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52 Cards in this Set
- Front
- Back
Adaptive use of Defense Mechanisms
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Helps ppls acheive their goals in acceptable ways. Defense mechanisms become maladaptive when they interfere with functioning, relationships, and orientation to reality
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Healthy Defense Mechanisms - 4
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(altruism, sublimation, humor, and suppression)
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Intermediate Defense - 6
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Repression, reaction formation, somatization, displacement, rationalization, undoing
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Immature Defense Mechanisms - 8
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Projection, acting-out behaviors, dissociation, devaluation, idealization, splitting, passive aggression, and denial
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Altruism
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Deal w/anxiety by reaching out to others
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Sublimation
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Dealing w/unacceptable feelings or impulses by unconsciously substituting acceptable forms of expression
(ex: person who has feelings anger toward work supervisor sublimates those feelings by working out vigorously at the gym during his lunch period) |
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Suppression
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Voluntarily denying unpleasant thoughts + feelings
Person lost job - says will worry about bills next week |
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Repression
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Putting unacceptable ideas, thoughts, and emotions out of conscious awareness
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Displacement
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Shifting feelings related to an object, person, or situation to another less threatening object, person or situation
Person angry about losing job destroys child's fav toy |
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Reaction Formation
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Overcompensating or demonstrating the ooposite behavior of what is felt
Person who dislikes her sister's daughter offters to babysit so that her sister can go out of town |
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Somatization
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Developing a physical symptom in place of anxiety
A school-age child develops abdominal pain to avoid going to school where bullied |
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Undoing
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Performing an act to make up prior behavior
Adolescent completes his chores w/out being prompted after having an argument w/parent |
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Rationalization
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Creating reasonable and acceptable explanations for unacceptable behavior
Had to driv ehome drunk from party bc had to feed dog |
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Passive Aggression
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Indirecting behaving aggressively but appearing to be compliant
person's coworker aggres to take on one of her assignments but then doesn't meet deadline |
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Acting-out behaviors
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Managing emotional conflicts thru actions, rather than self-reflection
Preschooler told to share toys, so she throws the toys across the room |
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Dissocation
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Temporarily blocking memories and perceptions from consciousness
Adolescent witnesses a shooting and is unable to recall any details of the event |
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Devaluation
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Expressing negative thoughts of self or others
*passed up for job - says his job is better anyways doesn't need it |
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Idealization
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Expressing extremely positive thoughts of self or others
School-age boy boasts about hsi older bro and his accomplishments |
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Splitting
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Demonstrating an inability to reconcile negative and positive attributes of self or others
PT tells nurse she is the only one who cares about her, yet following day - same PT refuses to talk to nurse |
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Projection
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Blaming others for unacceptable thoughts and feelings
Young adult blames his substance abuse on his parents refusal to buy him new car |
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Denial
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Pretending the trust is not reality to manage the anxiety of acknowledging what is real
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Normal Anxiety
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Healthy life force that is necessary for survival, normal anxiety motivates ppl to take action. Ex: potentially violent situation occurs on the mental health unit - nurse moves rapidly to defuse situation. Anxiety experienced by nurse during situation helped him perform quickly+efficiently.
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Acute State Anxiety
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Level of anxiety precipitated by an imminent loss or change that threatens one's sense of security. Ex: sudden death of loved one
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Chronic Trait Anxiety
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Usually develops over time - often starting in childhood. Adult who experiences this may display that anxiety in physical symptoms - fatigue and frequent headaches
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Mild Anxiety
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Occurs in normal experience of every day living
Increases one's ability perceive reality Identifiable cause -->Vague feeling of mild discomfort, impatience, apprehension |
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Moderate
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Occurs when mild anxiety escalates
Slightly reduced perception + processing of info occurs, and selective inattention may occur Ability to think clearly is hampered, but learning and problem solving may still occur Concentration difficult, tiredness, pacing, increased HR and RR **PT usually benefits from the direction of others |
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Severe Anxiety
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Perceptual field greatly reduced w/distorted perceptions
Learning and prob solving don't occur Confusion, feelings of impending doom, aimless activity **PT not usually able to take direction from others |
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Panic-Level
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Markedly disturbed behavior
PT not able to process what is occuring in the environment and may lose touch w/reality PT experiences extreme fright + horror Dysfunction in speech, inability to sleep, delusions, and hallucinations |
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Management of Milieu refers to
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management of the total environment of the mental health unit in order to provide the least amoutn of stress, while promoting the greatist benefit for all PTs
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Goal Of Milieu for PT
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While in this environment - PT will learn tools necessary to cope adaptively, interact more effectively and appropriately, and strengthen relationship skills.
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Orientation Phase
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Nnurse: introduce self + state purpose
-set contract meeting time, place, frequency, duration, and date of termination -Discuss confidentiality -Build trust by establishing expectations + boundaries -Set goals w. PT -explore PT's ideas, issues, and needs -explore meaning of testing behaviors |
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Working Phase
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Nurse: Maintain relationship as stated contract
- Perform ongoing assessment - Facilitate PT's expression of needs + issues - Promote PT's self-esteem - Explore/deal with restistance/ dm's -rec transference/contertransferance |
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Termination Phase
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Nurse: provide opportunity for PT to discuss toughts/feelings about term
-Discuss PT's prior experience w.separation + loss - Elicit PT's feelings about therapeutic work in the nurse-PT relationship -Summarize goals+Acheivements -Discuss ways for PT to incorporate new healthy behaviors into life -Maintain limits of final termination |
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Blurred Boundaries
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Occur if relationship begins to meet needs of nurse rather than PT, or if relationship becomes social rather than therapeutic
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Transference
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When PT views member of HC team as having characteristics of another person has been significant to PTs personal life
-->sees nurse as mom, treats like own mom **Transference by PT is more liekly to occur w/a person in authority |
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Countertransference
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When HC team member displaces characteristics of people in her past onto PT
reminds of friend she hates - treats like it |
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Acute Care Settings for Mental Health Care
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Provide intense treatment+supervison in locked units for PTs w/severe mental illness
Helps stabilize mental illness symptoms and promotes the PT's return to the community *Private or state owned |
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Community Settings for Mental Heath Care
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Primary care provided in community-based settings - clinics, schools, daycare centers, partial hospitalization programs, drug/alc treatment facilities, forenscic settings, psychosocial rehab programs, telephone crisis counseling centers, and home health care
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Nurse's job in Community Care Program
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Help to stabilize/improve PT's mental functioning w/in a community and teach, support, and make referrals in order to promote positive social activities
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Nursing Interventions in Community Setting
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Provide for primary treatment and primary, secondary, and tertiary prevention of mental illness
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Factors affecting future of mental health care
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Increase in aging population
Increase in cultural diversity w/in US Expansion of technology, which may provide new settings for client care, as well as new ways to treat mental illness more effectively |
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Criteria to justify admission to acute care facility
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Clear risk of PT's danger to self or others
-FAILURE of community-based treatment - Dangerous decline in mental health status of PT undergoing long-term treatment - PT having a medical need in addition to mental illness |
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Goals of Acute Mental Health Treatment
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Prevention of PT harming self/others
Stabilizing mental health crisis Return of PT who are severely ill to some type of community care |
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3 levels of implementing community care by Nurses for interventions/teaching
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Primary, secondary, tertiary
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Primary Prevention
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Promotes health and prevents mental health probs from occurring
ex: nurse leads group for parents of toddlers, discussing normal toddler behavior and ways to promote healthy development |
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Secondary Prevention
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Focuses on early detection of mental illness
ex: nurse screens parents of children who have developmental disorders |
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Tertiary Prevention
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Focuses on rehab and prevention of further probs in PTs previously diagnosed
ex: Nurse leads support group for PTs who have completed a chem dependency program |
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Partial Hospitalization Programs
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Provide intense short-term treatments for PTs who are well enough to go home very night and have a responsible person at home to provide support and safe encironment.
*certain detox programs are a specialized form of this for PT who requires medical supervison, stress management, addiction counseling, and relapse prevention |
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Assertive-Community Treatment (ACT)
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Nontraditional case management and treatment by an interdisciplinary team for a caseload of ptS W/SEVERE MENTAL ILLNESS WHO ARE NONCOMPLIANT w/trandition treatment
*helps to reduce reoccurences of hospitalizations and provides crisis interventions, assistance w/independent living, and info regarding resources for necessary support services |
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Community Mental Health Centers
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Provide a variety of services for wide range of community PTs, including:
-Educational groups - Medication dispensing programs - Individual counseling programs |
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Psychosocial Rehab programs
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Provide structured range of programs for PTs in a mental health setting:
residential services + day programs for older adults for whom care is probvided |
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Home Care
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Provides mental health assessment, interventions, and family support in PT's own home. This is implemented most often for children, older adults, and PT with medical conditions.
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