Term
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Definition
| successful performance of mental functions, resulting in the ability to engage in productive activities, enjoy relationships, cope with adversity |
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Term
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Definition
| a clinically significant behavioral or psychological syndrome experienced by a person and marked by distress, disability, or the risk of suffering a disability or loss of freedom (APA, 2000) |
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Term
| How do concepts of normal mental health change over time? |
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Definition
-Reflect change in:
Cultural norms
Society’s expectations and values
Professional biases
Individual differences
Political climate |
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Term
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Definition
| Ability to recover from or adjust to misfortune and change |
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Term
| What is resiliency associated w/? |
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Definition
Associated with the process of adapting
Helps people facing tragedy, loss, trauma, and severe stress |
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Term
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Definition
| Everyone pretty much! Can be developed. |
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Term
| What are common characteristics of resilient people? |
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Definition
Recognize feelings
Deal with feelings
Learn from experiences |
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Term
| What are the 7 signs of mental health? |
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Definition
1.)Happiness
2.)Control over behavior
3.)Appraisal of reality
4.)Effectiveness in work
5.)Healthy self-concept
6.)Satisfying relationships
7.)Effective coping strategies |
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Term
| What are the factors affecting severity of progress of mental illness? |
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Definition
Support systems
Family influence
Developmental events
Cultural beliefs and values
Health practices
Negative influences |
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Term
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Definition
Classifies mental disorders
Establishes criteria for classification of mental disorders
Evaluates individuals from numerous cultural/ethnic groups
Uses multiaxial system for diagnoses |
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Term
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Definition
Axis I: mental disorder(s)
The collection of signs and symptoms |
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Term
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Definition
| Axis II: personality disorder(s) and mental retardation |
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Term
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Definition
Axis III: general medical conditions
A physical disorder may be the cause of abnormal behavior |
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Term
| What is Dual diagnosis or comorbidity? |
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Definition
| a person having more than one mental disorder at the same time. |
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Term
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Definition
Axis IV: psychosocial and environmental problems
that may affect the diagnosis, treatment, and prognosis of a mental disorder |
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Term
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Definition
Axis V: Global Assessment of Functioning (GAF)
gives an indication of the person’s best level of psychological, social, and occupational functioning during the preceding year. Are they in danger of harming themselves or others, what was their highest level of functioning in the past year. |
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Term
| Why should you caution when using DSM-IV diagnoses? |
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Definition
| Avoid labeling or stereotyping when a medical or nursing diagnosis is being formulated |
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Term
| How does the DSM help with culturally defined mental disorders? |
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Definition
Describes culture-related syndromes
Discusses cultural variations for disorders
Assists clinicians in evaluating importance of culture in individual |
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Term
| What is the psychoanalytic theory? (Freud) |
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Definition
Importance of early life trauma in later mental disorders
-Focuses on three layers of mental activity
Conscious
Unconscious
Preconscious |
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Term
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Definition
| current awareness, thoughts, beliefs, and feelings (conscious mind is influenced by the others) |
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Term
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Definition
| houses our primitive feelings, drives, and memories, especially ones that are unbearable and traumatic |
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Term
| What is the preconscious? |
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Definition
| what is immediately below the surface, not currently the subject of our attention, but accessible. |
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Term
| What else does psychoanalytic theory focus on? |
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Definition
Focuses on three parts of personality
Id: pleasure principle
Ego: reality principle
Superego: conscience |
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Term
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Definition
| pleasure, especially sexual |
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Term
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Definition
| sense of self, is an intermediary between the id and the world: ego defense mechanisms; repression, denial, and rationalization. |
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Term
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Definition
| our conscience, influenced by our parents moral and ethical stances. |
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Term
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Definition
| the patent projects intense feelings onto the therapist related to unfinished work from previous relationships: safe expression is crucial to successful therapy. |
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Term
| What is counter transference? |
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Definition
| the therapists’ unconscious emotional responses to the patient. |
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Term
| What is the interpersonal theory? |
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Definition
Early interpersonal relationships are crucial for personality development
Anxiety is an interpersonal phenomenon
All behavior is aimed at avoiding:
Anxiety
Threats to self-esteem |
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Term
| What is the guide of IPT? |
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Definition
| Guide and challenge maladaptive behavior with emphasis on relationship issues |
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Term
| What is the method of IPT? |
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Definition
| Therapist as “participant observer” |
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Term
| What is the concept of IPT? |
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Definition
| Awareness of dysfunctional patterns leads to change in behavior |
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Term
| What is classical conditioning? |
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Definition
(Pavlov)
Involuntary behavior can be conditioned to respond to neutral stimuli
Dogs received food after the bell rang, later the dogs began to salivate in response to the bell alone.
Baby’s cry induces milk let down reflex |
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Term
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Definition
| Personality traits are learned |
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Term
| What is Operant Conditioning? |
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Definition
Voluntary behaviors are learned through consequences of reinforcement
Ex. , study hard= good grades, speed=speeding ticket. |
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Term
| What is the goal of behavioral therapy? (P, W, S) |
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Definition
| Correct maladaptive behavior by rewarding and reinforcing adaptive behavior |
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Term
| What are the methods used in behavioral therapy? |
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Definition
Systematic desensitization
Aversion therapy
Biofeedback |
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Term
| What is the basic concept of all 3 behavioral therapies? |
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Definition
| Maladaptive behavior is learned |
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Term
| What is systematic desensitization? |
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Definition
| Uses: phobias. Like classical conditioning, learned responses can be reversed by relaxation and then facing anxiety provoking stimulus. |
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Term
| What is aversion therapy? |
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Definition
| Uses: sex offenders, ex., electric shocks in response to arousal. Based on classical and operant conditioning, used to eradicate unwanted habits by associating unpleasant consequences with them. |
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Term
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Definition
| techniques used to control physiological responses such as breathing rates, heart rates, BP, brain waves, and skin temperature. Provide visual or auditory biofeedback of the response and then use relaxation techniques such as slow, deep breathing or meditation. |
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Term
| What is cognitive behavioral therapy? |
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Definition
| Modify negative thoughts, feelings, and behaviors |
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Term
| What are the methods of CBT? |
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Definition
-Identify negative patterns of thinking (cognitive distortions)
-Use ABC format for recording and analyzing
Activating event
Automatic beliefs
Consequences of beliefs
-Reformat negative thinking |
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Term
| What is Piaget's Theory of Cognitive Development? |
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Definition
Stages of cognition
Sensorimotor
Preoperational
Concrete operational
Formal operational |
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Term
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Definition
| (0-2): child has basic reflexes, then purposeful movement, spatial abilities, and hand-eye coordination. |
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Term
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Definition
| (2-7) cant think abstractly but thinks concretely. Egocentric, expects others to view the world as they do. |
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Term
| What is concrete operational? |
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Definition
| (7-11) interaction with the world increases, logical thought appears, and abstract problem skills. |
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Term
| What is formal operational? |
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Definition
| (11-adulthood): Conceptual reasoning, can think abstractly and problem solve as an adult. |
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Term
| How can you use piaget's theory in nursing? |
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Definition
Tailor care to cognitive level of patient
Useful in understanding cognitive ability in people with developmental delay and mental retardation. |
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Term
| What is Erikson's Psychosocial developmental theory? |
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Definition
Describes 8 stages from infancy to older adulthood
Each stage consists of central age-appropriate tasks |
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Term
| How can you apply erikson's theory to nursing? |
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Definition
| Tailor care to patient’s developmental level |
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Term
| What is the humanistic theory? |
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Definition
Focus on human potential for development
Patient-centered psychotherapy (Rogers) |
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Term
| What are the roles of the humanistic theory? |
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Definition
Role of patient in understanding one’s own problems
Role of therapist as facilitator |
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Term
| What is motivational psychotherapy? |
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Definition
Hierarchy of needs approach
Basic needs must be met before progressing to higher needs |
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Term
| What is the theory of object relations? |
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Definition
Focus on progression from infant’s complete self-absorption with inability to see self as separate from mother, to physically and psychologically differentiated toddler
Emphasize past relationships in influencing a person’s sense of self as well as the nature and quality of relationships in the present. |
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Term
| What are psychosocial problems a result of in theory of object relations? |
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Definition
| result of difficulty in separation-individuation stage of development (toddlerhood) |
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Term
| What is the moral development theory? |
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Definition
| Progression from black-and-white thinking about right and wrong to complex, context-dependent decision making process regarding right or wrong. |
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Term
| What is the ethics of care? |
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Definition
Describes importance of relationships
Banding together
Putting needs of others for whom we care above needs of strangers |
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Term
| What is the biological model of mental illness? |
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Definition
-Mental disorders believed to have physical causes
-Treatments directed toward physical interventions
+Pharmacological
+Electroconvulsive therapy (ECT) |
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Term
| What is the pharmacological view on treatment? |
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Definition
| correcting hormone levels (hypothyroidism), regulating deficient diets, balancing inadequate sleep patterns. |
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Term
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Definition
| severe depression and other psychiatric conditions. Uses electrical current to induce a seizure, affects neurotransmitters and neuroreceptors. |
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Term
| What is the peplau nursing model? |
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Definition
| Focus on interpersonal relationships and stages of nurses-patient relationship |
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Term
| What are the stages of the relationship in the nursing model? |
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Definition
Preintroduction
-occurs before the patient and nurse meet; shift assignment, report, reading chart; be aware of your own biases and preconceived notions.
Orientation
-introductory phase, decide how often to meet, length of meeting and termination. Begin to establish trust and rapport. Assess strengths and weaknesses, formulate nursing diagnoses, and establish goals.
Working
-I. Identification phase Trust and rapport are maintained. Patient id’s problems, may resist working on them, or may grow from the experience of illness.
Part II: Exploitation subphase: Encourage patient to make use of all resources. Patient becomes more independent and utilizes new skills in communicating.
Termination
-May have some feelings of loss and anxiety. Goals have been met, the patient is stronger and able to stand alone. Review patient’s progress. Plan for sources of support and coping methods. |
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Term
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Definition
| Interaction among members brings about change |
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Term
| What are the important concepts in group therapy? |
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Definition
Setting
Content vs. process
Stages of group development
Roles of leader and members |
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Term
| What is the role of the nurse in group therapy? |
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Definition
Basic level registered nurse (RN): teach psychoeducational groups
Advanced practice registered nurse (APRN): lead psychotherapeutic groups |
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Term
| What is a psychoeducational group? |
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Definition
| groups that focus on specific subjects. Provide written handouts, audiovisual aids to focus on teaching points. Ex. Medication education groups, dual-diagnosis groups, multifamily groups, stress management groups, self care groups. |
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Term
| What is therapeutic milieu? |
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Definition
| Setting for mental health care combining healthy environment and social structure |
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Term
| What are the goals of therapeutic milieu? |
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Definition
Allow members to try out new behaviors
Increase their ability to interact adaptively |
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Term
| What are the methods of therapeutic milieu? |
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Definition
Community meetings
Goal-setting approach |
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Term
| What are examples of therapeutic milieu? |
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Definition
| Recreational groups, physical activity groups, creative arts groups, storytelling groups. |
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Term
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Definition
| Uses variety of theoretical models as basis for treatment of the family |
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Term
| What are the goals of family therapy? |
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Definition
Reduce dysfunctional behavior and family conflict
Mobilize family resources and improve communication
Increase awareness of other members’ needs
Strengthen family coping
Integrate family into larger social system |
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Term
| What is therapeutic communication? |
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Definition
| Professional, goal-directed and scientifically based communication |
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Term
| What are the aspects of therapeutic communication? |
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Definition
Genuine respect for individual
Ability to listen and understand
Desire to work with individual to help with problems |
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Term
| What is the communication process? |
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Definition
1.) Stimuli - reason for convo
2.) Sender - person initiating communication
3.) Message - information being sent
4.) Receiver - recipient of message
5.) Feedback - response to message |
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Term
| What are the principles guiding the communication process? |
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Definition
-Clarity: meanings understood by both parties
-Continuity: connections exist between ideas. feelings, event, or themes are conveyed in those ideas. |
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Term
| What are factors affecting the communication process? |
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Definition
-Personal issues: emotional, social, cognitive
-Environmental issues: Physical, societal
-Relationship issues |
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Term
| What is a symmetrical relationship? |
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Definition
| relationship between friends |
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Term
| What is a complementary relationship? |
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Definition
| between nurse and patient (one is superior to the other), inequality |
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Term
| What is verbal communication? |
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Definition
| words and meaning of spoken words |
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Term
| What is nonverbal communication? |
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Definition
vital part of communication
Tone of voice and manner of pacing speech
Physical appearance
Facial expression
Posture
Eye contact
Movements and gestures |
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Term
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Definition
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Term
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Definition
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Term
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Definition
| Content and process match |
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Term
| What are double messages? |
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Definition
| Conflicting or mixed messages |
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Term
| What are double-blind messages? |
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Definition
Verbal and nonverbal message are not congruent
Creates no-win situation for recipient |
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Term
| What are effective communication skills for nurses? |
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Definition
-Help patient in:
+Feeling understood & comfortable
+Identify and explore problems r/t others
+Discover healthy ways of meeting emotional needs
+Explore satisfying interpersonal relationships |
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Term
| What are some therapeutic listening techniques? |
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Definition
Silence
Active listening
Clarification
Restating
Reflecting
Sharing observations
Exploring |
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Term
| What are some non therapeutic listening techniques? |
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Definition
Asking excessive questions
Giving approval or disapproval
Advising
Asking “why” questions |
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Term
| What are cultural differences in communication? |
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Definition
-Communication styles
-Use of eye contact
-Perception of touch
-Cultural filters
Bias as result of socialization process in particular culture |
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Term
| Who uses dramatic body language? |
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Definition
| Hispanic, French, and Italian |
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Term
| Who uses clam facade under duress? |
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Definition
| Asian, German, and British |
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Term
| Who uses guarded communication based on history? |
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Definition
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Term
| Who considers direct eye contact disrespectful? |
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Definition
| Hispanic, Asian, Native American |
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Term
| Who considers direct eye contract important? |
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Definition
| German Americans, French, British, African American |
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Term
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Definition
| Hispanic, Mexican American, Italian, and French |
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Term
| Who thinks physical touch is aggressive? |
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Definition
| German, British, Swedish, Indian, Japanese, Chinese |
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Term
| What is the creative process of nursing? |
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Definition
| Research validates therapeutic outcomes related to quality of the relationship between therapist and patient |
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Term
| What are the specific goals/fxns of therapeutic relationships? |
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Definition
Facilitates patient communication of problems/feelings
Assists patient with problem solving
Helps patient examine self-defeating behaviors and test alternatives
Promotes patient self-care and independence |
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Term
| What are social relationships? |
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Definition
-Nurse/patient social relationship: avoid minimizing the patient’s feelings by giving advice prematurely, avoid closing off the patient’s feelings and experiences. Non therapeutic: “Most of us feel like that sometimes.”
Mutual needs met
Enjoyment for both
Roles may shift |
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Term
| What are therapeutic relationships? |
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Definition
Focus on patient’s problems and needs
Boundaries and roles remain firm and clear
Knowledge applied from evidence-based research
Nonjudgmental attitude of nurse toward patient
Supervision by experienced clinician essential |
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Term
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Definition
Doing for patients what they are able to do themselves
Blurring lines |
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Term
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Definition
Asserting authority and assuming control for “patient’s own good”
Blurring lines |
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Term
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Definition
Focus on patient’s weaknesses rather than promoting strengths
Blurring lines |
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Term
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Definition
| Patient unconsciously displaces emotional reaction originating in childhood experiences onto helping person in the relationship |
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Term
| What is countertransference? |
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Definition
| Nurse displaces feelings related to people in one’s past onto patient |
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Term
| What is an ex of transference? |
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Definition
patient states, “you remind me of my…” patient continues with, “you are so high and mighty, you are cold and uncaring like others I know”
Nurse should state, “ tell me about others you know that are cold and uncaring” |
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Term
| What is an ex of countertransference? |
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Definition
| Nurse may have an alcoholic family member that she is dealing with at home, the nurse may have difficulty identifing the patients’ problems because they are simular to her own. |
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Term
| What are signs of countertransference? |
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Definition
Feeling either strongly positive or strongly negative toward patient
Over-identification with patient and patient problems
Power struggles, competition, or arguments with patient |
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Term
| What is the working phase of a relationship? |
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Definition
Explore areas in patient’s life that cause problems
Gather data
Promote patient problem solving
Facilitate/practice behavioral changes
Evaluate/redefine problems |
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Term
| What is the orientation phase? |
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Definition
Establish rapport
Establish parameters of relationship
Clarify role of nurse
Define nurse and patient responsibilities
Define contract issues
Setting, times of interviews
Confidentiality
Terms of termination |
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Term
| What defense mechanisms are normal for the working phase? |
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Definition
Acting-out
Withdrawal
Intellectualization
Manipulation
Denial
Transference |
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Term
| What is the patient difficulty with termination? |
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Definition
| Reawakening unresolved feelings of loss, abandonment, loneliness, rejection |
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Term
| What is the nurse difficulty with termination? |
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Definition
Guilt feelings about leaving patient
Unresolved feelings about loss |
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Term
| What factors enhance relationships |
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Definition
Consistency
Pacing
Listening
Positive initial impression
Promoting patient comfort; balancing control |
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Term
| What factors hinder relationships? |
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Definition
Inconsistency
Unavailability
Lack of self-awareness of nurse |
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Term
| How can the nurse enhance growth in a patient? |
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Definition
- Genuineness
-Empathy not sympathy
-Positive regard |
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Term
| What are the nurses' responsibilities in the clinical interview? |
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Definition
Permit patient to set pace
Use setting conducive to feeling of security
Use open-ended communication
Offer leads during interview
Use attending behaviors
Eye contact
Body language
Vocal qualities and verbal tracking
Use appropriate clinical supervision |
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Term
| What cultural influences do nurses need to be aware of? |
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Definition
Problems can arise when nurse’s beliefs, values differ from patient’s
Nurse needs to accept others’ values and beliefs with nonjudgmental attitude
Nurse needs to develop sensitivity toward different values and beliefs |
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