Week 3 - test 1 Flashcards
Duncan (2014) found the number one predictive factor of success was the therapist’s ability to form a therapeutic ________________ with the client.
alliance connection
The ability to establish ___________ relationships with clients is one of the most important skills a nurse can develop
therapeutic
What makes a successful therapist? Duncan (2014) examined these factors:
1.
2.
3.
4.
5.
- Undergoing personal psychotherapy.
- Treatment approach used.
- Advanced degrees in counseling.
- Ongoing education.
- Years of experience.
the most important tool the psychiatric nurse has is his or her ________
self
Self assessment question:
1.
2.
3.
4.
1.what are your beliefs
2. what are your attitudes about mental health, etc,.
3. what do you most value in life
4. Are you able to respect the uniqueness of others.
The Johari window is a concept developed by Joseph Luft and Harrington Ingham that helps promote _______________
self-awareness
Social relationships are __________: they meet the needs of both parties.
reciprocal
Therapeutic relationships, however, focus solely on the ___________ well-being.
clients
In this phase, the nurse prepares for the interaction by obtaining information from the chart, the client’s family, or team members. The nurse should also examine any feelings that may interfere with working with this particular client.
Preinteraction phase
During the ___________ phase, the focus is on building trust and rapport, defining roles, and mutually determining goals. Sadly, most clients are discharged during this phase.
Orientation phase
If the therapeutic relationship is able to continue, the client and nurse will progress to the __________ phase. Here the focus is on working toward the selected goals. The nurse provides feedback and support during this process
working phase
During this final phase, the client and nurse review and acknowledge the progress that has been achieved. This phase can sometimes elicit negative emotions (e.g., anxiety, feelings of abandonment). It may be important to explore these feelings with the client.
termination phase
Roger’s Therapeutic Factor:
1.
2.
3.
- genuineness (congruence between what the nurse feels and expresses)
- unconditional positive regard ( belief that each human is worthy of respect, time, attention)
- empathy ( ability to look beyond behaviors to understand, but not emotionally.)
Accepting financial gifts is __________ appropriate
never
Nurse-client boundary breach red flag:
1.
2.
3.
4.
5.
6.
- Bringing work home (e.g., worrying about your client).
- Developing a social or personal relationship. (Never share your personal contact information.)
- Attempting to “rescue” the client.
- Encouraging the client to be dependent on you.
- Defending a client’s behavior to other staff members.
- Keeping secrets.
Causes of miscommunication:
1.
2.
3.
- ambiguity (language is ambiguous)
- culture
- noise (constant interference)
Nonverbal communication:
S
O
L
E
R
S- Sit squarely facing the client.
O -Open posture. Keep your arms and legs uncrossed.
L-Lean forward toward the client.
E- Eye contact. Use intermittent eye contact.
R - Relax. Sit calmly and quietly. Avoid restlessness and fidgeting.
Allowing the client to choose the topic of discussion is?
Ex:What would you like to talk about today?”
broad opening
Delving into a topic that seems useful to discuss is?
Ex:“Tell me more about that.”
exploring
Asking a client who is rapidly changing topics, to focus on a single idea or thought is? (Not appropriate if the client is extremely anxious.)
Ex:If it’s OK, I’d like to go back to something you said a moment ago.”
focusing
Encouraging the client to come up with a plan for dealing with a problem or future situation is ?
Ex:“You said you lost control of your temper. How would you like to handle that situation if it happened again?”
Formulation a plan of action
Giving short verbal or nonverbal encouragement for the client to continue talking is?
Ex: “Mmm. Hmm.” Nodding.
general leads
Noticing a positive behavior from the client is? (This is better than complimenting.)
Ex:“I see that you went to your group therapy session this morning.
giving recognition
Verbalizing your perceptions of the client is?
Ex:“You seem sad.” “I notice that you are staring at the ground.”
making observations
Making yourself available to the client. Offering your time, presence, and attention is?
Ex:“I’m interested in how you are feeling right now
offering self
Informing the client that his or her misperceptions are not real. Used when clients experience hallucinations. Should be done in a non-threatening, empathetic manner is?
Ex:“It must be frightening to experience that, but I do not hear those voices. It’s just you and me in this room.”
Presenting reality
Directing questions and feelings back to the client so they can be recognized and accepted is?
Ex:Client: “What should I tell my mother?”
Nurse: “You would like me to give you the answer to your predicament
reflecting
Repeating the main idea of what the client has said is?
Ex: Client: “I can’t work. Not when I’m so worried about everything.”
Nurse: “It’s hard for you to concentrate on anything but your anxiety.”
Restating
Seeking to understand what a client meant is?
Ex:“I’m not sure I follow. Could you explain that again?”
“Let me try to summarize what I’m hearing. Tell me if I’m off…”
seeking clarification
Allowing time for the client to gather thoughts, think through an issue, experience a strong emotion, etc is?
Ex: Remaining silent when a client becomes tearful and not seeking to “rescue” them by changing the subject.
silence
Putting into words what the client has only implied or hinted at is?
Ex: Client: “I won’t be a bother to people much longer.
Nurse: “Are you having suicidal thoughts?”
Verbalizing the implied
Expressing uncertainty regarding a client’s perceptions or beliefs. Used when clients express delusions. Should be done in a non-confrontational, nonjudgmental manner is?
Ex:“I understand you believe that to be true, but I suppose we see things differently.”
voicing doubt
Non-therapeutic techniques:
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2.
3.
4.
5.
6.
7.
8.
9.
10.
- advice giving
2.moralizing - belittling the client’s feelings
- defending
- false reassurances
- interpreting
- introducing an unrelated topic
- probing
- stereotyped comments
- why questions
Telling the client what you do is?
ex: “You should find a hobby you enjoy.”
advice giving
Approving or disapproving of a client’s ideas or behaviors is?
Ex: Do you think that was the responsible thing to do?”
moralizing
Communicating to a client that you do not believe their feelings are legitimate is?
Ex:Client: “This disease has ruined me.”
Nurse: “Things could be a lot worse. At least you’re still alive.”
belittling the client’s feelings
Attempting to protect someone or something from the client’s criticism. Reveals a lack of empathy and encourages the client to double down in their criticism is?
Ex: “Your doctor wouldn’t lie to you. He’s one of the best doctors in this region.”
defending
Attempting to calm a client’s concerns by asserting that will be a good outcome. Minimizes the client’s concerns and discourages communication is?
Ex: I’m sure the test results will turn out just fine.”
false reassurances
Attempting to force a meaning or interpretation onto a client is?
Ex: “I think there’s something else going on under the surface here. What you really mean is…”
interpreting
Changing the topic. Gives evidence of poor listening skills or a desire to keep the conversation superficial is?
Ex:Client: “Ever since the accident I’m afraid to face people at work.”
Nurse: “Are you in a lot of physical pain?”
introducing an unrelated topic
Persistent questioning of the clients is?
Ex:Client: “This is the third time I’ve attempted suicide after my wife’s death.”
Nurse: “How long were you married?”
Client: “18 years.”
Nurse: “How did you meet?”
Client: “We met in college.”
Nurse: “What college did you go to?”
probing
Clichés. Discourages the client from expressing heavy thoughts or emotions is?
Ex: “Everything happens for a reason.”
“If God brought you to it, he’ll see you through it.”
stereotyped comments
Asking the client to explain or defend his or herself to the nurse. Does not build rapport is?
Ex:“Why did you stop going to your recovery group?
why questions
The ________________ involves asking lots of questions (usually closed questions).
questioning cycle (best:interview, worst: invasion of privacy)
Active listening benefits:
1.
2.
3.
- boosts self esteem
- empowers the client to solve problems
- enables the client to clarify thinking, link ideas, and decide what should be done
focusing on what the client is saying, instead of asking questions is?
active listening
