Psychiatric/Mental Health (Exam Three) Flashcards
In psychiatry, work with clients and families often takes the form of _______.
Groups
In what setting do clients tend to learn from each other?
Group setting
A collection of individuals whose association is founded on commonalities of interest, values, norms, or purpose is known as what?
Group
List the eight different functions that groups serve for their members.
- Socialization
- Support
- Task completion
- Camaraderie
- Information sharing
- Normative influence
- Empowerment
- Governance
Which group function assists group members in gaining a feeling of security?
Support
T/F: Groups may serve more than one function and usually serve different functions for different members of the group.
True
Which three types of groups do nurses most often participate?
- Task groups
- Teaching groups
- Supportive/therapeutic groups
What is the goal and the focus of task groups?
- Goal: accomplish a specific outcome or task
- Focus: solving problems and making decisions to achieve the goal
In which group might conflict be smoothed over or ignored in order to focus on the priority at hand?
Task groups
List the types of teaching groups in which nurses may be involved?
- Medication education
- Childbirth education
- Breast self-examination
- Parenting classes
A form of psychosocial treatment in which several clients meet together with a therapist for purposes of sharing, gaining personal insight, and improving interpersonal coping strategies is known as what?
Group therapy
Leaders of group therapy generally require what?
Advanced degrees
Leaders of group therapy and therapeutic groups must be knowledgeable about ________ ________ and _______ _________.
- Group processes
- Group content
Which type of group is run by members, and the leadership often rotates from member to member?
Self-help groups
Alcoholics Anonymous, Weight Watchers, Reach to Recovery, and Adult Children of Alcoholics are all examples of what type of groups?
Self-help groups
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 group is to accomplish a specific outcome
B. Group members receive comfort and advice from others undergoing similar experiences
What amount of group members provides a favorable climate for optimal group interaction and relationship development?
7 or 8 members
________ _________ are those in which members leave and others join at any time while the group is active.
Open groups
Closed groups are comprised of what type of individuals?
Those with common issues or problems they wish to address
Provide an example of a closed group.
Grief group
By observing the progress of others in a group with similar problems, a group member garners hope that their problems can also be resolved. Which curative factor does this describe?
Instillation of Hope
Describe the curative factor universality.
Individuals come to realize they are not alone in their current problems, thoughts, or feelings
Describe the curative factor altruism.
Individuals assist and support each other, helping create a positive self-image and promote self-growth
Through interaction with and feedback from other group members, individuals are able to correct maladaptive social behaviors and learn and develop new social skills. Which curative factor does this describe?
Development of socializing techniques
Describe the curative factor catharsis.
Group members can express both positive and negative feelings
Describe the curative factor imparting of information.
Group members share their knowledge with each other
List expectations or responsibilities of the group leader during Phase 1: Initial/Orientation phase of group development.
- Establish rules of the group
- Ensure that the rules do not interfere with the goals of the group
- Emphasize the need for and importance of maintaining confidentiality within the group
In what phase of group development are group members complementary to the leader and compete for different positions within the group?
Phase 1: Initial/Orientation phase
The leader becomes less of a leader and more of a facilitator during the ________ phase.
Working
During what phase of group development is trust established amongst is members?
Phase II: Middle/Working phase
Problem-solving and decision-making occur during which phase of group development?
Phase II: Middle/Working phase
What is the goal of the nurse during Phase III: Final/Termination phase of group development?
Guide the members in processing their feelings about termination of the group
What type of feelings are often triggered for members during Phase III: Final/Termination phase of group development?
- Abandonment
- Grief
Which leadership style conveys the message, “We will do it my way, my way is best” and solely focuses on the leader?
Autocratic leadership
Productivity is high, but morale is low with which type of leadership?
Autocratic leadership
Democratic leadership style focuses on the _________ of the group.
Members
Members are encouraged to participate fully in solving problems that affect the group, including taking action to effect change. This describes which type of leadership style?
Democratic leadership
Productivity is low and morale is low with which type of leadership?
Laissez-faire leadership
In which leadership style are no decisions made, no problems solved, and no action taken?
Laissez-faire leadership
Describe the task role of orienter within a group.
Maintains direction
Describe the task role of coordinator within a group.
- Foster relationships
- Clarifies ideas and suggestions
Describe the maintenance role of gatekeeper within a group.
- Encourages acceptance
- Encourages participation
Describe the personal role of aggressor within a group.
- Express negativism
- Express hostility
- Use sarcasm to degrade others
Describe the personal role of recognition seeker within a group.
Talks about personal accomplishments to gain attention for self
Describe the personal role of dominator within a group.
- Manipulates others to gain control
- Behaves in authoritarian manner
Describe the personal role of monopolizer within a group.
Maintains control of group by dominating conversation
Which roles contribute to the success or effectiveness of the group?
- Task role
- Maintenance role
___________ roles satisfy the needs of the individual member.
Personal
Describe the roles of group members in a psychodrama.
- Patients become “actors” in life-situation scenarios
- Patient is the protagonist
- Group members are the audience
- Group members may play the roles of people with whom the protagonist has unresolved issues
What is the purpose of a psychodrama?
Provide the patient with a safe place to confront unresolved conflicts to progress towards a resolution
List therapeutic groups that may only be lead by an APRN or a physician.
- Psychotherapy
- Psychodramatists
The psychiatric nurse considers this a key factor when it comes to interacting with patients and milieu therapy.
Every interaction is an opportunity for a therapeutic interaction
Describe a milieu.
- Group of people sharing the same space
- What occurs on a daily basis within the group atmosphere
A scientific structuring of the environment in order to effect behavioral changes and improve the psychological health and functioning of the individual is known as what?
Milieu therapy
In which settings or for which individuals has milieu therapy proved to be successful?
- Prison setting
- Schizophrenia patients
What is the nurses role in a milieu setting?
Manager of the milieu
List conditions that promote a therapeutic community.
- Containment
- Structure
- Involvement
- Support
- Validation
Within the milieu, how are medications administered to patients?
- Patients required to ask for medications
- Patients required to retrieve their medications at appropriate time
List members of the disciplinary team.
- Psychiatrist
- Clinical psychologist
- Psychiatric clinical nurse specialist
- Psychiatric nurse
- Mental health technician
- Psychiatric social worker
- Occupational therapist
- Recreational therapist
- Art/Music therapist
- Dietitian
- Chaplain
The essence of patient centered care emphasizes what two aspects?
- Patient involvement
- Patient decision-making authority
List the nursing interventions for establishing a therapeutic milieu.
- Orientating new patient to environment
- Explaining his/her rights and responsibilities within the milieu
- Explain structured activities
- Explain any limits or restrictions needed to maintain safety
List the nurses responsibilities within a milieu.
- Medication administration
- Development of one-on-one relationship
- Setting limits on behavior
- Patient education
List concrete statements that are aimed at developing trust between the patient and the nurse.
- “If you are frightened, I will stay with you”
- “If you are cold, I will bring you a blanket”
- “If you are thirsty, I will bring you a drink of water”
_____________ in enforcing the consequences of violating the established limits is essential for learning to be reinforced.
Consistency
List Skinners seven basic assumptions on which a therapeutic community is based.
- Individual health is to be realized and encouraged to grow
- Every interaction is an opportunity for therapeutic intervention
- Patient owns his or her environment
- Each patient owns his or her behavior
- Peer pressure is a useful and powerful tool
- Inappropriate behaviors are death with as they occur
- Avoid restrictions and punishments
Any stressful situation can precipitate a _________.
Crisis
A sudden event in ones life that disturbs homeostasis during which the usual coping mechanisms cannot resolve the problem is referred to as what?
Crisis
List the five characteristics of a crisis according to Aguilera and Caplan.
- Occur in all individuals at some time or another
- Precipitated by specific, identifiable events
- Personal in nature
- Acute events
- Contains potential for psychological growth or deterioration
Describe the four phases in the development of a crisis according to Caplan.
- Individual is exposed to a precipitating stressor
- If previous problem-solving techniques do not resolve the stressor, anxiety increases
- All internal and external resources are used to resolve the problem and relieve the discomfort
- If resolution does not occur in the previous phases, major disorganization of the individual occurs and results are drastic
Aguilera spoke of three ______ _________ that affect how an individual perceives and responds to a precipitating stressor.
Balancing factors
Describe Aguilera’s three balancing factors on whether individuals will experience a crisis in response to stressful situations.
- Individual’s perception of the event
- Availability of situational supports
- Availability of adequate coping mechanisms
List Baldwin’s six classes of emotional crisis.
- Dispositional crisis
- Crises of anticipated life transitions
- Crises resulting from traumatic stress
- Maturational/developmental crisis
- Crises reflecting psychopathology
- Psychiatric emergencies
Provide an example of a dispositional crisis.
- Individual who is having difficulties at work, exploded at home and becomes abusive to his wife and child
- Wife takes the child to the ED, not knowing what else to do
Provide an example of a crises of anticipated life transitions.
A college student is placed on probationary status because of his failing grades due to having to work overtime to support his wife and new baby
Provide an example of a crises resulting from traumatic stress.
- A waitress is abducted by armed men, raped, and beaten
- She can no longer be alone, is constantly fearful, has flashbacks and dreams, and is unable to eat, sleep, or work
Provide an example of a maturational/developmental crises.
A new mother who is overwhelmed by life may threaten to leave her child and partner because she is unable to cope
Individuals with what preexisting psychopathology’s are at an increased risk for having crises reflecting psychopathology?
- Personality disorders
- Anxiety disorders
- Bipolar disorders
- Schizophrenia
Provide an example of a crises reflecting psychopathology.
- A women diagnosed with bipolar is informed that her therapist will be moving and she will need to seek out a new therapist
- As a result the woman wanders into traffic of a busy expressway
List examples of a psychiatric emergency.
- Acute suicide risk
- Drug overdose
- Reactions to hallucinogenic drugs
- Acute psychoses
- Uncontrollable anger
- Alcohol intoxication
What is the primary goal of crisis intervention?
- Resolution of an immediate crisis
- Restore functioning
- Enhance personal growth
List questions a nurse in crisis intervention might ask during the assessment phase?
- “Can you describe the crisis?”
- “Have you experienced this crisis before? What type of coping methods did you use?”
- “Have you tried any coping methods for this crisis?”
- “How did previous coping methods work?”
List considerations a crisis nurse might make during the planning of therapeutic interventions.
- Type of crisis
- Individuals strengths
- Desired choices
- Available resources
