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56 Cards in this Set

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3 models of healing
supernatural (mystic)
Custodial
community based
(February 27, 1920 – November 21, 1997) was an American psychologist, best known for his book The Origin of Consciousness in the Breakdown of the Bicameral Mind (1976), in which he argued that ancient peoples were not conscious (did not possess an introspective mind-space), but instead had their behavior directed by auditory hallucinations, which they interpreted as the voice of their chief, king, or the gods. Jaynes argued that the change from this mode of thinking (which he called the bicameral mind) to consciousness occurred over a period of centuries about three thousand years ago and was based on the development of metaphorical language and the emergence of writing.
Julian Jaynes
first American psychiatric nurse, instrumental in the establishment of a number of psychiatric hospitals and the first school of psychiatric nursing at the McLean Asylum in Waverly, Massachusetts in 1882.
Linda Richards
: December 25, 1821 – April 12, 1912) was a pioneer American teacher, nurse, and humanitarian. She has been described as having a "strong and independent spirit" and is best remembered for organizing the American Red Cross.
Clara Barton
applied interpersonal theory to nursing practice and most specifically to nurse-client relationship development. Provided a framework for “psycholodynamic nursing.” Coorelates the stages of personality development in childhood to stages through which clients advance during the progression of an illness.
Hildegard Peplau
emphasized the nurse-client relationship as the foundation of nursing practice. At the time, her research and emphasis on the give-and-take of nurse-client relationships was seen by many as revolutionary. Peplau went on to form an interpersonal model emphasizing the need for a partnership between nurse and client as opposed to the client passively receiving treatment (and the nurse passively acting out doctor's orders).
Peplau
lobbied tirelessly on behalf of the mentally ill population. Independently wealthy ; former school work. Gov’t and president to get 30 mental hospitals to get laws changed. oversaw nurses mental health during war only homely people work. Got state institutions going. (former schoolteacher who lobbied tirelessly on behalf of the mentally ill population. She was unfaltering in her belief that mental illness was curable and that state hospitals should provide humanistic therapeutic care.)
Dorothy Dix
wrote 1st psychiatric text book for nurses
Harriet Bailey
First medical hospital in Europe for mentally ill and first hospital in America for mentally ill
1st hospital for mentally ill in Europe-Valencia Spain. Had all Jewish physicians because Spanish inquisition.

1st hospital in America: Hospital for the Insane-Williamsburg, Virginia. (used shock therapy, humane therapy)
during the middle ages (500-1500A.D.) the association of mental illness with witchcraft and the supernatural continued to prevail in Europe. During this period many mentally ill people were sent out to sea on sailing boats with little guidance to search for their lost rationality.
Ships of Fools
St. Mary’s of Bethlehem: hospital in England that accepted mentally ill. Rich people would walk by and view the people.
Bedlam
covering up a real or perceived weakness by emphasizing a trait one considers more desirable
compensation
refusing to acknowledge the existence of a real situation or the feelings associated with it
Denial
the transfer of feelings from one target to another that is considered less threatening or that is neutral
displacement
attempting to make excuses or formulate logical reasons to justify unacceptable feelings or behaviors
rationalization
preventing unacceptable or undesirable thoughts or behaviors from being expressed by exaggerating opposite thoughts or types of behaviors
reaction formation
retreating in response to stress to an earlier level of development and the comfort measures associated with that level of functioning
regression
an attempt to increase self-worth by acquiring certain attributes and characteristics of an individual one admires
Identification
an attempt to avoid expressing actual emotions associated with a stressful situation by using the intellectual processes of logic, reasoning, and analysis
Intellectualization
the internalization of beliefs and values of another individual such that they symbolically become a part of the self to the extent that the feeling of separateness or distinctness is lost.
Introjection
the separation of a thought or a memory from the feeling tone or emotions associated with it (sometimes called emotional isolation)
Isolation
the attribution of feelings or impulses unacceptable to one’s self to another person. The individual “passes the blame” for these undesirable feelings or impulses to another, thereby providing relief from the anxiety associated with them.
Projection
the attempt to make excuses or formulate logical reasons to justify unacceptable feelings or behaviors.
Rationalization
prevention of unacceptable or undesirable thoughts or behaviors from being expressed by exaggerating opposite thoughts or types of behaviors
reaction formation
retreating to an earlier level of development and the comfort measures associated with that level of functioning
Regression
involuntary blocking of unpleasant feelings and experiences from one’s awareness.
Repression
rechanneling of drives or impulses that are personally or socially unacceptable into activities that are more tolerable and constructive.
Sublimation
voluntary blocking of unpleasant feelings and experiences from one’s awareness
Suppression
act of symbolically negating or canceling out a previous action or experience that one finds intolerable
Undoing
if one is not overwhelmed could be positive or negative stressor
Stress
coping strategies are considered maladaptive when the conflict being experienced goes unresolved or intensifies. Coping strategies: awareness, relaxation, meditation, interpersonal communication with a caring other, problem solving, pets
Stress Management
modest group of summary statements based on what you observe (Peplau). Ample sensory information.
Inductive Therapy
large group propositional statements based on minimal sensory info. Developed and interconnected through deductive logic. May be expected to contain incorrect details. Faults corrected through research.

Ex: Freud psychoanalytical theory. Quantum theory, general systems theory
Deductive Theory
called a model; depicts or explains relationships between things or events objects or functions that are different but share similar attributes. (consists of “as if” thinking)

(Calista Roy theory, Helson theory of adaptation and learning)
Analogic Theory
Orientation phase: start prep for resolution-exploring patient
Identification phase: accept patient and identify goals
Exploitation phase: do actual work
Resolution phase: goals accomplished; relationship ends
Phases of Peplau
Groundwork for termination of the professional relationship takes place
initial phase or orientation phase
more common; with peers. Both parties equal in this relationship. No predetermined goals. Can be platonic
Social Relationship
nurse and client work together toward the goal of assiting the client to regain the inner resources to meet life’s challenges and facilitate growth.
Professional Relationship
what patient says
subjective data
what you see
objective data
Standard nomenclature of emotional illness published by the American Psychiatric Association and used by all health care practicioners. It classifies mental illness and presents guidelines and diagnostic criteria for various mental disorders.
DSM-IV-TR: (Diagnostic and Statistical Manual of Mental Disorders, 4th ed. Text Revision)
A feature of the DSM-IV in which individuals are classified on the basis of five dimensions, or “axes,” that include the individual’s history and highest level of functioning in the last year. This system ensures that the individual will not merely be assigned to a mental disorder category, but instead will be characterized by a number of clinical factors
multi-axial system
there are no tests for mental illnesses. They cannot be diagnosed by checking the blood or body fluids of the person experiencing symptoms. There is hope that in the future scans of the brain, or some other test, will be used to confirm the presence of specific mental illnesses, but this is not yet possible. A diagnosis will usually be made by an experienced psychiatrist in working with other health professionals.
Criteria for diagnosis of Mental Illness
occurs when a patient unconsciously displaces ( or transfers) to the nurse feelings formed toward a person from his or her past. These feelings toward the nurse may be triggered by something about the nurse’s appearance or personality characteristics that remind the client of the person. Can also take the form of overwhelming affection for the nurse or excessive dependency on the nurse. The nurse is overvalued and the client forms unrealistic expectations of the nurse.
Transference
refers to the nurse’s behavioral and emotional response to the client. These responses may be related to unresolved feelings toward significant others from the nurse’s past, or they may be generated in response to transference feelings on the part of the client. These feelings can interfere with the therapeutic relationship
Cross-transference
highest in persons older than 50; adolescents are also at high risk. Males are at higher risk than females. Caucasians are at higher risk than Native Americans whoare at higher risk than African Americans. Single, divorced and widowed are at higher risk than married. Individuals in the highest and lowest socioeconomic classes at a higher risk than those in the middle classes. Professional health care personnel and business executives are at highest risk. Use of firearms presents a significantly higher risk than overdose of substances. Individuals not affiliated with any religious group; people with family history of suicide.
Suicide
how many people commit suicide each year in U.S.
30,000
Guilt and self -recrimination are other aspects of desperation. Found in Vietnam vets with PTSD exhibiting suicide behaviors.
veteran's risk factors
confused about own identity. In a relationship codependent person declares self-worth form that of the partner, whose feelings and behaviors etermine how the codependent should feel and behave.
1. Have a long history of focusing thoughts and behavior of other people.
2. Are “people pleasers” and will do almost anything to get the approval of others.
3. Seem very competent on the outside but actually feel quite needy, helpless, or perhaps nothing at all
4. Have experienced abuse or emotional neglect as a child
5. Are outwardly focused toward others, and know every little thing about how to direct their own lives from their own sense of self.
Traits of Codependency
concept arose out of aneed to define the dysfunctional behaviors that are evident among members of the family of a chemically dependent person. The term has been expanded to include all individuals from families that harbor secrets of physical or emotional abuse, other cruelties, or pathological conditions.
Codependency origniates
impaired in function, (of a trait or condition) failing to serve an adjustive purpose
dysfunctional
is a family in which conflict, misbehavior and even abuse on the part of individual members of the family occur continually, leading other members to accommodate such actions
dysfunctional family
have a need to be in control, often strive for unrealistic level of achievement, self worth comes from the feeling of being needed by others and of maintaining control over their environment. Nurture dependence of others, accept the responsibility for happiness and contentment of others. Rarely express true feelings, do what is necessary to preserve harmony and maintain control. At high risk for physical and emotional burnout.
Symptoms of a codependent nurse
1. Survival stage-must let go of the denial
2. Reidentification stage: accept the label of codependent and take responsibility for their own dysfunctional behavior.
3. The core issues stage: each partner must be independent and autonomous. Detach from the struggles of life,
4. The reintegration stage: relinquish the power over others that are not rightfully theirs but reclaim the personal power that they do not possess. Control is achieved through dicipline and self confidence.
treating codependence
Promotes a feeling of personal power.
Assertiveness: behavior that enables individuals to act in their own best interest, to stand up for themselves without undue anxiety, to express their honest feelings comfortably, or to exercise their own rights without denying those of others.
gained by assertiveness training
an exaggerated dependent pattern of learned behaviors, beliefs, and feelings that make life painful. It is a dependence on people and things outside the self, along with neglect of the self to the point of having little self-identity
Codependency