Exam 3 Flashcards
this is a collection of individuals whose association is founded on shared commonalities: Interests, values, norms, or purpose
Membership into this is generally by chance, by choice, or by circumstance
group
there are 8 \_\_\_ that groups serve for their members which are: socialization support task completion camaraderie information sharing normative influence empowerment governance
functions
this is one of the functions of a group
The teaching of social norms occurs through groups.
socialization
this is one of the functions of a group
Fellow members are available in time of need.
support
this is one of the functions of a group
Groups can assist in endeavors that are beyond the capacity of a single individual.
task completions
this is one of the functions of a group
Individuals receive joy and pleasure from interactions with significant others.
camaraderie
this is one of the functions of a group
Learning takes place when group members share their knowledge with others in the group.
informational
this is one of the functions of a group
this function relates to the ways in which Different groups enforce established norms in various ways.
normative influence
this is one of the functions of a group
Change can be made by groups at times when individuals alone are ineffective.
empowerment
this is one of the functions of a group
Large organizations often have leadership that is provided by groups rather than by a single individual.
governance
what are the 3 types of groups in which nurses most often participate
task
teaching
supportive/therapeutic
these types of groups are Formed to accomplish a specific outcome.
Focus on solving problems and making decisions
task groups
these types of groups Convey knowledge and information to a number of individuals.
teaching groups
these types of groups Prevent future upsets by teaching the participants ways of dealing with emotional stress arising from situational or developmental crises.
supportive therapeutic groups
is a form of psychosocial treatment in which several patients meet with a therapist for purposes of sharing, gaining personal insight, and improving interpersonal coping strategies.
group therapy
these are based on theory. Focus is on group relations, interactions between group members, and the consideration of a selected issue.
therapy groups
Clients talk about fears and relieve feelings of isolation, while receiving comfort and advice from others undergoing similar experiences.
Composed of individuals with a similar problem.
May or may not have a professional leader.
Run by members, and leadership often rotates from member to member.
Nurse may function as a referral agent, resource person, member of an advisory board, or leader of the group.
self-help groups
what is one of the main differences between group therapy and therapeutic groups
- leaders of group therapy have advanced degrees
- therapeutic groups are not designed for psychotherapy
A patient expresses a desire to begin attending the self-help group Alcoholics Anonymous (AA). Which nursing response gives the patient pertinent information about this type of group?
A. “In this type of group, membership is always within a fixed time frame.”
B. “Group members receive comfort and advice from others undergoing similar experiences.”
C. “The purpose of this type of group is to convey information to a number of individuals.”
D. “The function of this type of group is to accomplish a specific outcome.”
B.
what are some physical conditions that influence group dynamics
seating
size
membership
when seating members and preparing the setting for a group there should be no ___ between the members; A circle of chairs is better than chairs set around a table.
Size
barrier
group __ does make a difference in the interaction among members.
The larger the group, the less time is available to devote to individual members.
Seven or eight members provide a favorable climate for optimal group interaction and relationship development
size
(conditions that influence dynamics of groups)
these groups are those in which members leave and others join at any time while the group is active.
The continuous movement of members in and out creates discomfort that encourages unsettled behaviors in individual members and fosters the exploration of feelings.
open-ended groups
(conditions that influence dynamics of groups)
All members join at the time the group is organized and terminate membership at the end of a designated time frame.
closed-ended groups
there are 11 \_\_\_\_ factors that individuals can achieve through interpersonal interactions within the group which are instillation of hope universality imparting of information altruism corrective recapitulation of the primary family group development of socializing techniques imitative behavior interpersonal learning group cohesiveness catharsis existential factors
therapeutic
this is a therapeutic factor
By observing the progress of others in the group with similar problems, a group member garners hope that their problems can also be resolved
instillation of hope
this is a therapeutic factor
Individuals come to realize that they are not alone in the problems, thoughts, and feelings they are experiencing.
universality
this is a therapeutic factor
Group members share their knowledge with each other. Leaders of teaching groups also provide information to group members.
imparting of information
this is a therapeutic factor
Individuals assist and support each other, thereby helping to create a positive self-image and promote self-growth.
altruism
this is a therapeutic factor
Group members are able to reexperience early family conflicts that remain unresolved.
corrective recapitulation of primary family group
this is a therapeutic factor
Through interaction with and feedback from other members, individuals correct maladaptive social behaviors, and learn to develop new social skills.
development of socializing techniques
this is a therapeutic factor
Group members who have mastered a particular psychosocial skill or developmental task serve as valuable role models for others.
imitative behavior
this is a therapeutic factor
Group offers varied opportunities for interacting with other people.
interpersonal learning
this is a therapeutic factor
Members develop a sense of belonging that separates the individual (“I am”) from the group (“we are”).
group cohesiveness
this is a therapeutic factor
Group members can express both positive and negative feelings.
catharsis
this is a therapeutic factor
The group can assist individual members to undertake direction of their own lives and to accept responsibility for the quality of their existence.
existential factors
how many phases are there of group development
3
what are the phases of group development
- phase 1 initial or orientation phase
- phase 2 middle or working phase
- phase 3 final or termination phase
during this part of the first phase of group development (orientation phase)
the Leader and members work together to establish rules and goals for the group.
Goals are established
group activities
during this part of the first phase of group development (orientation phase)
the Leader promotes trust and ensures that rules do not interfere with fulfillment of the goals.
leader expectations
during this past of the first phase of group development (orientation phase)
Members are superficial and overly polite. Trust has not yet been established.
member behaviors
during this part of the second phase of group development (working phase)
Productive work toward completion of the task is undertaken.
group activities
during this part of the second phase of group development (orientation phase)
the leader becomes more of a facilitator helps resolve conflict and makes sure that they don’t deviate from the task
leader expectations
during this part of the second phase of group development (orientation phase)
Trust has been established between members, and cohesiveness exists.
Conflict is managed by the group with minimal assistance from the leader.
member behaviors
during this part of the third phase of group development (termination phase)
A sense of loss that precipitates the grief process may be evident. Termination needs to be talked about for meetings prior to final one
group activities
during this part of the third phase of group development (termination phase)
The leader encourages members to discuss feelings of loss and to reminisce about what has occurred within the group, review the goals and discuss the outcomes and provide feedback to each other
leader expectations
during this part of the third phase of groups development (termination phase)
Feelings of abandonment and grief from previous losses may be triggered.
member behaviors
___ leaders have personal goals for the group, withhold info from the group “We will do it my way, my way is the best”
Focus is on the leader.
Members dependent
For problem-solving, decision making, and permission to perform
Production is high.
Morale is low.
autocratic
___ leadership style Focuses on members of the group
Members participate.
In problem-solving of group issues
In taking action to effect change
Production is somewhat lower than autocratic style.
Morale is much higher.
Input allows members of the group the potential for individual creativity.
democratic
this leadership style allows people to do as they please, no involvement from leader, no decisions made, no action taken No direction from leader.
Goals are undefined.
Members become frustrated and confused.
Productivity and morale are low.
laissez-faire
Members play one of three ___ within a group.
Complete the task of the group.
Maintain or enhance group processes.
Fulfill personal or individual needs.
roles
this task role clarifies ideas and suggestions that have been made within the group; brings relationships together to pursue common goals
coordinator
this task role examines group plans and performance, measuring against group standards and goals
evaluator
this task role explains and expands upon group plans and ideas
elaborator
this task role encourages and motivates group to perform at its maximum potential
energizer
this task role outlines the task at hand for the group and proposes methods for solution
initiator
this task role maintains direction within the group
orienter
this maintenance role relieves conflict within the group by assisting members to reach a compromise agreeable to all
compromiser
this maintenance role offers recognition and acceptance of others’ ideas and contributions
encourager
this maintenance role listens attentively to group interactions and is a passive participant
follower
this maintenance role encourages acceptance of and participation by all members of the group
gatekeepers
this maintenance role minimizes tension within the group by intervening when disagreements produce conflict
harmonizer
A specialized type of therapeutic group introduced by J. L. Moreno
Moreno’s method employs a dramatic approach in which patients become “actors” in life-situation scenarios.
An identified patient (called the protagonist) is selected to portray a life situation.
Other members of the group play the roles of people with whom the protagonist has unresolved issues.
psychodrama
Purpose is to provide the patient with a safe place to confront unresolved conflicts to progress toward resolution.
The setting provides the patient with a safer and less-threatening atmosphere than the real situation.
When the drama has been completed, group members from the audience discuss the situation they have observed.
psychodrama
A scientific structuring of the environment to effect behavioral changes and to improve the psychological health and functioning of the individual.”
Within the therapeutic community setting, the client is expected to learn adaptive coping and interaction and relationship skills that can be generalized to other aspects of his or her life.
milieu therapy or therapeutic community
Some programs have successfully adapted the concepts of milieu treatment to their specialty’s needs.
such as
prison settings
patients with schizophrenia
Skinner’s seven basic ___ of a therapeutic community
The health in each individual is to be realized and encouraged to grow.
Every interaction is an opportunity for therapeutic intervention.
Each client owns his or her own environment.
Each client owns his or her own behavior.
Peer pressure is a useful and powerful tool.
Inappropriate behaviors are dealt with as they occur.
Restrictions and punishment are to be avoided.
assumptions
what is the role of the nurse in milieu therapy
Medication administration
Development of a one-to-one relationship
Setting limits on unacceptable behavior
Client education
Crisis intervention and resolution
Requires ____solving skills
problem
Assistance with ___-solving during the crisis period preserves self-esteem and promotes growth with resolution.
problem
A sudden event in one’s life that disturbs homeostasis during which the usual coping mechanisms cannot resolve the problem.
crisis
a number of ___ have been identified that define a crisis which are:
- Crisis occurs in all individuals at one time or another and is not necessarily equated with psychopathology.
- Crises are precipitated by specific, identifiable events.
- Crises are personal by nature.
- Crises are acute, not chronic.
- A crisis situation contains the potential for psychological growth or deterioration.
characteristics
Caplan outlines ___ phases through which individuals progress in response to a precipitating stressor and that culminate in the state of acute crisis
4
during this phase in the development of a crisis
The individual is exposed to a precipitating stressor.
we start feeling anxious
phase 1
this phase in the development of a crisis occurs
When previous problem-solving techniques do not relieve the stressor, anxiety increases further.
feelings of confusion and disorganization prevail
phase 2
during this phase in the development of a crisis
All possible resources are called on to resolve the problem and relieve the discomfort.
New problem solving techniques are used
phase 3
during this phase in the development of a crisis
tension mounts beyond a further threshold or its burden increases to a breaking point.
Major disorganization of the individual occurs, often with drastic results.
phase 4
the paradigm set forth by Aguilera suggests that whether or not an individual experiences a crisis in response to a stressful situation depends on the following 3 factors
The individual’s perception of the event
The availability of situational supports
The availability of adequate coping mechanisms
this type of crisis is an acute response to an external situational stressor
dispositional crisis
this type of crisis is a Normal life-cycle transition that may be anticipated but over which the individual may feel a lack of control
crisis of anticipated life transitions
this type of crisis is precipitated by an unexpected, external stressor over which the individual has little or no control
He or she feels emotionally overwhelmed and defeated.
crisis resulting from traumatic stress
this type of crisis occurs in response to a situation that triggers emotions related to unresolved conflicts in one’s life
occur in response to failed attempts to master developmental tasks associated with transitions in the life cycle
maturational/developmental crisis
this type of crisis is an emotional crisis in which preexisting psychopathology has been instrumental in precipitating the crisis or in which psychopathology significantly impairs or complicates adaptive resolution
examples of psychopathology that may precipitate crises include personality disorders, anxiety disorders, bipolar disorder, schizophrenia etc.
crisis reflecting psychopathology
this type of crisis is a crisis situation in which general functioning has been severely impaired and the individual is rendered incompetent or unable to assume personal responsibility.
psychiatric emergency
in ___ ___ the therapist or other intervener becomes part of the individual’s life situation. Lengthy interpretations are not appropriate for this but rather it is a time for doing what is needed to help the individual get relief and for calling into action all the people and resources required to do so
crisis intervention
Using a crisis situation to restore functioning and at most to enhance personal growth.
crisis intervention
Aguilera described ___ specific phases in the technique of crisis intervention that are clearly comparable to the steps of the nursing process.
4
during this phase of crisis intervention
Information is gathered regarding the precipitating stressor and the resulting crisis that prompted the individual to seek professional help.
assessment
A nurse in crisis intervention might perform some of the following during the ___ phase
Ask individual to describe the event that precipitated crisis.
Determine when it occurred.
Assess the individual’s mental and physical status.
Determine if the individual has experienced this stressor before.
If previous coping methods were tried, what was the result?
If new coping methods were tried, what was the result?
Assess suicide or homicide potential, plan, and means.
Assess adequacy of support systems.
Determine level of pre-crisis functioning.
Assess individual’s perception of strengths and limitations.
Assess individual’s use of substances.
assessment
during this phase of the crisis intervention the
Nurse selects the appropriate nursing actions for the identified nursing diagnoses.
Considered in planning interventions
Type of crisis
Individual’s strengths
Desired choices
Available resources for support
Goals are established for crisis resolution and a return to or increase in the pre-crisis level of functioning.
planning of therapeutic intervention
during this phase of crisis intervention Actions identified in phase 2 are implemented.
Numerous interventions are the focus of nursing in crisis intervention.
Intervention
during this phase of crisis intervention the Nurse and client summarize what has occurred during the intervention.
They review what the individual has learned and anticipate how he or she will respond in the future.
A determination is made regarding follow-up therapy; if needed, the nurse provides referral information.
evaluation of crisis resolution and anticipatory planning
Aguilera suggests that ___ factors that affects how an individual deals with a crisis
3
Baldwin identified ___ classes of emotional crisis which progress by degree of severity
6
an example of this type of crisis by Baldwin’s perspective can include an acute suicide risk, drug overdose, reactions to hallucinogenic drugs, acute psychoses, uncontrollable anger, and alcohol intoxication
psychiatric emergency
what is the goal of crisis intervention
- resolution of an immediate crisis
- help them go back to a precrisis level or a higher level of functioning
this is not a diagnosis or a disorder it is a behavior
suicide
The act of taking one’s own life, derived from the Latin words for “one’s own killing”.
suicide
In the field of ___, suicide is considered an irrational act associated with mental illness and most commonly, but not exclusively, with depression.
psychiatry
more than ___% of all persons who attempt or die by suicide have a diagnosed mental disorder
90
In ancient ___, suicide was an offense against the state, and individuals who committed suicide were denied burial in community sites.
Greece
In ancient ___ culture, suicide was sometimes used to escape humiliation or abuse.
Roman
In the ___ ___, suicide was viewed as a selfish or criminal act.
middle ages
during what time period did the view of suicide become more philosophical and intellectuals could discuss suicide more freely
Renaissance
Most philosophers of the 17th and 18th centuries condemned suicide, but some individuals began to associate suicide with ___ ___
mental illness
these are identified as factors that have statistically been correlated with a higher incidence of suicide
suicide risk factors
___ is the The second-leading cause of death (behind unintentional injuries) among young Americans ages 10 to 34 years
suicide
suicide is the ___-leading cause of death for ages 35-54 and the 8th leading cause of death for 55-64
fourth
___ is the tenth-leading cause of death overall
suicide
these are identified as factors suggesting a more immediate concern compared to suicide factors
suicide warning signs
the suicide rate for single, never married persons is ___ that for married persons
twice
Divorce ___ risk for suicide particularly among men, who are three times more likely to take their own lives than are divorced women.
increases
true or false: women attempt suicide more often but more men succeed
TRUE
true or false: women tend to overdose and men tend to use more lethal means such as firearm
TRUE
risk of suicide ___ with age, particularly among men
increases
the highest rate of suicide occurred in the ___ -old age group and among those 85 or older
45-54
what is the most common method of completed suicide for adolescent males
firearms
what is the most common method of completed suicide for adolescent females
suffocation
true or false: Affiliation with a religious group decreases risk of suicide.
TRUE
Rates of suicide among protestants and Jews have been ___ than among Roman Catholic or Muslin populations
higher
Religious affiliation is associated with decreased suicide attempts.
In the general population
In those with a ___ ___
mental illness
which socioeconomic status individuals have a higher suicide rate
Individuals in the very highest and lowest social classes have higher suicide rates than those in the middle class.
occupation suicide rates are higher among what professions
physicians artists dentists law enforcement officers lawyers insurance agents
what ethnicity has the highest risk for suicide
whites (15.85%)
Individuals hospitalized for psychiatric illness have a __ to__ times greater suicide risk than those with psychiatric illness in the general population.
5 to 10
true or false: suicide risk may increase early in treatment with antidepressants
TRUE
Why does suicide risk increase early in treatment with antidepressants
As an individual’s energy returns they may have an increase ability to act out self-destructive wishes
true or false: severe insomnia is associated with increased risk of suicide
TRUE
these are all considered other ___factors for suicide
Use of alcohol and barbiturates
Psychosis with command hallucinations
Affliction with a chronic, painful, or disabling illness
Studies indicated a higher risk factor for suicide among gay men, lesbians, and transgender (LGBT) individuals.
Higher risk is also associated with a family history of suicide.
Loss of a loved one through death or separation
Lack of employment or increased financial burden
risk
what percentage of youth are victims of physical bullying (most often boys)
41%
what percentage of youth are victims of cyberbullying
17%
___ are more likely to be victims of psychological bullying
girls
these are considered predisposing factors and theories of suicide which are
____ theories that include
Anger turned inward
Hopelessness and other symptoms of depression
Desperation and guilt
History of aggression and violence
Shame and humiliation
psychological
Freud believes that suicide was a response to intense ___ -___
self-hatred
according to this psychological theory the anger is originated toward a love object but turned inward against self; Freud thought that suicide occurred as a result of an earlier repressed desire to kill someone
anger turned inward
this has long been identified as a symptom of depression and an underlying factor in the predisposition to suicide
hopelessness and other symptoms of depression
a history of ____ behavior or impulsive acts has been associated with increased risk for suicide
violent
some individuals have viewed suicide as a “face saving” mechanism or a way to prevent ____ ___ following a social defeat such as a sudden loss or status or income
public humiliation
what are Durkheim’s 3 social categories of suicide which are considered sociological theories
egoistic suicide
altruistic suicide
anomic suicide
his work studied the individual’s interaction with the society in which he or she lived
believed that the more cohesive the society and the more than the individual felt an integrated part of society, the less likely he or she was to carry out suicide
Durkheim’s theory
this is one of Durkheim’s social categories of suicide
this is the response of the individual who feels separate from the mainstream of society
individual doesn’t feel part of any group
egoistic suicide
this is one of Durkheim’s social categories of suicide
this is the opposite of egoistic suicide
the individual is excessively integrated in the group; allegiance is so strong they will sacrifice their lives for the group
altruistic suicide
this is one of Durkheim’s social categories of suicide
occurs in response to changes in an individual’s life like divorce that disrupt feelings of relatedness to the group
anomic suicide
Theory that introduces the concept that suicide ideation and suicide attempts need to be understood as distinct processes.
he said that low connectedness and a high sense of burden interact to increase suicide though but when mixed with the actual capability for suicide ideation can move to lethal attempts
interpersonal theory of suicide
this theory sought to identify the factors that elevate suicide ideation to an active risk for attempts
The Three-Step Theory
these are the ___ that elevate suicide ideation to an active risk for attempts in a three-step trajectory
Pain combined with hopelessness significantly increases suicide ideation.
Connectedness prevents suicide ideation from escalating in those at risk, but when pain and hopelessness exceed one’s sense of connectedness to others, suicide ideation becomes active.
When strong, active suicide ideation is present, it leads to an attempt only if one has capacity to make an attempt.
factors
Twin studies have shown a much higher concordance rate for monozygotic twins than for ____ twins.
dizygotic
a number of studies have revealed a deficiency of ___ in depressed clients who attempted suicide
However, Recent meta-analysis examining biological factors found they are weak predictors of a future suicide attempt or death by suicide.
serotonin
Only two biological factors had statistical significance as neurochemical factors associated with suicide
Cytokines (anti-inflammatory response chemicals)
Low levels of fish oil nutrients (including omega-3)
When nurses ___ a client’s suicide ideation, it is important to identify and distinguish ideas (thoughts), plans (intentions), and attempts (behavior).
When the client has attempted self-injury, it is important to distinguish between suicidal self-injury and non-suicidal self-injury.
assess
