Ch 8 Milieu Therapy Flashcards
Seven basic assumptions on which therapeutic community is based:
The health in each individual is to be realized and encouraged to grow (realize strengths/weakness) , every interaction is an opportunity for therapeutic intervention, the client owns their own environment (autonomy and can make decisions), each client owns their behavior, peer pressure is a useful and powerful tool, inappropriate behaviors are dealt with as they OCCUR (look at how the actions affect others and discuss more appropriate ways of acting), and restrictions and punishment are to be avoided (stick to isolation)
Milieu Therapy
Also called therapeutic community or therapeutic ENVIRONMENT, this type of therapy consists of a scientific structuring of the environment in order to effect behavioral changes and to improve the individual’s psychological health and functioning
Under what conditions is a hospital environment considered therapeutic? (6)
Basic physiological needs are fulfilled, physical facilities have good private space and homelike, self-government exists (clients can participate in decision-making but also democratic posture is enforced by restating rules and behavior limits at meetings), responsibilities are assigned according to client capabilities (to build self esteem), A structure of social and work related activities is scheduled into the treatment program, community and family are included in the program of therapy in an effort to facilitate discharge
In the therapeutic milieu, nurses are responsible for ensuring that clients’ ____ needs are met
Physiological
Reality orientation for clients
Using clocks with large hands and numbers, calendars with the date in large print
Psychiatric Staff Nurse
Responsible for administering medication. Provides ongoing assessments. Manages therapeutic milieu 24hr basis. 1-to-1 relationship. Reality orientation. NOT GROUP THERAPY
Clinical psychologist
Conduct psychological testing to help the psychiatrist determined a correct diagnosis. Also conducts individual, group and family therapy.
Clinical nurse specialist
Conduct assertiveness training. Presents educational programs for nursing staff. Conduct individual, group, and family therapy.
Psychiatrist
Leader of the team. Responsible for diagnosis. Performs psychotherapy and prescribes electro-convulsive therapy and prescribes medication.
Psychiatric social worker
Locates appropriate placement for the client following discharge. Conduct individual, group, and family therapy.
Occupational therapist
Assist clients to increase self-esteem by providing small craft items for completion. Helps clients develop independence in performance of ADLs
What team members can conduct individual, group, and family therapy?
Clinical psychologist, psychiatric clinical nurse specialist, and psychiatric social worker
Which team member plays an important role in reality orientation?
Psychiatric staff nurse
