Mental Health Nursing II NURS 2310. Unit 3 Therapeutic Communication. Objective 1. Defining therapeutic milieu.
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Defining therapeutic milieu
Within this structured environment, the client is expected to learn adaptive coping, interaction, and relationship skills that can be generalized to other aspects of his or her life.
Analyzing the nurse’s role in maintaining the therapeutic milieu in an inpatient psychiatric/mental health setting
the inpatient setting by:
Reviewing the components
of nurse-client relationship development and therapeutic communication
therapeutic relationship include:
Exploring the phases of the therapeutic relationship
Correlating appropriate modes of therapeutic communication with specific psychiatric behaviors
Community factors, such as social interactions, the physical structure of the treatment setting, and schedule of activities may generate negative responses which are used as examples to help the client learn how to manage stress more adaptively in real-life situations.
Examining the use of groups as a therapeutic tool
Group Therapy = a form of psychosocial treatment in which a number of clients meet together with a therapist for purposes of sharing, gaining personal insight, and improving interpersonal coping strategies.
Identifying group types, roles, functions, development and stages
Initial or Orientation Phase
Group activities – leader and members work together to establish the rules that will govern the group
Leader expectations – leader expected to orient members to specific group processes, encourage members to participate without disclosing too much too soon, promote an environment of trust, and ensure group rules don’t interfere with goal fulfillment
Member behaviors – members have not yet established trust; fear of not being accepted by the group
Middle or Working Phase
Group activities – productive work toward completion of the task is undertaken; problem-solving and decision-making occur
Leader expectations – role diminishes and becomes one of facilitator
Member behaviors – trust established among members; members turn to each other more often, and less so to the leader; members accept criticism from others and use it constructively to create change
Final or Termination Phase
Group activities – termination process discussed in depth for several meetings before the final session
Leader expectations – the leader encourages group members to reminisce about what has occurred, review the goals, and discuss actual outcomes
Member behaviors – grief response may be evident; may lead to discussion of previous losses; successful termination of the group may help members develop the skills needed when losses occur in other dimensions of their lives.