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Mental Health Unit 1 Review
Terms in this set (82)
process of interaction btw. people in which symbols are used to create, exchance, and intepret messages about idead, emotions, and mind states
health care quality, culture, safety, collaboration, care coordination
what are the interrelated concepts for communication?
therapeutic communicaton, therapeutic relationships, therapeutic groups, milieu therapy
what are the 4 exemplars for communication?
need for info, comfort, or advice
is sent or expressed
variety of media
interprets and responds through feedback
stimulus, sender, message, channel, receiver
what does the communication process involve?
personal, environmental, relationship
what factors affect communication?
lack of privacy, loud background noises, uncomfortable accomodations
what are examples of environmental factors?
language barriers, cognitive abilities, tone, mood, body language
what are examples of personal factors?
level of equality
what is an example of a relationship factor?
mutually contradictory messages, usually given by a person in power
paraphrasing, restating, reflecting, exploring
what are the diff. types of clarifying techniques?
open-ended, closed-ended, projective, "miracle"
what are the categories of questions ?
which type of question usually elicits a one-word response?
therapeutic use of self
the ability to use personality consciously in full awareness, attempt to establish relatedness, and structure nursing interventions
facilitate, assist, help, promote
what are the goals of the nurse-patient relationship?
needs of a patient are identified and explored, clear boundaries established, problem-solving approaches taken, new coping skills developed, behavioral change encouraged
what occurs in a therapeutic relationship?
physical boundaries, the contract, personal space
what establishes boundaries?
relationship slips into social context, nurse's needs are met at expense of patient's needs
when do boundaries begin to blur?
patient unconsciously and inappropriately displaces onto nurse feelings and behaviors related to significant figures in their past
nurse displaces feelings related to people in nurse's past onto patient
over-identification with the patient
what is a common sign of countertransferance?
preorientation, orientation, working, termination
what are peplau's phases of the therapeutic nurse-client relationship?
at what phase do you obtain info about the patient + examine one's own feelings, fear, and anxieties about working with the patient?
at what phase do you establish rapport, boundaries, contracts, confidentiality, and terms of termination?
at what phase do you maintain trust and rapport, gather further data, and promote patient's problem-solving, self-esteem, and use of language?
at what phase do you summarize goals and objectives achieved, discuss ways for patient to incorporate new coping strategies learned, review situations of relationship and exchange memories?
consistency, pacing, listening, initial impressions
what factors help nurse-patient relationships?
Trust, active participation
what factors promote patient comfort and balancing control?
genuineness, empathy, positive regard, attending, suspending value judgements, helping patients develop resources
what factors promote patient growth?
refers to any group of people who meet together for personal development and psychotherapeutic growth
catharsis, universality, altruism
what therapeutic factors are common in group therapy?
planning, orientation, working, termination
what are the phases of group development?
which phase of group development is this?: -Leader and members work together to establish rules and goals for the group.
-Leader promotes trust and ensures that rules do not interfere with fulfillment of the goals.
-Members are superficial and overly polite; trust has not yet been established.
what phase of group development is this?: -The name of the group
-Objectives of the group
-Types of patients (e.g., diagnoses, age, gender) for inclusion
-Leader and member responsibilities
-Methods of evaluating outcomes
what phase of group development is this?: ØProductive work undertaken to fulfill group task
ØLeader role diminishes; leader becomes facilitator
ØTrust is established between the members; cohesiveness exists
ØConflict is managed by group members
what phase of group development is this?: ØGroup members experience sense of loss and grief
ØLeader encourages members to discuss feelings of loss and reminisce about group accomplishments
ØFeelings of abandonment experienced by some members; grief for previous losses triggered
autocratic, democratic, laissez-faire
what are the 3 leadership styles?
exerts control over the group and doesnt encourage much interaction
supports extensive group interaction in the process of problem solving
allows the group members to behave in any way they choose and does not attempt to control
refers to physical and social environment
psychiatric philosophy that involves a secure environment including people, settings, structure, and emotional climate to effect positive change
-The health in each individual is to be realized and encouraged to grow.
-Every interaction is an opportunity for therapeutic intervention.
-The client owns his or her own environment.
-Each client owns his or her own behavior.
-Peer pressure is a useful and powerful tool.
-Encourage positive behaviors and discourage negative ones
-Inappropriate behaviors are dealt with as they occur.
-Restrictions and punishment are to be avoided.
name some basic assumptions of milieu therapy
basic needs met, democratic form of self-govt., responsibilities assigned according to patient capabilities, structure program with activities scheduled as part of the treatment program, community and family included in therapy to facilitate discharge from treatment
what are the conditions that promote a therapeutic community?
which communication technique does this describe?: gives the person time to collect thoughts or think through a point
which communication technique does this describe?: indicates that the person has been understood. an accepting statement does not necessarily indicate agreement but is nonjudgemental
which communication technique does this describe?: indicates awareness of change and personal efforts. Does not imply good or bad, right or wrong.
which communication technique does this describe?: offers presence, interest, and a desire to understand. is not offered to get the person to talk or behave in a specific way
offeirng general ideas
which communication technique does this describe?: allows other person to take direction in the discussion. indicates that the nurse is interested in what comes next.
giving broad openings
which communication technique does this describe?: clarifies that the lead is to be taken by the patient. still, the nurse discourages pleasantries and small talk.
placing the events in time or sequence
which communication technique does this describe?: puts events and actions in better perspective. notes cause-and-effect relationships and identifies patterns of interpersonal difficulties
which communication technique does this describe?: calls attn. to person's behavior. encourages patient to notice the behavior and describe thoughts and feelings for mutual understand. helpful with mute and withdrawn people.
encouraging descrption of perception
which communication technique does this describe?: increases nurse's understanding of the patient's perceptions. talking about feelings and difficulties lessen the need to act them out inappropriately
which communication technique does this describe?: brings out recurring themes in experiences or interpersonal relationships. helps the person clarify similarities and differences.
which communication technique does this describe?: repeats the main idea expressed. gives patient an idea of what's been communicated. if the msg has been misunderstood, they can clarify it.
which communication technique does this describe?: directs questions, feelings, and ideas back to the patient. encourages the patient to accept his or her own ideas and feelings. acknowledges the patient's right to have opinions and make decisions and encourages the patient to think of self as a capable person.
which communication technique does this describe?: concentrates attn. on a single point. it's especially useful when the patient jumps from topic to topic. if the person is experiencing a severe or panic level of anxiety, the nurse should not persist until the anxiety lessens
which communication technique does this describe?: examines certain ideas, experiences, or relationships more fully. if the patient chooses not to elaborate by answering no, the nurse does not probe or pry. in such a case, the nurse respects the patient's wishes.
which communication technique does this describe?: makes facts the person needs available. supplies knowledge from which decisions can be made or conclusions drawn.
which communication technique does this describe?: helps patients clarify their own thoughts and maximize mutual understanding between nurse and patient.
which communication technique does this describe?: indicates what is real. the nurse does not argue or try to convince the patient, just describes personal perceptions or facts in the situation.
which communication technique does this describe?: expressing uncertainty regarding the reality of the patient's perceptions or conclusions especially in hallucinations and delusions
seeking consensual validation
which communication technique does this describe?: clarifies that both the nurse and patient share mutual understanding of communication. helps the patient become clearer about what he or she is thinking
verbalizing the implied
which communication technique does this describe?: puts into concrete terms what the patient implies, making the patient's communication more explicit
which communication technique does this describe?: aids patient in considering other persons and events from the perspective of patient's own set of values
attempting to translate into feelings
which communication technique does this describe?: respond to the feelings expressed, not just the content. often termed decoding.
which communication technique does this describe?: emphasize working with the patient, not doing things for the patient. encourages the view that change is possible through collaboration
which communication technique does this describe?: brings together important points of discussion to enhance understanding. also allows the opportunity to clarify communications so that both nurse and patient leave the interview with the same ideas in mind.
encouraging formulation of a plan of action
which communication technique does this describe?: allows the patient to identify alternative actions for interpersonal situations the patient finds disturbing (e.g. when anger and anxiety is provoked)
giving premature advice
which nontherapeutic communication technique is this?: Assumes the nurse knows best and the patient can't think for self. Inhibits problem solving and fosters dependency.
which nontherapeutic communication technique is this?: indicates the nurse is unable to understand or empathize with the patient. here the patient's feelings are being belittled, which can cause the patient to feel small or insignificant
which nontherapeutic communication technique is this?: underrates a person's feelings and belittles a person's concerns; may cause patient to stop sharing feelings if the patient thinks he or she will be ridiculed or not taken seriously
making value judgements
which nontherapeutic communication technique is this?: prevents problem solving. can make patient feel guilty, angry, misunderstood, not supported, or anxious to leave
Asking "why" questions
which nontherapeutic communication technique is this?: implies criticism, often has the effect of making the patient feel defensive
asking excessive questions
which nontherapeutic communication technique is this?: results in patient's not knowing which question to answer and possible being confused about what is being asked
giving approval, agreeing
which nontherapeutic communication technique is this?: implies the patient is doing the right thing and that not doing it is wrong; may lead patient to focus on pleasing the nurse or clinician; denies patient the opportunity to change his or her mind/decisiion
which nontherapeutic communication technique is this?: can make a person defensive
changing the subject
which nontherapeutic communication technique is this?: may invalidate the patient's feelings and needs; can leave the patient feeling alienated and isolated and increase feelings of hopelessness
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