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168.263 > Week four > Flashcards

Week four Flashcards

1
Q

What are the principles of a therapeutic relationship?

A
  • Open communication
  • Working with the person’s priorities
  • Awareness of a contextual experience
  • Respect and privacy
  • Purposeful and professional
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2
Q

What is relational awareness?

A
  • Linked to self-esteem and self-awareness
  • To set up boundaries and work alongside a person experiencing distress we need to understand ourselves and our own responses in order to convey empathy and engage a person.
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3
Q

What is emotional labour?

A

Recognising and handling emotions at a personal level supports the capability to undertake and manage emotional aspects of nursing work-related issues

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4
Q

What is emotional competence?

A

The ability to become self aware, have regard for ourselves and work on aspects of our personal coping and emotional reactions so that we become more aware of how we operate with others

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5
Q

What are the stages of change?

A

1) Pre-contemplation
2) Contemplation
3) Determination
4) Action
5) Maintenance

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6
Q

What is the Moral Model?

A

Views addiction as a sin or a moral weakness

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7
Q

What is the Psychodynamic Model?

A

Asserts childhood traumas are associated with how we cope or do not cope as adults

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8
Q

What is the Disease Model?

A

Argues that the origins of addiction lie in the individual him/herself

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9
Q

What is the Social Learning Model?

A

Suggests that dependence behaviours are learned, exist on a continuum and consist of a number of behavioural and cognitive (thought) processes

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10
Q

What is the Public Health Model

A

Drug use seen as the interaction between the drug, the individual and the environment

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11
Q

What is the Socio-cultural Model?

A

Argues that substance abuse should be examined in a wider social context and can be linked to inequality

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12
Q

Why are drugs addictive?

A
  • Drugs of abuse such as alcohol, amphetamine, cocaine act as primary reinforcers
  • This operates directly through dopaminergic systems in the mesolimbic region
  • Some people find this hard to resist
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13
Q

What does the therapeutic intervention of pre-contemplation mean?

A

Raise doubt. Increase the client’s perception of risks and problems with current behaviour

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14
Q

What does the therapeutic intervention of contemplation mean?

A

Tip the balance. Evoke reasons for change and risks of not changing. Strengthen the client’s self-efficiency for change of current behaviour

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15
Q

What does the therapeutic intervention of determination mean?

A

Help client to determine the best course of action to take in seeking change

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16
Q

What does the therapeutic intervention of action mean?

A

Help the client to take steps forward

17
Q

What does the therapeutic intervention of maintenance mean?

A

Help the client to identify and use strategies to prevent relapse

18
Q

What does the therapeutic intervention of relapse mean?

A

Help the client to renew the processes of contemplation, preparation and action, without becoming ‘stuck’ or demoralised because of the relapse

19
Q

What are brief interventions?

A
  • Establish rapport through empathy
  • Focus on raising the issue (i.e. drug misuse)
  • Build commitment
  • Agree goal
  • Use self-monitoring and reinforcing feedback
20
Q

What are motivational interventions?

A
  • Opening strategy: Ask about lifestyle, stresses and problem behaviour
  • A typical day
  • The good things and the less good things about the current drug use
  • Current concerns
21
Q

What are risk factors?

A
  • Psychiatric disorders
  • Situational/adjustment, conduct, personality
  • Socio-economic - changes and pressure
  • Whanau/family instability
  • Abuse and neglect
  • Exposure to suicidal behaviour
  • Sexual orientation and identity crisis
  • Problematic behaviour
22
Q

How do you formulate risk for self harm?

A
  • Background - demographics, culture, history of violence
  • Current situation - stressors, previous coping
  • Risk factors - identification of sources of information, prioritisation
23
Q

How do you formulate risk for suicide?

A
  • Plan
  • Means
  • Method
  • Motivation
  • Lethality
24
Q

What are protective factors?

A
  • Optimistic attitude
  • Good current mental health
  • Responsibility for children or meaningful role
  • Strong supports interpreted by client
  • Supportive Whanau
25
Q

What are strength based questions for self-harm?

A
  • What are the coping and defence mechanisms that keep people alive
  • How are these coping mechanisms working or not
26
Q

How do you anchor the individual?

A
  • Associating feelings with memories
  • Creating anchoring to reframe contradictory states
  • Managing emotions
  • Seeing yourself as successful
  • Affirming yourself through positive self talk
  • Assuming posture and breathing
  • Using a stimulus associated with the desired state (reframing the view)
27
Q

How do you resolve the issue with the client?

A

1) Pre-contemplation - Resource state of mind for helper
2) Contemplation - Establish rapport
3) Action - Open up their model of the world
4) Leading to the desired outcomes: skill based interventions
5) Maintenance - Verify the change
6) Recycling - Relapse prevention

28
Q

What is risk?

A

Likelihood of an identified behaviour occurring in response to changing personal circumstances. The outcomes are more frequently harmful for self or others, although occasionally they may have a beneficial aim in pursuit of a positive change.

29
Q

What are precipitating factors for risk?

A
  • Interpersonal stress
  • Loss/separation
  • Anniversaries
  • Imprisonment or threat
  • School/work problems
  • Pregnancy
  • Move
  • Job loss
  • Exposure to suicidal behaviour
  • Cultural issues
  • Intoxication
30
Q

What are risk factors for violence?

A
  • Same as general population
  • Increased risk with severe mental illness when experiencing active psychosis
  • Risk further increased with symptoms and substance abuse
31
Q

When is disclosure of information appropriate?

A

When another’s life is immediately endangered and urgent action is required

32
Q

What are static risk factors?

A

Fixed risk factors:

  • Chronic medical illness
  • Childhood abuse/trauma
  • Brain injury
33
Q

What are dynamic risk factors - internal?

A

The individuals internal fluid risk factors:

  • Emotional states
  • Hallucinations
  • Suicidal thoughts
34
Q

What are dynamic risk factors - situational?

A

The individuals situational fluid risk factors:

  • Substance abuse
  • Major life events and/or loss
  • Poor social support
35
Q

What is CASE?

A

Chronological Assessment of Suicide Events

36
Q

What is the chronological structure of interview?

A

Structuring interviews by categories of time can provide coherence:

  • Historical → Past events, last 8 weeks
  • Current → Current mental states, presenting even

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