Mental Health Exam 1

Front 1

Grief

Back 1

The subjective state of emotional, physical, and social responses to the loss of a valued entity; the loss may be real or perceived.
Resolution of the grief response is thought to occur when an individual can look back on the relationship with the lost entity and accept both the pleasures and the disappointments of the association.

Front 2

5 Stages of Grief

Back 2

Denial
Anger
Bargaining
Depression
Acceptance

developed by Kubler-Ross

Front 3

Peplau’s four levels of anxiety

Back 3

Mild - seldom a problem
Moderate - perceptual field diminishes
Severe - perceptual field is so diminished that concentration centers on one detail only or on many extraneous details
Panic - the most intense state

Front 4

Anxiety

Back 4

A diffuse apprehension that is vague in nature and is associated with feelings of uncertainty and helplessness

Front 5

Hans Selye

Back 5

defined stress as “the state manifested by a specific syndrome which consists of all the nonspecifically induced changes within a biologic system.”
“Fight-or-flight” syndrome

Front 6

Maslow identified

Back 6

A “hierarchy of needs”
Self-actualization as fulfillment of
one’s highest potential

Front 7

The Fight-or-Flight Syndrome

Back 7

Initial stress response
Sustained stress response
Sustained physical responses to stress promote
susceptibility to diseases of adaptation

Front 8

Adaptation

Back 8

is determined by the extent to which the thoughts, feelings, and behaviors interfere with an individual’s functioning.

Front 9

DSM-IV-TR Multiaxial Evaluation System

Back 9

Axis I - Clinical disorders and other conditions that may be a focus of clinical attention
Axis II - Personality disorders and mental retardation
Axis III - General medical conditions
Axis IV - Psychosocial and environmental problems
Axis V - The measurement of an individual’s psychological, social, and occupational functioning on the GAF Scale

Front 10

defense mechanisms

Back 10

At the mild to moderate level, the ego calls on defense mechanisms for protection, such as
Compensation
Denial
Displacement
Identification
Intellectualization
Introjection
Isolation
Projection
Rationalization
Reaction formation
Regression
Repression
Sublimation
Suppression
Undoing

Front 11

Anxiety at the moderate to severe level

Back 11

that remains unresolved over an extended period can contribute to a number of physiological disorders--for example, migraine headaches, irritable bowel syndrome, and cardiac arrhythmias.

Front 12

Extended periods of repressed severe anxiety

Back 12

can result in psychoneurotic patterns of behaving--for example, anxiety disorders and somatoform disorders.

Front 13

Extended periods of functioning at the panic level of anxiety

Back 13

may result in psychotic behavior; for example, schizophrenic, schizoaffective, and delusional disorders.

Front 14

Self Awareness

Back 14

A process by which the therapist gains recognition of his/her own feelings, beliefs and attitudes and the impact these may have on therapist-client interactions.
At times, therapist’s values may be in conflict with those held by the client.
The therapist should not impose his/her values on the client.

Front 15

therapeutic interpersonal relationship

Back 15

the process by which nurses provide care for clients in need of psychosocial intervention.

Front 16

GAF Scale

Back 16

is a numeric scale (0 through 100) used by mental health clinicians and physicians to subjectively rate the social, occupational, and psychological functioning of adults, e.g., how well or adaptively one is meeting various problems-in-living. The scale is presented and described in the DSM-IV-TR on page 34.

Front 17

Conditions Essential to Development of a Therapeutic Relationship

Back 17

Trust
Rapport
Respect
Genuineness
Empathy
Acceptance of person
Unconditional Positive Regard

Front 18

Phases of a Therapeutic Relationship
Pre-interaction phase

Back 18

Examine one’s own feelings, fears, and anxieties about working with a particular client.

Front 19

Phases of a Therapeutic Relationship
Orientation (Introductory ) Phase

Back 19

nurse and client meet and roles established
purposes and parameters of future meetings established
expectations are clarified and client’s problems identified
nurse builds trust, may establish a contract, and discusses confidentiality and need to share information with the treatment team.

Front 20

Phases of a Therapeutic Relationship
Working Phase

Back 20

Ongoing problem identification
examination of client’s feelings and responses to identified issues and problems
development of coping strategies, behavior change, increase in self esteem and independence
during this phase, may see transference and counter-transference.
Therapeutic work is accomplished.

Front 21

Phases of a Therapeutic Relationship
Termination or Resolution Phase

Back 21

occurs when mutually agreed upon goals are met or issues are resolved.
when the relationship is terminated for some other reason, like hospital discharge.
New material is not raised during the termination phase
must deal with feelings of anger and/or abandonment that may occur.

Front 22

Behaviors that diminish therapeutic relationships

Back 22

Inappropriate boundaries
feelings of sympathy rather than empathy
encouraging client dependency
non-acceptance of a client as person

Front 23

Working Phase Problems
Transferance

Back 23

client unconsciously transfers to the nurse feelings and behavioral predispositions formed
From the person from his or her past (Saddock 7 Saddock, 2007).
Triggered by things like nurse’s appearance or personality.
Can translate into anger, affection, excess dependency on the nurse.

Front 24

Working Phase Problem
Cross Transference

Back 24

Cross Transference - refers to nurse’s behavioral and emotional response to the client.
Nurse:
Over-identifies with client’s feelings.
Develops a social or personal relationship with client.
Encourages client dependence.
Has difficulty setting limits with client.

Front 25

Boundaries in Nurse-client Relationship

Back 25

Material: physical boundary
Social: established within a culture & define how an individual is expected to behave.
Personal: defined by the individual and include physical and emotional boundaries like how closely they stand with another and how much they want to express their emotions.
Professional: limit & outline expectations for appropriate professional relationships with clients.

Front 26

Problem –Solving Model

Back 26

Identify what is troubling the client @ this time.
2.Encourage client to discuss changes they would make.
3. Discuss which changes are possible & which ones are not and their feelings.
4. Help client explore alternative ways of coping.
5. Discuss strategies and alternatives the client desires.

Front 27

Problem –Solving Model (con't)

Back 27

6. Weigh the benefits & consequences of each.
7. Assist client to select an alternative.
8. Encourage them to implement the change.
9. Provide positive feed-back for the client’s attempts to create change.
10.Assist client to evaluate outcomes of the change & modify as needed.

Front 28

Therapeutic Communication

Back 28

An interpersonal interaction between the nurse and client during which the nurse focuses on the clients specific needs to promote an effective exchange of information

Front 29

Therapeutic communication techniques

Back 29

Offering self
silence
reflection
exploring
restating
clarifying