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Psychotherapy has been identified as an important competency that all psychiatric mental health nurse practitioners (PMHNP) must achieve according to the Psychiatric Mental Health Nurse Practitioner Competencies (2003). Historically, psychiatric clinical nurse specialists (PCNS) have always practiced psychotherapy but many PMHNP programs did not include a course, content, or practicum for teaching basic techniques. With the competencies delineated, and the endorsement of these by the Commission on Collegiate Nursing Education (CCNE) for accreditation, it is clear that all graduate advanced practice psychiatric nurse programs seeking CCNE accreditation must teach these skills.
The challenge for educators is how to teach this content while including other requisite competencies and essentials that are also required of graduate nursing curricula without increasing the total credit load. To remain competitive, programs need to offer a graduate degree in a reasonable amount of time and credits; thus, psychotherapy skills must be acquired expeditiously in a short amount of time. The plethora of psychological theories, approaches, and techniques makes it difficult for faculty to teach the most salient skills needed to achieve competency in this area. The novice nurse psychotherapist needs to know several models that have the most utility and some idea of when and how to use techniques germane to these approaches for the specific client problems encountered in clinical practice.
Since Peplau's 1952 seminal book Interpersonal Relations in Nursing, no contemporary overarching nursing framework has been proposed to unite disparate psychotherapeutic approaches into one that is user friendly, and at the same time parsimonious and comprehensive. The textbooks used in advanced practice psychiatric graduate programs are prepared for and by psychologists, psychiatrists, and other mental health disciplines. Clearly, there is a need for a nursing framework and textbooks specific to conducting psychotherapy as an advanced practice psychiatric nurse.
It is also important to note that numerous studies have documented that what is most important for positive client outcome is the therapeutic relationship, not the model or technique employed. Yet how many psychiatric nurse practitioner programs focus on relationship-building skills and what percent of didactic time in our curriculum is spent on teaching the student how to develop a therapeutic alliance and advanced communication skills beyond what was taught at an undergraduate level? And then how...