Experiential Therapy
The student will complete the discussion assignment in paragraph format, answering the questions given in the Discussion assigned week. The student will post one thread of at least 400 words. The student will answer each question thoroughly and must use a minimum of the three required scholarly journal articles published within the last three years.
Reducing Missed Mental Health Appointments Among Veterans Through Nurse-Led Motivational Interventions
Reducing Missed Mental Health Appointments Among Veterans Through Nurse-Led Motivational Interventions
Veterans are at increased risk for complex mental health disorders such as PTSD, depression, and substance use, yet their continuity of care is frequently disrupted due to missed outpatient appointments. According to the U.S. Department of Veterans Affairs, over 20% of scheduled outpatient mental health appointments are missed annually, contributing to worsening clinical outcomes, increased hospitalizations, and elevated suicide risk (VA Office of Inspector General, 2022). This disruption undermines recovery, delays medication adjustments, and erodes therapeutic alliances. The purpose of this paper is to describe the identified practice problem of high no-show rates in a VA mental health setting, present a problem and AIM statement, and propose a change framework to address the issue through nurse-led motivational engagement strategies.
Practice Setting
The practice setting is a VA outpatient behavioral health clinic located in an urban area, serving military veterans aged 18 and older. The clinic operates Monday through Friday, providing services such as psychiatric evaluations, medication management, therapy, and case management. Staffing includes psychiatrists, psychiatric mental health nurse practitioners (PMHNPs), social workers, nurses, and peer support specialists. The clinic is part of a larger Veterans Health Administration medical center that serves thousands of veterans annually, many of whom face transportation issues, homelessness, or co-occurring physical health challenges.
Population
The population includes adult veterans diagnosed with a variety of psychiatric disorders, including post-traumatic stress disorder (PTSD), major depressive disorder, generalized anxiety disorder, schizophrenia, and substance use disorders. The majority are male, with an increasing number of female veterans, many of whom are of diverse racial and cultural backgrounds. Common barriers to care include stigma, low motivation, chronic pain, limited support systems, and difficulties navigating the VA system. Many of these veterans have had previous trauma that impacts trust in providers and engagement in treatment.
Description of the Problem
Missed mental health appointments among veterans are a persistent challenge, with data from the local VA clinic revealing a no-show rate of approximately 28% over the past six months. This exceeds the national benchmark and disrupts care continuity, resulting in delayed symptom management and increased crisis interventions. Observations show that many missed appointments are due to avoidable causes such as lack of motivation, poor understanding of treatment goals, and limited therapeutic engagement. Despite automated reminders and follow-up calls, the clinic lacks a systematic, nurse-led approach to address ambivalence and enhance commitment to care. Research supports that motivational interviewing and relational interventions led by nurses can foster engagement and reduce missed visits (Tahan et al., 2021; Adams et al., 2023).
Problem Statement
In adult veterans receiving outpatient mental health services at a Veterans Administration clinic, current efforts to reduce missed appointments have been ineffective due to the absence of nurse-led motivational engagement strategies, resulting in continued high no-show rates and disrupted continuity of care.
Reducing Missed Mental Health
AIM Statement
The aim of this project is to reduce the outpatient mental health no-show rate by 25% within six months by implementing a nurse-led motivational engagement intervention for veterans who have missed two or more appointments in the past 90 days, thereby improving continuity of care and patient outcomes.
Theoretical Framework
Lewin’s Change Theory will guide the development and implementation of this intervention. This theory includes three phases: unfreezing, change, and refreezing. In the unfreezing phase, data on no-show rates will be presented to staff and stakeholders to increase awareness of the problem and establish urgency. During the change phase, nurses will receive training on motivational interviewing techniques and begin implementing structured motivational calls and brief interventions before and after appointments. In the refreezing phase, successful strategies will be embedded into routine nursing workflows and supported through policy updates and continued staff development. Lewin’s framework supports a structured approach to behavior change and is well-suited to addressing clinical inertia and staff resistance (Burnes, 2020). This model aligns with the VA’s commitment to evidence-based, veteran-centered care and highlights the vital role of nurses in behavior-driven interventions.
Reducing Missed Mental Health
Conclusion
High no-show rates for mental health appointments among veterans continue to challenge continuity of care in VA outpatient settings. This paper identified the lack of structured, nurse-led motivational engagement as a key contributor to the problem. Through the application of Lewin’s Change Theory and a clearly defined AIM statement, a targeted intervention can be developed and implemented to improve attendance, strengthen therapeutic alliances, and support recovery. This initiative emphasizes the power of nursing in leading change and the importance of evidence-based solutions tailored to the unique needs of veterans.
References
Adams, J. R., Vega, R. J., & Schnurr, P. P. (2023). Enhancing engagement in PTSD treatment for veterans: A review of motivational interventions. Journal of Psychiatric Services, 74(2), 125–132. https://doi.org/10.1176/appi.ps.202200146
Burnes, B. (2020). The origins of Lewin’s three-step model of change. The Journal of Applied Behavioral Science, 56(1), 32–59. https://doi.org/10.1177/0021886319892685
Tahan, H. A., Watson, A. C., Sminkey, P. V., & Mullahy, C. M. (2021). Case management engagement and strategies to reduce missed appointments in behavioral health settings. Professional Case Management, 26(3), 107–114. https://doi.org/10.1097/NCM.0000000000000490
U.S. Department of Veterans Affairs Office of Inspector General. (2022). Veterans Health Administration: Review of outpatient appointment scheduling and telehealth utilization. https://www.va.gov/oig/pubs/VAOIG-22-00457-174.pdf
Transcultural Nursing Theory
Paper Length and Formatting Requirements:
• Your formal paper should be 5 pages in length, not including the title
page and reference pages.
• Use the following formatting settings:
• Double-spaced text
• 12-point font (preferably Times New Roman)
• 1-inch margins on all sides
• Follow APA 7th Edition guidelines for:
• Title (cover) page
• Headers and pagination
• In-text citations and reference list
Content and Structure
Your paper must be organized into the following sections. Each section
should be clearly labeled and addressed in your final submission.
Introduction
• Purpose: Begin your paper by introducing the nursing theory you
have chosen.
• Content Requirements:
• Provide a brief background of the theorist—include information about
their education, career, and any contributions that are relevant to the
development of the theory.
• Explain why the theorist is significant in the world of nursing.
• Tips: Keep this section concise, yet informative enough for the
reader to understand the origin of the theory.
Basic Concept Analysis
Transcultural Nursing Theory
• Purpose: Clearly outline the core components of the nursing theory.
• Content Requirements:
• Identify and briefly explain the major concepts that form the basis of
the theory.
• Discuss how these core concepts work together to define the theory.
• Use clear definitions and simple examples if appropriate to illustrate
each concept.
• Tips: Focus on the essential ideas that make the theory unique and
applicable to nursing practice.
Relevance
• Purpose: Demonstrate how the nursing theory is connected to
broader healthcare practices and current research.,
• Content Requirements:
• Explain how the theorist’s work connects to the theory and in turn
how the theory influences healthcare practices.,
• Discuss the application of the theory in today’s clinical settings.,
• Reference current research or clinical practice studies that apply the
theory.,
• Scholarly Sources:
• Incorporate at least two peer-reviewed or research articles that
detail how the theory is being utilized in clinical practice or research.,
• Summarize the key findings of each article including the results of the
study and the implications they have for future practice.,
• Tips: Be analytical and use evidence-based practice (EBP) to
support your relevance discussion.,
Summary
Transcultural Nursing Theory
• Purpose: Your summary should provide a critical reflection on the
theory.
• Content Requirements:
• Summarize the strengths and limitations of the nursing theory.
• Reflect on how well the theory bridges theoretical frameworks with
practical application.
• Tips: Offer a balanced perspective that recognizes both the benefits
and potential shortcomings of the theory in advancing nursing
practice.
Additional Guidelines
• APA Formatting:
• Ensure that your cover sheet, headers, pagination, and reference
pages adhere to APA 7th Edition standards.
• All in-text citations must match your reference list.
• Assignment Quality:
• The writing should be formal, well-organized, and clearly written at a
graduate level.
• Each section should logically flow into the next, maintaining
coherence throughout your paper.
• Review the Rubric:
• Refer to the grading rubric provided (if available) to ensure that you
have met all the criteria required for a high-quality submission.
• Proofread Your Paper:
• Before submission, check for grammatical errors and clarity. Make
sure your arguments are well-supported by evidence from your
scholarly sources.
Final Submission Reminder
By following these expanded instructions, you are well equipped to produce
a comprehensive, well-structured, and evidence-based paper on your
selected nursing theory. Taking the time to address each section thoroughly
will enhance your chance for success and contribute thoughtfully to your
field of study. Happy writing!
Please refer to the grading rubric in the assignment drop box.
RUBRIC:
Exemplary Work 40 POINTS
The paper presents a thorough and insightful analysis of the chosen
nursing theory. All key concepts are clearly articulated, relevant to the
theory, and expertly linked to contemporary nursing practices. Evidence
from multiple scholarly sources enhances the discussion.
Exemplary Work
The paper is exceptionally well-organized with clear section headings and a
logical flow of ideas. Each section seamlessly transitions to the next.
30 POINTS
Exemplary Work 20 POINTS
The paper includes multiple peer-reviewed articles that are highly relevant
and current. Each source is well-integrated into the discussion and
supports key arguments effectively. At least 2 sources are used to develop
the paper.
Exemplary Work 10 POINTS
The paper strictly follows APA 7th Edition guidelines throughout, including
formatting, citations, and references. The writing is clear, formal, and free of
grammatical errors.
Accuracy and Precision with respect to presumptive testing
What do you think is the difference between accuracy and precision in relation to blood testing protocols? Do you think its better to be very precise or very accurate?
Importance of testing for the presence of Blood
Do you think it is important to tell the jury that a stain is blood when you know one can individualize a stain by DNA testing?
TV shows and blood tests
Many times in TV shows minute specs of blood are tested. What do you think is the minimal size of a stain of blood whereby an analyst would be able to perform DNA typing? ,Judge your answer on what you saw on these shows alone not by any hard facts you may know.,
Crime scene bloodstains
What do you think? When performing a blood test for a dried bloodstain in a crime scene is it important to use as specific a test as possible?, Think of issues like sample size sample collection final individualization and weight of testimony in court., There is a lot to think about when you run batteries of tests and then perform further tests after presumptive testing on the same sample.,
Accuracy and precision with respect to presumptive testing
What do you think is the difference between accuracy and precision in relation to blood testing protocols?, Do you think its better to be very precise or very accurate?,
Importance of testing for the presence of Blood
Do you think it is important to tell the jury that a stain is blood when you know one can individualize a stain by DNA testing?,
Accuracy and Precision
TV shows and blood tests
Many times in TV shows minute specs of blood are tested. What do you think is the minimal size of a stain of blood whereby an analyst would be able to perform DNA typing? Judge your answer on what you saw on these shows alone, not by any hard facts you may know.
Crime scene bloodstains
What do you think? When performing a blood test for a dried bloodstain in a crime scene; is it important to use as specific a test as possible? Think of issues like; sample size, sample collection, final individualization and weight of testimony in court. There is a lot to think about when you run batteries of tests and then perform further tests after presumptive testing on the same sample.
Ethical Leadership- Select your prompt from one of the three options provided. Your initial post is due by Wednesday of week 3, continue the conversation with at least 3 responses to your peers by the end of week 3. Your initial post should be between 300-500 words and end with a provocative question that will either deepen the conversation or solicit suggestions for personal growth. Be sure to cite resources using APA format to support your comments.
Ethical Leadership- Select your prompt from one of the three options provided. Your initial post is due by Wednesday of week 3, continue the conversation with at least 3 responses to your peers by the end of week 3. Your initial post should be between 300-500 words and end with a provocative question that will either deepen the conversation or solicit suggestions for personal growth. Be sure to cite resources using APA format to support your comments.
Ethical Leadership
Case Report Assignment
For this Research Paper: Case Report Assignment, you will prepare a research paper. To date in the course, you have learned about the role of notetaking and the language required to complete a case/offense report. For this Research Paper: Case Report Assignment, you should discuss the elements of notetaking and its role in completing a thorough offense/case report. Additionally, the Research Paper: Case Report Assignment should discuss the major components of a case report in detail, to include the face sheet/cover sheet, Introduction, Reporting Person/Victim Statements, Witness Statements, Suspect Statements and Facts of the case and how these elements are critical to both, the completion of the report as well as any future investigations.
Instructions
The must include the following elements:
All components of the Research Paper: Case Report Assignment must be written using current APA formatting and must specifically focus upon and discuss the topics listed above.,
The title page must use proper formatting as set by the APA style guide. The Introduction must be between 150–250 words and provide a clear summary of the paper.,
The body of the Research Paper: Case Report Assignment must be comprised of 3–5 pages of content., The Title Page and Reference Page are not included in the page count., The introduction must include background information on the topics discussed a well-written thesis statement and a preview of points., The body must thoroughly discuss the elements listed to include the role of notetaking the purpose for effective in-depth notetaking in the documentation of case/offense reports., Additionally the Research Paper: Case Report Assignment should discuss with some depth the major components of a Case Report in detail.
The Reference Page must include at least 3 scholarly/industry sources published within the last five years. The sources must be cited both in the body of the paper as well as in the Reference Page. Biblical references do not count toward the citation requirement.
Note: Your assignment will be checked for originality via the Turnitin plagiarism tool.
Protocol for Asthma Treatment
Follow the CPG guidelines attached when completing the assignment .
Protocol for Asthma Treatment
Include the following sections (detailed criteria listed below and in the grading rubric).
Pharmacological Treatment
Treatment Differences in Adults and Children
Treatment Monitoring
Protocol for Asthma Treatment
Treatment Failure
Include the following sections (detailed criteria listed below and in the grading rubric).
Pharmacological Treatment
Protocol for Asthma Treatment
Treatment Differences in Adults and Children
Treatment Monitoring
Treatment Failure
Disease Diagnosis and Treatment
An understanding of cells and cell behavior is a critically important component of disease diagnosis and treatment. But some diseases can be complex in nature, with a variety of factors and circumstances impacting their emergence and severity
Effective disease analysis often requires an understanding that goes beyond isolated cell behavior. Genes, the environments in which cell processes operate, the impact of patient characteristics, and racial and ethnic variables all can have an important impact.
An understanding of the signals and symptoms of alterations in cellular processes is a critical step in the diagnosis and treatment of many diseases. For APRNs, this understanding can also help educate patients and guide them through their treatment plans.
In this Assignment, you examine a case study and analyze the symptoms presented. In 1-2 pages, you will answer the questions provided following the case scenario. You must use current evidence-based resources to support your answers. Follow APA guidelines. Follow the grading rubric.
To prepare:
By Day 1 of this week, you will be assigned to a specific case study for this Case Study Assignment. Please see the “Announcements” section of the classroom for your assignment from your Instructor.
The Assignment
Develop a 1- to 2-page case study analysis by answering the questions provided following the case scenario.
By Day 7 of Week 2
Submit your Case Study Analysis Assignment by Day 7 of Week 2.
Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The sample paper provided at the Walden Writing Center provides an example of those required elements (available at https://academicguides.waldenu.edu/writingcenter/templatesLinks to an external site.). All papers submitted must use this formatting.
disease diagnosis and treatment
submission information
Develop a 1- to 2-page case study analysis examining the patient signs and symptoms presented in the case study discussing the primary cellular pathophysiological processes and the significance for symptom development and diagnosis.,
What role do genetic mutations play in the development of the disease?,
What is the impact of the disease on the immune system? , How do treatment strategies target the pathophysiological mechanisms of the disease?,
Written Expression and Formatting – Paragraph Development and Organization:, Paragraphs make clear points that support well-developed ideas flow logically and demonstrate continuity of ideas., Sentences are carefully focused neither long and rambling nor short and lacking substance. ,Content is supported by current evidence-based sources.,
Written Expression and Formatting – English Writing Standards: Correct grammar mechanics and proper punctuation
disease diagnosis and treatment
Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running heads, parenthetical/in-text citations, and reference list.
Discuss the Impact of a Clinical Practice problem on the patient or patients and the organization it affects.
1. Identify each of the following PICO components of the clinical practice problem:
• P: patient, population, or problem
• I: intervention
• C: comparison
• O: outcome
2. Develop an evidence-based practice (EBP) question based on the clinical practice problem discussed in part B and the PICO components identified in part B1.
Note: Refer to the “Appendix B: Question Development Tool” web link for information on the creation of an EBP question.
C. Select a research-based article that answers your EBP question from part B2 to conduct an evidence appraisal.
Note: The article you select should not be more than five years old.
1. Discuss the background or introduction (i.e. the purpose) of the research-based article.,
2. Describe the research methodology used in the research-based article.,
3. Identify the level of evidence for the research-based article using the Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) model.,
Note: Refer to the “Appendix E: Research Evidence Appraisal Tool” web link for information on how to level a research-based article.,
4. Summarize how the researcher analyzed the data in the research-based article.,
5. Summarize the ethical considerations of the research-based article. If none are present explain why.,
6. Identify the quality rating of the research-based article according to the JHNEBP model.,
Note: Refer to the “Appendix E: Research Evidence Appraisal Tool” web link for information on how to establish the quality rating.,
7. Analyze the results or conclusions of the research-based article.,
a. Explain how the article helps answer your EBP question.,
D. Select a non-research-based article from a peer-reviewed journal that helps to answer your EBP question from part B2 to conduct an evidence appraisal.
Note: The article you select should not be more than five years old.
Impact of a Clinical Practice
1. Discuss the background or introduction (i.e., the purpose) of the non-research-based article.
2. Describe the type of evidence (e.g., case study, quality improvement project, clinical practice guideline) used in the non-research-based article.
3. Identify the level of evidence in the non-research-based article using the JHNEBP model.
Note: Refer to the “Appendix F: Non-Research Evidence Appraisal Tool” web link for information on how to level the non-research-based article.
4. Identify the quality rating of the non-research-based article according to the JHNEBP model.
5. Discuss how the author’s recommendations in the non-research-based article help answer your EBP question.
E. Recommend a practice change that addresses your EBP question using both the research-based and non-research-based articles you selected for part C and part D.
Impact of a Clinical Practice
1. Explain how you would involve three key stakeholders in supporting the practice change recommendation.
2. Discuss one specific barrier you may encounter when implementing the practice change recommendation.
3. Identify one strategy that could be used to overcome the barrier discussed in part E2.
4. Identify one outcome (the O component in PICO) from your EBP question that can be used to measure the recommended practice change.
F. Acknowledge sources, using in-text citations and references, for content that is quoted, paraphrased, or summarized.
G. Demonstrate professional communication in the content and presentation of your submission.
Integrative Paper Outline
Writing an integrative paper can be a daunting task. To help you get started, you will need to draft an outline of how you plan to approach the paper. You do not have to have your entire paper ready to be written, but you should select a client or agency in mind that will provide you with the information you need to complete each paper that is required.
It is recommended that you review the rubrics for each of the papers you will be writing this semester.
Use the template below to complete the outline assignment. The template is set up so you can compose directly onto the document, save, and upload as your assignment submission.
(Template has been attached)
Integrative Paper Outline
Rubric : Introduction, Outline, reference page, Apa formatting.
Note: This is a big paper that has been divided into parts. The outline is the first part that outlines each section for the rest of the paper to come. Later each section will have it’s own paper based on this outline. Here’s what’s said to keep in mind.
Top 10 Things to Keep in Mind
As mentioned above, the Integrative Paper is different than other papers you’ve written in the MSW program so far. Here are the top 10 mistakes students make and how to avoid them.
Integrative Paper Outline
If it helps, this assignment is to better gear us to deal with the real population and should go hand in hand with the internship that we’re doing. Currently My internship is at a therapy wellness clinic and it’s called Center to Rise Wellness Spa Studio. You’ve wrote about it on my previous assignment as well.