ATI Engage Module: Therapies
Treatment for mental illnesses can take the form of
- Evidence based medication - Therapies - Supportive services
Phases of group therapy
- Forming - Storming - Norming - Working - Adjouring
Aditional therapies include
- brain-stimulating therapies
Often the nurse will not be performing the therapy, but rather
- collecting initial assessment data - recognizing the client's need for therapy - documenting interventions - evaluating manifestation and treatment progression, or even advocating for the client's right to treatment .
Telehealth can reduce
- delays in care - decrease stigma for those not wanting to see a therapist in person - potentially prevent emergency room visits by having the ability to contact the therapist during off-hours
Family therapy can be related to
- divorce - the death of a family member - communication problems - substance use - interpersonal conflicts - behavioral problems, potentially among children
Key factors to individual therapy
- establishing trust and building a therapeutic relationship
Client Teaching
- geared toward informing the client about the therapy - Instruct the client on the benefits of the different types of therapies and what types of diagnoses they can assist with. - reinforcing the client's confidentiality related to the therapy and assisting the client with any goals or homework the therapist may have given the client.
Components of Milieu therapy
- having a therapeutic relationship - encouraging a daily routine - socializing with others - focusing on self-care - making sure the client has a supportive environment, which can be staff or family
Phases of group therapy: storming (transitional phase)
- occurs when group members act out behaviors to find their role in the group - agreements and disagreements may occur
The psychiatric mental health (PMH) nurse assists in
- providing health promotion and maintenance - teaching self-care activities - administering psychopharmacological treatments - educating clients, families, and those in the community - working with interprofessional team members.
Types of therapy
- psychoanalytic therapy - behavioral therapy - cognitive therapy - Cognitive-behavioral therapy - Individual therapy - Group therapy - Family therapy - Milieu therapy - Biological therapy - Telehealth
Behavioral Therapy is a type of ______ that fouceses on ...
- psychotherapy modifying a client's maladaptive behavior patterns and responses, and instead utilizing adaptative behaviors.
Psychoanalytic therapy is a type of _________ (based on talking) through which a ...
- psychotherapy therapist assists a client to consider issues that are rooted in the unconscious mind, gain insight into the thoughts or motivations, and change behaviors or ways of thinking.
Therapies can be geared toward
- talking - examining past experiences relateing to current or causing behaviors - transitioning maladaptive responses to adaptive - improving dynamics within family communication
Brain-stimulating therapies
- vagus nerve stimulation (VNS) - repetitive transcranial magnetic stimulation (rTMS) - magnetic seizure therapy (MST) - deep brain stimulation (DBS) - electroconvulsive therapy (ECT).
Types of treatment include
- yoga - exercise - meditation - pet therapy - dietary patterns
Milieu therapy description
A form of psychotherapy in which the environment is controlled to assist the client in preventing self-destructive or maladaptive behaviors.
Group therapy: nursing considerations
A nurse may lead this group. The nurse is in a leadership role.
Complementary Therapies: meditation
A practice in calming the mind that may decrease anxiety and manifestations of other mental illnesses.
Complementary Therapies: Pet therapy
A practice that uses pets to help clients decrease anxiety and improve emotional response.
Behavioral Therapy Description
A type of psychotherapy that focuses on modifying a client's maladaptive behaviors, patterns, and responses, and instead encourages adaptive behaviors.
A client reports that the noise in the day room is causing increased anxiety, so the nurse recommends the client exercise in another room for a while. Which of the following types of therapy would this fall under? A. Milieu Therapy B. Group Therapy C. Cognitive Therapy D. Biological Therapy
A. Milieu Therapy A form of psychotherapy in which the environment is controlled to assist the client in preventing self-destructive or maladaptive behaviors.
Cognitive behavioral therapy: interventions
Acknowledge the patient's feelings related to their illness. Encourage the client to explore alternative actions and ways to assess their own thinking and behavior.
Individual therapy: nursing considerations
Advocate for the client's treatment and ensure their dignity and respect is maintained.
Individual therapy: interventions
Assist the client in finding a therapist who fits the client's individual needs.
Complementary Therapies: Yoga
Assists with muscle movement and can improve mood.
Adaptive Behaviors
Behaviors that allow an individual to cope with their environment in a positive manner.
Maladaptive behavior
Behaviors that prevent an individual from coping with new or difficult circumstances, problems, or environments.
Family therapy: nursing considerations
Being aware of the different family functions.
Complementary Therapies: exercise
Can assist with improving mood, but also reducing side effects such as fatigue or weight gain from many traditional medications for mental health.
Telehealth and online therapy description
Clients meet with a therapist virtually. This can be in the form of a viral video conference, telephone, or even online chat.
Cognitive therapy: nursing considerations
Collect and analyze data related to the client throughout the process.
Behavioral therapy: nursing considerations
Collect and analyze data related to the client's behaviors.
Cognitive-behavioral therapy description
Considers how a client's feelings influence their behaviors or thoughts and uses a cognitive and behavioral approach to decrease their anxiety.
Joseph wants to know if he can use his medications with the yoga and meditation. Which of the following is the most appropriate response by the nurse? A. You need to stay on your medication, as you cannot use both together. B. You need to stay on your medication. Once you are doing better, then you can add in yoga or meditation. C. Complementary or alternative therapies must be used by themselves. D. Complementary or alternative therapies can be used with your medication or by themselves.
D. Complementary or alternative therapies can be used with your medication or by themselves. Complementary and alternative therapies are treatments for clients with interventions that are based on biomedical treatment instead of, or in conjunction with, traditional medical treatment. The client should always consult their provider when thinking about starting or stopping any form of medication.
The client reports concern with mental health care as members of their family will find the weekly trips to therapy an obstacle. Which of the following is the best option to assist the client? A. Milieu Therapy B. Individual Therapy C. Behavioral Therapy D. Telehealth Therapy
D. Telehealth Therapy Telehealth therapy allows clients to meet with a therapist virtually. This can be in the form of a viral video conference, telephone, or even online chat.
Cognitive therapy: interventions
Encourage the client to have a positive thought process that is focused on reality.
Behavioral therapy: interventions
Encourage the client to identify their maladaptive behaviors and any adaptive coping skills they practice.
Cognitive therapy: education
Explain to the client that cognitive therapy involves using an individual's past to understand current problems and how they affect mental health. Reassure the client it is a safe place to talk about past events.
Group therapy: interventions
Interventions are geared toward encouraging all group members to participate in the session and providing guidance on the topic.
This is a process of developing way of coping with life -->
It is by better understanding past behaviors, developing new motivations to change behaviors, and learning to change thinking that the client learns to deal with problematic emotions and change their behaviors
Are these treatments approved by the FDA for the treatment of mental illness?
NO
Psychoanalytic therapy: interventions
Planning interventions that are geared toward helping the client make a change when desired. Helping the client to see themselves as an individual
Group therapy: education
Provide education related to the specific group topic (e.g., positive coping skills, ways to decrease stress).
Behavioral therapy: education
Provide education related to the use of adaptive coping skills, which assist the client is recognizing there is a problem and using a healthy way to deal with it. The nurse can assist the client in understanding what a healthy coping skill is.
Family therapy: education
Provide education to the family on expectations related to this type of therapy.
Cognitive behavioral therapy: education
Provide psychoeducation, which is information related to the individual's mental illness, such as understanding what is and how to cope with it.
Individual therapy: education
Provide the client with education related to the benefits of individual therapy. Benefits of therapy include gaining a better understanding of self, learning how to recognize and respond adaptively to emotions, identifying manifestations of mental illness, and identifying and using adaptive coping strategies.
Psychoanalytic therapy: education
Providing them with information that explains that the purpose is to express any repressed emotions and learn adaptive coping skills.
Group therapy description
Psychosocial therapy in which multiple clients meet together with a therapist, where ideas and insights are shared for the purpose of improving one's coping skills.
Psychoanalytic therapy: nursing consideration
Recognize behaviors noted through psychoanalysis (e.g., an irrational fear).
Family therapy: interventions
Recognize when there is dysfunction within a family or when a problem exists.
Individual therapy description
Reduces or eliminates clients' manifestations to promote well-being so they can continue with daily life. Therapy sessions can be weekly for any given length of time.
Complementary Therapies: dietetics
Some supplements, such as omega-3 fatty acids, may relieve symptoms of depression or schizophrenia.
Cognitive Therapy Description
The concept that problems can stem from an individual's past but are guided and maintained by what is going on in the present.
Family therapy description
The focus of this therapy is to work as a unit, focusing on the family as a whole rather than the individuals.
Cognitive behavioral therapy: Nursing considerations
The nurse must be aware of the principles of cognitive behavioral therapy.
Psychoanalytic Therapy Description
This therapy examines the unconscious mind and how it can influence an individual's thoughts, feelings, or behaviors.
Psychosocial therapy
Treatment designed to assist with emotional or behavioral disturbances that required social interactions.
Biological therapy description
Treatment for mental illness that alters the individual's psychological functioning; can be pharmacological or brain-stimulating therapy.
Individual therapy involves
a client and a therapist working one-on-one through talk therapy
Typically groups are formed based on
a specific diagnosis to best assist group members
During group therapy. members often
act as a support network and guide their peers toward ways to improve coping skills and adapt to life changes
Biological therapy is the treatment for mental illness that
alters the individual's psychological functioning
Complementary and alternative therapies are treatments for clients with interventions that are
based on biomedical treatment instead of, or in conjunction with, traditional medical treatment
The person must now learn
better ways to coping (new ways of thinking) that will lead to better patterns of living (behaviors)
Cognitive-Behavioral Therapy (CBT) is based on the premise that the
client's mental health problem is based in part on faulty thinking or unhealthy thoughts, related feelings, and learned patterns of behaviors - the learned behaviors has resulted in unhealthy ways of living or behaving
Phases of group therapy: Working (performing phase)
consists of growth and teamwork occuring
Goals to individual therapy are
established to assist in guiding the length of treatment
Group therapy in children
form of play, thus showing the other group memebers how to adapt through play
Family therapy involves those who
have a relationship in which members are engaged with one another
Psychoanalytic therapy can be used with
hypnosis to assist the client in recalling items in their unconscious mind
Key to family therapy is
improving communication among the family members
Phases of group therapy: adjourning (termination phase)
involves closure for the group and reviewing outcomes and achievements made.
Phases of group therapy: norming (cohesiveness phase)
involves standards developing and therapeutic alliances forming
Behavioral Therapy follow the concept that behaviors are
learned and can have negative consequences
Phases of group therapy: forming (orientation phase)
occurs when the norms of the group are discussed such as confidentiality and when termination of the group may occur
Behavioral therapy is often with with clients with
phobias or even substance use disorders
Cognitive Therapy is based on the concept that
problems can stem from an individual's past but are guided and maintained by what is happening in the present - to treat and deal with the problem, one must address the current issues
The goal of individual therapy is to
promote the client's well-being and assist or eliminate a client's symptoms so they can continue with daily life
Biological therapy can be
psychopharmacology
Group Therapy is a
psychosocial therapy in which multiple clients meet with a therapist
Individual therapy is also referred to as
psychotherapy
Milieu Therapy is a form of
psychotherapy
The nurse uses therapeutic communication and counseling techniques to
reinforce therapy goals and empower the client in their own recovery
In a group therapy setting, ideas and insights are
shared to improve one's coping skills
Often these interventions are geared toward the
support of the therapy and reinforce mental health recovery and trauma-sensitive care
Milieu Therapy
the environment is controlled to assist the client in preventing self-destructive or maladaptive behavior
Group therapy in older adults
the key features are socialization and sharing memories to which other can relate
CBT treatment involved helping the individual recognize
the thought patterns that created their current situation and reevaluate them in light of the current situation and apply new behaviors
In cognitive therapy, the therapist will often identify
the thoughts an individual has that enhance or contribute to one's anxiety
Group therapy with adolescents
the value of peer relationships is often key
Countertransference
therapist or health care worker has unconscious feelings toward a client who reminds them of an individual from their past; can be positive or negative. Example: - a nurse seeing a child who is suffering from a broken leg. This prompts the nurse to recall their sibling having a broken leg, and the nurse then brings the client extra popsicles.
Group therapy allows clients to realize
they are not alone in their struggles
It is believed that for an individual to change these behaviors,
they do not necessarily have to address the underlying cause but simply adjust the behavior to an adaptive response
Purpose of psychoanalytic therapy
to help a client to express any repressed emotions, brining unconscious thoughts to the conscious mind
Psychoanalytic Therapy examines how the
unconscious mind can influence individual thoughts, behaviors, and feelings - this is rooted in experiences from childhood and how they influence an individual's current actions
Transference
when the client develops feelings toward the therapist or health care worker in a way that mimics a relationship that was significant in their childhood. Example: - a client seeing a nurse who reminds them of their grandmother, then referring to the nurse as "dear" and "honey" if that was what they called their grandmother.
The focus of family therapy is to
work as a unit—the family as a whole rather than the individuals
