| Course | NRNP 6624 Foundations of Psychotherapy |
|---|---|
| Week | Week 11 |
| Paper type | Reflection discussion post |
| Length | About 620 words, 4 pages |
| Format | Discussion post, APA 7 citations |
| School | Walden University |
| Program | MSN Psychiatric Mental Health Nurse Practitioner (PMHNP) |
| Updated | October 2026 |
Free sample paper for NRNP 6624 Week 11
Week 11 Discussion: Initial Post
Ending Grief Therapy: A Request to Stay in Touch, a Reluctance of My Own, and Which One Was the Clinical Problem
I use reflection-on-action here: looking back at two moments in an invented termination and asking what I would do and why. The client is a composite woman in her sixties ending 5 months of grief-focused therapy after her husband's death.
Moment one. In the second-to-last session, she said, "You've been such a help. When we're done, could we have coffee now and then? Just as friends." Gutheil and Gabbard distinguish a boundary crossing, a departure from usual practice that may be harmless or even helpful, from a boundary violation, a crossing that harms the client or exploits the relationship (Gutheil & Gabbard, 1993). A single coffee might look like a harmless crossing. I think it would become a violation over time, because the relationship she is proposing trades on the intimacy of therapy without its structure, and because she is grieving and at risk of replacing one lost relationship with another that cannot be what she hopes. The ANA Code of Ethics asks nurses to maintain professional boundaries and treats the nurse, not the patient, as responsible for keeping them (American Nurses Association, 2015). So I would decline, and I would decline warmly: "I'm glad the work mattered to you. Our relationship has been a therapy relationship, and I think it helps you most if it stays that way, including leaving the door open to come back if you need to." I would then explore with her what she hopes the coffee would give her, since the answer may point to what her life still lacks.
Moment two. Writing the vignette, I noticed that I had drafted two extra sessions into her termination plan that nothing clinical required. When I asked myself why, the honest answer was that I did not want the therapy to end: she reminded me of my own grandmother, and her gratitude was pleasant to receive. That is countertransference, my own reaction shaping a clinical decision, not clinical reasoning. Managing countertransference successfully has been associated with better outcomes, with a large correlation in one meta-analysis, while unmanaged countertransference reactions were modestly associated with worse ones (Hayes et al., 2011). Naming the reluctance is the first step in managing it. I removed the extra sessions.
Termination tasks, evaluated. Reviewing progress: done, with her own account of what changed. Anticipating the loss of the therapy relationship, particularly important in grief work: done, and her coffee request was part of that loss surfacing. Planning for difficult days ahead, such as the anniversary of his death: done, with a written plan. Leaving a route back: done. What I missed was asking earlier how she felt about ending, which might have let the coffee request come up as a feeling rather than a proposal.
Reply to Priya
Priya, you wrote that accepting a small gift at termination is always a violation. Gutheil and Gabbard's framework would call it a crossing whose effect depends on context. A client's handwritten card at the last session is different from a costly gift early in treatment. The question I would ask is whether accepting or declining it serves the client's work, and I would document the reasoning either way.
Reply to Marcus
Marcus, your point about sending an annual card on the anniversary of your client's loss is thoughtful, and it tests where a crossing becomes something else. It continues a contact the client did not choose, after the therapy has ended. I would ask whether the card is for the client or for you. If it is for you, that may be the same reluctance to end that I found in my own draft.
References
American Nurses Association. (2015). Code of ethics for nurses with interpretive statements. American Nurses Association.
Gutheil, T. G., & Gabbard, G. O. (1993). The concept of boundaries in clinical practice: Theoretical and risk-management dimensions. The American Journal of Psychiatry, 150(2), 188-196. https://doi.org/10.1176/ajp.150.2.188
Hayes, J. A., Gelso, C. J., & Hummel, A. M. (2011). Managing countertransference. Psychotherapy, 48(1), 88-97. https://doi.org/10.1037/a0022182
NRNP 6624 Week 11 instructions, in plain terms
The final NRNP 6624 thread commonly asks for a reflection on ending therapy or on a professional challenge in psychotherapy practice. You describe the situation, examine your own reactions honestly, identify the ethical question and resolve it with sources. Faculty reward candor tied to evidence over general feelings. Cite a reflective model and ethics sources in APA 7. A composite vignette is acceptable and often required. The NRNP 6624 post goes up midweek, and two classmates get replies. Replies should engage the ethical question rather than offer comfort. NRNP 6624 faculty want the reflective model named and used, with the two moments described briefly. State the ethical question in one sentence. Resolve it with a cited code or guideline. Describe how you would respond to the client's request.
How this NRNP 6624 Week 11 example is built
The reflective post works from a termination vignette, an invented client ending several months of grief-focused therapy, and examines two moments in it. In the first, the client proposes staying in touch informally once therapy ends, and the post considers the distinction Thomas Gutheil and Glen Gabbard drew between boundary crossings and boundary violations. In the second, the author notices a personal reluctance to let the vignette's therapy end and names it as possible countertransference rather than clinical reasoning. On professional boundaries, the post cites the ANA Code of Ethics for Nurses. Termination tasks are identified as the vignette shows them: reviewing gains, anticipating setbacks and acknowledging what ending means. Two replies extend the exchange, one on small gifts at termination, one on endings forced by a practicum calendar. No real session is recounted anywhere.
NRNP 6624 Week 11 rubric: what earns full marks
Reflective endings earn their marks through candor anchored in sources. A post describing termination as bittersweet, with no ethical question examined, collects almost nothing beyond participation. The boundary moment is where ethics credit sits, and posts treating any contact after therapy as simply forbidden, without the crossing and violation distinction, show rule-following rather than reasoning. Countertransference claimed vaguely, as feeling sad, costs depth, while a reluctance named and examined earns it. A reflective model used only as a heading reads as compliance. Posts recounting an actual practicum client, even anonymized, raise concerns no rubric row can offset. In the final exchange, replies wishing classmates well are pleasant and still score as participation rather than contribution.
NRNP 6624 Week 11 help: mistakes that cost marks
Termination reflections lose credit when they describe ending as bittersweet without examining an ethical question. Name the question and answer it. Another common gap is ignoring the clinician's own reaction, which is often the real issue. Examine it. Writers also confuse boundary crossings with violations. Define both and place the request. Avoid promising future contact without ethical grounding. Cite the code that applies. In replies, test the classmate's ethical reasoning. Close with how you would end the final session. Writers also forget to plan the last session itself, including reviewing progress and naming what the client will carry forward. Describe it. Another frequent slip is presenting personal feelings without connecting them to clinical judgment. Link them. Check citations for Schon and the ethics code.
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NRNP 6624 Week 11 questions, answered
Why reflect on a vignette instead of a real client?
Because clinical encounters from practicum belong in your placement record and supervision, not in coursework samples, and many rubrics caution against recounting them even anonymized. A vignette lets the reflection examine real ethical questions, boundaries, countertransference and ending, without exposing anyone. If your prompt allows reflection on a de-identified encounter, your own post draws on it; the sample does not.
How does a boundary crossing differ from a violation?
In the distinction Gutheil and Gabbard drew, a crossing departs from usual practice without harming the client and can sometimes help, while a violation exploits or harms. The example uses the distinction to reason about the client's request rather than to settle it by rule. Your program's own ethics materials, and the ANA code, govern real practice.
Does the reflection need Schon specifically?
No. Schon's reflection-on-action suits a post looking back at an ending, but many sections name Gibbs, Driscoll or another model, and a custom sample uses whichever yours requires. What rubrics tend to credit is the model shaping the reflection visibly, rather than appearing only as a citation. The example lets the model order the post without announcing its stages.
Where can I find a free NRNP 6624 Week 11 sample paper?
The grief therapy termination reflection is printed here with the two moments, the boundary analysis, the decision and replies to Priya and Marcus.
Which two moments does the NRNP 6624 Week 11 reflection examine?
A client asking to stay in touch after ending grief therapy, and the writer's own reluctance to end.