Safety and Therapeutic Use of Self

Question 1

reduce crisis=

Answer 1

keep client engaged in treatment

Question 2

is a client in fully psychotic or mania a candidate for group intervention?

Answer 2

no!

Question 3

what 4 things may you see in someone attending to internal stimuli?

Answer 3

a. preoccupied
b. appear to talk to themselves
c. tangential/circumstantial conversation
d. misinterpret actions of others

Question 4

As you enter a room you should….

Answer 4

a. call the person’s name
b. explain who you are
c. explain what you are doing
d. explain why you are there

Question 5

Establish a calm environment by:

Answer 5

a. not touching/invading personal space w/o permission
b. speak slowly, calmly, quietly; simple, concrete language
c. wait for response
d. reduce competing stimuli

Question 6

When hallucinations arise:

Answer 6

a. help the person focus on reality rather than hallucination but DO NOT try to convince the person that the hallucination does not exist
b. have them listen to your voice, not the other one; look at you and not other things
c. do not agree with hallucination or delusion, just acknowledge

Question 7

what is the most common delusion?

Answer 7

Paranoid. Characterized by extreme suspicion and difficulty trusting others.

• misinterpretation of others words and actions
• ordinary things may be seen as a threat

Question 8

Appropriate response to delusions:

Answer 8

a. keep yourself safe from violent reactions until you kno w the content
b. keep safe distance and barrier
c. do not touch person w/o permission
d. position yourself at eye level if safe

Question 9

What kinds of activities should be used with someone having hallucinations?

Answer 9

Highly structured, simple, concrete that hold the individual’s attention –activity may be higher level since attention is mainly interrupted by the delusional thinking

Question 10

What are the appropriate measures for intimate distance and when should it be used?

Answer 10

a. close phase: less than 6 inches (15 cm)
b. far phase: 6-18 inches (15-46 cm)
c. for embracing, touching, or whispering

Question 11

What is the appropriate measure for personal space interactions and when should it be used?

Answer 11

a. close phase: 1.3 to 2.5 feet (46 to 76 cm) Arms length
b. far phase: 2.5 to 4 feet (76 to 120 cm)
c. for interactions among close friends or family members

Question 12

What is the appropriate measure for social distance and when should it be used?

Answer 12

a. close phase: 4 to 7 feet (1.2 to 2.1 m)
b. far phase: 7 to 12 feet (2.1 to 3.7 m)
c. for interactions among acquaintance

Question 13

what are the appropriate measures for public distance and when should it be used?

Answer 13

a. close distance: 12 to 25 feet (3.7 to 7.6m)
b. far phase (7.6 m or more)
c. for use during public speaking

Question 14

In kinetics and proxemics of interaction with the client, the therapist should

Answer 14

a. *** supportive stance: stand one leg length away, on an angle, off to the side
b. listen carefully
c. be calm, do not overreact
d. avoid jargon
e. pay attention to body language and psychomotor agitation

Question 15

When using supplies in an activity the therapist should:

Answer 15

a. count everything you use
b. sharps under supervision!
c. remove potential weapons
d. be mindful of the person’s condition, note conditions from their baseline

Question 16

When seated as the therapist you should have:

Answer 16

direct access to the door!. If possible, use a U format in groups with dangerous clients

Question 17

What is the order you should do things in in case of emergency?

Answer 17

a. security
b. 911
c. code purple: crisis management team
d. help!

Question 18

If you observe a situation becoming escalated break the “set” by

Answer 18

DIVERTING attention —pretend to call the receptionist, go to bathroom

Question 19

In Level 1, anxiety, there is increasing change in behavior by the client, then the therapist should provide ______

Answer 19

Support. Staff offers diversion, listening and empathy to alleviate anxiety.

Question 20

In level 2, defensive, the client begins to lose rationality and becomes challenging. The therapist should respond by being:

Answer 20

Directive. The therapist sets boundaries and consequences for behavior.

Question 21

In level 3 acting out, the patient exhibits total loss of control or physically acts out. The therapist should:

Answer 21

Evoke a crisis plan: institute the plan, call Code, Stat, etc. Soft restrains indicated.

Question 22

In level 4, of client tension reduction, the client returns to rationality, in this time the therapist should:

Answer 22

use therapeutic rapport and communication with the individual to reduce tensions and restore professional relationship

Question 23

Self disclosure can be beneficial when:

Answer 23

it can normalize a client’s experience and provide an opportunity for modeling appropriate behaviors and responses. Always ask for permission to share your story.

Question 24

Never give ____ to you client!

Answer 24

personal information!

Question 25

With clients, avoid—-

Answer 25

hugging and personal touching

Question 26

Duty to warn

Answer 26

only have to believe that the situation is dangerous