Exam 1: week 2 Flashcards
What is the best treatment for most psychiatric problems
A combination of medications and psychotherapy
Can basic RNs work in psychotherapy
No, basic RNs do counseling
advanced practice RNs can do psychotherapy
What are the three types of relationships
Social
Intimate
Therapeutic
What is a social relationship
Initiated for the purpose of friendship, socialization, enjoyment, or accomplishment of a task
- not helpful to your patients
- mutual needs are met
- uses small talk
What is a therapeutic relationship
Needs of patient identified and explored
- Clear boundaries established
- Problem-solving approaches taken
- New coping skills developed
- Behavioral change encouraged
What are boundaries
The expected legal, ethical, and professional standards that separate nurses from patients
Why are boundaries so important in the nurse- patient relationship
- protects patients
- ensures patient confidentiality
What is considered boundary crossing
- when the relationship crosses over into a personal context
- when the nurses needs are met at the expense of the patient
How does one determine their values and beliefs
- reflects ones culture/subculture
- derived from a range of choices
- chosen from many role models and influences
What are the phases of Peplau’s nurse-patient relationship model
- preorientation phase
- orientation phase
- working phase
- termination phase
What is happening during the preorientation phase
- Develop self awareness
- Prepare for your assignment
- research patients history
- set ground rules before the first meeting
What is happening during the orientation phase
First meeting with patient
- establish rapport
- set parameters of relationship
- formal/informal contract
- confidentiality
- terms of termination
What is happening during the working phase
- gather more data
- promote problem solving skills and self-esteem
- change behavior
- evaluate problems and goals
What is happening during the termination phase
- summarize goals
- incorporate learned healthy behaviors into real life
What are attending behaviors
A special kind of listening that means just being with the patient during a difficult time; this includes:
- eye contact
- body language
- vocal qualities
What is the difference between sympathy and empathy
Sympathy is feeling bad for someone who is in pain
- sorry you feel that way
- understanding from your own perspective
- giving unsolicited advice
Empathy is understanding someone’s pain
- put yourself in their shoes
- really listening to the person
What are the characteristics of therapeutic communication
- patient-centered
- goal-directed
- scientifically based
In what ways does therapeutic communication benefit the patient
- helps patient feel safe and protected
- patient is more satisfied with their care
- increased recovery rates
- improved adherence to treatment
What are the characteristics of the transactional model of communication
Communicator- the person communicating
Message- what they are communicating
Channel- how they are communicating
Feedback- how the nurse responds
Encoding/Decoding- implied/inferred messages
Context- situation of communication
Environmental Noise- distractions (physical or physiological)
What are the characteristics of Peplau’s interpersonal communication theory
Clarity
Continuity
Nondirective listening
What is clarity when talking about communication
ensuring that the meaning of the message is accurately understood by both parties
What is continuity when talking about communication
continuous treatment which promotes connection between both parties
What is nondirective listening when talking about communication
Nurse provides nonjudgmental feedback which allows patients to clarify their thoughts
What are some factors that can effect communication between the nurse and the patient
Personal factors (depression, cognition, language barriers)
Environmental factors (noise, privacy)
Relationship factors (equality between nurse/patient; patients are vulnerable and you are seen to have more power than them)
What are some types of non-verbal communication
- tone of voice
- physical appearance
- facial expressions
- body posture
- eye contact
- hand gestures
What is a double-bind message
Given by a person in power:
- contradictory messages
- no-win situation
(sarcastically saying “yeah ill do whatever you want” in order to try and maintain power or control)
What are some therapeutic communication techniques
- Silence
- active listening
- clarifying techniques
- asking questions
What kinds of questions will a nurse use to utilize therapeutic communication with their patients
Open-ended
- not a yes or no answer
Closed-ended
- yes or no answer
Projective
- “what if” questions
Miracle question
- “If a miracle happened and the problem was gone, what would your life look like?”
- goal setting question
How do you engage in active listening
S - sit facing the client
O - open posture
L - learn forward towards client
E - eye contact
R - relax
What are some examples of non-therapeutic techniques
- asking too many questions
- giving approval or disapproval
- giving advice
- asking “why”
What is kinesic communication
A type of nonverbal communication made by body movement - facial expressions
- body posture
- gestures
What is proxemics
The study of personal space
What is considered an intimate distance in the united states
0-18 inches
What is considered a personal distance
18 inches-4 feet
What is considered a social distance
4-12 feet
What is considered a public distance
12+ feet
What are some advantages of group therapy
- treat multiple people at the same time
- members benefit from other clients viewpoints
- safe place tp practice new skills
- can make them feel like they belong
What are some disadvantages of group therapy
- privacy concerns
- disruptions
- discouraging group norms may hinder self expression
What are the phases of group therapy development
Planning phase
Orientation phase
Working phase
Termination phase
Evaluation phase
What happens during the planning phase of group therapy development
- name of group
- objectives of group
- who is going to be in the group
- group schedule
- location
- seating configuration
- leader and member responsibilities
- methods of evaluating outcomes
What happens during the orientation phase of group therapy development
- formation of the group and getting members together
- establish purpose of group
What happens during the working phase of group therapy development
leader facilitates communication, the flow of group processes, and group conduct
What happens during the termination phase of group therapy development
members express the effectiveness of the group
What happens during the evaluation phase of group therapy development
Objective measures of feedback from group members
What does group therapy from a humanistic approach look like
- focuses on self-actualization
- leader practices nondirective, active listening, and Socratic dialogue (determining the accuracy and helpfulness of thoughts)
What does group therapy from a cognitive behavioral approach look like
- focuses on specific maladaptive behaviors and thought patterns
- leader practices goal setting, planning, and reinforcing good behaviors/thought patterns
What does group therapy from a psychodynamic approach look like
- focuses on resolving inner conflicts of patients
- leader practices listening, interpreting, confronting, and working through these thoughts
What does group therapy from an educational approach look like
- focuses on coping, emotional and practical support
- leader practices teaching, organizing, and leading discussions
What does group therapy from a systems approach look like
- focuses on positive interactions with social and political environment and social equality
- leader practices strategizing, activism, and lifestyle investigation
What are the different styles of leadership
Autocratic
Democratic
Laissez-faire
What are the characteristics of an autocratic leader
- exerts control over the group
- does not encourage much interaction
- leader has all the power
- rewards and punishment
What are the characteristics of a democratic leader
- promotes extensive group interaction
- delegates authority
- encourages participation
- feedback
What are the characteristics of a laissez-faire leader
- hands off
- very little leading
- little to no direction
- allows freedom as much as possible
How do you deal with a monopolizing member of your group therapy session
- remind entire group to let everyone talk
- talk to them privately if needed
How do you deal with a disruptive member of your group therapy session
- listen objectively
- ask in private about cause of anger
- empathize
How do you deal with a silent member of your group therapy session
- determine cause
- require a response to ease group discomfort
- come back to them to allow them to think of an answer
