PMHNP: Instilling Hope as an Advanced Psychiatric Provider

00:01 Hi, I'm Jack. I'm a psychiatric mental health nurse practitioner.

00:06 Today we're going to talk about how I instill hope as an advanced psychiatric provider whose clients are experiencing mental illness.

00:14 This is really important to me because it empowers patients and fosters resilience during the journey towards recovery.

00:21 Instilling hope is a critical aspect of psychiatric care.

00:26 Each patient is unique, so tailoring your approach to their specific circumstances and readiness for change is essential.

00:34 Providing a steady, compassionate and hopeful presence can profoundly impact their recovery journey.

00:41 The foundation of hope oriented care has three main elements.

00:46 One, authentic connection, which I believe is the most important.

00:49 Without this connection, nothing else is going to work.

00:52 Two, evidence based practice, still very important.

00:56 And three, recognition of the individual resilience.

01:00 Research actually shows that clients who maintain hope show a 40 to 60% better treatment outcome across various diagnoses.

01:09 When you look at the literature of hope-oriented care, you're going to see five essential provider approaches: strength-based assessment, recovery-focused language, collaborative goal setting, progress recognition, and consistent relationship building.

01:26 Again, I believe this is the most important part.

01:29 What are these things? First is using strength-based assessment.

01:34 It is what it sounds like when I work with a client, I spend a lot of time identifying and building up their existing capabilities, resources, and resilience factors.

01:45 Every time I can, I try to reconnect back to those factors and build them up.

01:51 Second is recovery-focused language.

01:54 This one builds up on the concept of person-centered language and adds how they are successfully living or managing life with their condition.

02:03 For example, instead of saying you are bipolar, we might say you're managing bipolar disorder.

02:11 This seemingly small shift emphasizes that the person isn't defined by their diagnosis. Third is collaborative goal setting.

02:20 The DSM-5 TR billing and facility policy will have goals to meet, like immediate goals, which we want to accomplish within 24 to 48 hours. This focus is on safety and stability.

02:33 A short-term goal within 1 to 4 weeks develop coping skills and our long-term goal which we would like to see in 3 to 6 months, we want to work towards that larger life changes.

02:47 To find out what is important to them and maximize your partnership with the client, ask them questions like what would a good day look like for you? Or if things were better.

02:58 What would you do? Fourth is one of the best progression recognition, but this can be tricky if you make it all about you, being proud of them, or setting up a dynamic where they make changes for you.

03:14 Instead, it's more therapeutic to do what we call deliberate noticing where we might track and notice subtle changes that the client may miss, such as sleeping an hour more than the week before or saying something positive about themselves.

03:31 Encouraging the client to celebrate these micro gains, we can assist the client to maintain realistic expectations.

03:40 Fifth and last is consistent relationship building.

03:45 It's really built with all the other actions, but at the heart of it.

03:49 Being present during all interactions, following through on commitments, no matter how small.

03:57 We must maintain therapeutic optimism and again celebrate those small gains. Regular check ins, even when things are going well, is important and you need to acknowledge the challenges, but remind them of previous success.

04:15 Before we end this video, sometimes it's helpful to hear some of the phrasings that I use with my clients to know what to say in certain situations. Here's an example of something you can say to get a conversation about strength started with a new client you may not have a strong rapport with yet.

04:33 Tell me about a time when things felt more manageable, or what strategies have helped you cope in the past.

04:41 These questions not only gather information but help clients reconnect with their own capabilities. The way we discuss diagnosis and treatment deeply impacts hope. Rather than presenting mental illness as a fixed state, we can frame it as something that can be understood, managed, and often significantly improved.

05:03 For example, when talking about depression, it can help to explain that since brain chemistry fluctuates based on life experiences and these change over time, the experience of depression also changes, so treatment has to change too.

05:20 Real-world examples make hope tangible.

05:23 Sharing anonymized stories of other clients' progress with appropriate boundaries, of course, helps demonstrate that recovery is possible. Patients love hearing success stories of other patients.

05:36 It gives them hope. We might say, I've worked with many people who felt similarly overwhelmed and they found ways to rebuild their lives.

05:45 But make sure you acknowledge each person's unique journey while highlighting common themes of resilience. In conclusion, advanced providers can consistently instill hope by recognizing setbacks are part of the journey.

06:03 We normalize these experiences while maintaining a steadfast belief in recovery.

06:09 This might involve saying something like this is a difficult moment, but it doesn't erase your progress.

06:15 Let's understand what happened and adjust our approach.