Week 2 - Important concepts Flashcards
Primary intention is to regulate the administration of mental health care in Ontario
Ontario Mental Health Act
deprived of oxygen at birth – challenges in emotional lability – got a frontal lobotomy
Rosemary Kennedy
induces seizures – led to ECT
insulin therapy
behaviours would change when certain degrees of seizures were induced – sometimes still used
ECT
neuroleptic – administered to patients and found that it had sedating effects – decreased agitation and restlessness
chlorpromazine - drug in the 50s
used in psychotic syndromes and ADHD
Thorazine and its derivatives - 50s drugs
What were some notable side effects related to thorazine and its derivatives, and chlorpromazine?
Drowsiness, dry mouth, tardive dyskenisia, orthostatic hypotension, weight gain, neuroleptic malignant syndrome
involuntary, uncoordinated movements of the face – choking risk
tardive dyskinesia
mood stabilizer used in treatment of bipolar disorder (sometimes MDD if other antidepressants do not work)
lithium (carbonate)
What monitoring is required when administering lithium?
Hydration status, thyroid and kidney function
behaviours always motivated; repressed memories and early childhood experiences
Freudian
similar to Freud but less strict on everything had a sexual motivation
Jungian
environmental interactions and biologic interactions at play with one another
Pluralism
clinical judgements about individual, family or community responses to actual or potential life processes
nursing diagnoses
What are the two major types of nursing interventions?
Direct - apply directly to client
Indirect - involving service for the care, or team meeting to discuss where to go next
therapeutic communities that have people living and functioning together and being responsible for aspects of their community; often a consequence system set in place
milieu therapy - social domain intervention
nurse uses their experience to help the patient without burdening them with their experience.
therapeutic use of self
• A form of psychotherapy that identifies, analyzes, and ultimately changes habitually inflexible and negative cognitions
CBT
Most widely researched form of psychotherapy
CBT
What is the cognitive model?
Think –> feel –> behave
What is the cognitive behavioural sequence?
Thoughts –> emotions –> bodily sensations –> behaviour
What are the levels of cognition?
Automatic thoughts
Intermediate beliefs
Core beliefs
one that doesn’t have to make sense, but just pops into your mind – the most superficial and easiest to change
automatic thoughts
things you truly believe; cognitive products, automatic thoughts
- If, should or must statements – often fairly rigid but unrealistic
intermediate beliefs
accepted as absolute truths; fundamental and hard to articular require exploration
core beliefs
What is the pathological nature of the levels of cognition? How does treatment using CBT go about it?
Pathological nature is bottom-up; CBT treatment is top down (i.e. start at automatic thoughts)
Initial CBT sessions are directed by whom?
the therapist
CBT patients encouraged to view their thoughts and feelings in hypotheses
Their viewpoint is one of many that are plausible
inductive reasoning
Specific way of questioning that supports inductive reasoning
Reasoned dialogue helping the patient to determine how own broader perspective on the validity, accuracy, and functionality of his or her thought process
How would this change if you tried this instead?
Socratic questioning
• Provided at the end of each session with the expectation that the patient will work on them throughout the week and be prepared to discuss them at the beginning of the following session
Self-reflection
What is the goal of self-reflection?
Experience new insights
a way to test and challenge both maladaptive thinking patterns and newly acquired rational thoughts
behavioural experiments
include exposure techniques, relaxation training, and activity monitoring
behavioural strategies to modify symptoms
not a replacement for CBT, but a nice adjunct therapy; form of self-trained self-observation based on meditation practices.
mindfulness
Who is at risk for suicide?
unemployed, vulnerable populations, lives alone, depressed or other mental health disorder
the voluntary and intentional act of killing onself
suicide
thinking about or planning one’s own death
SI
self-inflicted actions, with a nonfatal outcome, accompanied by explicit or implicit evidence that the person intended to die
suicidal behaviour or attempted suicide
self-injurious or self-harm that may mimic suicidal behaviour; primary intention NOT to kill oneself
parasuicide
the probability that an individual will be successful in completing suicide – varies by method, means and availability of means
lethality
Describe gender and suicide.
women try it 4x more; men complete it 3x more
How many survivors are left after each suicide?
around 6
What are some pediatric considerations for suicide?
rare under 10
more somatic symptoms
SI and self harm are highest in adolescents; serious risk at 15-19 for suicide
How are survivors impacted by suicide?
Increased stigmatization and social rejection
When was suicide decriminalized?
1972
What are the factors for MAID application?
cannot be used for children
must be mentally competent to make the decision
no secondary decision makers can decide
What are the indicators for a form 1?
Threatening harm to self or others
Violent behaviour
incompetence and safety risk
What is the form 1 timeline?
72 hours
When performing a suicide assessment, what are the factors to focus on?
Risk factors AND protective factors
