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60 Cards in this Set

  • Front
  • Back
What are the phases of the therapeutic relationship?
Which phase of the therapeutic relationship consists of small talk before intro?
Pre-orientation phase
Which phase of the therapeutic relationship sets the scene for what's going to happen?
Orientation phase
What is discussed during the orientation phase?
Parameters of the relationship
Termination Begins
Which phase of the therapeutic relationship involves that actual work; explores pt feelings?
Working phase
Which phase of the therapeutic relationship summarizes goals and ends relationship?
Termination phase
Thoughts and feelings that a patient has toward the nurse/psychiatrist that are rooted in the pt's unconscious/repressed emotions/feelings toward people in his/her past?
Thoughts and feelings that a health provider has toward the patient that may be related to the pt's unconscious/repressed emotions/feelings toward people in his/her past?

0-18 in. between people
usually comfortable between parents and child
Intimate zone

18-36 in. between people
distance between family/friends talking
Personal zone

4-12 ft between people
distance for communication in social/work/business setting
Social Zone

12-25 ft between people
distance between speaker and audience/small groups
Public Zone
Functional-Professional Touch
Used in examinations or procedures
Social-Polite Touch
used in greeting, handshake, or when guiding someone
Friendship-Warmth Touch
Involves a hug or touch in shoulder
tight hugs and kissing
Tells the person what he should think, feel, or do. Implies that the person incapable of making decisions for him/herself. May result in a "Yes, but" interaction between both parties
Giving Advice
Tells the pt what he should think, feel, or do
ex.: "You need to..." "You should..."
Giving advice

Instead: "Have you considered..."

Sanctions the person's ideas or behavior which implies the opposite is "bad"
ex.: "I'm happy to see that you're feeling more cheerful and positive today"
Giving approval

Instead: "You seem more cheerful today, tell me about it"
Indicates there is not cause for anxiety. Devalues the patients feelings.
ex.: "I wouldn't worry about that problem. It'll work itself out in time."
Opposes the pts ideas and implies the s/he is wrong.
ex.: "Your plan won't work"
Asks the pt to provide reasons for thoughts, feelings, behavior and events
ex.: "Why do you feel this way?"
"How could act in such an inappropriate way?"
Requesting and explanation

Instead: "Help me understand what went into you acting in that way."
Minimizes the impact of feelings. Conveys that the person's feelings are not serious, unique or important.
ex.: :I know jut how you feel"
"Everyone feels that way."
Belittling the person's feelings
Implies that the pt has no right to express his feelings or opinions
ex.: I always listen to you. Why would you say such a thing?"
"This hospital is very well equipped to handle your health care needs"
(Often Abruptly) directs the conversation where the nurse wants it to go
ex.: Pt. "I'm so tired of feeling this way."
Nurse "Let's talk about something more positive like how you're responding to the medication"
Changing the subject

Instead.: "You sound very defeated and tired of feeling as you do. It must be frustrating. Let's take a moment to discuss the gains you've made since beginning the new medication"
Demands an explanation or questions the pt's motives
ex.: "What makes you think you'll do anything different this time?"
Challenging or Testing

Instead: "What are your thoughts about how you'll do this differently?"
Impose your perceptions on another
ex.: "You have unresolved issues with your father that you're continuing to act out with your abusive husband."

Instead: "How do you understand that you're living with an abusive man and that you were raised be one, too?"
Allows the pt to take initiative in introducing the topic
ex.: "How are things going"
"What would you like to talk about today?"
Giving broad opening
Indicated interest and encourages the pt to continue talking
ex.: "Go on"
"Then what happened"
Offering general leads
Encourages the pt to consider what s/he just said
ex.: pt "I'm really scared about what just happened"
nurse "You're really scared?"
States observation of the pts behavior. Encourages pt to describe his/her experience.
ex.: "You're trembling"
"You seem upset"
Sharing observation/perceptions
Attempts to voice the feelings that are being addressed, only indirectly
ex.: "Sounds like you're being really demoralized about that encounter"
Attempting to translate into feelings
Encourages verbal communication, permits time for thought and conveys respect
Provides facts/information the pt may benefit from.
ex.: "If you wish to leave before your doctor discharges you, you'll need to sign a 72 hr release."
Giving information
Voices what the pt has hinted or suggested.
ex.: pt "It's a waste of time for me to attend activities on the unit."
nurse "You don't feel like these activities are helpful?"
Verbalizing the implied
Seeks to make clear that which is not understandable.
ex.: "I'm not sure I understand how you think that not taking your medicine ultimately benefits you?"
Attempt to clarify the relationship of events in chronological order and to time
ex: "Was this before or after?"
When did this happen?"
Placing the event in time or sequence
Organizes and sums up what has been discussed
Concentrates on a single point or issue
ex: "Let's talk about how you really feel about having to take medication."
Expresses uncertainty as to the reality of the pt's perception
ex: "Well, I'm not sure that i understand that..."
"That's a very uncommon occurrence but tell me more..."
Voicing doubt
Delves further and deeper into a particular subject or idea
ex: "Tell me more about your experience at the clinic"
Repeats the main idea communicated and prevents misunderstandings
The unconscious exclusion of a painful thought, feeling, memory or impulse from awareness?
Conscious, deliberate forcing of unpleasant,anxiety-producing experiences from consciousness
An attempt to explain and/or justify one's idea, actions and feelings into a plausible, believable light. May sound like excuses; form of self-deception.
Discharge of pent up feelings onto something or someone else in the environment that is less threatening than the original source of the feelnig
Separation and detachment of emotional significance and affect from an idea or situation

ex: Rape victim describes her rape experience with a bland, flat affect.
Painful or anxiety producing experiences or realities are blocked from consciousness.

ex: Man reacts to son's death "No, this couldn't be so. The Dr. said he was fine."
Unconscious substitution of constructive and socially acceptable activity for unacceptable strong impulses. These impulses are often sexual or aggressive in nature.

ex: Hostility is displayed in sports or debate"
"A women with strong sexual impulse becomes a sculptor."
Attributing one's own unacceptable motives or characteristics to another person, group, objects or situations. Often sounds like blaming.

ex: Man is attracted to other women and blames wife of being flirtatious.
Returning to a previous level of adaptation

ex: A stressed adolescent curls up in bed with a teddy bear and wants to be nurtured by his mother
Unacceptable desires are kept from awareness by adopting the opposite behaviors in an exaggerated way.

ex: An individual shows extreme concern for someone he does not like
reaction formation
Overuse of abstract thinking, excessive details or generalization to control or minimize painful feelings.

ex: A man facing a divorce engages in a lengthy and lofty disclosure about divorce statistics and without mentioning feelings.
Atonement for or attempt to dissipate unacceptable acts or wishes.

ex: A women has an affair and then buys her husband an expensive watch.
Incorporation of the image of an emulated person, then acting, thinking and feeling like that person (unconscious mental mimicry)

ex: Gang members dress like their leader and steal like the leader does.
Counterbalances for deficiencies in one area be excelling in another.

ex: Man fails in sports but studies hard and excels academically
Deal with emotional conflicts or stressors by focusing on amusing aspects or ironic aspects with humor
Results in a polarized image of self/others as either all good or all bad

ex: Patient tells Nurse A she is the best, prettiest, etc and tells Nurse B she's the worst, meanest, etc
Devotion of self to serving others as a way to manage stressors; gratifying but not self-sacrificing.

ex: Nuns/priests serve others for unselfish reasons
Transforming anxiety on an unconscious level to a physical symptom that has no organic cause

ex: A doctoral student develops laryngitis on the day he is scheduled to defend his dissertation