Assignment 2: Practicum Experience Plan (PEP)

As you establish your goals and objectives for this course, you are committing to an organized plan that will frame your practicum experience in a clinical setting, including planned activities, assessment, and achievement of defined outcomes. In particular, they must address the categories of clinical reasoning, quality in your clinical specialty, and interpersonal collaborative practice. 

For this Assignment, you will consider the areas you aim to focus on to gain practical experience as an advanced practice nurse. Then, you will develop a Practicum Experience Plan (PEP) containing the objectives you will fulfill in order to achieve your aims. For this practicum experience, be sure to develop goals and objectives that allow you to synthesize knowledge and skills related to assessment, diagnosis, and treatment planning. 

To Prepare

· Review your Clinical Skills Self-Assessment Form you submitted last week and think about areas for which you would like to gain application-level experience and/or continued growth as an advanced practice nurse. How can your experiences in the practicum help you achieve these aims?  

· Review the information related to developing objectives provided in this week’s Learning Resources. Your practicum learning objectives that you want to achieve during your practicum experience must be: 

· Specific  

· Measurable  

· Attainable  

· Results-focused  

· Time-bound 

· Reflective of the higher-order domains of Bloom’s taxonomy (i.e., application level and above)  

· Discuss your professional aims and your proposed practicum objectives with your Preceptor to ascertain if the necessary resources are available at your practicum site.  

· Select one nursing theory and one counseling/psychotherapy theory to best guide your clinical practice. Explain why you selected these theories. Support your approach with evidence-based literature.

· Create a timeline of practicum activities that demonstrates how you plan to meet these goals and objectives based on your practicum requirements.

The Assignment

Record the required information in each area of the Practicum Experience Plan template, including 3–4 measurable practicum learning objectives you will use to facilitate your learning during the practicum experience.  

Rubric Detail

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Content

Name: PRAC_6675_Week2_Assignment2_Rubric

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	Excellent	Good	Fair	Poor
Record the required information in each area of the Practicum Experience Plan (PEP): Part 1: Quarter/Term/Year and Contact Information: ᵒ Identify Quarter/Term/Year ᵒ Identify Student Contact Information: Name, Street Address, City, State, Zip, Home Phone, Work Phone, Cell Phone, Fax, and Walden University Email ᵒ Identify Preceptor Contact Information: Name, Organization, Street Address, City, State, Zip, Work Phone, Cell Phone, Fax, and Professional/Work Email	Points: Points Range: 5 (5%) – 5 (5%) The response accurately and clearly identifies the Quarter/Term/Year, all Student Contact Information, and all Preceptor Contact Information. Feedback:	Points: Points Range: 4 (4%) – 4 (4%) The response identifies the Quarter/Term/Year, and at least 90% of Student Contact Information and Preceptor Contact Information. Feedback:	Points: Points Range: 3.5 (3.5%) – 3.5 (3.5%) The response identifies the Quarter/Term/Year, and at least 80% of Student Contact Information and Preceptor Contact Information. Feedback:	Points: Points Range: 0 (0%) – 3 (3%) The response is inaccurate, incomplete, or is missing identification of the Quarter/Term/Year and/or identifies less than 80% of Student Contact Information and Preceptor Contact Information. Feedback:
Part 2: Individualized Practicum Learning Objectives: Explain 3 Individualized Practicum Learning Objectives that address your self-assessment of the skills found in the Clinical Skills Self-Assessment, are SMART (i.e., Specific, Measurable, Attainable, Results-Focused, Time-Focused), and meet the requirements for this course. Each Practicum Learning Objective must describe planned activities, mode of assessment, and PRAC course outcome(s) addressed for the skills you would like to improve from your self-assessment.	Points: Points Range: 69 (69%) – 75 (75%) The response clearly, accurately, and thoroughly explains 3 Individualized Practicum Learning Objectives that address the self-assessment of the skills found in the Clinical Skills Self-Assessment. They are SMART (i.e., Specific, Measurable, Attainable, Results-Focused, Time-Focused) and meet the requirements for this course. For each Learning Objective, the response clearly, accurately, and thoroughly describes planned activities, mode of assessment, and PRAC course outcome(s) addressed for the skills to be improved from the self-assessment. Feedback:	Points: Points Range: 60 (60%) – 68 (68%) The response accurately explains 3 Individualized Practicum Learning Objectives that address the self-assessment of the skills found in the Clinical Skills Self-Assessment, are SMART (i.e., Specific, Measurable, Attainable, Results-Focused, Time-Focused), and meet the requirements for this course. For each Learning Objective, the response accurately describes planned activities, mode of assessment, and PRAC course outcome(s) addressed for the skills to be improved from the self-assessment. Feedback:	Points: Points Range: 53 (53%) – 59 (59%) The response somewhat vaguely explains 3 Individualized Practicum Learning Objectives that address the self-assessment of the skills found in the Clinical Skills Self-Assessment. They may not all be SMART (i.e., Specific, Measurable, Attainable, Results-Focused, Time-Focused), or fully meet the requirements for this course. For each Learning Objective, the response somewhat vaguely describes planned activities, mode of assessment, and PRAC course outcome(s) addressed for the skills to be improved from the self-assessment. Feedback:	Points: Points Range: 0 (0%) – 52 (52%) The response inaccurately or incompletely explains 3 Individualized Practicum Learning Objectives that address the self-assessment of the skills found in the Clinical Skills Self-Assessment. Some or all are not SMART (i.e., Specific, Measurable, Attainable, Results-Focused, Time-Focused), and/or do not meet the requirements for this course. For each Learning Objective, the response has a vague, inaccurate, and/or incomplete or missing description of planned activities, mode of assessment, and PRAC course outcome(s) addressed for the skills to be improved from the self-assessment. Feedback:
Part 3: Projected Timeline/Schedule: Describe your practicum timeline/schedule: ᵒ Number of weekly hours projected to work on your practicum ᵒ Number of weekly hours for professional development	Points: Points Range: 14 (14%) – 15 (15%) The response includes a clear, accurate, and thorough description of the practicum timeline/schedule, including number of weekly hours projected to work on the practicum and number of weekly hours for professional development. Feedback:	Points: Points Range: 12 (12%) – 13 (13%) The response includes an accurate description of the practicum timeline/schedule, including number of weekly hours projected to work on the practicum and number of weekly hours for professional development. Feedback:	Points: Points Range: 11 (11%) – 11 (11%) The response includes a somewhat vague description of the practicum timeline/schedule, and may be missing details about the number of weekly hours projected to work on the practicum or number of weekly hours for professional development. Feedback:	Points: Points Range: 0 (0%) – 10 (10%) The response includes a vague, incomplete, and/or inaccurate or missing description of the practicum timeline/schedule, including number of weekly hours projected to work on the practicum or number of weekly hours for professional development. Feedback:
Written Expression and Formatting—English Writing Standards: Assignment follows correct grammar, mechanics, and proper punctuation.	Points: Points Range: 5 (5%) – 5 (5%) Uses correct grammar, spelling, and punctuation with no errors. Feedback:	Points: Points Range: 4 (4%) – 4 (4%) Contains 1-2 grammar, spelling, and punctuation errors. Feedback:	Points: Points Range: 3.5 (3.5%) – 3.5 (3.5%) Contains 3-4 grammar, spelling, and punctuation errors. Feedback:	Points: Points Range: 0 (0%) – 3 (3%) Contains ≥ 5 grammar, spelling, and punctuation errors that interfere with the reader’s understanding. Feedback:

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Record the required information in each area of the Practicum Experience Plan (PEP):

Part 1: Quarter/Term/Year and Contact Information:

ᵒ Identify Quarter/Term/Year

ᵒ Identify Student Contact Information:

Name, Street Address, City, State, Zip, Home Phone, Work Phone, Cell Phone, Fax, and Walden University Email

ᵒ Identify Preceptor Contact Information:

Name, Organization, Street Address, City, State, Zip, Work Phone, Cell Phone, Fax, and Professional/Work Email

—

Levels of Achievement:

Excellent
5 (5%) – 5 (5%)

The response accurately and clearly identifies the Quarter/Term/Year, all Student Contact Information, and all Preceptor Contact Information.

Good
4 (4%) – 4 (4%)

The response identifies the Quarter/Term/Year, and at least 90% of Student Contact Information and Preceptor Contact Information.

Fair
3.5 (3.5%) – 3.5 (3.5%)

The response identifies the Quarter/Term/Year, and at least 80% of Student Contact Information and Preceptor Contact Information.

Poor
0 (0%) – 3 (3%)

The response is inaccurate, incomplete, or is missing identification of the Quarter/Term/Year and/or identifies less than 80% of Student Contact Information and Preceptor Contact Information.

Feedback:

Part 2: Individualized Practicum Learning Objectives:

Explain 3 Individualized Practicum Learning Objectives that address your self-assessment of the skills found in the Clinical Skills Self-Assessment, are SMART (i.e., Specific, Measurable, Attainable, Results-Focused, Time-Focused), and meet the requirements for this course.

Each Practicum Learning Objective must describe planned activities, mode of assessment, and PRAC course outcome(s) addressed for the skills you would like to improve from your self-assessment.

—

Levels of Achievement:

Excellent
69 (69%) – 75 (75%)

The response clearly, accurately, and thoroughly explains 3 Individualized Practicum Learning Objectives that address the self-assessment of the skills found in the Clinical Skills Self-Assessment. They are SMART (i.e., Specific, Measurable, Attainable, Results-Focused, Time-Focused) and meet the requirements for this course.

For each Learning Objective, the response clearly, accurately, and thoroughly describes planned activities, mode of assessment, and PRAC course outcome(s) addressed for the skills to be improved from the self-assessment.

Good
60 (60%) – 68 (68%)

The response accurately explains 3 Individualized Practicum Learning Objectives that address the self-assessment of the skills found in the Clinical Skills Self-Assessment, are SMART (i.e., Specific, Measurable, Attainable, Results-Focused, Time-Focused), and meet the requirements for this course.

For each Learning Objective, the response accurately describes planned activities, mode of assessment, and PRAC course outcome(s) addressed for the skills to be improved from the self-assessment.

Fair
53 (53%) – 59 (59%)

The response somewhat vaguely explains 3 Individualized Practicum Learning Objectives that address the self-assessment of the skills found in the Clinical Skills Self-Assessment. They may not all be SMART (i.e., Specific, Measurable, Attainable, Results-Focused, Time-Focused), or fully meet the requirements for this course.

For each Learning Objective, the response somewhat vaguely describes planned activities, mode of assessment, and PRAC course outcome(s) addressed for the skills to be improved from the self-assessment.

Poor
0 (0%) – 52 (52%)

The response inaccurately or incompletely explains 3 Individualized Practicum Learning Objectives that address the self-assessment of the skills found in the Clinical Skills Self-Assessment. Some or all are not SMART (i.e., Specific, Measurable, Attainable, Results-Focused, Time-Focused), and/or do not meet the requirements for this course.

For each Learning Objective, the response has a vague, inaccurate, and/or incomplete or missing description of planned activities, mode of assessment, and PRAC course outcome(s) addressed for the skills to be improved from the self-assessment.

Feedback:

Part 3: Projected Timeline/Schedule:

Describe your practicum timeline/schedule:

ᵒ Number of weekly hours projected to work on your practicum

ᵒ Number of weekly hours for professional development

—

Levels of Achievement:

Excellent
14 (14%) – 15 (15%)

The response includes a clear, accurate, and thorough description of the practicum timeline/schedule, including number of weekly hours projected to work on the practicum and number of weekly hours for professional development.

Good
12 (12%) – 13 (13%)

The response includes an accurate description of the practicum timeline/schedule, including number of weekly hours projected to work on the practicum and number of weekly hours for professional development.

Fair
11 (11%) – 11 (11%)

The response includes a somewhat vague description of the practicum timeline/schedule, and may be missing details about the number of weekly hours projected to work on the practicum or number of weekly hours for professional development.

Poor
0 (0%) – 10 (10%)

The response includes a vague, incomplete, and/or inaccurate or missing description of the practicum timeline/schedule, including number of weekly hours projected to work on the practicum or number of weekly hours for professional development.

Feedback:

Written Expression and Formatting—English Writing Standards: Assignment follows correct grammar, mechanics, and proper punctuation.–

Levels of Achievement:

Excellent
5 (5%) – 5 (5%)

Uses correct grammar, spelling, and punctuation with no errors.

Good
4 (4%) – 4 (4%)

Contains 1-2 grammar, spelling, and punctuation errors.

Fair
3.5 (3.5%) – 3.5 (3.5%)

Contains 3-4 grammar, spelling, and punctuation errors.

Poor
0 (0%) – 3 (3%)

Contains ≥ 5 grammar, spelling, and punctuation errors that interfere with the reader’s understanding.

Feedback:

Total Points: 100

Name: PRAC_6675_Week2_Assignment2_Rubric

Master of Science in Nursing  

Practicum Experience Plan

Overview:

Your Practicum experience includes working in a clinical setting that will help you gain the knowledge and skills needed as an advanced practice nurse. In your practicum experience, you will develop a practicum plan that sets forth objectives to frame and guide your practicum experience.

As part of your Practicum Experience Plan, you will not only plan for your learning in your practicum experience but also work through various patient visits with focused notes as well as one (1) journal entry.

Complete each section below.

Part 1: Quarter/Term/Year and Contact Information

Section A

Quarter/Term/Year:

Student Contact Information

Name:

Street Address:

City, State, Zip:

Home Phone:

Work Phone:

Cell Phone:

Fax:

E-mail:

Preceptor Contact Information

Name:

Organization:

Street Address:

City, State, Zip:

Work Phone:

Cell Phone:

Fax:

Professional/Work E-mail:

Part 2: Individualized Practicum Learning Objectives

Refer to the instructions in Week 2 to create individualized practicum learning objectives that meet the requirements for this course. These objectives should be aligned specifically to your Practicum experience. Your objectives should address your self-assessment of the skills found in the “PMHNP Clinical Skills Self-Assessment Form” you completed in Week 1.

As you develop your individualized practicum learning objective, be sure to write them using the SMART format. Use the resources found in Week 2 to guide your development. Once you review your resources, continue and complete the following. Note: Please make sure each of your objectives are connected to your self-assessment. Also, consider that you will need to demonstrate how you are advancing your knowledge in the clinical specialty.

** YOU MUST HAVE 3 NEW OBJECTIVES EACH QUARTER. You may include previous practicum objectives; however, you still must have 3 new objectives for your current course.

Objective 1: <write your objective here> (
Note
: this objective should relate to a specific skill you would like to improve from your self-assessment)

Planned Activities:

Mode of Assessment: (Note: Verification will be documented in Meditrek)

PRAC Course Outcome(s) Addressed:

· (for example) Develop professional plans in advanced nursing practice for the practicum experience

· (for example) Assess advanced practice nursing skills for strengths and opportunities 

Objective 2: <write your objective here> (
Note
: this objective should relate to a specific skill you would like to improve from your self-assessment)

Planned Activities:

Mode of Assessment: (Note: Verification will be documented in Meditrek)

PRAC Course Outcome(s) Addressed:

·

Objective 3: <write your objective here> (
Note
: this objective should relate to a specific skill you would like to improve from your self-assessment)

Planned Activities:

Mode of Assessment: (Note: Verification will be documented in Meditrek)

PRAC Course Outcome(s) Addressed:

·

Part 3: Projected Timeline/Schedule

Estimate how many hours you expect to work on your Practicum each week. *Note: All of your hours and activities must be supervised by your Preceptor and completed onsite. Your Preceptor will approve all hours, but your activities will be approved by both your Preceptor and Instructor. Any changes to this plan must be approved.

This timeline is intended as a planning tool; your actual schedule may differ from the projections you are making now.

I intend to complete the 144 or 160 Practicum hours (as applicable) according to the following timeline/schedule. I also understand that I must see at least 80 patients during my practicum experience. I understand that I may not complete my practicum hours sooner than 8 weeks. I understand I may not be in the practicum setting longer than 8 hours per day unless pre-approved by my faculty.

	Number of Clinical Hours Projected for Week (hours you are in Practicum Setting at your Field Site)	Number of Weekly Hours for Professional Development (these are not practicum hour)	Number of Weekly Hours for Practicum Coursework (these are not practicum hours)
Week 1
Week 2
Week 3
Week 4
Week 5
Week 6
Week 7
Week 8
Week 9
Week 10
Week 11
Total Hours (must meet the following requirements)	144 or 160 Hours

Part 4 – Signatures

Student Signature (electronic): Date:

Practicum Faculty Signature (electronic)**: Date:

** Faculty signature signifies approval of Practicum Experience Plan (PEP)

Submit your Practicum Experience Plan on or before Day 7 of Week 2 for faculty review and approval.

Once approved, you will receive a copy of the PEP for your records. You must share an approved copy with your Preceptor. The Preceptor is not required to sign this form.

© 2020 Walden University 3

Clinical Skills Self-Assessment

Everyone ought to have specific attributes, including their strengths and weaknesses. My experience as a nurse has equipped me with several skills that will come in handy when I start working as a psychiatrist. Recognizing the signs and symptoms of mental illness is one of my strengths, thanks to the knowledge and abilities I have gained over the years. On the other side, I must have a lot of weaknesses. The options for professional development that I need to investigate during my career to increase my skills in making use of the results of psychological tests. This paper will discuss three strengths and weaknesses and three clinical skills that a nursing student would like to become a professional before graduating from a nursing program. These strengths and weaknesses will be compared to three clinical skills that a nursing student would like to have.

PRAC 6665/6675 Clinical Skills 

Self-Assessment Form

Desired Clinical Skills for Students to Achieve	Confident (Can complete independently)	Mostly confident (Can complete with supervision)	Beginning (Have performed with supervision or needs supervision to feel confident)	New (Have never performed or does not apply)
Comprehensive psychiatric evaluation skills in:
Recognizing clinical signs and symptoms of psychiatric illness across the lifespan
Differentiating between pathophysiological and psychopathological conditions
Performing and interpreting a comprehensive and/or interval history and physical examination (including laboratory and diagnostic studies)
Performing and interpreting a mental status examination
Performing and interpreting a psychosocial assessment and family psychiatric history
Performing and interpreting a functional assessment (activities of daily living, occupational, social, leisure, educational).
Diagnostic reasoning skill in:
Developing and prioritizing a differential diagnoses list
Formulating diagnoses according to DSM 5-TR based on assessment data
Differentiating between normal/abnormal age-related physiological and psychological symptoms/changes
Pharmacotherapeutic skills in:
Selecting appropriate evidence based clinical practice guidelines for medication plan (e.g., risk/benefit, patient preference, developmental considerations, financial, the process of informed consent, symptom management)
Evaluating patient response and modify plan as necessary
Documenting (e.g., adverse reaction, the patient response, changes to the plan of care)
Psychotherapeutic Treatment Planning:
Recognizes concepts of therapeutic modalities across the lifespan
Selecting appropriate evidence based clinical practice guidelines for psychotherapeutic plan (e.g., risk/benefit, patient preference, developmental considerations, financial, the process of informed consent, symptom management, modality appropriate for situation)
Applies age-appropriate psychotherapeutic counseling techniques with individuals and/or any caregivers
Develop an age-appropriate individualized plan of care
Provide psychoeducation to individuals and/or any caregivers
Promote health and disease prevention techniques
Self-assessment skill:
Develop SMART goals for practicum experiences
Evaluating outcomes of practicum goals and modify plan as necessary
Documenting and reflecting on learning experiences
Professional skills:
Maintains professional boundaries and therapeutic relationship with clients and staff
Collaborate with multi-disciplinary teams to improve clinical practice in mental health settings
Identifies ethical and legal dilemmas with possible resolutions
Demonstrates non-judgmental practice approach and empathy
Practices within scope of practice
Selecting and implementing appropriate screening instrument(s), interpreting results, and making recommendations and referrals:
Demonstrates selecting the correct screening instrument appropriate for the clinical situation
Implements the screening instrument efficiently and effectively with the clients
Interprets results for screening instruments accurately
Develops an appropriate plan of care based upon screening instruments response
Identifies the need to refer to another specialty provider when applicable
Accurately documents recommendations for psychiatric consultations when applicable

Summary of strengths:

As a nurse, I have several strengths that keeps me strong to work as a mental nurse. My expertise and ability to spot the signs and symptoms of mental illness is one of my strengths as a mental health professional. After spending some time working in a psychiatric hospital, I can differentiate between psychiatric symptoms and medical symptoms with complete accuracy. My second strength is the ability to effectively interact with other healthcare practitioners to offer appropriate care for patients. According to Delaney and Vanderhoef (2019), the collaboration between specialists is an essential strategy for improving the treatment outcomes of mental patients. My third strength is that I can authorize to administer and analyze results of mental status examinations. My fourth strength I can choose appropriate screening procedures for psychiatric patients. I am also able to analyze the results of the screening to design the treatment plan that is intended for the patient. My last strength is that I have the capacity to preserve professional boundaries while also fostering therapeutic relationships. According to Smythe et al. (2018), nurses have a responsibility to maintain a high level of professionalism in their work. Therefore, to accomplish the necessary capabilities throughout my internship experience, I will make use of the strengths that have been discussed previously.

Opportunities for growth:

During the internship, one of the areas for improvement that needs to be investigated is the development of abilities to implement the results of screening tests in psychiatric practice. Although I have experience with a variety of screens for psychiatric patients, I have observed that the outcomes of these screenings are not always effectively implemented. To guarantee that I come out of my internship experience with the skills and knowledge necessary for this field of work, I will need to collaborate closely with members of my academic faculty as well as other healthcare professionals. The application of psychotherapy methods that are suitable for the patient’s age is yet another area of development that I need to investigate during my internship experience. According to Zeeck et al. (2018), there is a wide variety of psychotherapy that can be utilized with individuals suffering from mental illness. The age of the patient is also a factor that must be addressed when providing treatment. I do not have the knowledge or the abilities necessary to be able to apply various forms of psychotherapy to patients of varying ages who seek treatment in psychiatric practice. Because of this, I need to gain the necessary abilities in the application of psychotherapy to be able to give psychiatric patients with care that is high-quality, risk-free, and effective. Assessing the efficacy of care provided to psychiatric patients is another area of development that needs to be investigated throughout the internship. Notify you of any adjustments to ensure the highest possible level of care for your patients. When it comes to evaluating psychiatric care, I don’t feel as though I have the necessary knowledge or skills. As a result, one of my goals for the internship is to enhance the talents I already possess in this area.

Now, write three to four (3–4) possible goals and objectives for this practicum experience. Ensure that they follow the SMART Strategy, as described in the Learning Resources.

1. Goal: To equip participants with the skills necessary to conduct mental illness screenings by the time the internship ends a. Objective: To perform the interpretation of the results of at least ten psychiatric screenings every week while I am doing my internship b. Objective: To construct at least ten treatment plans for psychotic patients based on the screening data gathered from those individuals while participating in the internship c. Objective: To collaborate with the instructors and other healthcare professionals at the internship site to interpret and put into action treatment programs for psychotic patients while they are enrolled in the internship program 2. Goal: To achieve the level of competence required to provide a variety of psychotherapy therapies to psychotic patients of varying ages a. Objective: To acquire knowledge regarding the several psychotherapy modalities that are utilized by the psychotic patients. b. Objective: To put into practice the utilization of a variety of psychotherapy modalities to provide care for patients of varying ages c. Objective: To collaborate with my professors and other healthcare professionals in the management of a variety of mental illnesses. 3. Goal: To have developed abilities in the evaluation of psychiatric treatment a. Objective: To assess the treatment plans of at least 10 patients on a weekly basis b. Objective: To provide interventions that are supported by evidence to conduct psychiatric treatment evaluations. c. Objective: To participate in an evaluation of mental therapy alongside my instructor

Signature:

Date: June 5, 2022

Course/Section: NRNP PRAC 6675/33

References

Delaney, K. R., & Vanderhoef, D. (2019). The psychiatric mental health advanced practice registered nurse workforce: Charting the future. Journal of the American Psychiatric Nurses Association, 25(1), 11-18.

Fletcher, T. L., Hogan, J. B., Keegan, F., Davis, M. L., Wassef, M., Day, S., & Lindsay, J. A. (2018). Recent advances in delivering mental health treatment via video to the home. Current psychiatry reports, 20(8), 1-9.

Lee, W. J., Liao, Y. C., Wang, Y. F., Lin, I., Wang, S. J., & Fuh, J. L. (2018). Plasma MCP-1 and cognitive decline in patients with Alzheimer’s disease and mild cognitive impairment: a two-year follow-up study. Scientific reports, 8(1), 1-8.

Smythe, E., Hennessy, J., Abbott, M., & Hughes, F. (2018). Do professional boundaries limit trust?. International journal of mental health nursing, 27(1), 287-295.

Zeeck, A., Herpertz-Dahlmann, B., Friederich, H. C., Brockmeyer, T., Resmark, G., Hagenah, U., … & Hartmann, A. (2018). Psychotherapeutic treatment for anorexia nervosa: a systematic review and network meta-analysis. Frontiers in psychiatry, 9, 158.