UNIT II MAJOR DISORDERS AND CARING INTERVENTIONS

1. UNIT II MAJOR DISORDERS AND CARING INTERVENTIONS Traditional Therapeutic approaches Psychobiology Suicide and Crisis Intervention Anger and Aggression Mood Disorders Schizophrenia Cognitive Disorders Anxiety Disorders

2. Psychodynamic Theories

3. Freud's Psychoanalytic Theory Levels of awareness Conscious - contains all of the material that the person is aware of Preconscious – material that can be retrieved rather easily through conscious effort Unconscious – repressed memories, passions, and unacceptable urges

4. Freud's Psychoanalytic Theory Continued Personality structure Id Pleasure principle Reflex action Primary process Ego Problem solver Reality tester Superego Moral component

5. Freud's Psychoanalytic Theory Continued Defense mechanisms and anxiety Operate on unconscious level Deny, falsify, or distort reality to make it less threatening

6. Freud's Psychoanalytic Theory Continued Experiences during the early stages of life determine an individual's lifetime adjustment patterns and personality traits.

7. Freudian Theory and Nursing Formation of personality Conscious and unconscious influences Importance of individual talk sessions Attentive listening

8. Erikson's Ego Theory Eight stages of development Personality continues to develop through old age Failures at one stage can be rectified at another stage

9. Erickson's Theory and Nursing Developmental model part of nursing assessment Helps determine what types of interventions are most likely to be effective

10. Sullivan's Interpersonal Theory Purpose of all behavior is to get needs met through interpersonal interactions and decrease or avoid anxiety Security operations –those measures that the individual employs to reduce anxiety and enhance security. Self system – all of the security operations an individual uses to defend against anxiety and ensure self esteem

11. Sullivan's Theory and Nursing Foundation for Hildegard Peplau's theory Participant observer Mutuality Respect for the patient Unconditional acceptance Empathy

12. Humanistic Theories

13. Maslow’s Hierarchy of Needs Human beings are active participants in life, striving for self-actualization Basic needs D-motives/deficiency needs Self-esteem and self-actualization B-motives/being needs

14. Maslow's Theory and Nursing Emphasis on human potential and the client's strengths Prioritizing nursing actions in the nurse-client relationship

15. Behavioral Theories Pavlov's classic conditioning theory Watson's behaviorism theory Skinner's operant conditioning theory Implications for nursing Altering targeted behaviors Behavior management

16. Biological Theories Focus on Neurological Chemical Biological Genetic How do the body and brain interact to create Emotions Memories Perceptual experiences

17. Biological Theories and Nursing Consider other influences that play a role in the development and treatment of mental disorders Social, environment, cultural, economic Focus on the qualities of a therapeutic relationship Apply newest findings of biological model in nursing practice

18. Biological Theories Focus on Neurological Chemical Biological Genetic How do the body and brain interact to create Emotions Memories Perceptual experiences

19. Nursing TheoriesPEPLAU – INTERSPERSONAL RELATIONS IN NURSINGPatricia BennerDorothea OremSister Callista RoyBetty NeumanJoyce Travelbee

20. Peplau and the Therapeutic Relationship Peplau influenced by Sullivan's work Interpersonal Relations in Nursing (1952) Major paradigm shift in nursing Levels of anxiety

21. Hildegard Peplau The art of nursing Provide care, compassion, and advocacy Enhance comfort and well-being The science of nursing Application of knowledge To understand a broad range of human problems and psychosocial phenomena To intervene in relieving clients' suffering and promote growth

22. Therapeutic Approaches Classical psychoanalysis Transference Countertransference Psychodynamic and psychoanalytic ? oriented more to here and now Short-term dynamic psychotherapy ? ten or fewer sessions, best for the “worried well” Interpersonal psychotherapy ? used in specific problem areas – grief, role disputes, role transition, interpersonal deficit

23. Therapeutic Approaches Continued Cognitive therapy Behavioral therapy Modeling Operant conditioning Systematic desensitization Aversion therapy Milieu therapy Bruno Bettelheim

24. ECT Procedure Advantages Potential adverse reactions

25. Basic Concepts Related to Group Work Group Psychotherapy: Specialized treatment intervention Led by trained leader or co-leaders Purpose is to treat clients with psychiatric disorders

26. Advantages of Group Work Cost effective Client feels less isolated Clients receive peer feedback Teach different problem-solving approaches

27. Phases of Group Development: Roles of Leader and Group Initial phase Leader: Set up an atmosphere of respect, confidentiality, and trust Group: Get to know one another Working phase Leader: Encourage members to cooperate with each other and handle conflict Group: Issues of power and control Mature phase Leader: Keep group focused on therapeutic goals of individual members Group: Develops functional norms and a sense of group identity Termination Leader: Acknowledge the contributions of each member and the experience as a whole Group: Prepare for the separation and for the future

28. Informal Roles of Group Members Task Maintenance Individual roles

29. Role of Group Leader Starting Maintaining Terminating

30. Styles of Group Leadership Autocratic leader Democratic leader Laissez-faire leader

31. Therapeutic Factors in Groups Instillation of hope Universality Imparting of information Altruism Corrective recapitulation of the primary family group Development of socializing techniques Imitative behavior Interpersonal learning Group cohesiveness Catharsis Existential resolution

32. Basic Level Registered Nurse Able to assume responsibility for the following groups: Medication education Sexuality Dual-diagnosis Multifamily Symptom management Stress management Community Self-care

33. Advanced Practice Nurse Able to assume responsibility for the following groups: Same groups as the basic level RN Psychotherapy—with different types of theoretical foundations

34. Patterns of Problematic Behaviors in Group Members Monopolizes group Complains but continues to reject help Demoralizes others Silent person