to assess progress, gather feedback, and make any necessary adjustments
to the treatment plan to ensure that it is effective and promotes the individual's overall well-being.

In the spiritual aspect of a person with mental health issues, the evaluation process in psycho-spiritual
therapy involves assessing the effectiveness of the spiritual practices and interventions used in the
treatment plan. Here are some steps involved in the evaluation process:
 DOÑA REMEDIOS TRINIDAD ROMUALDEZ MEDICAL FOUNDATION
CALANIPAWAN ROAD, TACLOBAN CITY, LEYTE
COLLEGE OF NURSING
(2nd SEMESTER S.Y. 2023-2024)

1. Reviewing Spiritual Practices: The therapist will review the spiritual practices that were
incorporated into the treatment plan. They will assess whether these practices were helpful in promoting
the individual's spiritual growth and well-being.

2. Assessing Connection with Higher Power: For individuals who have a belief in a higher power or
divine force, the therapist will assess whether the individual feels a sense of connection to this higher
power. They may also explore whether this connection has played a role in the individual's mental health
and well-being.

3. Gathering Feedback: The therapist will gather feedback from the individual about their experience
of the spiritual practices used in therapy. They may ask questions about what has been helpful or
challenging, and whether there are any changes they would like to make to the spiritual practices.

4. Revising Spiritual Goals: Based on the review of progress and feedback from the individual, the
therapist may revise the spiritual goals. This may involve adjusting the focus of the spiritual practices or
setting new goals that are more aligned with the individual's needs and preferences.

5. Adjusting Spiritual Techniques: The therapist may also adjust the spiritual techniques used in
therapy. For example, if a particular spiritual practice is not resonating with the individual, the therapist
may explore other practices that may be more effective for them.

6. Identifying New Spiritual Challenges: As the individual progresses through therapy, new spiritual
challenges may arise. The therapist will work with the individual to identify these challenges and develop
strategies to address them.

7. Re-Evaluating Spiritual Progress: The therapist will continue to monitor the individual's spiritual
progress and evaluate the effectiveness of the spiritual practices and interventions used in the treatment
plan. They will adjust the plan as necessary to ensure that it is meeting the individual's spiritual needs
and promoting their overall well-being.

The evaluation process in psycho-spiritual therapy for individuals with mental health issues involves
assessing the effectiveness of the spiritual practices and interventions used in the treatment plan and
making any necessary adjustments to ensure that they are promoting the individual's spiritual growth and
well-being. The therapist will work with the individual to address any spiritual challenges that may arise
and continue to monitor progress to ensure that the treatment plan is effective.

E. TERMINATION AND FOLLOW-UP PHASE

The termination and follow-up phase in psycho-spiritual therapy involves ending the therapy process and
providing support to the individual as they transition out of therapy. Here are the steps involved:

1. Termination Session: The therapist will schedule a final session with the individual to review their
progress and discuss their readiness to end therapy. During this session, the therapist will review the
individual's goals and the progress made towards achieving them. They will also discuss any future plans
or goals that the individual may have.

2. Closure Ritual: In some cases, the therapist may lead the individual through a closure ritual that
helps to solidify the therapeutic gains and provide a sense of completion. This may involve a ritual that is
specific to the individual's spiritual or cultural beliefs.
 DOÑA REMEDIOS TRINIDAD ROMUALDEZ MEDICAL FOUNDATION
CALANIPAWAN ROAD, TACLOBAN CITY, LEYTE
COLLEGE OF NURSING
(2nd SEMESTER S.Y. 2023-2024)

3. Referral: If the individual needs additional support or care, the therapist may provide referrals to
other healthcare professionals or support groups that may be helpful.

4. Follow-Up: The therapist may schedule a follow-up session with the individual to check in on their
progress and provide additional support as needed. This may involve providing resources, additional
therapy sessions, or other forms of support.

5. Supportive Care: The therapist may also provide supportive care after the individual has ended
therapy. This may involve regular check-ins or ongoing support to ensure that the individual is
maintaining their progress and continuing to grow spiritually.

The termination and follow-up phase in psycho-spiritual therapy is an important component of the therapy
process. It provides an opportunity to review progress, solidify therapeutic gains, and provide ongoing
support as the individual transitions out of therapy. The therapist will work with the individual to develop a
plan that is tailored to their needs and goals and provides the necessary support to promote their
ongoing spiritual growth and well-being.

In the spiritual aspect of a person with mental health issues, the termination and follow-up phase in
psycho-spiritual therapy involves ending the therapy process and providing ongoing support to the
individual's spiritual growth and well-being. Here are some steps involved in this process:

1. Reviewing Spiritual Progress: The therapist will review the individual's progress in achieving their
spiritual goals and evaluate the effectiveness of the spiritual practices and interventions used in therapy.
This review will help to identify any areas of progress and growth, as well as any challenges that may
require ongoing support.

2. Discussing Future Spiritual Goals: The therapist will work with the individual to identify any future
spiritual goals that they would like to pursue after therapy ends. This may involve exploring new spiritual
practices or setting new goals that build on the progress made in therapy.

3. Providing Referrals: If the individual needs additional support or care, the therapist may provide
referrals to other healthcare professionals or support groups that may be helpful. This may include
spiritual leaders or organizations that can provide ongoing support and guidance.

4. Developing a Follow-Up Plan: The therapist will work with the individual to develop a follow-up
plan that provides ongoing support for their spiritual growth and well-being. This may involve scheduling
regular check-ins or therapy sessions to ensure that the individual is maintaining their progress and
continuing to grow spiritually.

5. Providing Supportive Care: The therapist may also provide supportive care after the individual has
ended therapy. This may involve regular check-ins or ongoing support to ensure that the individual is
maintaining their progress and continuing to grow spiritually.

The termination and follow-up phase in psycho-spiritual therapy for individuals with mental health issues
involves ending therapy and providing ongoing support for their spiritual growth and well-being. The
therapist will work with the individual to evaluate progress, set future goals, and develop a follow-up plan
that provides ongoing support and guidance. This will help to ensure that the individual is able to
maintain their progress and continue to grow spiritually even after therapy has ended.
 DOÑA REMEDIOS TRINIDAD ROMUALDEZ MEDICAL FOUNDATION
CALANIPAWAN ROAD, TACLOBAN CITY, LEYTE
COLLEGE OF NURSING
(2nd SEMESTER S.Y. 2023-2024)

XIV. Inner Shouting

Overview
Inner shouting, also known as internal screaming or inner yelling, refers to the metaphorical
process of accessing and expressing intense emotions in a controlled and therapeutic manner within the
context of psychotherapy. It shares similarities with primal scream therapy, a psychotherapeutic
approach developed by psychologist Arthur Janov in the 1960s.

Purposes
● To facilitate emotional expression, exploration, and processing, similar to the aims of primal
scream therapy.
● Enhance self-awareness and self-expression.
● By confronting and expressing these emotions, individuals can gain a deeper understanding of
themselves and their emotional experiences, leading to improved mental health and better
relationships with others.

Procedure
Inner Shouting has different types and can be broken down into several phases or aspects that
individuals may go through during their emotional release. These types and phases can vary from person
to person and may not always be linear or sequential.

Types:
1. Cathartic Expression
Encouraging clients to release pent-up emotions through verbal expression, which may
include shouting, screaming, or vocalizing intense emotions.
2. Narrative Therapy
Helping clients construct and share their personal stories, including their innermost
thoughts and feelings, which can involve emotionally charged verbal expression.
3. Emotion-Focused Therapy
Focusing on exploring and processing emotions to promote emotional healing and growth,
often through intense emotional expression.

Phases:
1. Preparation and Trust Building
Before engaging in Inner Shouting, a strong therapeutic relationship and trust between the
individual and the therapist are crucial. This phase involves setting up a safe environment,
discussing the individual's expectations, and ensuring they feel comfortable and supported
throughout the process.

2. Emotional Trigger or Focus

Inner Shouting may involve focusing on specific childhood experiences, emotions, or
triggers that the individual wishes to address. This helps them channel their emotions and create
a starting point for their emotional release.

3. Emotional Release
During Inner Shouting, individuals shout, scream, or cry to express their deep-seated
emotions. This phase can involve intense feelings of anger, sadness, fear, or other emotions that
have been suppressed for a long time.

4. Processing and Insight

 DOÑA REMEDIOS TRINIDAD ROMUALDEZ MEDICAL FOUNDATION
CALANIPAWAN ROAD, TACLOBAN CITY, LEYTE
COLLEGE OF NURSING
(2nd SEMESTER S.Y. 2023-2024)

After the emotional release, individuals may begin to process their feelings and gain new
insights into their experiences, emotions, and behaviors. This phase can help them develop a
better understanding of themselves and their emotional responses.

5. Integration and Growth

As individuals continue their therapeutic journey, they integrate their newfound insights
and emotional growth into their daily lives. This phase involves applying the lessons learned
during therapy to improve their relationships, emotional regulation, and overall well-being.

XIV. Thought Stopping

Overview
Thought stopping is a skill that therapists may teach people to help them deal with unwanted or intrusive
thoughts. This technique focuses on helping individuals create healthier ways of thinking by stopping
negative thoughts in their tracks and replacing them with more positive ones.

Purpose
When we practice this technique, we're training our minds to be more aware of the thoughts we're having
and to be more in control of how we react to them. This increased awareness can allow us to recognize
when a negative thought is starting to take hold. We can then make the choice to stop it before it
becomes overwhelming. With consistent practice, we can learn to catch these ideas more easily and shift
our focus away from them.

This technique is not about ignoring or suppressing thoughts entirely but learning to better manage them.
Negative beliefs are a normal part of life, and trying to avoid them completely might be unrealistic. With it,
we can balance our thoughts by redirecting our attention to more productive ideas. This technique may
be a useful technique for building resilience, improving emotional well-being, and reducing the impact
that negative thoughts can have on our daily lives.

Procedure
In some cases, these techniques can be helpful for managing problematic thinking and creating a
healthier mindset. There are various thought stopping techniques that may be beneficial, depending on a
person’s preferences and needs. It may be a good idea to consult with a healthcare professional before
engaging in a practice like this. You may also want to try different techniques to see which works best for
you.

● The "stop" technique

The "Stop" technique involves firmly saying "Stop!" (either out loud or in your head) when a negative
thought emerges. This command can act as a mental interruption, helping you break the chain of
negative thinking. You then have the opportunity to redirect your focus to something more positive.

● Thought replacement
Thought replacement is the process of consciously replacing a negative thought with a more
positive or neutral one. When you notice a negative thought, you can pause for a moment and
think of something that brings you joy. You could also choose a more positive thought to focus on.
This practice may help shift your mindset and reduce the power of negative thinking.

● Rubber band technique

 DOÑA REMEDIOS TRINIDAD ROMUALDEZ MEDICAL FOUNDATION
CALANIPAWAN ROAD, TACLOBAN CITY, LEYTE
COLLEGE OF NURSING
(2nd SEMESTER S.Y. 2023-2024)

To implement the rubber band technique, you wear a rubber band around your wrist and gently
snap it when you notice a negative thought. The physical sensation can serve as a reminder to
stop the thought and refocus your attention on something more positive. Note that, because this
technique can cause pain and minor injury, it is unlikely to be recommended by a healthcare
professional.

● Progressive muscle relaxation

Progressive muscle relaxation is a technique that can help you reduce stress and anxiety by
focusing on tensing and relaxing different muscle groups in your body. As you practice this, it can
help you become more aware of your thoughts and make it easier to stop negativity when it arises.

● Visualization
Visualization involves using your imagination to create mental images that promote positive
thinking. When a negative thought comes up, try to visualize a calming or happy scene, like a
beautiful beach or a memory that makes you smile. This can help shift your focus away from
negative ideas.

● Auditory interruption
Auditory interruption methods such as snapping your fingers or clapping your hands, for example,
can help disrupt negative thinking by creating a sudden noise. This noise serves as a cue to stop
the thought and redirect your attention to something more positive or neutral.

● Scheduled worry time

Scheduled worry time involves setting aside a specific time each day to focus on your concerns or
negative beliefs. By designating a limited time for this purpose, you can reduce the frequency of
negative thoughts throughout the day and gain more control over your thought patterns.

REFERENCES:
● Jennings, S. (1997). Drama therapy: Theory and Practice (Vol. 3). Routledge.
● Lawrence, L. (2022, May 27). Drama therapy: Techniques, benefits, and exercises.
Www.medicalnewstoday.com. https://www.medicalnewstoday.com/articles/drama-
therapy#summary
● Rubin, J. (1998). Art Therapy: an Introduction. Bruner- Routledge.
● Stuart-Shaller, K., & Caldwell, J. (2021). Principles and practice of psychiatric nursing (11th ed.).
Elsevier.
● Videbeck, S. L. (2020). Psychiatric-mental health nursing (Eighth edition). Wolters Kluwer.
● World Health Organization. (2019). Mental Health: Strengthening Our Response. Retrieved
from https://www.who.int/news-room/fact-sheets/detail/mental-health-strengthening-our-
response
● American Psychological Association. (2017). Understanding psychotherapy and how it works.
Retrieved from https://www.apa.org/helpcenter/understanding-psychotherapy