Safety and Therapeutic Use of Self Flashcards
reduce crisis=
keep client engaged in treatment
is a client in fully psychotic or mania a candidate for group intervention?
no!
what 4 things may you see in someone attending to internal stimuli?
a. preoccupied
b. appear to talk to themselves
c. tangential/circumstantial conversation
d. misinterpret actions of others
As you enter a room you should….
a. call the person’s name
b. explain who you are
c. explain what you are doing
d. explain why you are there
Establish a calm environment by:
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
When hallucinations arise:
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
what is the most common delusion?
Paranoid. Characterized by extreme suspicion and difficulty trusting others.
- misinterpretation of others words and actions
- ordinary things may be seen as a threat
Appropriate response to delusions:
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
What kinds of activities should be used with someone having hallucinations?
Highly structured, simple, concrete that hold the individual’s attention –activity may be higher level since attention is mainly interrupted by the delusional thinking
What are the appropriate measures for intimate distance and when should it be used?
a. close phase: less than 6 inches (15 cm)
b. far phase: 6-18 inches (15-46 cm)
c. for embracing, touching, or whispering
What is the appropriate measure for personal space interactions and when should it be used?
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
What is the appropriate measure for social distance and when should it be used?
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
what are the appropriate measures for public distance and when should it be used?
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
In kinetics and proxemics of interaction with the client, the therapist should
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
When using supplies in an activity the therapist should:
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
When seated as the therapist you should have:
direct access to the door!. If possible, use a U format in groups with dangerous clients
What is the order you should do things in in case of emergency?
a. security
b. 911
c. code purple: crisis management team
d. help!
If you observe a situation becoming escalated break the “set” by
DIVERTING attention —pretend to call the receptionist, go to bathroom
In Level 1, anxiety, there is increasing change in behavior by the client, then the therapist should provide ______
Support. Staff offers diversion, listening and empathy to alleviate anxiety.
In level 2, defensive, the client begins to lose rationality and becomes challenging. The therapist should respond by being:
Directive. The therapist sets boundaries and consequences for behavior.
In level 3 acting out, the patient exhibits total loss of control or physically acts out. The therapist should:
Evoke a crisis plan: institute the plan, call Code, Stat, etc. Soft restrains indicated.
In level 4, of client tension reduction, the client returns to rationality, in this time the therapist should:
use therapeutic rapport and communication with the individual to reduce tensions and restore professional relationship
Self disclosure can be beneficial when:
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.
Never give ____ to you client!
personal information!
With clients, avoid—-
hugging and personal touching
Duty to warn
only have to believe that the situation is dangerous
