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23 Cards in this Set
- Front
- Back
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Yalom’s Curative Factors – what makes group helpful
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Instillation of hope – see others get better
Universality – others share my problem Education/information – about disease, management, where to get help Altruism - get a boost to self-esteem by trying to help others in same boat Re-experience and attempt to resolve earlier life conflicts – somebody in group might remind you of someone (mother) Development/correction of socialization skills Role modeling – emulate another in group, how to confront somebody Interpersonal learning – learn about self Group cohesion – be part of a group Catharsis – emotional cleansing |
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Role of RN in group therapy
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facilitate and encourage
keep group moving focus on specifics rather than generalizations change group leadership as needed use framework of nsg process |
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what makes a good group therapist
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Good group therapist pays attention to Process – how they interact, who responds a lot, who doesn’t talk. Try to incorporate others into the conversation. If someone rolls eyes or interrupts, you need to call them on it. Make lots of observations, noticed being fidgety don’t say you looked nervous
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advantages of group therapy
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cost effective
learn from others in group learn how to communicate/socialize |
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disadvantages of group therapy
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confidentiality is violated
clients may be shy or unable to participate in group |
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list the 11 affective signs of depression
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Flat affect
Despair Devoid of emotional tone Emptiness Hopelessness Helplessness Anhedonia Apathy Loneliness Worthlessness sadness |
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list the 7 behavioral signs of depression
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Psychomotor retardation/ agitation
Slumped posture Sitting in curled up position Walking slowly/rigidly Limited verbalization Decline in hygiene/ grooming Social isolation |
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list the 11 cognitive signs of depression
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Delusions (somatic most common)
Confusion Lose track of time Indecisiveness Impaired concentration Stop reading paper Hallucinations Self depreciated statements Self-blame Suicide ideation Hypersensitive Pessimistic guilt |
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list the 8 physiological signs of depression
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sluggish digestion
constipation urinary retention amenorrhea impotence/diminished libido anorexia/weight loss sleep changes feels worse in am |
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nursing diagnoses related to depression
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Risk for suicide
Dysfunctional grieving – R/T depression Low self esteem Powerlessness Social isolation Disturbed thought processes Imbalanced nutrition, less/more than body requirements Disturbed sleep Self-care deficit |
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which is the priority nursing diagnosis related to depression
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risk for suicide
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list some interventions for depression
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safety considerations
interpersonal/psychotherapy medications ECT |
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what are some safety consideration interventions for depression
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do a suicide assessment & provide level of observation that matches their need for safety
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what are some interpersonal/ psychotherapy interventions for depression
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help improve anger, self-esteem, problem solving
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other interventions for depression
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Withdrawl is their defense – do need company & companionship, sitting with them helpful, don’t approach in overly cheery manner, use therapeutic comm. To identify & name feelings, accept expressions of anger w/o being defensive, avoid compliments but make observations
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nutritional interventions for depression
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if they’re not eating enough offer more frequent small hi-calorie meals, monitor weights if this is an issue, teach about fiber in diet, appropriate fluids, might need stool softener/laxative
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interventions for disturbed sleep in depression
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encourage normal sleep/wake pattern, stay out of bed during day as much as possible to promote restful sleep at night
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S/S borderline personality disorder
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chronic depression w/suicidal gestures
inability to be alone (abandonment) clinging & distancing dependent, childlike splitting manipulation self-destructive behaviors impulsivity |
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nsg diagnoses for BPD
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risk for suicide
risk for injury impaired social interaction anxiety chronic low self-esteem powerlessness ineffective individual coping |
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nsg interventions for BPD
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Close observation, attitude of acceptance
Verbal contracting against cutting behavior If injury occurs, care matter-of-fact, no attention or sympathy Encourage them to talk about feelings they were having before SIB occurs (self-injurous behavior) Talk about feelings, anger Teach appropriate expression of anger Journaling is very helpful Explore abandonment fears Redirect violent behavior w/physical outlets Sufficient staff Meds prn 1:1 observation of suicidal Set limits, explain consequences Rotate staff to avoid dependence on one person Do not allow them to talk about other people |
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describe Dialectical Behavioral Therapy
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– focuses on developing life skills that decrease emotional dysregulation and unhealthy attempts to cope w/emotions
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symptoms of antisocial personality disorder
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Don’t conform to society rules, will exploit if they can, don’t have functioning superego (no guilt), disregard for authority & law, manipulative, low frustration tolerance, impulsive thrillseekers, immune to sense of danger
Defense mechanism is projection see themselves as victims Poor judgment, very egocentric If in a relationship only to use them Need for immediate gratification Manipulate on unit for special privileges Exploit people |
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interventions for antisocials
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Accept individual, not behavior
Develop trust relationship Matter-of-fact honesty Watch promises but keep word Low stimulus environment Watch closely (Q15) to be sure they aren’t bothering other people Help identify object of anger or hostility Work w/them to appropriately deal with anger/hostility Explore other ways to manage No special privileges, uphold unit rules Calm attitude, sufficient staff if necessary |
