Module 2.1 : Therapeutic skills in the assessment process

Question 1

Describe the key skills/ principles for engaging with people with mental illness

Answer 1

• Treat any consumer with TRUST and respect
• Be GENUINE in your interactions
• Remember your ROLE & professional boundaries & standards
• Show EMPATHY & unconditional acceptance

Question 2

Identify barriers that may compromise engagement - Patient’s perspective

Answer 2

• Distrust
• Fear
• Stigma
• Long waiting lists
• Poor accessibility
• Marginalised groups (CALD, ATSI)
• Co-morbidity with substance abuse

Question 3

Identify barriers that may compromise engagement - Nurse’s perspective

Answer 3

• Time constraints
• Personal discomfort
• Knowledge deficit
• Skills deficit
• Lacking empathy

Question 4

List issues or factors the nurse should consider when a person presents with mental illness

Answer 4

• Suicidal ideation and suicidal attempt
• Poor emotional regulation (anger, outbursts, violence)
• Non-suicidal self-injury (self-harm, mutilation)
• Drugs and/or alcohol
• Sexual abuse or assault
• Psychiatric illness (incl. personality disturbances)
• Homelessness and/or parental abandonment
• Physical illness / chronic disease (co-morbid illness)
• Interpersonal conflict, domestic violence
• Sex and sexuality (incl. STIs)
• Legal issues / forensics (criminal justice system)

Question 5

Relationship - Resistance

Answer 5

Disruption to smooth flow of feelings, memories, and thoughts.
Person maybe struggling against change

Question 6

Relationship - Transference

Answer 6

Is concerned with transferring points of view in the form of personal attitudes between relationships.

Feelings are often directed towards the nurse as well as others n the environment

Question 7

Relationship - Countertransference

Answer 7

Is the response of the nurse to the patient; these feelings can be positive or negative.

Potential for damage or deterioration of the therapeutic relationship

Question 8

Biopsychosocial model of care - holistic approach

Answer 8

The BPS model is a concept for understanding health and illness, addressing biology, psychology, and social factors.

Holistic nursing is generally defined as all nursing practice that has healing the whole person as its goal.

Question 9

Biopsychosocial model of care - Biological

Answer 9

Physical /Medical

• Medications
• Genetics
• Illness

Question 10

Biopsychosocial model of care - Psychological

Answer 10

Mind / Psychology

• Thoughts / feelings
• Emotions
• Therapies

Question 11

Biopsychosocial model of care - Social

Answer 11

Sociology

• Relationships
• Family
• Work / education
• Environment

Question 12

Describe why the BPS model is important to MH

Answer 12

• It allows the nurse to gather a holistic view on an individual, in order to provide the best care available.
• Study the interactions between Medical, mental, and environmental factors that impact on the patient’s MH.

Question 13

The therapeutic alliance / relationship and MH

Answer 13

A strong TR or alliance with the client enhances treatment outcomes and facilitates shared understanding of the situation, while identifying strengths and potential barriers to treatment.

Question 14

Principles of engaging : TR

Answer 14

• Make the client feel safe & supported - validate feelings
• Gather information from the patient and family through the assessment process to provide appropriate interventions & care management.
• Goals of discussion to be -
  1) Mutually defined
  2) Collaborative
  3) Goal-orientated / directed