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Psych

The document discusses various psychiatric treatments including therapeutic communication, nurse-client relationships, therapeutic interventions, defense mechanisms, electroconvulsive therapy, and psychopharmacology. It also outlines basic principles of psychiatric nursing and techniques for therapeutic communication during client interviews. Various therapies and their characteristics are defined such as group therapy, family therapy, psychodrama, and reality therapy.

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Mhiane Noto
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93 views

Psych

The document discusses various psychiatric treatments including therapeutic communication, nurse-client relationships, therapeutic interventions, defense mechanisms, electroconvulsive therapy, and psychopharmacology. It also outlines basic principles of psychiatric nursing and techniques for therapeutic communication during client interviews. Various therapies and their characteristics are defined such as group therapy, family therapy, psychodrama, and reality therapy.

Uploaded by

Mhiane Noto
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPT, PDF, TXT or read online on Scribd
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PSYCHIATRIC TREATMENTS

1.Therapeutic Communication 2. Nurse-Client Relationship 3. Therapeutic Interventions 4. Defense Mechanisms 5. Electroconvulsive Therapy 6. Psychopharmacology

BASIC PRINCIPLES OF PSYCHIATRIC NURSING 1. All behaviors has purpose and is meeting the needs of the individual 2. Accept and respect the client regardless of his behavior 3. Limit or reject the inappropriate behavior but not the individual. 4. Recognize and accept the dependency needs of the client while encouraging and supporting moves toward independence. 5. Encourage and support expression of feelings in a safe and non-judgmental environment. 6. Recognize that the client needs to use his defense mechanisms until other defenses can be substituted with more appropriate ones. 7. Behaviors are learned. 8. All behaviors have meanings.

CHARACTERISTICS OF THERAPEUTIC COMMUNICATION 1. 2. 3. 4. 5. 6. 7. 8. Clear Contain words that can be understood Allows for a response from the client Deals with cognitive and emotional aspects of the client Consistent Implies the same message through time Direct Contains the essential points that need to be communicated

DURING CLIENT INTERVIEW ..


IF THE BEHAVIOR OF THE CLIENT IS: THE FOCUS OF THE INTERVIEW IS:

Withdrawn Depressed Aggressive Presence of psychosomatic complaints Delusional Hyperactive

Non-verbal behavior Eliciting the client s suicidal plan Setting limits Assuring client that complaint is real. Not challenging the delusion directly Setting limits

TECHNIQUES OF COMMUNICATION
TECHNIQUES ACCEPTING CLARIFYING EXPLORING FOCUSING EXAMPLES I accept what you said. What do you mean by what you just said? Tell me more about your thoughts . Sabihin mo sa akin kung sino yung binabanggit mong sila

TECHNIQUES OF COMMUNICATION
TECHNIQUES
GIVING BROAD OPENINGS GIVING INFORMATION GIVING RECOGNITION OFFERING ONE S SELF

EXAMPLES Ano ang nasa isip mo ngayon?. The reason of my being here is I notice you ve combed your hair Let me stay here with you

TECHNIQUES OF COMMUNICATION
TECHNIQUES
OFFERING GENERAL LEADS OBSERVING

EXAMPLES Tell me about that I notice that you re biting your nails Kailan ito nangyari? I understand that hearing a voice is real to you, but I don t hear it.

PLACING THE EVENT IN TIME OR IN SEQUENCE PRESENTING REALITY

TECHNIQUES OF COMMUNICATION
TECHNIQUES
RESTATING

EXAMPLES
CLIENT : I stayed awake all night NURSE : Are you saying that you have difficulty sleeping? CLIENT: I can t imagine that my friend can do this to me. NURSE: This causes you to feel angry We can talk about how you are coping with your anxiety. In the past thirty minutes, you and I have talked about .

REFLECTING

SUGGESTING COLLABORATION SUMMARIZING

TECHNIQUES OF COMMUNICATION
TECHNIQUES
USING SILENCE VALIDATING

EXAMPLES

Tell me whether my interpretation of what I thought you said is what you really mean.

COMMON PROBLEMS IN THE NCR 1. RESISTANCE ambivalent attitude towards self-exploration 2. TRANSFERENCE development of feelings, either positive or negative, by the client towards the nurse. 3. COUNTER-TRANSFERENCE development of feelings by the nurse towards the client.

PRE-INTERACTION PHASE Begins when the nurse is assigned to a client Client is excluded as an active participant Nurse feels a certain degree of anxiety Includes all the things the nurse thinks and does before interacting with the client. MAJOR TASK OF THE NURSE self-awareness. Develop

ORIENTATION PHASE Begins when the nurse and the client interact for the first time Parameters of the relationship are set The nurse begins to know about the client The client tests the nurse s sincerity Client s questions are focused on the nurse MAJOR TASK OF THE NURSE mutually acceptable contract. Develop

WORKING PHASE Highly individualized More structured than the orientation phase The longest and most productive phase of the NCR Limit setting is employed.

MAJOR TASK OF THE NURSE Resolve the client s problems.

Identify and

TERMINATION PHASE A gradual weaning process A mutual agreement Involves feelings of anxiety, fear and loss Should be recognized in the orientation phase.

MAJOR TASK OF THE NURSE Assist the client to review what he has learned and transfer his learning to his relationship with others.

THERAPEUTIC INTERVENTIONS
1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. GROUP PSYCHOTHERAPY FAMILY THERAPY PSYCHODRAMA CRISIS INTERVENTION PLAY THERAPY LOGO THERAPY REALITY THERAPY BEHAVIOR THERAPY GESTALT THERAPY RECREATIONAL THERAPY OCCUPATIONAL THERAPY MUSIC THERAPY COGNITIVE THERAPY HORTICULTURAL THERAPY REMOTIVATION THERAPY ART THERAPY VOCATIONAL THERAPY

3.1. GROUP THERAPY


A psychotherapy that involves selected group of individuals for the purpose of assisting each individual to attain emotional growth and personal problem-solving.

3.2. FAMILY THERAPY


A psychotherapy indicated for treatment of family problems through improved communication.

3.3. PSYCHODRAMA
Involves the use of role training, actions and group dynamics to facilitate constructive change in the client s life.

3.4. CRISIS INTERVENTION


Problem-solving method aimed to assist the individual to develop new coping skills and return to the pre-crisis level of functioning.

3.5. PLAY THERAPY


Therapeutic use of play to provide opportunities to a child to experience feelings and emotions in a safe environment.

3.6. LOGO THERAPY


Meaning-oriented therapy that enables an individual to develop a meaningful, fulfilling life.

3.7. REALITY THERAPY


Problem-solving method that focuses on the here-and-now of the client to enable them to focus on changing their own behaviors and thoughts.

3.8. BEHAVIOR THERAPY


Structured approach that reinforces an individual s positive behavior.

3.9. GESTALT THERAPY


Involves encouraging individuals to develop a sense of awareness of his/her feelings and behaviors and their effects upon his/her environment in the present time.

3.10. RECREATIONAL THERAPY


Therapeutic process that utilizes recreation to improve an individual s quality of life.

3.11. OCCUPATIONAL THERAPY


Incorporates meaningful and purposeful occupation to enable people with limitation and impairment to participate in the activities of everyday life.

3.12. MUSIC THERAPY


The prescribed us of music to effect positive changes in an individual with health or educational problem.

3.13. COGNITIVE THERAPY


Involves identifying distorted thinking (irrational thoughts) and learning and replacing it with more realistic ideas.

3.14. HORTICULTURAL THERAPY


Use of plants and plant-related activities to improve mobility, balance, endurance, socialization and memory skills.

3.15. REMOTIVATION THERAPY


Simple group therapy that focuses on client s abilities and enables them to think about reality in relation to themselves.

3.16. ART THERAPY


Therapeutic use of making art to increase awareness of self and others, cope with stress, trauma and enhance cognitive abilities.

3.17. VOCATIONAL THERAPY


Process that involves assessment of skills and provision of vocational training to enable an individual with a mental health problem to have a job.

VAILLANT S FOUR LEVELS OF DEFENSE MECHANISMS

LEVEL I (Psychotic Mechanisms) - Common in healthy individuals before age 5. 1. Delusional Projection 2. Denial 3. Distortion

VAILLANT S FOUR LEVELS OF DEFENSE MECHANISMS

LEVEL II (Immature Mechanisms) - Common in healthy individuals ages 3 - 15. 1. 2. 3. 4. 5. Projection Schizoid Fantasy Hypochondriasis Passive-Aggressive Behavior Acting-out

VAILLANT S FOUR LEVELS OF DEFENSE MECHANISMS

LEVEL III(Neurotic Mechanisms) - Common in healthy individuals aged 3 - 90. 1. 2. 3. 4. 5. Intellectualization Repression Displacement Reaction Formation Dissociation

VAILLANT S FOUR LEVELS OF DEFENSE MECHANISMS

LEVEL IV (Mature Mechanisms) - Common in healthy individuals aged 12 - 90. 1. Altruism 2. Humor 3. Sublimation

5. ELECTROCONVULSIVE THERAPY
Is the application of electrical current of 70 to 150 volts on client s temporal lobe. The electrical shock is applied to the client in about 0.5 to 2 seconds. The procedure usually takes 10 to 15 minutes to complete. Usually administered 3x a week with 48 hours interval, usually early in the morning. CANDIDATES: Severely depressed patients for whom psychotherapy & medication have proven ineffective Patients at immediate risk for suicide Patients with certain schizophrenic syndromes

CONTRAINDICATIONS TO ELECTROCONVULSIVE THERAPY


Fever Cardiac arrythmias Tb with history of hemorrhage Recent fracture Retinal detachment Pregnancy (with complications) Increased ICP (absolute contraindication)

PRE-MEDICATIONS TO ECT
ATROPINE SULFATE - to decrease secretions ANECTINE (Succinylcholine) - to promote muscle relaxation BREVITAL (Methohexital Sodium) - anesthetic agent

COMPLICATIONS OF ECT
Loss of memory Headache Apnea Fracture Respiratory depression

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