study notes Flashcards
Trauma informed care
A trauma-informed approach recognises and understands trauma can negatively affect whānau, groups, organisations and communities, as well as individuals.
Realisation
Recognition
Responding
Trauma informed care principles
Safety Trustworthiness and transparency Peer support Collaboration and mutuality Empowerment, voice and choices Cultural, historical, and gender
Substance disorders
a wide variety of problems associated with substance abuse. there is 11 criteria’s. Depending on how many criteria is met with the DSM-5 , determines the severity of substance abuse.
2-3 - mild substance use disorder
4-5 - moderate
6 or more - severe
transference
A person transfers beliefs, feelings, thoughts and behaviors that occurred in one situation, usually in their past, to a situation that is happening in the present.
Traditionally referred to the consumer with unconscious feelings or beliefs about someone in their past transferring these feelings or beliefs onto the therapist.
counter-transference
The response of the therapist to the consumer. Having strong feelings for the consumer, either negative or positive, might be a cue that one is experiencing counter-transference.
Interpersonal skills
behaviors and tactics a person uses to interact with others effectively. Clarifying paraphrasing active listening Pinpointing confronting interpersonal feedback linking summarizing
Pinpointing
verbalising what you have noticed or heard that the person may not have openly stated; for example, “it seems you may not see eye-to-eye on this”.
Confronting
addressing inconsistencies between what the person says and what the facts appear to be; for example, the person may look uncomfortable, but has not said anything about it.
Interpersonal feedback
Involves providing clear information about your own response to the person’s behaviour, or other people’s responses that you have noticed when the person behaves in a specific way.
Linking
Linking is the nurse’s uncovering of connections between consumer events and feelings, or behaviours and consequences. This joining together of experience and reaction helps the consumer make more sense of what is happening to them.
Summarising
Is pulling together main points, insights or agreements that emerged in conversation.
Emotional competence
refers to the essential social skills to recognize, interpret, and respond constructively to emotions in yourself and others achieved through: Self-management Self-awareness Social awareness Relationship management
Emotional competence:Self-management
You’re able to control impulsive feelings and behaviours, manage your emotions in healthy ways, take initiative, follow through on commitments, and adapt to changing circumstances.
Emotional competence:Self-awareness
You recognize your own emotions and how they affect your thoughts and behaviour. You know your strengths and weaknesses, and have self-confidence.
Emotional competence:Social awareness
You can understand the emotions, needs, and concerns of other people, pick up on emotional cues, feel comfortable socially, and recognize the power dynamics in a group or organization
Emotional competence: Relationship management
You’re able to develop and maintain good relationships, communicate clearly, inspire and influence others, work well in a team, and manage conflict.
Diagnostic criteria DSM V
how psychiatric disorders are classified
Axis I - Mental Disorder (schizophrenia, PTSD, Bipolar mood disorder)
Axis II - Personality, Developmental issues (Narcissistic disorder, borderline personality disorder)
Axis iii - Physical / medical issues of note (Diabetic, cardiovascular, HTN)
Axis IV - Psychosocial issues (Precipitating factors, financial, social)
GAF - Global assessment of Functioning (objective assessment: Score from 0-10 - 90-100, how well you function in society)
ICD 10-
classification of mental and behavioural disorders
Major Depression: Diagnosis
DSM-5: At least five symptoms, for more than 2 weeks with significant reduction in functioning: - loss of pleasure (anhedonia) - change in weight (up/down) - sleep disturbance - psychomotor retardation/agitation - dysthymic mood - feelings of worthlessness, guilt, impaired concentration - suicidal ideation
Factors that can increase risk of Generalised anxiety disorder
- neurochemical
- familial, genetic
- social/cultural, life experiences
Generalised anxiety disorder: S/S
irritability, feeling on edge, poor concentration, sleep disturbance, physical tension
Generalised anxiety disorder: Approaches to care
- practical lifestyle changes
- nutrition and exercise
- self-talk and strength based approach to concerns
- disrupting patterns/ linking feeling and drive to thinking and acting on behavioural responses
- anxiolytics (and for some antidepressants or low dose antipsychotics).
- Self-management in relaxation and occupation
Panic disorders
- Characterized by repeated panic attacks, combined with major changes in behavior or persistent anxiety over having further attacks.
- S/S- severe anxiety episodes (overestimating threat, and underestimation ability to cope).
E.g - Panic with agoraphobia include significant avoidance
Co-morbid depression and substance use is common.
Factors that can cause PTSD
Post traumatic stress disorder
major trauma (natural disasters); accidents, rape, combat, torture, postnatal. Symptoms persist more than 1 month with significant impairment or distress.
PTSD: S/S
- intrusive thoughts and feelings (nightmares, re-experiencing the event, flashbacks, anxiety/anger)
- avoidance
- anhedonia
- detachment
- social isolation
- physical manifestation (sweats, increased heart beat, hyper startle reflex, muscle tension).
PTSD: approaches to care
Specific talk around the intrusive thinking and avoidance. As for anxiety other symptoms
what is OCD?
Obsessive compulsive disorder
persistent and recurrent intrusive thoughts or feelings perceived to be inappropriate by person, obsession that leads to compulsion (acting in order to relieve anxiety)
OCD: S/S
pathological doubt, contamination, physical somatisation, need for symmetry (lining up, counting, checking), religious excessive compulsions, co-morbid substance use, particularly alcohol.
OCD: Approaches to care
- Linking thinking and changing drive in feeling and behaviour
- work on panic
- lifestyle changes
- medication (as for anxiety) with more use of typical anti-depressants
- self-talk work and gradual exposure to changes in behaviour.
Bipolar disorder- manic depression
Characterised by episodes of depression and mania (which last for more than one week). Mania by insomnia, increased energy, poor concentration, over activity, with persistent elevated mood, irritability and lability.
Bipolar I
- involves periods of severe mood episodes from mania to depression. (can require hospitalization)
- at least one episode of mania with more depression.
Bipolar II
episodes of depression and hypomania.
