2 therapeutic communication

Question 1

mental health team

Answer 1

• staff rn
• psych specialist
• psychiatrist
• occupational therapist
• recreational therapist
• mvmt therapist
• psych social worker
• marriage family therapist
• advanced practice nurse

Question 2

therapeutic boundaries

Answer 2

• set of rules that establish the relationship bw the staff + client/families
• focus client’s energy on goals + protect fr misperceptions which could result in harm or liability
• unequal power balance bw staff + client
• nursing privy to HIPAA + personal care issues (bathing, changing clothes)
• power of staff derived fr pt’s trust

Question 3

types of boundary violations

Answer 3

• self-disclosure
• dual relationships
• becoming friends
• physical contact
• gift-giving
• sexual contact

Question 4

self-disclosure

Answer 4

• discussing personal issues w client

- give client’s fam/personal info (address, phone)

Question 5

dual relationship

Answer 5

-friends/fam relationship (transfer care)

Question 6

becoming friends

Answer 6

seeing clients outside of hospital

Question 7

physical contact

Answer 7

hugs, kisses, hand-tholding

Question 8

gift giving

Answer 8

DO NOT ACCEPT $$

• gift acceptance changes the relationship bw nurse + pt
• what gift giving means to pt must be explored

Question 9

nursing process

Answer 9

1 interactive, problem solving process
2 systematic + individualized way to achieve outcome of nursing care
3 accepted by the nursing profession as a standard for providing ongoing nursing care that is adapted to individual client needs

Question 10

serious mental illness SMI

Answer 10

• affects 5-7% of U.S.
• presents difficulties in multiple areas
• chronic or recurrent
• pt at risk for multiple physical, emo, social problems
• difficulties in a wide range of functions

Question 11

SMI older adults

Answer 11

pt becomes dependent on services + structure + were unable to function independently

Question 12

before de-institutionalization…

Answer 12

psych hospitals were long-term residence

Question 13

SMI younger adults

Answer 13

• limited exerience w formal treatment
• contribute to a cycle of Tc, brief recovery, + relapse
• incr frequency of relapse, legal difficulties, homesles,ness, unemployment

Question 14

Rehabilitation

Answer 14

focuses on managing pt deficits

• helpin them learn to live w illness
• disease + present

Question 15

Recovery

Answer 15

focuses on achieving goals of pt choosing

• leading increasingly productive + meaningful lives
• person + future

Question 16

Issues confronting those w SMI

Answer 16

1establishing a meaningful life
2comorbid conditions
3social problems
4economic challenges
5treatment issues

Question 17

2comorbid conditions

Answer 17

• physical disorders
• depression + suicide
• substance abuse

Question 18

3social problems

Answer 18

• stigma
• isolation + loneliness
• victimization

Question 19

4economic challenges

Answer 19

• unemployment + poverty
• housing instability
• caregiver burden

Question 20

5treatment issues

Answer 20

• non-adherence
• anosognosia
• med S/E
• Tx adequacy
• residual symptoms
• relapse, chronicity, + loss

Question 21

anosognosia

Answer 21

inability to accept that that they have a condition that matches w their own symptoms or formal diagnosis

Question 22

community services + program

resources for persons w SMI

Answer 22

• emergency psych service
• group/indvdl psychotherapy
• housing service
• partial hospitalization
• guardianship
• community outreach programs
• substance abuse Tx

Question 23

***assertive community treatment [ACT]

Answer 23

utilizes evidence-based practice that improves outcomes for people w severe mental illness who are most at risk of

• psych crisis
• hospitalization
• involvement in criminal justice systm

Question 24

social skills training is for..

Answer 24

ppls w schizo or autism

-teaches them to recognize social cues

Question 25

***cognitive-behavioral therapy [CBT]

Answer 25

type of psychotherapeutic Tx

-helps pt understand: thoughts + feelings influence behavior

Question 26

***cognitive-enhancement therapy [CET]

Answer 26

evidence-based practice designed to help ppl w schizophrenia + related cognitive disorders improve brain and cognitive dvlpt, social cognition, + increase vocational capabilities

Question 27

current issues

Answer 27

• mandatory outpatient Tx
• criminal offenses + incarceration
• transinstitutionalization

Question 28

**transinstitutionalization

Answer 28

process whereby individuals, supposedly deinstitutionalized as a result of community care policies,
-in practice end up in different institutions, rather than their own homes

Question 29

list of serious mental illnesses

Answer 29

• schizo
• bipolar
• PTSD
• ADLS

Question 30

risk of anosognosia

Answer 30

-less likely to comply w meds or treatment

Question 31

DO NOT agree or argue a hallucination/delusion. Instead…

Answer 31

focus on client’s feelings + possibly offer reasonable explanations

Question 32

ask the client ___ about hallucinations

Answer 32

directly

Question 33

assess the client for ___ which bc it can increase the risk of violence against others

Answer 33

paranoid delusions

-give lorazepam