Ch.7 Psychiatric Nursing Flashcards
Therapeutic Communication
Description?
Communication Barriers?
Description: It includes both verbal and nonverbal interactions that involve facial expressions, as well as body language, among the nurse, clients, colleagues, and health care providers.
Communication
What is it?
Face-to-Face?
Communication is the primary tool used in the delivery of psychiatric nursing care and all nurse–client interactions. Face-to-face: Face-to-face communication involves both the verbal and nonverbal expression of the sender’s thoughts or feelings.
Types of Communication
Nonverbal?
Verbal?
Verbal: Voice inflection, rate of speech, and words convey cognitive and affective messages. Non-verbal: Nonverbal messages are communicated via body language, eye movements, facial expressions, and gestures.
Messages
What are they?
Power of nonverbal messages?
Messages are conveyed by the sender to the recipient through sight, sound, touch, and smell.
Nonverbal messages can be very powerful; for example, wrinkling your nose at a malodorous client conveys a negative and rejecting message (
Communication Techniques
pt.1
Acknowledge?
Clarifying?
Confrontation?
Focusing?
Acknowledgement: Recognizing the client’s opinions and statements without imposing your own values and judgment. Clarifying:The process of making sure you have understood the meaning of what was said. Confrontation: Should be used judiciously, calling attention to inconsistent behavior. Focusing: Assisting the client to explore a specific topic, which may include sharing perceptions and theme identification.
Communication Techniques pt.2
Information Giving?
Open Ended Questions?
Reflecting/Restating?
Silence?
Suggesting?
Information giving: Feedback about client’s observed behavior.
Open-ended questions: Questions that require more than a yes or no response.
Reflecting/restating: Paraphrasing or repeating what the client has said (be careful not to overuse; client will feel as though you are not listening)
Silence: Can be therapeutic or can be used to control interaction; use carefully with paranoid client; may be misinterpreted or could be used to support paranoid ideation Suggesting: Offering alternatives, such as, “Have you ever considered …?” (THIS IS DIFFRENT FROM ADVICE.)
Coping Styles (Defense Mechanisms)
Description?
Awhereness?
Description: Coping styles are automatic psychological processes that protect theindividual against anxiety and from awareness of internal and external dangers and stressors.
Awareness: The individual may or may not be aware of these processes.
Defense Mechanisms pt.1
Denial? Ex?
Displacement? Ex?
Identification? Ex?
Intellectualization? Ex?
Introjection? Ex?
Denial: Unconscious failure to acknowledge an event, thought, or feeling that is too painful for conscious awareness
- A woman diagnosed with cancer tells her family all the ests were negative.
Displacement: The transference of feelings to another person or object.
- After being scolded by his supervisor at work, a mancomes home and kicks the dog for barking.
Identification: Attempt to be like someone or emulate the personality, traits, or behaviors of another person.
- A teenage boy dresses and behaves like his favorite singer.
Intellectualization: Using reason to avoid emotional conflicts.
- The wife of a substance abuser describes in detail the dynamics of enabling behavior yet continues to call her husband’s workplace to report his Monday-morning absences as an illness.
Defense Mechanisms pt.2
Isolation? Ex?
Passiveaggression? Ex?
Projection? Ex?
Rationalization? Ex?
Reaction formation? Ex?
Isolation: Separation of an unacceptable feeling, idea, or impulse fromone’s thought process.
- A nurse working in an emergency room is able to care for the seriously injured by isolating or separating thenurse’s feelings and emotions related to the clients’ pain, injuries, or death.
Passive-aggression: Indirectly expressing aggression toward others; a facade of overt compliance masks covert resentment.
- An employee arrives late to a meeting and disruptsothers after being reminded of the meeting earlier that day and promising to be on time.
Projection: Attributing one’s own thoughts or impulses to another person.
- A student who has sexual feelings toward a teacher tells friends the teacher is “coming on to the student.”
Rationalization: Offering an acceptable, logical explanation to make unacceptable feelings and behavior acceptable.
- A student who did not do well in a course says it was poorly taught and the course content was not important anyway.
Reaction- formation: Development of conscious attitudes and behaviors that are the opposite of what is really felt.
- A person who dislikes animals does volunteer work for the Humane Society.
Defense pt 3
Treatment modalities
Description?
Diffrent Types?
Description: Psychiatric and mental health treatment modalities used to promote mental health.
Diffrent Types: Milieu therapy, Behavior modification, Family therapy, Crisis intervention, Cognitive therapy, Electroconvulsive therapy (ECT), Group intervention.
Milieu therapy
What is it?
Where is it used?
Envrioment?
Enviroment setting?
Activities?
Nursing Interventions?
- The planned use of people, resources, and activities in the environmentto assist in improving interpersonal skills, social functioning, andperforming the activities of daily living (ADLs), as well as safety and protection for all clients.
- Milieu therapy occurs in inpatient and outpatient settings by providing clients an opportunity to actively participate in treatment, decrease social isolation, encourage appropriate social behaviors, and educate clients in basic living skills.
- Clients are provided a safe place to learn and adopt mature and responsible behavior through staff limit setting and client responses to maladaptive social responses.
- Limit setting is a component that requires consistent setting of appropriate limits by all staff, nurses, physicians, and health care workers to work with one another via shared communication to maintain and reestablish limit setting.
Behavior modification
Goal of ?
Positive Reinfrocment?
Negative Reinformnet?
Role Modeling?
Family therapy
What is it?
Based on what?
The focus of it?
The therapists role?
Congreunt and incongruent communication patterns?
Life Scripts?
The overall goal?
- This form of group therapy identifies the entire family as the client.
- It is based on the concept of the family as a system of interrelated parts
forming a whole.
- The focus is on the patterns of interaction within the family, not on any
individual member.
- The therapist assists the family in identifying the roles assigned to each
member based on family rules.
- Congruent and incongruent communication patterns and behaviors
are identified.
- Life scripts (living out parents’ dreams) and self-fulfilling prophecies
(unconsciously following what one thinks should happen, therefore
setting it up to happen) are identified.
- The goal is to decrease family conflict and anxiety and to develop
appropriate role relationships.
What make a phrase useful when communicating?
Examples?
Keep focus on patient
Be aware of your own anxiety level.
________
Tell me about…
Go on…
Id like to discuss what your thinking…
What are your thoughts…?
Are you saying that…?
What are you feeling…?
It seems as if…?
