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PT20E Therapeutic Communications and Relationships. PowerPoint #3. Course Objective #1. Define and describe the Psychotherapeutic Management Model according to the Diagnostic and Statistical Manual, (DSM) current edition. Psychopathology. Definition : the systematic study of mental disorders.
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PT20E Therapeutic Communications and Relationships PowerPoint #3
Course Objective #1 • Define and describe the Psychotherapeutic Management Model according to the Diagnostic and Statistical Manual, (DSM) current edition.
Psychopathology • Definition: the systematic study of mental disorders.
Psychotherapeutic Management Model • Definition: Nursing care that balances the three (3) primary interventions used in care of D.D. and Psychiatric patients.
Psychotherapeutic Management Model • Three (3) primary interventions: • Communicated Nurse-Patient Relationship (words) • Psychopharmacology (drugs) • Milieu management (environment)
Therapeutic Nurse-Pt. Relationship • Communication skills
Psychopharmacology • Psychotropic drugs:
Course Objective #4 • Relate why a psychopharmacologic understanding is important for the psychiatric technician
Importance of Psychopharmacology • Assess response • Respond to side effects • Evaluate for desired results • Safely dispense • Teaching • Idiosyncratic reactions
Milieu Management • Definition: Purposeful manipulation of the environment to promote a therapeutic atmosphere.
Course Objective #5 • Define milieu management and its six elemental components
Milieu Management • Components: • Safety • Structure • Norms • Setting limits • Balance • Environmental modifications
Safety • Freedom from danger or harm
Structure • Physical environment • Regulations • Schedules
Norms • Expectations of behavior • Promote community
Beliefs • Truths held by a culture
Values • Deep feelings that determine what is considered good or bad.
Norms • Society accepted rules
Setting Limits • Clear & enforceable limitations on behavior
Setting Limits • Behaviors: • Physical aggressiveness • Self-destructive acts • Lack of compliance • Use of alcohol or drugs • Elopement
Setting Limits • Anticipate behavior!
Balance between Independence vs. Dependence • Gradual process • too fast • Overwhelmed
Environmental Modifications • Changing the environment to promote mental health • Physical arrangement • safety issues • orientation features
Course Objective # 2 • Describe the consequences of an imbalance in nursing care
Consequences of an Imbalance in Nursing Care • Patient needs & setting • Utilization Influence
Consequences of an Imbalance in Nursing Care • All components must be present if pt’s. are to fully benefit
Consequences of an Imbalance in Nursing Care • Imbalance • compromise tx
Course Objective #3 • Relate the difference between therapy and being therapeutic.
Therapeutic vs. TherapyEducation • Therapy • graduate-level psychiatric training • Therapeutic • undergraduate-level psychiatric nurses
TherapeuticTasks • Communication • Respect • Desire • Understanding • Active listening
Therapeutic • Knowledge/skills • Each encounter is part therapeutic milieu
Therapeutic • Real! • Problems • Solutions • Practice situations
Therapeutic • Consistent • Spontaneous • Informal • Recreational
Therapy • Cure or manage the course of mental disorder • Trained • Selective pt
Therapy • Sessions • Formalized • On-going • Specific time, place, & length • Specialized techniques
Therapeutic Nurse-Pt. Relationship • Definition: A series of goal-directed interactions that focus on the patient • T, F, B’s • potential solutions • Purposeful • Unique
Therapeutic Nurse-Pt. Relationship • Client challenges: • Communicating • Relating • Functioning
Role of the Psych. Nurse • Identify problems • Discover ways of meeting needs • Experience relationship
Characteristics of the TxN-PR • Planned • Patient centered • Goal directed
Brief Encounters • Brief encounters • Process feelings • Validation • Feedback • Quickly
Course Objective #21 & 22 • List the stages of the therapeutic P.T.—patient relationships. • Identify and describe the major tasks of each stage of the P.T.—patient relationship
Stages of TxNPR • Orientation Stage • Working Stage • Termination Stage
Orientation stage • Establishing trust and rapport • Nurses learns • Concerns • Patient learns • Role of the nurse
Orientation stage • Create an environment • Honest • consistent, • keeps promises • Clear, specific communications • Confidentiality explained
Orientation stage • Initiating conversations • Non-confrontational
Orientation stage • Establish a contract • Expectation • responsibilities
Orientation stage • Gather assessment information • intake interview • Needs • coping strategies • defense mech. • recurring thoughts, feelings, behaviors • awareness of problems • ability and motivation to change
Orientation stage • Gather assessment information • Defining goals • Prioritize • Needs • Coping strategies • Defense mech. • Recurring T, F, B • Motivate to change
Orientation stage • Management of emotions: • Fear of losing control • Feelings • Anger
Orientation stage • Feelings natural • Expression • Empathy • Not alone • Hope