2 therapeutic communication Flashcards
mental health team
- staff rn
- psych specialist
- psychiatrist
- occupational therapist
- recreational therapist
- mvmt therapist
- psych social worker
- marriage family therapist
- advanced practice nurse
therapeutic boundaries
- 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
types of boundary violations
- self-disclosure
- dual relationships
- becoming friends
- physical contact
- gift-giving
- sexual contact
self-disclosure
- discussing personal issues w client
- give client’s fam/personal info (address, phone)
dual relationship
-friends/fam relationship (transfer care)
becoming friends
seeing clients outside of hospital
physical contact
hugs, kisses, hand-tholding
gift giving
DO NOT ACCEPT $$
- gift acceptance changes the relationship bw nurse + pt
- what gift giving means to pt must be explored
nursing process
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
serious mental illness SMI
- 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
SMI older adults
pt becomes dependent on services + structure + were unable to function independently
before de-institutionalization…
psych hospitals were long-term residence
SMI younger adults
- limited exerience w formal treatment
- contribute to a cycle of Tc, brief recovery, + relapse
- incr frequency of relapse, legal difficulties, homesles,ness, unemployment
Rehabilitation
focuses on managing pt deficits
- helpin them learn to live w illness
- disease + present
Recovery
focuses on achieving goals of pt choosing
- leading increasingly productive + meaningful lives
- person + future
Issues confronting those w SMI
1establishing a meaningful life 2comorbid conditions 3social problems 4economic challenges 5treatment issues
2comorbid conditions
- physical disorders
- depression + suicide
- substance abuse
3social problems
- stigma
- isolation + loneliness
- victimization
4economic challenges
- unemployment + poverty
- housing instability
- caregiver burden
5treatment issues
- non-adherence
- anosognosia
- med S/E
- Tx adequacy
- residual symptoms
- relapse, chronicity, + loss
anosognosia
inability to accept that that they have a condition that matches w their own symptoms or formal diagnosis
community services + program
resources for persons w SMI
- emergency psych service
- group/indvdl psychotherapy
- housing service
- partial hospitalization
- guardianship
- community outreach programs
- substance abuse Tx
***assertive community treatment [ACT]
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
social skills training is for..
ppls w schizo or autism
-teaches them to recognize social cues
