Week 2 - test 1 Flashcards
A life magazine expose in 1946 revealed what?
similarities between Nazi concentration camps and mental health hospitals in the U.S.
In 1954 _____________ was found to decrease many symptoms of psychosis
chlorpromazine
A massive number of clients were discharged in a mass exodus called ________________
deinstitutionalization
Deinstitutionalization was a result of:
1.
2.
3.
4.
- the fall of the eugenics movement
- public criticism of mental hospitals
- states’ desire to reduce costs
- Development of psychiatric drugs
_____________ units receive clients that are very ill and must discharge them before they are completely recovered
inpatient hospital
Inpatient hospitals limited length of stay has led to the _______________ phenomenon
revolving door
During hospitalization, treatment focuses on __________ therapy, __________ therapy and _____________ management
milieu, talk/group, medication
partial hospitalization allows clients to?
get treatment during the day and go home afterward
Partial hospitalization is a good bridge to help clients after ____________ from an _________ stay
discharge, inpatient
____________ residential treatment setting facilitate a clients _________ needs and various other needs
community, basic
group homes, supervised apartments and adult foster care are example of ________ settings
residential
therapeutic environment is also called ________ ________
milieu therapy
A therapeutic milieu includes:
1.
2.
3.
4.
5.
6.
- basic physiological needs are met
- space is provided for privacy and socializing
- clients are given responsibilities
- clients participate in decision making as much as possible
- clients have a structured schedule of activities that are tailored to their needs.
- community and family are included as much as possible
Milieu therapy is difficult to implement today because:
1.
2.
- the average length of hospitalization is much shorter (2-3 days)
- biologically- based treatment (meds) is the primary focus
Maslow’s basic fundamental level require _____________ needs, and _________
physiological, safety
Managing the milieu requires:
1.
2.
3.
4.
5.
6.
7.
8.
9.
- safety first
- ongoing assessments
- orienting clients
- setting limits
- promoting autonomy
- teaching
- promoting the development of interpersonal skills
- reality orientation
- collaboration
milieu: the regular assessment of each clients physical and mental health, and proactively addressing issues is?
ongoing assessment
milieu: orientation of the physical environment, prohibited items, the schedule of activities, rules and expectations is?
orienting clients
milieu: using a calm matter of fact tone, clear understandable terminology, explaining consequences of unacceptable behavior, ensuring consistency among staff is considered?
setting limits
milieu: independent functioning such as lining up for meds at the appropriate times, care for own hygiene needs, and participating in treatment team meeting is considered?
promoting automony
milieu: informal and formal covering of topics such as diagnoses, meds side effects, importance of adhering to meds, coping skills is considered?
teaching
milieu: developing skills such as interaction skills, relationship skills, conflict resolution skills and health coping mechanisms is considered?
promoting the development of interpersonal skills
an effective nurse _________ the feelings of the client and help empower the client to effectively solve the problem
acknowledge
___________ therapy promotes interpersonal skill development
group
milieu: orientation methods such as large clocks, printed schedule, signs/pictures/indicators and discussion of weather/season/event are considered?
reality orientation
milieu: nurse ____________ with the interdisciplinary team
collaborate
Team leader. Responsible for diagnosis and treatment of mental disorders. Prescribes medicines and treatments?
psychiatrist
Conducts therapy. Administers psychological tests. Assists in diagnosis?
clinical psychologist
Conducts therapy. Provides education and consultation for nursing staff.
psychiatric nurse specialist
Manages the milieu. Provides ongoing mental and physical assessments. Administers medications. Assists clients with the therapy process. Focuses on therapeutic relationships. Provides teaching about illness and medications?
psychiatric nurse
Functions under the supervision of the psychiatric nurse. Assists in ADLs. Assists therapists (e.g., occupational, recreational, music). May also form therapeutic relationships.
mental health tech/aide/assistant
Conducts therapy. Assesses social needs (placement, financial support, family/social support). Works to ensure requirements for discharge are met.
psychiatric social worker
Helps clients develop independent functioning and vocational skills.
occupational therapist
Uses recreation to help clients redirect their destructive emotions/energy to healthy outlets (e.g., sports, exercise).
recreational therapist
Promotes positive, creative expression of thoughts, feelings, and emotions through music and art.
musical/arts therapist
Provides consultation on the nutritional needs of clients with nutritional deficits (e.g., a client with anorexia nervosa).
dietician
vulnerable groups to mental illness include:
1.
2.
3.
- homeless people (140,000 with mental illness)
- incarcerated population (440,000 suffer)
- active military and veterans (prone to PTSD)
who was born:1856
died: 1939
is the father of psychotherapy
sigmund freud
who was born 1875
died: 1961
carl jung
Most of our behaviors are driven by unconscious forces. These unconscious forces are often in _______________ with each other.
conflict
The most primitive part of the psyche. It operates on the ____pleasure___ principle. It pushes us to fulfill our basic, carnal desires
Id
Develops as the psyche matures. It operates on the _____reality_____ principle. The _______ helps the id find realistic ways to obtain (or delay) gratification.
Ego
Develops as a person incorporates values from parents and other respected figures. It operates on the ____moral______ principle. It helps restrain the shameful desires of the id and persuades the ego to pursue noble goals.
Superego
Reducing your pain by helping others.
Ex:Doing volunteer work for a suicide prevention organization after losing a loved one to suicide
altruism
Covering up a real or imagined weakness by emphasizing some other strength.
Ex:A student who is uncoordinated in sports works hard and excels in academics.
compensation
Converting strong emotional stress into a physical symptom.
Ex:Witnessing a violent murder and becoming blind—even though the eyes appear to function correctly.
conversion
Not acknowledging reality because it is too painful or difficult.
Ex: Being arrested twice for drunk driving but refusing to admit a drinking problem.
denial
Redirecting your anger at another object, person, or situation.
Ex.Yelling at your spouse when you are actually angry at your boss at work.
displacement
Temporarily losing your connection to the outside world to escape the pain.
Ex:A child who is being abused feels separated from her body, almost as if she is existing in a different realm.
dissociation
Attempting to improve feelings about self by emulating an admired person.
Ex:Dressing like a favorite professional athlete.
identification
Avoiding painful emotions by focusing on logic and reasoning.
Ex:Using cold, clinical terminology when describing a close relative’s health condition.
intellectualization
Attributing your own unacceptable thoughts, feelings, or behaviors to someone else.
Ex:Stealing money but then accusing that person of stealing from you.
projection
Justifying unacceptable feelings or behavior by giving excuses.
Ex:Cheating on an exam because the teacher has “unrealistic standards.”
rationalization
Feeling negative or unacceptable feelings but demonstrating the opposite.
Ex:Buying a gift for a coworker who grates on your nerves.
reaction formation
Returning to childlike, immature behaviors during a time of stress.
Ex: Stomping your feet and slamming the door when you get into a fight with your college roommate.
regression
Unknowingly pushing an unpleasant thought or memory out of your consciousness.
Ex: Being abused as a child but not remembering it as an adult.
repression
Seeing people, situations, or events as either completely good or completely evil.
Ex: Thinking your mother is absolutely evil because she grounded you for the weekend.
splitting
Redirecting unacceptable drives or passions into socially acceptable forms.
Ex:Taking out feelings of hostility or rage on the football field or some other rigorous workout.
Sublimation
Consciously deciding to ignore a thought, emotion, or desire.
Ex: Choosing to push the image of a dog getting run over out of your head.
suppression
Trying to reverse a negative or guilty feeling by doing something to make up for it.
Ex: Being extra friendly after being caught misbehaving.
undoing
______________ -using a predefine list of words to see what thoughts/images they spontaneously produce in the client. This is meant as a way to reveal subconscious processes.
free association
_____________ -keeping a dream journal and interpreting their meaning with the therapist.
dream analysis
____________ -using a set of ambiguous images (ink blots) and asking the client to describe them. This too is meant to elucidate hidden mental processes.
rorschach inkblot test
Notable behaviorist:
1.
2.
- John Watson
- B.F. Skinner
behaviorist believe _________ hypotheses about the mind, dreams, etc, are ____________ and unnecessary
freudian, unscientific
Behavior say psychological problems are caused by having _________ maladaptive responses. These behaviors can be unlearned
learned
Behavioral therapy techniques include:
1.
2.
3.
4.
5.
6.
7.
- operant conditioning
- token economies
- extinction
- modeling (role playing)
- systematic desensitization
- relaxation techniques (reciprocal inhibition)
- aversion therapy
Actions that are followed by rewards are strengthened and more likely to occur again.
operant conditioning
__________ systems in which behavior is regulated by emphasizing and rewarding positive behaviors and removing those rewards when misbehaving. This approach is commonly used in elementary schools.
token economies
This technique involves the intentional removal of a reward for a maladaptive behavior (which is sometimes given unintentionally) so as to decrease it’s likelihood of recurring. An example of this is teaching parents to ignore and walk away when a child throws a temper tantrum.
extinction
Teaching a client behavioral skills by acting out scenarios and practicing them.
modeling
A technique in which therapists help clients extinguish phobias by experiencing increasingly anxiety-provoking situations. Typically relaxation techniques are practiced during these exposures.
systemic desensitization
Teaching clients proven techniques that decrease anxiety and stress (e.g., deep breathing, progressive muscle relaxation, meditation, etc.).
relaxation techniques
Helping a client avoid a behavior by teaching a client to associate it with something negative. An example of this is prescribing disulfiram to treat alcoholism. Disulfiram works by causing extreme discomfort when the patient consumes alcohol.
aversion therapy
Notable cognitive-behavior therapist
1.
2.
- albert ellis
- aaron beck
Epictetus, the ancient Stoic philosopher, summarized the essence of cognitive-behaviorism: “Men are not disturbed by things, but by the __________ which they take of them.
view
CBT theorist emphasize the link between ___________, __________ and _________
thought, behaviors, emotions
CBT theorist believe mental disorders are caused by _________ ________
irrational patterns (cognitive distortions)
CBT: Cognitive distortion include:
1.
2.
3.
4.
5.
6.
- all or nothing thinking
- emotional reasoning
- magnification
- mental filter
- minimization
- personalization
This is sometimes called black-and-white thinking. Someone with anorexia nervosa might think, “If I eat one cookie, I’ll eat a hundred and become disgustingly obese.”
all or nothing thinking (cognitive distortion)
This fallacy involves mistaking one’s emotions or feelings as actual facts. It fails to recognize that emotions are often wrong. For example, emotions are greatly impacted by how much sleep we’ve had and if we are hungry. They are not very reliable.
emotional reasoning (cognitive distortion)
This is the error of blowing things hugely out of proportion. It is making a small problem into a crisis or catastrophe. For example, if a person you are in a relationship with forget to call you, you might falsely conclude they no longer care for you. Or perhaps they were in a terrible car accident!
magnification (cognitive distortion)
This is the error of focusing only on the negative aspects of situation and ignoring or discounting the positive ones. A common example is a person dismissing a compliment with the thought, “They are just saying that to be nice.
mental filter (cognitive distortion)
This is the error of making something of great importance into something small or trivial. It is the opposite of magnification.
minimization (cognitive distortion)
This error involves feeling bad or guilty about things you have little or no control over.
personalization (cognitive distortion)
CBT therapy techniques include:
1.
2.
3.
- education
- socratic questioning
- assertiveness training
Therapists aims to teach the client to be his or her own therapist. As such, they spend time teaching concepts and skills. They often assign homework.
education (CBT technique)
This is the technique of asking a series of focused but open ended questions that help clients discover unrecognized deeply held beliefs and values that are impacting the client.
socratic questioning (CBT technique)
Some clients need help standing up for themselves and creating healthy boundaries. It teaches client how to stick up for themselves without becoming overly aggressive.
assertiveness training (CBT technique)
One particularly powerful CBT technique is teaching a client to recognize that negative emotions involve a predictable pattern that can be challenged and changed is called?
cognitive restructuring (ABCD method)
Notable humanist
1.
2.
- Carl Rogers
- Abraham Maslow
Humanist therapist believe what?
the client will improve if the therapist can create the proper climate.
Rogers therapeutic factors include:
1.
2.
3.
- genuineness
- unconditional positive regard
- empathy
Roger’s believed constructive change is likely to occur if you are real/transparent with the client.
genuineness (humanist)
Rogers believed constructive change is likely to occur if you feel genuine caring/acceptance/prizing/love for the client
unconditional positive regard (humanist)
Rogers believed constructive change is likely to occur if you can understand the inner world of the client (i.e., see the world through the client’s eyes).
empathy (humanist)
Humanists believe people are ___________ motivated to meet their needs and reach their greatest potential (self-actualization)
inherently
Humanistic therapists do not act as authority figures or tell the client what to do. They create an atmosphere of __________, __________, and _________
trust, acceptance, empathy
Humanistic therapists are highly skilled in ________ listening
active
the ________________________ the therapist builds with the client is more important than the psychotherapeutic techniques used.
relationship
Humanist therapy is useful today in regard to forming __________ alliance with clients
therapeutic
_________ groups aim to provide information to group members (e.g., medication education, disease information). Nurses can lead many types of ________ groups
teaching, teaching
___________ groups are designed to help members to receive guidance and support from others who are undergoing (or have undergone) similar experiences. A classic example of a self-help group is Alcoholic Anonymous.
Self help
A classic example of a self-help group is Alcoholic Anonymous.
_______________ groups aim to help clients cope with a problem or mental illness. Leaders of this type of group must be knowledgeable in group processes and the topic/issue being discussed. Many psychiatric nurses lead ______________ groups.
supportive/therapeutic, supportive/therapeutic
____________ is an actual form of psychotherapy. Leaders of this therapy must have advanced education/training. Psychotherapy is performed (e.g., psychoanalysis, CBT, DBT).
group therapy
Yalom 11 therapeutic factors of group therapy include:
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
- instillation of hope
- universality
- altruism
- corrective recapitulation of the primary family group
- development of socializing techniques
- imitative behaviors
- interpersonal learning
- group cohesiveness
- catharsis
- existential factors
- imparting information
___________- Witnessing other members’ progress can help a person believe in their own ability to improve.
instillation of hope
__________ -People often feel like their problems are unique. Hearing others share similar experiences can be comforting and decrease feelings of isolation.
universality
_____________ -Group members often learn helpful coping strategies from each other.
imparting information
____________ -Helping other members is gratifying and increases a person’s feelings of self-worth.
altruism
___________________ -Sometimes a member can unconsciously transfer feelings toward their parents or siblings onto others. Group therapy provides an opportunity to identify and process these issues.
corrective recapitulation of the primary family group
_____________ -Group therapy provides opportunities to practice and enhance social skills. Group therapy can also help clients identify and change maladaptive social behaviors.
development of socializing techniques
___________ -Group members often imitate the therapist and to other members that are successfully dealing with problems.
imitative behaviors
____________ -Group therapy allows members to learn about relationships and experience intimacy. For many members, this provides important opportunities to experience healthy relationship dynamics.
interpersonal learning
_____________ -Members of therapeutic groups often form strong bonds. Although a personal identity is maintained, members also form a group identity.
group cohesiveness
____________ -The supportive nature of group therapy allows members to express positive and negative emotions. Sometimes these expressions are powerful and meaningful.
catharsis
____________ -Group therapy invites clients to take responsibility for the quality and direction of their lives.
existential factors
Group considerations:
1.
2.
3.
- seating arrangement (circular is best)
- group size ( ideal size is 12 or less)
- membership policies (can be open or closed policy)
Leadership style:_____________
These leaders are authoritative. They dictate the groups, policies, activities, and determine the group’s goals.
autocratic
Leadership style:_____________
These leaders seek participation from group members in determining policies, activities, and goals
democratic
Leadership style: ___________
These leaders have a hands-off approach. They allow the members to self-determine policies, activities, and goals.
laissez-faire
___________ teaches clients to experience thoughts as mere thoughts that come and go
Acceptance and commitment therapy (ACT)
__________ is the best treatment for borderline personality disorder. It is a modified version of CBT and was developed by ___________
dialectical behavior therapy (DBT), Marsha Linehan
______________ is an alternative to the 12 step framework. It is effective in treating addictions and motivating people to make positive lifestyle changes
motivational interviewing
____________ therapy emphasizes clients cannot be understood in isolation; they must be understood in the context of the interlocking relationships in which they belong. This approach teaches family members to explore their roles, how to change roles, ways to support each other, and how to build a healthier family system.
family systems
