Psychiatric Nursing Notes

PSYCHIATRIC NURSING
PSYCHIATRIC NURSING
COPING AND ADAPTATION COPING AND ADAPTATION
MENTALLY HEALTHY INDIVIDUAL MENTALLY HEALTHY INDIVIDUAL
ATTITUDE OF SELF ACCEPTANCE ATTITUDE OF SELF ACCEPTANCE
AUTONOMY AUTONOMY
ABILITY TO ABSTRACT,TRUST ,COPE WITH STRESS ABILITY TO ABSTRACT,TRUST ,COPE WITH STRESS
ACCURATE SELF PERCEPTION ACCURATE SELF PERCEPTION
AWARENESS OF SELF AWARENESS OF SELF
MENTAL HEALTH – balance in a e!"#n" in$e!nal li%e an& a&a$a$i#n $# !eali$' MENTAL HEALTH – balance in a e!"#n" in$e!nal li%e an& a&a$a$i#n $# !eali$'
  Men$al ILL Heal$( – "$a$e #% i)balance c(a!ac$e!i*e& b' a &i"$+!bance in a e!"#n" Men$al ILL Heal$( – "$a$e #% i)balance c(a!ac$e!i*e& b' a &i"$+!bance in a e!"#n"
$(#+,($", %eelin," an& be(a-i#! $(#+,($", %eelin," an& be(a-i#!
  P#-e!$' an& ab+"e" a!e )a.#! !i"/ %ac$#!" P#-e!$' an& ab+"e" a!e )a.#! !i"/ %ac$#!"
  P"'c(ia$!ic n+!"in, – in$e!e!"#nal !#ce"" 0(e!eb' $(e !#%e""i#nal n+!"e !ac$i$i#ne! P"'c(ia$!ic n+!"in, – in$e!e!"#nal !#ce"" 0(e!eb' $(e !#%e""i#nal n+!"e !ac$i$i#ne!
,$(!#+,( $(e $(e!ae+$ic +"e #% "el%1a!$2 an& n+!"in, $(e#!ie" 1"cience2, a""i"$ clien$" $# ac(ie-e ,$(!#+,( $(e $(e!ae+$ic +"e #% "el%1a!$2 an& n+!"in, $(e#!ie" 1"cience2, a""i"$ clien$" $# ac(ie-e
"'c(#"#cial 0ell bein,3 "'c(#"#cial 0ell bein,3
  C#!e #% "'c( n+!"in, – in$e!e!"#nal !#ce"" – (+)an $# (+)an !ela$i#n"(i1b#$( %#! C#!e #% "'c( n+!"in, – in$e!e!"#nal !#ce"" – (+)an $# (+)an !ela$i#n"(i1b#$( %#!
)en$all' (eal$(' an& ill2 )en$all' (eal$(' an& ill2
  Men$al (',iene – )ea"+!e" $# !#)#$e )en$al (eal$( , !e-en$ )en$al illne"" an& Men$al (',iene – )ea"+!e" $# !#)#$e )en$al (eal$( , !e-en$ )en$al illne"" an&
"+%%e!in, an& %acili$a$e !e(abili$a$i#n4431an& i% nece""a!' %in& )eanin, in $(e"e e5e!ience"2 "+%%e!in, an& %acili$a$e !e(abili$a$i#n4431an& i% nece""a!' %in& )eanin, in $(e"e e5e!ience"2
  Main $##l – $(e!ae+$ic +"e #% "el% Main $##l – $(e!ae+$ic +"e #% "el%
  I$ !e6+i!e" "el%7a0a!ene"" I$ !e6+i!e" "el%7a0a!ene""
  Me$(#&" $# inc!ea"e "el%7a0a!ene""8 Me$(#&" $# inc!ea"e "el%7a0a!ene""8
– – In$!#"ec$i#n ,Di"c+""i#n, E5e!ience, R#le la' In$!#"ec$i#n ,Di"c+""i#n, E5e!ience, R#le la'
Neurosis Neurosis
  an' l#n, $e!) )en$al #! be(a-i#!al &9# in 0(ic( an' l#n, $e!) )en$al #! be(a-i#!al &9# in 0(ic( contact with reality contact with reality i" !e$aine& $(e i" !e$aine& $(e
c#n&i$i#n i" !ec#,ni*e& b' $(e a$ien$ a" abn#!)al3 E""en$iall' %ea$+!e" c#n&i$i#n i" !ec#,ni*e& b' $(e a$ien$ a" abn#!)al3 E""en$iall' %ea$+!e" anxiety anxiety #! be(a-i#! #! be(a-i#!
e5a,e!!a$e& &e"i,ne& $# a-#i& an5ie$' e5a,e!!a$e& &e"i,ne& $# a-#i& an5ie$'
  1 an5ie$' &9# : ('"$e!ia $# c#n-e!"i#n &9#,a)ne"ia,%+,+e,)+l$ile e!"#nali$' an& 1 an5ie$' &9# : ('"$e!ia $# c#n-e!"i#n &9#,a)ne"ia,%+,+e,)+l$ile e!"#nali$' an&
&ee!"#nali*a$i#n7 &i""#cia$i-e &9# &ee!"#nali*a$i#n7 &i""#cia$i-e &9#
:#c &9#2 :#c &9#2
  Re"+l$ #% ina!#!ia$e ea!l' !#,!a))in,1"'c(#anal'"i" li$$le -al+e2 Re"+l$ #% ina!#!ia$e ea!l' !#,!a))in,1"'c(#anal'"i" li$$le -al+e2
  Bene%i$" %!#) Bene%i$" %!#) B B ehavior Therapy ehavior Therapy
Psychosis Psychosis
  Men$al #! be(a-i#!al &i"#!&e! 0(e!ein a$ien$ Men$al #! be(a-i#!al &i"#!&e! 0(e!ein a$ien$ looses contact with reality looses contact with reality
  P!e"ence #% &el+"i#n", (all+cina$i#n","e-e!e $(#+,($ &i"$+!bance",al$e!a$i#n #% )##&, P!e"ence #% &el+"i#n", (all+cina$i#n","e-e!e $(#+,($ &i"$+!bance",al$e!a$i#n #% )##&,
#-e!$' #% $(#+,($ an& abn#!)al be(a-i#! #-e!$' #% $(#+,($ an& abn#!)al be(a-i#!
  1"c(i*#(!enia , )a.#! &i"#!&e! #% a%%ec$ 1 )ania – &e!e""i#n2, )a.#! a!an#i& "$a$e" 1"c(i*#(!enia , )a.#! &i"#!&e! #% a%%ec$ 1 )ania – &e!e""i#n2, )a.#! a!an#i& "$a$e"
an& #!,anic )en$al &i"#!&e! an& #!,anic )en$al &i"#!&e!
  Bene%i$" %!#) Bene%i$" %!#) "'c(#anal'"i" "'c(#anal'"i" an& an& antipsychotics antipsychotics
C#))#n Be(a-i#!al Si,n" an& S')$#)" C#))#n Be(a-i#!al Si,n" an& S')$#)"
  Disturbances in perception Disturbances in perception
  Ill+"i#n7 )i"in$e!!e$a$i#n #% an ac$+al e5$e!nal "$i)+li Ill+"i#n7 )i"in$e!!e$a$i#n #% an ac$+al e5$e!nal "$i)+li
  Hall+cina$i#n" – %al"e "en"#!' e!ce$i#n in $(e ab"ence #% e5$e!nal "$i)+li Hall+cina$i#n" – %al"e "en"#!' e!ce$i#n in $(e ab"ence #% e5$e!nal "$i)+li
  Disturbances in thinking and speech Disturbances in thinking and speech
  ne#l#,i") – c#inin, #% 0#!&" $(a$ e#le &# n#$ +n&e!"$an& ne#l#,i") – c#inin, #% 0#!&" $(a$ e#le &# n#$ +n&e!"$an&
  Ci!c+)"$an$iali$' – #-e! incl+"i#n #% ina!#!ia$e $(#+,($" an& &e$ail" Ci!c+)"$an$iali$' – #-e! incl+"i#n #% ina!#!ia$e $(#+,($" an& &e$ail"
  W#!& "ala& – inc#(e!en$ )i5$+!e #% 0#!&" an& (!a"e" 0i$( n# l#,ical "e6+ence W#!& "ala& – inc#(e!en$ )i5$+!e #% 0#!&" an& (!a"e" 0i$( n# l#,ical "e6+ence
  Ve!bi,e!a$i#n – )eanin,le"" !ee$i$i#n #% 0#!&" an& (!a"e" Ve!bi,e!a$i#n – )eanin,le"" !ee$i$i#n #% 0#!&" an& (!a"e"
  Pe!"e-e!a$i#n – e!"i"$ence #% a !e"#n"e $# a !e-i#+" 6+e"$i#n Pe!"e-e!a$i#n – e!"i"$ence #% a !e"#n"e $# a !e-i#+" 6+e"$i#n
  Ec(#lalia – a$(#l#,ical !ee$i$i#n #% 0#!&" #% #$(e!" Ec(#lalia – a$(#l#,ical !ee$i$i#n #% 0#!&" #% #$(e!"
  A(a"ia – "eec( &i%%ic+l$' an& &i"$+!bance A(a"ia – "eec( &i%%ic+l$' an& &i"$+!bance
  E5!e""i-e , !ece$i-e #! ,l#bal E5!e""i-e , !ece$i-e #! ,l#bal
  Fli,($ #% i&ea"7 "(i%$in, #% #ne $#ic %!#) #ne "+b.ec$ $# an#$(e! in a "#)e0(a$ !ela$e& Fli,($ #% i&ea"7 "(i%$in, #% #ne $#ic %!#) #ne "+b.ec$ $# an#$(e! in a "#)e0(a$ !ela$e&
0a' 0a'
  L##"ene"" #% a""#cia$i#n7inc#(e!en$ ,ill#,ical %l#0 #% $(#+,($"1+n!ela$e& 0a'2 L##"ene"" #% a""#cia$i#n7inc#(e!en$ ,ill#,ical %l#0 #% $(#+,($"1+n!ela$e& 0a'2
  Clan, a""#cia$i#n – "#+n& #% 0#!& ,i-e" &i!ec$i#n $# $(e %l#0 #% $(#+,($ Clan, a""#cia$i#n – "#+n& #% 0#!& ,i-e" &i!ec$i#n $# $(e %l#0 #% $(#+,($
  Del+"i#n – e!"i"$en$ %al"e belie%,!i,i&l' (el& Del+"i#n – e!"i"$en$ %al"e belie%,!i,i&l' (el&
  Del+"i#n" #% ,!an&e+!7 "ecial 9i)#!$an$ in a 0a' Del+"i#n" #% ,!an&e+!7 "ecial 9i)#!$an$ in a 0a'
  Pe!"ec+$#!'7$(!ea$ene& Pe!"ec+$#!'7$(!ea$ene&
  I&ea" #% !e%e!ence7"i$+a$i#n9e-en$" in-#l-e $(e) I&ea" #% !e%e!ence7"i$+a$i#n9e-en$" in-#l-e $(e)
  S#)a$ic7 b#&' !eac$in, in a a!$ic+la! 0a' S#)a$ic7 b#&' !eac$in, in a a!$ic+la! 0a'
  Ma,ical $(in/in, – !i)i$i-e $(#+,($ !#ce"" $(#+,($" al#ne can c(an,e e-en$" Ma,ical $(in/in, – !i)i$i-e $(#+,($ !#ce"" $(#+,($" al#ne can c(an,e e-en$"
  A+$i"$ic $(in/in, – !e,!e""i-e $(#+,($ !#ce""7"+b.ec$i-e in$e!!e$a$i#n" n#$ -ali&a$e& 0i$( A+$i"$ic $(in/in, – !e,!e""i-e $(#+,($ !#ce""7"+b.ec$i-e in$e!!e$a$i#n" n#$ -ali&a$e& 0i$(
#b.ec$i-e !eali$' #b.ec$i-e !eali$'
  Disturbances of affect Disturbances of affect
  Ina!#!ia$e – &i"(a!)#n' be$0een $(e "$i)+li an& $(e e)#$i#nal !eac$i#n Ina!#!ia$e – &i"(a!)#n' be$0een $(e "$i)+li an& $(e e)#$i#nal !eac$i#n
  Bl+n$e& a%%ec$ – "e-e!e !e&+c$i#n in e)#$i#nal !eac$i#n Bl+n$e& a%%ec$ – "e-e!e !e&+c$i#n in e)#$i#nal !eac$i#n
  Fla$ a%%ec$ – ab"ence #! nea! ab"ence #% e)#$i#nal !eac$i#n Fla$ a%%ec$ – ab"ence #! nea! ab"ence #% e)#$i#nal !eac$i#n
  Aa$(' – &+lle& e)#$i#nal $#ne Aa$(' – &+lle& e)#$i#nal $#ne
  Dee!"#nali*a$i#n – %eelin, #% "$!an,ene"" %!#) #ne;" "el% Dee!"#nali*a$i#n – %eelin, #% "$!an,ene"" %!#) #ne;" "el%
  De!eali*a$i#n – %eelin, #% "$!an,ene"" $#0a!&" en-i!#n)en$ De!eali*a$i#n – %eelin, #% "$!an,ene"" $#0a!&" en-i!#n)en$
  A,n#"ia – lac/ #% "en"#!' "$i)+li in$e,!a$i#n A,n#"ia – lac/ #% "en"#!' "$i)+li in$e,!a$i#n
  Disturbances in motor activity Disturbances in motor activity
  Ec(#!a5ia – i)i$a$i#n #% #"$+!e #% #$(e!" Ec(#!a5ia – i)i$a$i#n #% #"$+!e #% #$(e!"
  Wa5' %le5ibili$' – )ain$ainin, #"i$i#n %#! a l#n, e!i#& #% $i)e Wa5' %le5ibili$' – )ain$ainin, #"i$i#n %#! a l#n, e!i#& #% $i)e
  A$a5ia – l#"" #% balance A$a5ia – l#"" #% balance
  A/a$(e"ia – e5$!e)e !e"$le""ne"" A/a$(e"ia – e5$!e)e !e"$le""ne""
  D'"$#nia7 +nc##!&ina$e& "a"$ic )#-e)en$" #% $(e b#&' D'"$#nia7 +nc##!&ina$e& "a"$ic )#-e)en$" #% $(e b#&'
  Ta!&i-e &'"/eni"ia – in-#l+n$a!' $0i$c(in, #! )+"cle )#-e)en$" Ta!&i-e &'"/eni"ia – in-#l+n$a!' $0i$c(in, #! )+"cle )#-e)en$"
  A!a5ia – in-#l+n$a!' +n+!#"e%+l )#-e)en$" A!a5ia – in-#l+n$a!' +n+!#"e%+l )#-e)en$"
  Disturbances in memory Disturbances in memory
  C#n%ab+la$i#n – %illin, #% )e)#!' ,a" C#n%ab+la$i#n – %illin, #% )e)#!' ,a"
  D<.= -+ – > D<.= -+ – >
n& n&
$i)e7li/e %eelin, $i)e7li/e %eelin,
  ?a)ai" -+7 n#$ (a-in, been $# $(e lace #ne (a" been be%#!e ?a)ai" -+7 n#$ (a-in, been $# $(e lace #ne (a" been be%#!e
  A)ne"ia – )e)#!' l#"" 1inabili$' $# !ecall a"$ e-en$"2 A)ne"ia – )e)#!' l#"" 1inabili$' $# !ecall a"$ e-en$"2
  Re$!#,!a&e7&i"$an$ a"$ Re$!#,!a&e7&i"$an$ a"$
  An$e!#,!a&e – i))e&ia$e a"$ An$e!#,!a&e – i))e&ia$e a"$
  An#)ia – lac/ #% )e)#!' #% i$e)" An#)ia – lac/ #% )e)#!' #% i$e)"
D'na)ic" #% H+)an Be(a-i#! D'na)ic" #% H+)an Be(a-i#!
  Pe!"#nali$' – in$e,!a$i#n #% "'"$e)" an& (abi$" !e!e"en$in, anin&i-i&+al" c(a!ac$e!i"$ic Pe!"#nali$' – in$e,!a$i#n #% "'"$e)" an& (abi$" !e!e"en$in, anin&i-i&+al" c(a!ac$e!i"$ic
a&.+"$)en$ $# (i" en-i!#n)en$ e5!e""e& $(!#+,( be(a-i#! a&.+"$)en$ $# (i" en-i!#n)en$ e5!e""e& $(!#+,( be(a-i#!
  In&i-i&+ali"$ic, +ni6+e, !e&ic$able1"$abili$' an& c#n"i"$enc'2 In&i-i&+ali"$ic, +ni6+e, !e&ic$able1"$abili$' an& c#n"i"$enc'2
  De$e!)inan$"8 "'c(#l#,ical,c+l$+!al, bi#l#,ical 1 n#$ in(e!e$e&2 an& %a)ilial De$e!)inan$"8 "'c(#l#,ical,c+l$+!al, bi#l#,ical 1 n#$ in(e!e$e&2 an& %a)ilial
Anal'"i" Anal'"i"
  P#$en$ial "+#!$ "'"$e)" #! "$!e""#!" P#$en$ial "+#!$ "'"$e)" #! "$!e""#!"
  P#$en$ial !i"/ %ac$#! P#$en$ial !i"/ %ac$#!
  Sa$i"%ac$i#n #% (+)an nee&" Sa$i"%ac$i#n #% (+)an nee&"
– – P('"i#l#,ical1#5',en , %l+i&", n+$!i$i#n, $e)3,eli)ina$i#n,"(el$e!,!e"$,"e52 P('"i#l#,ical1#5',en , %l+i&", n+$!i$i#n, $e)3,eli)ina$i#n,"(el$e!,!e"$,"e52
– – Sa%e$' an& "ec+!i$'1('"ical an& "'c(#l#,ical2 Sa%e$' an& "ec+!i$'1('"ical an& "'c(#l#,ical2
– – L#-e an& bel#n,in,ne"" L#-e an& bel#n,in,ne""
– – Sel% e"$ee) Sel% e"$ee)
– – Sel% –ac$+ali*a$i#n Sel% –ac$+ali*a$i#n
@ &i-i"i#n" #% $(e )in& @ &i-i"i#n" #% $(e )in&
  C#n"ci#+" – %#c+""e& #n a0a!ene"" C#n"ci#+" – %#c+""e& #n a0a!ene""
  S+bc#n"ci#+" – !ecalle& a$ 0ill S+bc#n"ci#+" – !ecalle& a$ 0ill
  Unc#n"ci#+" – ne-e! !ecalle& 9 la!,e"$ a!$ Unc#n"ci#+" – ne-e! !ecalle& 9 la!,e"$ a!$
Lea!nin, – c(an,e in be(a-i#! $(!#+,( – in"i,($ , !elea!nin, an& !e)#$i-a$i#n Lea!nin, – c(an,e in be(a-i#! $(!#+,( – in"i,($ , !elea!nin, an& !e)#$i-a$i#n
Theories of personality development Theories of personality development
Freuds psychosexual theory Freuds psychosexual theory
  Libi&# – inne! &!i-e Libi&# – inne! &!i-e
  Pa!$" #% b#&' –%#c+" #% ,!a$i%ica$i#n Pa!$" #% b#&' –%#c+" #% ,!a$i%ica$i#n
  Un"+cce"%+l !e"#l+$i#n 7 %i5a$i#n Un"+cce"%+l !e"#l+$i#n 7 %i5a$i#n
  S$!+c$+!e" #% e!"#nali$' S$!+c$+!e" #% e!"#nali$'
– – I& – lea"+!e !incile7in"$inc$ I& – lea"+!e !incile7in"$inc$
– – E,# – c#n$!#l" ac$i#n an& e!ce$i#n –!eali$' !incile E,# – c#n$!#l" ac$i#n an& e!ce$i#n –!eali$' !incile
– – S+e!e,# – )#!al be(a-i#! 7 c#n"cience S+e!e,# – )#!al be(a-i#! 7 c#n"cience
  A7BC )A" :#!al – )#+$( – $!+"$ an& &i"c!i)ina$in, A7BC )A" :#!al – )#+$( – $!+"$ an& &i"c!i)ina$in,
  BC )#"3 – @ 'ea!" : anal – b#0el" – (#l&in, #n #! le$$in, ,# BC )#"3 – @ 'ea!" : anal – b#0el" – (#l&in, #n #! le$$in, ,#
– – Ne,a$i-i") an& $#ile$ $!ainin, a,e Ne,a$i-i") an& $#ile$ $!ainin, a,e
  @ 7D 'ea!" (allic : ,eni$al" –e5l#!a$i#n an& &i"c#-e!' 1 inc3 "e5+al $en"i#n2 @ 7D 'ea!" (allic : ,eni$al" –e5l#!a$i#n an& &i"c#-e!' 1 inc3 "e5+al $en"i#n2
– – Gen&e! i&en$i%ica$i#n an& ,eni$al a0a!ene"" Gen&e! i&en$i%ica$i#n an& ,eni$al a0a!ene""
– – Oe&i+" an& Elec$!a c#)le5 99 Oe&i+" an& Elec$!a c#)le5 99
– – Ca"$!a$i#n an5ie$' an& eni" en-' Ca"$!a$i#n an5ie$' an& eni" en-'
  D7B> 'ea!" –la$enc' 16+ie$ "$a,e2 "e5+al ene!,' &i-e!$e& $# la'3 In"$i$+$i#n #% "+e!e,#4 D7B> 'ea!" –la$enc' 16+ie$ "$a,e2 "e5+al ene!,' &i-e!$e& $# la'3 In"$i$+$i#n #% "+e!e,#4
c#n$!#l #% in"$inc$+al i)+l"e" c#n$!#l #% in"$inc$+al i)+l"e"
  B> – '#+n, a&+l$ – ,eni$al : !ea0a/enin, #% "e5+al &!i-e" –!ela$i#n"(i" B> – '#+n, a&+l$ – ,eni$al : !ea0a/enin, #% "e5+al &!i-e" –!ela$i#n"(i"
– – Se5+al )a$+!a$i#n Se5+al )a$+!a$i#n
– – Se5+al i&en$i$' ,abili$' $# l#-e an& 0#!/ Se5+al i&en$i$' ,abili$' $# l#-e an& 0#!/
Psychosocial – Erickson Psychosocial – Erickson
&e-el#)en$al )ile"$#ne" 99&ela' &e-el#)en$al )ile"$#ne" 99&ela'
  A7B>)#": A7B>)#": TRUST TRUST
  B7@' B7@' AUTONOMY AUTONOMY
  @7D @7D INITIATIVE INITIATIVE
  D7B> D7B> INDUSTRY INDUSTRY
  B>7BC B>7BC IDENTITY IDENTITY
  BC7>E BC7>E INTIMACY INTIMACY
  >E7DA >E7DA GENERATIVITY GENERATIVITY
  DA an& ab#-e DA an& ab#-e EGO INTEGRITY EGO INTEGRITY
PIAGET’S COGNITIE T!EO"# PIAGET’S COGNITIE T!EO"#
A7> SENSORIMOTOR A7> SENSORIMOTOR
  REFLEFIVE REFLEFIVE
  IMITATIVE REPETITIVE BEHAVIOR IMITATIVE REPETITIVE BEHAVIOR
  SENSE OF OB?ECT PERMANENCE AND SELF SEPARATE FROM ENVT3 SENSE OF OB?ECT PERMANENCE AND SELF SEPARATE FROM ENVT3
  TRIAL AND ERROR RESULTS IN PROBLEM SOLVING TRIAL AND ERROR RESULTS IN PROBLEM SOLVING
>7GY PRE7OPERATIONAL >7GY PRE7OPERATIONAL
  SELF7CENTERED,EGOCENTRIC SELF7CENTERED,EGOCENTRIC
  CANNOT CONCEPTUALIHE OTHER;S VIEW CANNOT CONCEPTUALIHE OTHER;S VIEW
  ANIMISTIC THINIING ANIMISTIC THINIING
  IMAGINARY PLAYMATE – SYMBOLIC MENTAL REPRESENTATION – CREATIVITY IMAGINARY PLAYMATE – SYMBOLIC MENTAL REPRESENTATION – CREATIVITY
  >7J PRE7CONCEPTUAL 1PRE7LOGICAL2 >7J PRE7CONCEPTUAL 1PRE7LOGICAL2
  J7G INTUITIVE 1UNDERSTANDING OF ROLES2 J7G INTUITIVE 1UNDERSTANDING OF ROLES2
G7B>Y CONCRETE OPERATIONAL G7B>Y CONCRETE OPERATIONAL
  LOGICAL CONCRETE THOUGHT LOGICAL CONCRETE THOUGHT
  INDUCTIVE RESAONING 1SPECIFIC TO GENERAL2 INDUCTIVE RESAONING 1SPECIFIC TO GENERAL2
  CAN RELATE ,PROBLEM SOLVING ABILITY CAN RELATE ,PROBLEM SOLVING ABILITY
  REASONING AND SELF7REGULATION REASONING AND SELF7REGULATION
B>7ABOVE FORMAL OPERATIONAL THOUGHT B>7ABOVE FORMAL OPERATIONAL THOUGHT
  Ab"$!ac$ $(in/in, Ab"$!ac$ $(in/in,
  Sea!a$i#n #% %an$a"' an& %ac$ Sea!a$i#n #% %an$a"' an& %ac$
  Reali$' #!ien$e& Reali$' #!ien$e&
  De&+c$i-e !ea"#nin, De&+c$i-e !ea"#nin,
  Al' "cien$i%ic )e$(#& Al' "cien$i%ic )e$(#&
$ohl%er& – 'O"A( )EE(OP'ENT* T!IN$ING* +,)GE'ENT $ohl%er& – 'O"A( )EE(OP'ENT* T!IN$ING* +,)GE'ENT
  PRE7CONVENTIONAL 1A7D2 PRE7CONVENTIONAL 1A7D2
– – PUNISHMENT AND OBEDIENCE PUNISHMENT AND OBEDIENCE
– – OBEDIENCE TO RULES TO AVOID PUNISHMENT OBEDIENCE TO RULES TO AVOID PUNISHMENT
  CONVENTIONAL 1 D7B> 2 CONVENTIONAL 1 D7B> 2
– – MUTUAL INTERPERSONAL EFPECTATIONS,RELATIONSHIPS AND CONFORMITY MUTUAL INTERPERSONAL EFPECTATIONS,RELATIONSHIPS AND CONFORMITY
– – SOCIAL SYSTEM AND CONSCIENCE MAINTENANCE SOCIAL SYSTEM AND CONSCIENCE MAINTENANCE
– – BEING GOOD IS IMPORTANT SELF RESPECT OR CONSCIENCE BEING GOOD IS IMPORTANT SELF RESPECT OR CONSCIENCE
  POST –CONVENTIONAL 1B> – BC Y2 POST –CONVENTIONAL 1B> – BC Y2
PRIOR RIGHT OR SOCIAL CONTRACT PRIOR RIGHT OR SOCIAL CONTRACT
UNIVERSAL ETHICAL PRINCIPLE UNIVERSAL ETHICAL PRINCIPLE
ABIDE FOR COMMON GOOD ABIDE FOR COMMON GOOD
RATIONAL PERSON7VALIDITY OF PRINCIPLES7AND BECOME COMMITTED TO THEM RATIONAL PERSON7VALIDITY OF PRINCIPLES7AND BECOME COMMITTED TO THEM
INNER CONTROL OF BEHAVIOR UNDERSTANDING THE EKUALITY OF HUMAN INNER CONTROL OF BEHAVIOR UNDERSTANDING THE EKUALITY OF HUMAN
RIGHTS AND DIGNITY OF HUMAN BEINGS AS INDIVIDUALS RIGHTS AND DIGNITY OF HUMAN BEINGS AS INDIVIDUALS
DEFENSE MECHANISMS DEFENSE MECHANISMS
• • +nc#n"ci#+" in$!a"'c(ic a&#$i-e e%%#!$" $# !e"#l-e e)#$i#nal c#n%lic$ an& c#e 0i$( an5ie$' +nc#n"ci#+" in$!a"'c(ic a&#$i-e e%%#!$" $# !e"#l-e e)#$i#nal c#n%lic$ an& c#e 0i$( an5ie$'
• • a+$#)a$ic a+$#)a$ic
• • a$(#l#,' i" &e$e!)ine& b' $(e %!e6+enc' #% +"e a$(#l#,' i" &e$e!)ine& b' $(e %!e6+enc' #% +"e
e5a)le" #% DEFENSE MECHANISMS e5a)le" #% DEFENSE MECHANISMS
• • DENIAL – %ail+!e $# ac/n#0le&,e an in$#le!able $(#+,($ , %eelin,, e5e!ience #! !eali$' DENIAL – %ail+!e $# ac/n#0le&,e an in$#le!able $(#+,($ , %eelin,, e5e!ience #! !eali$'
• • DISPLACEMENT – !e&i!ec$i#n #% e)#$i#n" #! %eelin," $# a "+b.ec$ $(a$ i" )#!e acce$able #! DISPLACEMENT – !e&i!ec$i#n #% e)#$i#n" #! %eelin," $# a "+b.ec$ $(a$ i" )#!e acce$able #!
le"" $(!ea$enin, le"" $(!ea$enin,
• • PRO?ECTION – a$$!ib+$in, $# #$(e!" #ne;" %eelin,", i)+l"e" , $(#+,($ #! 0i"(e" PRO?ECTION – a$$!ib+$in, $# #$(e!" #ne;" %eelin,", i)+l"e" , $(#+,($ #! 0i"(e"
• • UNDOING – an a$$e)$ $# e!a"e an ac$ , $(#+,($ , %eelin, #! &e"i!e UNDOING – an a$$e)$ $# e!a"e an ac$ , $(#+,($ , %eelin, #! &e"i!e
• • COMPENSATION – an a$$e)$ $# #-e!c#)e !eal #! i)a,ine& "(#!$c#)in, COMPENSATION – an a$$e)$ $# #-e!c#)e !eal #! i)a,ine& "(#!$c#)in,
  SYMBOLIHATION – a le"" $(!ea$enin, #b.ec$ #! i&ea i" +"e& $# e!e"en$ an#$(e! SYMBOLIHATION – a le"" $(!ea$enin, #b.ec$ #! i&ea i" +"e& $# e!e"en$ an#$(e!
  SUBSTITUTION – !elacin, &e"i!e& , i)!ac$ical , +na$$ainable #b.ec$ 0i$( #ne $(a$ i" SUBSTITUTION – !elacin, &e"i!e& , i)!ac$ical , +na$$ainable #b.ec$ 0i$( #ne $(a$ i"
acce$able acce$able
  INTRO?ECTION – a %#!) #% i&en$i%ica$i#n in 0(ic( $(e!e i" a $a/in, in$# #ne"el% $(e INTRO?ECTION – a %#!) #% i&en$i%ica$i#n in 0(ic( $(e!e i" a $a/in, in$# #ne"el% $(e
c(a!ac$e!i"$ic #% an#$(e!1l#-e #b.ec$2 c(a!ac$e!i"$ic #% an#$(e!1l#-e #b.ec$2
  REPRESSION – +nacce$able $(#+,($" i" /e$ %!#) a0a!ene""1+nc#n"ci#+"2 REPRESSION – +nacce$able $(#+,($" i" /e$ %!#) a0a!ene""1+nc#n"ci#+"2
  SUPPRESSION7 c#n"ci#+"l' +$$in, a &i"$+!bin, $(#+,($ #! inci&en$ #+$ #% a0a!ene"" SUPPRESSION7 c#n"ci#+"l' +$$in, a &i"$+!bin, $(#+,($ #! inci&en$ #+$ #% a0a!ene""
• • REACTION FORMATION 7 REACTION FORMATION 7 e5!e""in, a$$i$+&e &i!ec$l' ##"i$e $# +nc#n"ci#+" 0i"( #! %ea! e5!e""in, a$$i$+&e &i!ec$l' ##"i$e $# +nc#n"ci#+" 0i"( #! %ea!
• • REGRESSION – !e$+!nin, $# an ea!lie! &e-el#)en$al (a"e in $(e %ace #% "$!e"" REGRESSION – !e$+!nin, $# an ea!lie! &e-el#)en$al (a"e in $(e %ace #% "$!e""
• • DISSOCIATION – &e$ac()en$ #% ain%+l e)#$i#nal c#n%lic$" %!#) c#n"ci#+"ne"" DISSOCIATION – &e$ac()en$ #% ain%+l e)#$i#nal c#n%lic$" %!#) c#n"ci#+"ne""
• • CONVERSION – e)#$i#nal !#ble)" a!e c#n-e!$e& in$# "')$#)" CONVERSION – e)#$i#nal !#ble)" a!e c#n-e!$e& in$# "')$#)"
• • FANTASY – c#n"ci#+" &i"$#!$i#n #% +nc#n"ci#+" %eelin," #! 0i"(e" FANTASY – c#n"ci#+" &i"$#!$i#n #% +nc#n"ci#+" %eelin," #! 0i"(e"
• • IDENTIFICATION – c#n"ci#+" a$$e!nin, #% #ne;" "el% %!#) an#$(e! e!"#n IDENTIFICATION – c#n"ci#+" a$$e!nin, #% #ne;" "el% %!#) an#$(e! e!"#n
• • INTELLECTUALIHATION 7 #-e! +"e #% in$ellec$+al c#nce$" b' an in&i-i&+al $# a-#i& INTELLECTUALIHATION 7 #-e! +"e #% in$ellec$+al c#nce$" b' an in&i-i&+al $# a-#i&
e5!e""i#n #% %eelin," e5!e""i#n #% %eelin,"
• • RATIONALIHATION – .+"$i%'in, #ne" ac$i#n" 0(ic( a!e ba"e& #n #$(e! )#$i-e" RATIONALIHATION – .+"$i%'in, #ne" ac$i#n" 0(ic( a!e ba"e& #n #$(e! )#$i-e"
• • SUBLIMATION 7 !ec(annelin, #% +nacce$able in"$inc$+al &!i-e" 0i$( #ne (a$ i" ace$able SUBLIMATION 7 !ec(annelin, #% +nacce$able in"$inc$+al &!i-e" 0i$( #ne (a$ i" ace$able
NURSE – PATIENT RELATIONSHIP NURSE – PATIENT RELATIONSHIP
• • SULLIVANS THEORY ON INTERPERSONAL RELATIONSHIP – DEVELOPED BY PEPLAU SULLIVANS THEORY ON INTERPERSONAL RELATIONSHIP – DEVELOPED BY PEPLAU
INTO NURSE7 PATIENT RELATIONSHIP INTO NURSE7 PATIENT RELATIONSHIP
• • SERIES OF INTERACTION BETWEEN THE NURSE AND PATIENT IN WHICH THE NURSE SERIES OF INTERACTION BETWEEN THE NURSE AND PATIENT IN WHICH THE NURSE
ASSISTS THE PATIENT TO ATTAIN POSITIVE BEHAVIORAL CHANGE ASSISTS THE PATIENT TO ATTAIN POSITIVE BEHAVIORAL CHANGE
• • T RUST T RUST
• • R APPORT R APPORT
• • U NCONDITIONAL POSITIVE REGARD U NCONDITIONAL POSITIVE REGARD
• • S ETTING LIMITS S ETTING LIMITS
• • T HERAPEUTIC COMUNICATION T HERAPEUTIC COMUNICATION
PHASES PHASES
• • PRE7INTERACTION – SELF – AWARENESS PRE7INTERACTION – SELF – AWARENESS
• • ORIENTATION PHASE – DEVELOP A MUTUALLY ACCEPTABLE CONTACT ORIENTATION PHASE – DEVELOP A MUTUALLY ACCEPTABLE CONTACT
• • WORIING – IDENTIFICATION AND RESOLUTION OF THE PATIENT;S PROBLEMS WORIING – IDENTIFICATION AND RESOLUTION OF THE PATIENT;S PROBLEMS
• • TERMINATION – ASSIST PATIENT TO REVIEW WHAT HE HAS LEARNED AND TERMINATION – ASSIST PATIENT TO REVIEW WHAT HE HAS LEARNED AND
TRANSFER HIS LEARNING TO HIS REL3 W9 OTHERS TRANSFER HIS LEARNING TO HIS REL3 W9 OTHERS
WHEN TO TERMINATE NPR WHEN TO TERMINATE NPR
• • GOALS ACCOMPLISHED GOALS ACCOMPLISHED
• • EMOTIONALLY STABLE EMOTIONALLY STABLE
• • GREATER INDEPENDENCE GREATER INDEPENDENCE
• • ABLE TO COPE WITH ANFIETY, LOSS , FEAR AND SEPARATION ABLE TO COPE WITH ANFIETY, LOSS , FEAR AND SEPARATION
COMMON PROBLEMS 7 NPR COMMON PROBLEMS 7 NPR
• • TRANSFERENCE – DEVELOPMENT OF EMOTIONAL ATTITUDE L OR – TOWARDS THE TRANSFERENCE – DEVELOPMENT OF EMOTIONAL ATTITUDE L OR – TOWARDS THE
NURSE NURSE
• • RESISTANCE – DEVELOPMNET OF AMBIVALENT FEELINGS TOWARDS SELF – RESISTANCE – DEVELOPMNET OF AMBIVALENT FEELINGS TOWARDS SELF –
EFPLORATION EFPLORATION
• • COUNTER – TRANS FERENCE – TRANSFERENCE AS EFPERIENCED BY THE NURSE COUNTER – TRANS FERENCE – TRANSFERENCE AS EFPERIENCED BY THE NURSE
PRINCIPLES OF CARE PRINCIPLES OF CARE
• • ACCPETS PATIENT AS UNIKUE WITH INHERENT VALUE AND WORTH ACCPETS PATIENT AS UNIKUE WITH INHERENT VALUE AND WORTH
• • PATIENT IS VIEWED AS HOLISTIC HUMAN BEINGS WITH INTERDEPENDENT AND PATIENT IS VIEWED AS HOLISTIC HUMAN BEINGS WITH INTERDEPENDENT AND
INTERRELATED NEEDS INTERRELATED NEEDS
• • FOCUS ON STRENGTHS AND ASSETS FOCUS ON STRENGTHS AND ASSETS
• • NON – ?UDGEMENTAL ASSISTANCE TOWARDS COPING NON – ?UDGEMENTAL ASSISTANCE TOWARDS COPING
• • EFPLORE THE PATIENTS BEHAVIOR AND THE NEED IT IS DESIGNED TO MEET AND EFPLORE THE PATIENTS BEHAVIOR AND THE NEED IT IS DESIGNED TO MEET AND
THE MESSAGE IT IS COMMUNICATING THE MESSAGE IT IS COMMUNICATING
LEVELS OF INTERVENTION LEVELS OF INTERVENTION
• • PRIMARY – INTERVENTIONS AIMED AT THE PROMOTION OF MENTAL HEALTH AND PRIMARY – INTERVENTIONS AIMED AT THE PROMOTION OF MENTAL HEALTH AND
LOWERING THE RATE OF CASES BY ALTERING THE STRESSORS LOWERING THE RATE OF CASES BY ALTERING THE STRESSORS
• • SECONDARY – INTERVENTIONS THAT LIMIT THE SEVERITY OF THE DISORDER SECONDARY – INTERVENTIONS THAT LIMIT THE SEVERITY OF THE DISORDER
– – CASE FINDING AND PROMPT T5 CASE FINDING AND PROMPT T5
• • TERTIARY – REDUCING THE DISABILITY AFTER A DISORDER TERTIARY – REDUCING THE DISABILITY AFTER A DISORDER
– – PREVENTION OF COMPLICATION AND ACTIVE PROGRAM OF REHABILITATION PREVENTION OF COMPLICATION AND ACTIVE PROGRAM OF REHABILITATION
CHARACTERISTICS OF A PSYCHIATRIC NURSE7)a.#! !#le" #% a n+!"e 7 "#ciali*in, a,en$ CHARACTERISTICS OF A PSYCHIATRIC NURSE7)a.#! !#le" #% a n+!"e 7 "#ciali*in, a,en$
an& a$ien$ a&-#ca$e an& a$ien$ a&-#ca$e
• • EMPATHY7 abili$' $# "ee be'#n& #+$0a!& be(a-i#! an& "en"e acc+!a$el' an#$(e! e!"#n" EMPATHY7 abili$' $# "ee be'#n& #+$0a!& be(a-i#! an& "en"e acc+!a$el' an#$(e! e!"#n"
inne! e5e!ience inne! e5e!ience
• • GENUINENESS9CONGRUENCE – abili$' $# +"e $(e!ae+$ic $##l" a!#!ia$el' GENUINENESS9CONGRUENCE – abili$' $# +"e $(e!ae+$ic $##l" a!#!ia$el'
• • UNCONDITIONAL POSITIVE REGARD 7 !e"ec$ UNCONDITIONAL POSITIVE REGARD 7 !e"ec$
THERAPEUTIC COMMUNICATION THERAPEUTIC COMMUNICATION
• • CLARIFICATION CLARIFICATION
• • LIMIT SETTING LIMIT SETTING
• • EMPATHETIC 9 ENCOURAGE EFPRESSION EMPATHETIC 9 ENCOURAGE EFPRESSION
• • ANSWERS NEEDS ANSWERS NEEDS
• • REFLECTIVE AND INSIGHTFUL REFLECTIVE AND INSIGHTFUL
THERAPEUTIC COMMUNICATION THERAPEUTIC COMMUNICATION
• • FOCUS ON FEELING TONE ,NEEDS ,MOTIVATION FOCUS ON FEELING TONE ,NEEDS ,MOTIVATION
• • MUST HAVE CONSISTENCY AND IS NON ?UDGEMENTAL MUST HAVE CONSISTENCY AND IS NON ?UDGEMENTAL
• • CRITERIA OF SUCCESSFUL COMMUNICATION – FEEDBACI , APPROPRIATENESS, CRITERIA OF SUCCESSFUL COMMUNICATION – FEEDBACI , APPROPRIATENESS,
FLEFIBILITY AND EFFICIENCY FLEFIBILITY AND EFFICIENCY
TECHNIKUES OF COMMUNICATION TECHNIKUES OF COMMUNICATION
• • TO INITIATE A CONVERSATION – TO INITIATE A CONVERSATION –
– – ,i-in, b!#a& #enin," ,i-in, b!#a& #enin,"
– – ,i-in, !ec#,ni$i#n 9 ac/n#0le&,e)en$ ,i-in, !ec#,ni$i#n 9 ac/n#0le&,e)en$
• • TO ESTABLISH RAPPORT TO ESTABLISH RAPPORT
– – GIVING INFORMATION GIVING INFORMATION
– – USE OF SILENCE USE OF SILENCE
• • TO GATHER INFORMATION TO GATHER INFORMATION
– – FOCUSING FOCUSING
– – VALIDATING VALIDATING
– – REFLECTING REFLECTING
– – RESTATING RESTATING
• • TO CLOSE A CONVERSATION TO CLOSE A CONVERSATION
– – "+))a!i*in, "+))a!i*in,
TYPES OF PSYCHOTHERAPIES TYPES OF PSYCHOTHERAPIES
REMOTIVATION THERAPY REMOTIVATION THERAPY
• • TREATMENT MODALITY THAT PROMOTES EFPRESSION OF FEELINGS THROUGH TREATMENT MODALITY THAT PROMOTES EFPRESSION OF FEELINGS THROUGH
INTERACTION FACILITATED BY DISCUSSION OF NEUTRAL TOPICS INTERACTION FACILITATED BY DISCUSSION OF NEUTRAL TOPICS
• • STEPS 8 STEPS 8
cli)a$e #% acce$ance cli)a$e #% acce$ance
c!ea$in, b!i&,e $# !eali$' c!ea$in, b!i&,e $# !eali$'
"(a!in, $(e 0#!l& 0e li-e in "(a!in, $(e 0#!l& 0e li-e in
a!ecia$i#n #% 0#!/" #% $(e 0#!l& a!ecia$i#n #% 0#!/" #% $(e 0#!l&
cli)a$e #% a!ecia$i#n cli)a$e #% a!ecia$i#n
MUSIC THERAPY MUSIC THERAPY
• • INVOLVES USE OF MUSIC TPO FACILITATE EFPRESSION OF FEELINGS,FACILITATE INVOLVES USE OF MUSIC TPO FACILITATE EFPRESSION OF FEELINGS,FACILITATE
RELAFATION AND OUTLET OF TENSION RELAFATION AND OUTLET OF TENSION
PLAY THERAPY PLAY THERAPY
  enable" a$ien$ $# e5e!ience in$en"e e)#$i#n in a "a%e en-i!#n)en$ 0i$( $(e +"e #% la' enable" a$ien$ $# e5e!ience in$en"e e)#$i#n in a "a%e en-i!#n)en$ 0i$( $(e +"e #% la'
  c(il&!en e5!e"" $(e)"el-e" )#!e ea"il' in la'3 !e-ealin, a" !e%lec$i#n #% c(il&;" c(il&!en e5!e"" $(e)"el-e" )#!e ea"il' in la'3 !e-ealin, a" !e%lec$i#n #% c(il&;"
"i$+a$i#n in $(e %a)il' "i$+a$i#n in $(e %a)il'
  !#-i&e $#'" an& )a$e!ial" – %acili$a$e in$e!ac$i#n – #b"e!-e an& (el c(il& !e"#l-e !#-i&e $#'" an& )a$e!ial" – %acili$a$e in$e!ac$i#n – #b"e!-e an& (el c(il& !e"#l-e
!#ble)" $(!#+,( la' !#ble)" $(!#+,( la'
G!#+ $(e!a' G!#+ $(e!a'
• • T!ea$)en$ )#&ali$' in-#l-in, $(!ee #! )#!e a$ien$" 0i$( a $(e!ai"$ $# !elie-e e)#$i#nal T!ea$)en$ )#&ali$' in-#l-in, $(!ee #! )#!e a$ien$" 0i$( a $(e!ai"$ $# !elie-e e)#$i#nal
&i%%ic+l$ie", inc!ea"e "el% – e"$ee), &e-el# in"i,($ , LEARN NEW ADAPTIVE WAYS TO &i%%ic+l$ie", inc!ea"e "el% – e"$ee), &e-el# in"i,($ , LEARN NEW ADAPTIVE WAYS TO
COPE WITH STRESS an& i)!#-e be(a-i#! 0i$( #$(e!"1 RELATIONSHIP WITH OTHERS COPE WITH STRESS an& i)!#-e be(a-i#! 0i$( #$(e!"1 RELATIONSHIP WITH OTHERS
CAN BE WORIED THROUGH2 CAN BE WORIED THROUGH2
• • IDEAL C – BA MEMBERS IDEAL C – BA MEMBERS
MILIEU THERAPY MILIEU THERAPY
• • CONSISTS OF TREATMENT BY MEANS OF CONTROLLED MODIFICATION OF THE CONSISTS OF TREATMENT BY MEANS OF CONTROLLED MODIFICATION OF THE
PATIENTS ENVIRONMENT , FACILITATE POSITIVE BEHAVIORAL CHANGE PATIENTS ENVIRONMENT , FACILITATE POSITIVE BEHAVIORAL CHANGE
• • INCREASE PATIENTS AWARENESS OF FEELINGS, INCREASE SENSE OF INCREASE PATIENTS AWARENESS OF FEELINGS, INCREASE SENSE OF
RESPONSIBILITY AND HELP ETURN TO COMMUNITY RESPONSIBILITY AND HELP ETURN TO COMMUNITY
• • clien$" lan "#cial an& ,!#+ in$e!ac$i#n clien$" lan "#cial an& ,!#+ in$e!ac$i#n
• • $#/en !#,!a)" , #en 0a!&" an& "el% )e&ica$i#n $#/en !#,!a)" , #en 0a!&" an& "el% )e&ica$i#n
FAMILY THERAPY FAMILY THERAPY
• • A METHOD OF PSYCHOTHERAPY WHICH FOCUSES ON THE TOTAL FAMILY AS AN A METHOD OF PSYCHOTHERAPY WHICH FOCUSES ON THE TOTAL FAMILY AS AN
INTERACTIONAL SYSTEM INTERACTIONAL SYSTEM
• • PROBLEM IS A FAMILY PROBLEM PROBLEM IS A FAMILY PROBLEM
• • %#c+" #n "ic/ )e)be!" be(a-i#! a" "#+!ce #% $!#+ble 9 "')$#) "e!-e a %+nc$i#n %#! $(e %a)il' %#c+" #n "ic/ )e)be!" be(a-i#! a" "#+!ce #% $!#+ble 9 "')$#) "e!-e a %+nc$i#n %#! $(e %a)il'
• • members develop sense of identity members develop sense of identity
• • #in$" #+$ %+nc$i#n #% $(e "ic/ )e)be! %#! $(e !e"$ #% $(e %a)il' #in$" #+$ %+nc$i#n #% $(e "ic/ )e)be! %#! $(e !e"$ #% $(e %a)il'
PSYCHOANALYTIC PSYCHOANALYTIC
• • %#c+"e" #n $(e e5l#!a$i#n #% $(e +nc#n"ci#+", $# %acili$a$e i&en$i%ica$i#n #% $(e a$ien$" %#c+"e" #n $(e e5l#!a$i#n #% $(e +nc#n"ci#+", $# %acili$a$e i&en$i%ica$i#n #% $(e a$ien$"
&e%en"e" &e%en"e"
• • ANFIETY RESULTS BETWEEN CONFLICTS OF ID AND EGO1DEFENSE MECHANISMS ANFIETY RESULTS BETWEEN CONFLICTS OF ID AND EGO1DEFENSE MECHANISMS
FORM TO WARD OFF2 FORM TO WARD OFF2
• • BECOMES AWARE OF UNCONSCIOUS THOUGHTS AND FELINGS3UNDERSTAND BECOMES AWARE OF UNCONSCIOUS THOUGHTS AND FELINGS3UNDERSTAND
ANFIETY AND DEFENSES ANFIETY AND DEFENSES
HYPNOTHERAPY HYPNOTHERAPY
• • VARIOUS METHODS AND TECHNIKUES TO INDUCE A TRANCE STATE WHERE VARIOUS METHODS AND TECHNIKUES TO INDUCE A TRANCE STATE WHERE
PATIENT BECOMES SUBMISSIVE TO INSTRUCTIONS PATIENT BECOMES SUBMISSIVE TO INSTRUCTIONS
BEHAVIOR MODIFICATION BEHAVIOR MODIFICATION
A THERAPEUTIC INTERVENTION INVOLVOING THE APPLICATION OF LEARNING A THERAPEUTIC INTERVENTION INVOLVOING THE APPLICATION OF LEARNING
PRINCIPLES IN ORDER TO CHANGE MAL7ADAPTIVE BEHAVIOR PRINCIPLES IN ORDER TO CHANGE MAL7ADAPTIVE BEHAVIOR
PSYCHOLOGICAL PROBLEMS ARE A RESULT OF LEARNING PSYCHOLOGICAL PROBLEMS ARE A RESULT OF LEARNING
DEFICIENCIES CAN BE CORRECTED THROUGH LEARNING DEFICIENCIES CAN BE CORRECTED THROUGH LEARNING
• • OPERANT CONDITIONING OPERANT CONDITIONING
– – USE OF REWARDS TO EINFORCE POSITIVE BEHAVIOR USE OF REWARDS TO EINFORCE POSITIVE BEHAVIOR
– – PERCEIVED AND SELF REINFORCEMENT BECOMES MORE IMPORTANT THAN PERCEIVED AND SELF REINFORCEMENT BECOMES MORE IMPORTANT THAN
EFTERNAL EFTERNAL
• • DESENSITIHATION DESENSITIHATION
– – SLOW AD?USTMENT OR EFPOSURE TO FEARED OB?ECTS1USED IN PHOBIAS2 SLOW AD?USTMENT OR EFPOSURE TO FEARED OB?ECTS1USED IN PHOBIAS2
– – PERIODIC EFPOSURE,UNTIL UNDESIRABLE BEHAVIOR DISAPPEARS OR LESSENS PERIODIC EFPOSURE,UNTIL UNDESIRABLE BEHAVIOR DISAPPEARS OR LESSENS
• • AVERSION THERAPY 7 EFAMPLE OF BEHAVIOR MODIFICATION IN WHICH PAINFUL AVERSION THERAPY 7 EFAMPLE OF BEHAVIOR MODIFICATION IN WHICH PAINFUL
STIMULUS IS INTRODUCED TO BRING ABOUT AN AVOIDANCE OF ANOTHER STIMULUS IS INTRODUCED TO BRING ABOUT AN AVOIDANCE OF ANOTHER
STIMULUS WITH THE END VIEW OF FACILITATING BEHAVIORAL CHANGE STIMULUS WITH THE END VIEW OF FACILITATING BEHAVIORAL CHANGE
OT!E" T!E"APIES OT!E" T!E"APIES
TO$EN ECONO'# TO$EN ECONO'#7REWARDING DESIRED BEHAVIOR 7REWARDING DESIRED BEHAVIOR
COGNITIE T!E"AP# COGNITIE T!E"AP# – SHORT TERM STRUCTURED THERAPY –ORIENTED TOWARDS – SHORT TERM STRUCTURED THERAPY –ORIENTED TOWARDS
PRESENT PROBLEMS ABD SOLUTIONS – AMIN FOCUS OF DEPRESSIVE DISORDERS PRESENT PROBLEMS ABD SOLUTIONS – AMIN FOCUS OF DEPRESSIVE DISORDERS
!,'O" T!E"AP# !,'O" T!E"AP# – TO FACILITATE EFPRESSION AND ENHANCE INTERACTION – TO FACILITATE EFPRESSION AND ENHANCE INTERACTION
ACTIIT# T!E"AP# ACTIIT# T!E"AP# – GROUP INTERACTION WHILE WORIING ON A TASI TOGETHER – GROUP INTERACTION WHILE WORIING ON A TASI TOGETHER
PSYHCHOPHARMACOLOGIC AGENTS
I. ANTI-PSYCHOTICS
SUB-CLASSIFICATIONS
PHENOTHIAZINES NON-PHENOTHIAZINES
MOA
- antagonizes dopamine in the CNS and also blocs Choline!gic" Histaminic"
Se!otogenic" Ad!ene!gic ne#!ot!ansmitte!s
- - 1 an$ic(#line!,ic, an$i(i"$a)inic, an$i7e)e$ic 2 bl#c/" ac$i-i$' #% $(e CNS 1 an$ic(#line!,ic, an$i(i"$a)inic, an$i7e)e$ic 2 bl#c/" ac$i-i$' #% $(e CNS
!ece$#!" an& "')a$(e$ic ne!-#+" !ece$#!" an& "')a$(e$ic ne!-#+"
"'"$e) "'"$e)
INDICATION
- - %#!)e!l' calle& )a.#! $!an6+ili*e!" 9 ne+!#le$ic"3 +"e& $# %#!)e!l' calle& )a.#! $!an6+ili*e!" 9 ne+!#le$ic"3 +"e& $#
!elie-e "'c(#$ic "')$#)"1 &el+"i#n" , (all+cina$i#n" !elie-e "'c(#$ic "')$#)"1 &el+"i#n" , (all+cina$i#n"
an& l##"ene"" #% a""#cia$i#n2#% "c(.i*#(!enia, )ania an& "'c(#$ic an& l##"ene"" #% a""#cia$i#n2#% "c(.i*#(!enia, )ania an& "'c(#$ic
&e!e""i#n an& #!,anic )en$al &i"#!&e!" &e!e""i#n an& #!,anic )en$al &i"#!&e!"
- ac#te management o$ agitation and h%pe!acti&it%
SIDE/ ADVERSE EFFECTS:
Chlo!p!omazine 'Tho!azine(
)l#phenazine 'P!oli*in(
Pe!phenazine ' T!ila$on(
P!ochlo!pe!azine
'Compazine(
Thio!idazine ' +ella!il(
T!i$lo#pe!azine 'Stelazine(
Clozapine ' Cloza!il(
Halope!idol ' Haldol(
Olanzapine ' Z%p!e*a (
,ispe!idone ' ,ispe!dal(
THIOXANTHENES
Thiothi*ene ' Na&ane(
 ANTICHO-INE,.IC E))ECTS
  1EPS2EFTRAPYRAMIDAL SYMPTOMS 1EPS2EFTRAPYRAMIDAL SYMPTOMS
– – PSEUDOPARIINSONISM7$!e)#! , )a"/ li/e %acie" &!##lin, , !e"$le"""ne"" PSEUDOPARIINSONISM7$!e)#! , )a"/ li/e %acie" &!##lin, , !e"$le"""ne""
– – AIATHISIA7 !e"$le""ne"",an& an5ie$' AIATHISIA7 !e"$le""ne"",an& an5ie$'
– – DYSTONIA7,!i)acin, , $#!$ic#lli" ,#c+l#,'!ic c!i"i", in$e!)i$$en$ )+"cle "a")" DYSTONIA7,!i)acin, , $#!$ic#lli" ,#c+l#,'!ic c!i"i", in$e!)i$$en$ )+"cle "a")"
- TA,/I0E /1S2INESIA-lip smaing and tong#e and mo#th
 'N+S( NE3,O-EPTIC +A-I.NANT S1N/,O+E4
- h%pe!the!mia" and se&e!e EPS -m#sc#la! !igidit%" t!emo!s" t!ism#s" cho!ei$o!m
mo&ements"a#tonomic instabilit% 5h%pe!acti&it%
and alte!ations in -OC
 SEIZ3,ES
HEPATOTO6ICIT14
O,THOSTATIC H1POTENSION
PHOTOSENSITI0IT1 and H1PE,SENSITI0IT1
EN/OC,INE /ISO,/E,S
/1SC,ASIAS 4
A.,AN3-OC1TOSIS – so!eth!oat"chills"$e&e!"malaise
-E32OPENIA
CONTRAINDICATIONS AND SPECIAL PRECAUTIONS:
C9I 8 ('e!"en"i$i-i$' , ,la+c#)a , c#n-+l"i-e &9# , !e,nanc' an& lac$a$i#n, el&e!l' clien$" C9I 8 ('e!"en"i$i-i$' , ,la+c#)a , c#n-+l"i-e &9# , !e,nanc' an& lac$a$i#n, el&e!l' clien$"
NURSING CARE GUIDELINES:
C- antips%chotics" ne#!oleptics" ma7o! t!an8#ilize!s
H- dec!eased o&e!t o! positi&e mani$estations o$ ps%chosis
E- p9c9
C- !ise slo:l%
a&oid s#nlight
,epo!t –so!eth!oat"$e&e!"m#sc#la! !igidit%
,ed#ced ps%chomoto! agitation and insomnia – ; :ee
,ed#ction o$ hall#cinations" del#sions and tho#ght diso!de! taes <-= :ees $o! $#ll
the!ape#tic e$$ect
>P and tempe!at#!e
K – monito! blood le&els
Seiz#!es" N+S and EPS
-9)9T9?s
C>C :ith di$$e!ential
medical management @
N+S – >!omoc!iptine o! Amantadine' dopamine agonist( and
/ant!olene '/ant!i#m( m#sc#la! !ela*ant
/%stonia – /iphenh%d!amine">enzt!opine " /iazepam" -o!azepam
Pse#dopa!insonism – Antipa!insonian" Anticholine!gic
Aathisia – Anticholine!gic" >enzodiazepines" >eta-bloce!s"Clonidine
Ta!di&e d%sinesia – ea!l% !e$e!!al-dose !ed#ction " no anticholine!gics
II. ANTI-PARKINSONIAN AGENTS
CLASSIFICATIONS
A T1PES @
;9( /OPA+INE,.IC /,3.S
MOA@ enhance dopamine!gic acti&it%
slo:s dete!io!ation o$ dopamine!gic ne!&e cells
Inc!easing dopamine
Ca!bidopa – -e&odopa ' Sinemet(
Amantadine ' S%mmet!el(
>!omoc!iptine +es%late ' Pa!lodel(
-e&odopa ' -a!odopa(
Pe!golide +es%late ' Pe!ma*(
,opini!ole',e8#ip(
Tolcapone ' Tasma!(
2.) ANTI-CHO-INE,.IC A.ENTS
MOA:inhibit !elati&e e*cess in choline!gic acti&it%" s%mptomatic !elie$
/ec!ease signs and s%mptoms ' t!emo!s"!igidit%" d!ooling p!omote optimal le&els
o$ moto! $#nction 'gait" post#!e and speech (
INDICATIONS: )o! management o$ anti ps%chotic ind#ced EPS- pse#dopa!insonism
SIDE AND ADVERSE EFFECTS
Anticholine!gic E$$ects >l#!!ing o$ &ision" constipation" B/?s and o!thostatic h%potension"
so!eth!oat4
Headache" photosensiti&it%" d!o:siness" CH) and hall#ciantions
CONTRAINDICATIONS AND SPECIAL PRECAUTION
.la#coma" tach%ca!dia" HPN" Ca!diac /5O" asthma" d#odenal #lce!
NURSING CARE GUIDELINES
C- dopamine!gic o! anti-choline!gic
H- dec!ease t!emo!s and !igidit% in A-B da%s
E- p.c.
C- a&oid s#dden position change
A&oid 0it9 >< and CHON !ich $oods- dec9 abso!ption o$ medication
A&oid alcohol-inc!eases sedati&e e$$ects
K- chec >P- o!thostatic h%potension
d!#gs not :ithd!a:n ab!#ptl%
III. ANTI DEPRESSANTS
COMMON TYPES

T,IC1C-ICS +ONO A+INE O6I/ASE SE-ECTI0E SE,OTONIN
INHI>ITO,S ,E3PTA2E INHI>ITO,S
T!ihe*%pheiedil ' A!tane(
>ipe!iden H%d!ochlo!ide ' Aineton(
>enzt!opine +es%late ' Cogentin(
/iphenh%d!amine H%d!ochlo!ide
'>enad!%l(

+isc9 agent
Selegiline ' Eldep!%l(
Imip!amine'To$!anil(
Amit!ipt!%line ' Ela&il(
Clomip!amine 'Ana$!il(
/o*epin ' Sine8#an(
No!t!%pt%line ' A&ent%l(
T!an%lc%p!omine 'Pa!nate(
Isoca!bo*azid ' +a!plan(
Phenelzine 'Na!dil(
Citalop!am ' Cele*a(
)lo#*etine 'P!ozac(
Pa!o*etine ' Pa*il(
Se!t!aline ' Zolo$t(
)l#&o*amine '-#&o*(
Mec!"#$% &'
Ac(#&"
CNS STI+3-ANTS
INDICATIONS
e$$ecti&e in management and t!eatment o$ dep!ession and !elated mood and dep!essi&e diso!de!s
s#ch as@
Obsessi&e comp#lsi&e "Eating d5o"Obesit%">ipola! diso!de!"Panic d5o
SIDE EFFECTS AND ADVERSE REACTIONS:

TCA’S MAOI SSRI CNS Stimulants
Ca!diac a!!h%thmias"
palpitations"o!thostatic
h%potension
Constipation"Sedation"
anticholine!gic e$$ects
Con$#sion
>one ma!!o: dep!ession
H%pe!tensi&e c!isis
-i&e! and ca!dio&asc#la!
disease
Ceight gain
Se*#al d%s$#nction
photosensiti&it%
T!emo!s" dec!eased
libido" NA0/A
Ne!&o#sness" insomnia"
d!o:siness
an*iet%
.!o:th s#pp!ession"
insomnia
CONTRAINDICATIONS AND SPECIAL PRECAUTIONS
TCA’S MAOI SSRI CNS Stimulants
H%pe!sensiti&it%" li&e!
disease " gla#coma
H%pe!tension
Ca!dio&asc#la! disease
and -i&e! disease
same
NURSING CARE GUIDELINES
C- anti-dep!essants
H- dec!eased signs and s%mptoms o$ dep!ession'inc!eased appetite and sleep
E – p9c9
TCA’S MAOI SSRI CNS Stimulants
C-
A-B :s initial e$$ect
B-< :s $#ll the!ape#tic
e$$ect
A-B initial
B-D $#ll the!9 E$$ect
A&oid $oods !ich in
A-B initial
B-D $#ll the!9 e$$ect
.i&e in A+ " not
be%ond A pm
< ho#!s be$o!e bedtime
Inhibits !e#ptae and
dest!#ction o$
se!otonin to p!olong its
action
>locs the
metabolic
dest!#ction o$
ne#!ot!ansmitte!s b%
the enz%me mono-
amine o*idase
P!olongs the action
o$ no!epineph!ine
/opamine
Se!otonin b%
blocing the
!e#ptae o$ this
ne#!ot!ansmitte!s
,italin ' +eth%lphenidate(
Amphetamine ' >enzed!ine(
Inc!eases le&els o$ ne#!ot!ansmitte!s
in the b!ain the!eb% inc!easing CNS
acti&it% and dec!easing
h%pe!acti&it%9
Emphasize compliance
A&oid cit!#s 7#ice –
dec!ease abso!ption
K-
+onito! >P" H, and
EC.
t%!amine –leads to
h%pe!tensi&e c!isis
' p!ocessed"p!ese!&ed and
$e!mented (
+onito! >P and $ood
items
IV. ANTI – MANIC
E)AMPLES
MOA
E*act mechanism #nno:n " alte!s the le&el o$ no!epineph!ine and othe! ne#!ot!ansmitte!s
INDICATIONS
• • T!ea$)en$ #% ac+$e )ania an& %#! !#('la5i" #% !ec+!!en$ )anic an& &e!e""i-e ei"#&e" in T!ea$)en$ #% ac+$e )ania an& %#! !#('la5i" #% !ec+!!en$ )anic an& &e!e""i-e ei"#&e" in
bi#la! &i"#!&e! bi#la! &i"#!&e!
SIDE AND ADVERSE EFFECTS
NA0/A
)ine t!emo!s leading to coa!se t!emo!s
Thi!st
N%stagm#s
Neph!oto*icit%4
Ca!diac to*icit%4
H%pe!th%!oidism – Th%!oid C!isis4
CONTRAINDICATIONS AND SPECIAL PRECAUTION
Ca!dio&asc#la! disease " !enal disease" clients on lo: sodi#m diet and on di#!etic the!ap%" b!ain damage"
p!egnanc% and lactation
NURSING CARE GUIDELINES
C- mood stabilize! – anti manic
H- dec!ease h%pe!acti&it%5manic episodes
Initial e$$ect – ;E-;D da%s
)#ll the!ape#tic e$$ect B-D :ees
E- a$te! meals :ith mil o! $ood
C- antips%chotics gi&en :ith lithi#m $o! immediate management o$
manic episodes9
/iet – Na <-;E g!ams a da%F $l#ids- B lite!s pe! da%
A&oid ca$$eine " di#!etics and acti&ities that inc!ease pe!spi!ation
K- monito! $o! #nto:a!d signs and s%mptoms
+onito! se!#m le&el at least once a month'A9+9 ;A ho#!s a$te!
the last dose
maintenance dose - 9G – ;9A mE8 5 -
ac#te le&el – ;9G mE8 5 -
le&el $o! the elde!l% 9D – ;9E mE8 5 -
Antidote $o! to*icit% – +annitol 'Osmit!ol( o! Acetazolamide '/iamo*(
V. ANTI ANXIETY
CLASSIFICATION:
>ENZO/IAZEPINES AZASPI,ONES NON->ENZO/IAZEPINE
+iscellaneo#s agents
-ithi#m Ca!bonate ' Esalith"
-ithane" H#ilini#m –,"
-ithionate(
Ca!bamazepine 'Teg!etol (
Alp!azolam ' 6an8a*(
Chlo!diazepo*ide ' -ib!i#m(
Clo!azepate ' T!an*ene(
/iazepam ' 0ali#m(
-o!azepam ' Ati&an(
O*azepam ' Se!a*(
MOA@ dep!esses ,etic#la! Acti&ating s%stem and !ed#ces an*iet% b% stim#lating the action o$ an inhibito!%
ne#!ot!ansmitte! called .A>A
INDICATIONSF t!eatment o$ an*iet% diso!de!s and $o! sho!t te!m !elie$ o$ s%mptoms o$
An*iet%F selecti&e medications e$$ecti&e $o! seletal m#scle !ela*ation" p!e
and post-op sedation" seiz#!e cont!ol9
SIDE AND ADVERSE EFFECTS
Sedation and /izzinees"d!o:siness and d!% mo#th
Pa!ado*ical !eactions4'hall#cination and del#sions("CNS dep!ession4
Addison?s disease " /ependenc%4" hepatoto*icit%4
CONTRAINDICATIONS AND SPECIAL PRECAUTION
.la#coma" h%pe!sensiti&it%" li&e! and idne% d%s$#nction" ps%choses"
elde!l% " p!egnanc% and lactation
NURSING CARE GUIDELINES
C- an*iol%tics" mino! t!an8#ilize!s
H- dec!ease an*iet%
E- a9c9 – $ood dela%s abso!ption
C- !ise slo:l%
A&oid ca$$eine and alcohol
K- monito! C>C" -)T?s"
!epo!t so!eth!oat" 7a#ndice" :eaness and $e&e!
>#spi!one
'>#spa!(
H%d!o*%zine ' 0ista!il(
+ep!obamate ' E8#anil(