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Mental Health Nursing > Lecture 2 - Theoretical Foundations, Theories, Therapies > Flashcards

Lecture 2 - Theoretical Foundations, Theories, Therapies Flashcards

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1
Q

According to Freud’s Psychoanalytic theory, what is the preconscious?

A

Memories and thoughts accessible with effort

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2
Q

What is the main idea of Freud’s psychoanalytic theory? What is the role of the therapist?

A

The main theory is that traumatic memories and emotions placed in unconscious (repressed) because they are too painful.

The role of the therapist is to help the patient move unconscious material to the conscious.

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3
Q

What is transference?

A

When the patient develops emotions towards the nurse that were previously held toward other significant other.

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4
Q

What is counter-transference?

A

An unconscious personal emotional response from the nurse towards the patient.

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5
Q

What are the tenets of object relations theory? What is a critique of it?

A

A person’s self is constructed in relation to other objects (persons), particularly the mother

Psychological problems are therefore a result of the disruption of the separation between a child and a mother

Critique: sexism

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6
Q

What is interpersonal theory’s perspective on personality development?

A

Personality develops as a behaviour through interpersonal relationships. (separation from mother promotes identity formation)
Therefore the goal of therapy is to improve the functioning and underlying dynamics to treat symptoms.

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7
Q

What is Peplau’s Interpersonal Relations Theory?

A

The nurse and the patient are in a relationship where the goal of the nurse is to help this relationship through observation of both the patient and their own behaviour.

Critique: There are no power dynamics discussed in Peplau’s theory (Nurse usually has more power)

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8
Q

What is behaviourism?

A

Watson’s application of Pavlov’s classical condition to humans.

Watson contends that personality traits and responses are socially learned through classical conditioning.

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9
Q

What is modelling?

A

When someone models the behaviour of another

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10
Q

Which populations is operant conditioning most effectively used with?

A

Children with ASD or developmental disabilities

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11
Q

What are the four steps of systematic desensitization?

A

Behavioural tasks are based on the patient’s fears

1 - fears broke down into components
2 - Incremental exposure to components of fear
3 - Hierarchy of components of fear and relation strategies
4 - Daily practice

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12
Q

What behavioural therapies are discussed in this class?

A

Modelling
Operant conditioning
Systematic Desensitization
Aversion Therapy

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13
Q

What is Aversion therapy? What is it used to treat? What are some techniques?

A

A last resort when other measures have failed. Treatment for alcoholism, sexual deviancy, aggressive behaviours.

Techniques:
Maladaptive behaviour with noxious stimulus (classical conditioning)
Punishment (operant conditioning)
Avoidance

Always done with consent d/t ethical ramifications.

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14
Q

What are the basis of cognitive theories?

A

Thoughts provoke feelings which provoke actions

Thoughts are unique to an individual’s experiences

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15
Q

Which cognitive therapies are discussed in this class?

A

REBT, CBT, DBT

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16
Q

What is the aim and therapists goal for rational emotive behavioural therapy?

A

The aim is to eradicate irrational beliefs that cause negative emotions
The therapist’s role is to help recognize and challenge distorted thoughts (Should, ought, must)

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17
Q

What is the aim and therapist’s role in cognitive behavioural therapy?

A

CBT is time limited and structured. The aim is to identity, challenge, and correct automatic thoughts (cognitive distortions) based on assumptions developed from previous experiences)

The therapist’s role is to teach patients to autonomously challenge and replace distorted thoughts.

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18
Q

What is the goal and target population of dialectical behavioural therapy?

A

To teach persons methods to manage swings in emotions, and tolerate distress and acceptance. To learn to live with powerlessness or frustration.

The target population is persons with behavioural disorders with emotional dysregulation.

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19
Q

What is the biological model of mental health theory? What are strengths and risks of this model?

A

The neurological, chemical, biological, and genetic understanding of the link between the brain/body (like emotions, memories, perceptions, thoughts)

This is linked to a reduction is stigma because is links physical attribute to mental illness (the person is no longer “responsible” for the mental illness.
The risk with this model is that we might see mental illness as an exclusively physical issue and we might not fix the underlying issue causing poor mental health.

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20
Q

What is Milieu therapy?

A

Milieu is the people, setting, structure, emotional, and psychological climate. Uses naturally occurring events in the environment as learning opportunities for patients.

Ensuring maintenance of a therapeutic environment

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21
Q

What did Moyo et al. identity as the 8 major components of mental health nursing?

A
  1. Assessment and management of risk
  2. Understanding recovery principles
  3. Person and family-centered care
  4. Good communication skills
  5. Knowledge about mental disorders and treatment
  6. Evaluating research and promoting physical health
  7. A sense of humour
  8. Physical and psychological interventions
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22
Q

What are the three phases of a nurse-patient relationship according to Peplau?

A

Orientation
–> Getting to know each other, developing of trust

Working
–> When the patient examines their difficulties and learns new ways to approach them

Termination Phase
–> Extends from the moment the issue is resolved to the end of the relationship

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23
Q

What is the role of stigmatization?

A

To preserve what we believe to be social order and proper society

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24
Q

What is blurring of boundaries?

A

When a nurse client relationship slips into a social context, the nurse’s needs are met at the the expense of the client’s needs

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25
Q

What is an example of blurring of roles?

A

transference or countertransference

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26
Q

What is an example of over-involvement?

A

Visiting person during break, taking time away from other paitients

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27
Q

What is an example of under-involvement?

A

Negligent care due to trying to avoid a patient

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28
Q

What is the benefit of silence in therapeutic communication?

A

Allows time for both parties to gather their thoughts

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29
Q

Despite being designed to categorize and systematically assess a patients, mental status assessments findings are _____

A

Highly subjective

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30
Q

What is the difference between a hallucination and an illusion?

A

Hallucinations are false sensory perceptions

Illusions are misrepresentations of real sensory stimuli

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31
Q

What is the difference between thought content and thought process?

A

Content is what a person is thinking about

Process is the manner in which those thoughts are formed and expressed

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32
Q

What are delusions of control?

A

Belief that one’s thoughts are controlled by an outside force (includes insertion, broadcasting, ideas of reference)

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33
Q

What is thought insertion?

A

The belief that thoughts are being inserted into one’s mind by someone else

34
Q

What is thought broadcasting?

A

The belief that one’s thoughts are obvious to other or are being broadcast to the world

35
Q

What are ideas of reference delusions?

A

The belief that other people, objects, or events are related to or have a special significance for one’s self. For example, a person on tv is talking to or about them.

36
Q

Circumstantiality is a kind of thought process disturbance, what is it?

A

The person will continue to remind themselves of other things while speaking, the topic will rotate but eventually reach the point)

37
Q

Tangentiality is a kind of thought process disturbance, what is it?

A

The person is distracted by their thoughts, the original point will be lost

38
Q

Word salad is a kind of thought process disturbance, what is it?

A

Words that are put together do not make sense

associated with dementia, schizophrenia.

39
Q

Neologisms are a kind of thought process disturbance, what is it?

A

The creation of new words

40
Q

Altruism is a kind of defense mechanism. Describe this defense mechanism?

A

Dedicating oneself to meeting the needs of others as a means of diffusing potentially anxious situations

e.g., a person who is worried their boss is angry will go out of their way to try and be helpful

41
Q

Compensation is a kind of defense mechanism. Describe this defense mechanism?

A

Makes up for perceived deficiencies and cover up shortcomings related to these deficiencies

42
Q

Conversion is a kind of defense mechanism. Describe this defense mechanism?

A

Unconscious transformation of anxiety into a physical symptom, often to gain attention or provide excuse.

e.g., A student is unable to take a final exam d/t terrible headache

43
Q

Displacement is a kind of defense mechanism. Describe this defense mechanism?

A

The transference of emotions associated with one thing to another - not always negative emotions

e.g., the patient criticizes the nurse after family fails to visit

44
Q

Dissociation is a kind of defense mechanism. Describe this defense mechanism?

A

Results in separation between feelings and thoughts, can also be manifested by compartmentalization of uncomfortable or unpleasant aspects of one’s self

45
Q

Identification is a kind of defense mechanism. Describe this defense mechanism?

A

Attributing oneself characteristics of another person or group

46
Q

Projection is a kind of defense mechanism. Describe this defense mechanism?

A

Putting your own attributes or faults on someone else - almost always negative emotion

47
Q

Rationalization is a kind of defense mechanism. Describe this defense mechanism?

A

Justifying illogical or unreasonable acts or feelings by developing acceptable explanations to satisfy the teller and listener

48
Q

Reaction formation is a kind of defense mechanism. Describe this defense mechanism?

A

Doing the opposite of what is expected or felt

e.g., addict in recovery preaching about dangers of drugs

49
Q

Regression is a kind of defense mechanism. Describe this defense mechanism?

A

First-line psychological defense against anxiety - temporary or long-term exclusion of pleasant or unwanted experiences, emotions, or ideas from conscious awareness

50
Q

Splitting is a kind of defense mechanism. Describe this defense mechanism?

A

The inability to integrate the positive and negative qualities of oneself or others into a cohesive image. Black and White thinking

51
Q

Sublimation is a kind of defense mechanism. Describe this defense mechanism?

A

The unconscious process of substituting mature, constructive activity instead of immature or destructive impulses

52
Q

Suppression is a kind of defense mechanism. Describe this defense mechanism?

A

Conscious denial of a disturbing situation or feelings

53
Q

What are paranoid delusions?

A

Irrational distrust of others or the belief that others are threatening or harassing you.

54
Q

What are bizarre delusions?

A

An absurd or implausible belief
e.g., the electricity is making me gain weight

55
Q

What are somatic delusions?

A

A false belief involving the body or bodily functions

56
Q

What are delusions of grandeur?

A

An exaggerated belief in one’s importance or power

57
Q

What are religious delusions?

A

The belief that one is an agent of or specially favoured by a greater being.

58
Q

What is erotomania?

A

The belief that someone (often a public figure) unknown to the individual is in love with or in a relationship with them.

59
Q

Loosening of associations is a disturbance of though processes. What does it mean?

A

The lack of logical relationship between thoughts and ideas; conversations shift from one topic to another in a completely unrelated manner, making it difficult and confusing to follow.

60
Q

Though blocking is a disturbance of though processes. What does it mean?

A

an abrupt pause or interruption in one’s train of thoughts, after which the individual cannot recall what he or she was saying

61
Q

Flight of ideas is a disturbance of though processes. What does it mean?

A

Rapid, continuous verbalizations, with frequent shifting from one topic to another

62
Q

Preservation is a disturbance of though processes. What does it mean?

A

A persisting response to a stimulus even after a new stimulus has been presented

63
Q

Clang associations is a disturbance of though processes. What does it mean?

A

The use of words or phrases that have similar sounds but are not associated in meaning; may include rhyming or puns

64
Q

Echolalia is a disturbance of though processes. What does it mean?

A

The persistent echoing or repetition of words or phrases said by others.

65
Q

Verbigeration is a disturbance of though processes. What does it mean?

A

The meaningless repetition of incoherent words or sentences; typically associated with psychotic states and cognitive impairment.

66
Q

How will you adapt the way you ask questions to a person with thought content impairment (such as with depression, schizophrenia, dementia)?

A

Ask closed ended questions to keep conversation centered.

67
Q

What is the purpose of a psychological intervention?

A

To support the immediate experience of emotions/situations.

68
Q

What is psychotherapy?

A

Fundamentally changing a person’s sense of self

69
Q

What is counselling?

A

Supporting a person through an immediate experience, can be done through entry practice nursing

70
Q

What is the controlled act of psychotherapy?

A

Limited act of doing psychotherapy for people that have a major mental illness - requires a prescription.

70
Q

What is psychological education?

A

An intervention that informs someone about the nature of their illness, symptoms, treatments, and recovery.

70
Q

What is self-care psychoeducational interventions?

A

Helping individual with self care activities and developing techniques for them to take care of themselves autonomously

71
Q

What is a therapeutic metaphor?

A

Use of metaphors to validate experiences, a kind of psychoeducational intervention

72
Q

What is a therapeutic cheat sheet?

A

Crisis plans, management of medications side-effects, assertive communication, physical activity. A kind of psychoeducational intervention.

73
Q

What are behavioural interventions?

A

Problem solving, fragmentation of skills, social skills training, in vivo support, distractions, lifestyle, journaling, assertive communication.

74
Q

What is in vivo support?

A

In the moment support, going with patient for challenging encounters

75
Q

What is social skills training?

A

Practice in social situations, helpful in schizophrenia and ASD.

76
Q

What are cognitive interventions?

A

Education about and promoting self esteem, description of automatic thoughts, dedramatization

77
Q

What is dedramatization?

A

Imagining the worst case, realist, and ideal scenarios in situations

78
Q

What are emotional interventions?

A

Deep breathing for 5-10 minutes, progressive muscle relaxation, mental imagery, meditation

Mental Health Nursing (18 decks)

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