NSG 526 Test 2

Behavioral therapy is effective in treating people with phobias, alcoholism, -------------- and many other conditions

(phobias/ETOH) schizophrenia,

While therapeutic touch has uncertain research support, practitioners of therapeutic touch believe that the therapy is useful in relieving -premenstrual syndrome -depression -complications in ----------------- babies -secondary infections associated with ------------(HN) infection -lowering b------------ ----------- -decreasing e------------ -easing abdominal c--------- and nausea -resolving f-------------- -accelerating the healing of fractures, wounds, and in--------------.

-premenstrual syndrome -depression -complications in premature babies -secondary infections associated with human immunodeficiency virus (HN) infection -lowering blood pressure -decreasing edema -easing abdominal cramps and nausea -resolving fevers -accelerating the healing of fractures, wounds, and infections.

CBT Techniques -Validity Testing -Cognitive Rehearsal -Guided Discovery -Writing in a journal -Homework -Modeling -Systematic positive reinforcement -Aversive conditioning Which one........... The client is asked to think about and recreate a difficult situation from their past. The client and the therapist work through a positive solution to the problem. The client is shown how to draw from this rehearsed solution to better cope with similar future problems.

Cognitive Rehearsal

Therapeutic Factors Universality Altruism Instillation of hope Imparting information Corrective recapitulation of primary family experience Development of socializing techniques Imitative behavior Cohesiveness Existential factors Catharsis Interpersonal learning Self-Understanding Which one In a mixed group that has members at various stages of development or recovery, a member can be inspired and encouraged by another member who has overcome the problems with which they are still struggling.

Instillation of hope

Milieu Therapy for the Suicidal Client: In accordance with unit policies and procedures the client is observed continuously by nursing staff. This intense attention provides for safety and allows for constant reassessment of risk. Monitoring flow sheets for suicidal precautions are more clinically useful if they include a description of a----------- as well as b---------. Flow sheets should also indicate clear accountability for staff starting and ending their periods of observation. In addition to observing the client, the nurse is responsible for monitoring the environment for safety hazards.

AFFECT as well as BEHAVIOR

Rational-Emotive Therapy (RET); Exposure Therapy for Anxiety (Albert Ellis) The therapist asks himself/herself the following: A - A------- - what is the activating experience? B - Be------- - is it irrational or rational? C - Con------- do they result from irrational thinking? D - Dis------ what is the client's internal dialogue? E - Ef-------- - what is the e------and how does this redefining help the client?

A - Activity - what is the activating experience? B - Belief - is it irrational or rational? C - Consequences - do they result from irrational thinking? D - Dispute - what is the client's internal dialogue? E - Effect - what is the effect and how does this redefining help the client?

Therapeutic Factors Universality Altruism Instillation of hope Imparting information Corrective recapitulation of primary family experience Development of socializing techniques Imitative behavior Cohesiveness Existential factors Catharsis Interpersonal learning Self-Understanding Which one The group is a place where members can help each other, and the experience of being able to give something to another person can lift the member's self esteem and help develop more adaptive coping styles and interpersonal skills.

Altruism

CBT Techniques -Validity Testing -Cognitive Rehearsal -Guided Discovery -Writing in a journal -Homework -Modeling -Systematic positive reinforcement -Aversive conditioning Which one........... This technique uses principles of classical conditioning to lessen the appeal of a behavior that is difficult to change because of the habitual nature. The behavior is exposed to unpleasant stimulus while engaged in the behavior. Eventually the behavior is associated with the unpleasant stimulus.

Aversive Conditioning

The holistic natural, alternative, and complementary (NAC) therapies that are commonly used today in the United States include: Acupuncture A------------ (the traditional medical system of India, has delineated three categories of fundamental regulatory principles of the body, mind, and behavior. These three categories, called doshas, are named Vata, Pitta, and Kapha.) Biofeedback Chiropractic manipulation Diet-based therapies Deep-breathing exercises Energy healing therapy/Reiki Exercise therapy Guided imagery Hypnosis Massage Meditation Herbal therapy Aromatherapy re----------- Yoga Prayer and spiritual practices

Ayurveda Reflexology

------------ Theory of Depression the cognitive model of depression and the concept that cognitive processing distortions underlie psychological disorders. According to ------------et al. (1979), depression can be understood via schemas, cognitive errors, and the cognitive triad (i.e., negative views of ----------, tendency toward interpreting experiences in a negative manner, and holding negative views of the ---------).

Beck's Beck/self/future

Therapeutic Factors Universality Altruism Instillation of hope Imparting information Corrective recapitulation of primary family experience Development of socializing techniques Imitative behavior Cohesiveness Existential factors Catharsis Interpersonal learning Self-Understanding Which one Is the primary therapeutic factor from which all others flow. Humans are herd animals with an instinctive need to belong to groups, and personal development can only take place in an interpersonal context. A ------------- group is one in which all members feel a sense of belonging, acceptance, and validation.

Cohesiveness/cohesive

CAM stands for -C------------ and Alternative Medicine (CAM)

Complementary

Therapeutic Factors Universality Altruism Instillation of hope Imparting information Corrective recapitulation of primary family experience Development of socializing techniques Imitative behavior Cohesiveness Existential factors Catharsis Interpersonal learning Self-Understanding Which one Members often unconsciously identify the group therapist and other group members with their own parents and siblings in a process that is a form of transference specific to group psychotherapy. The therapist's interpretations can help group members gain understanding of the impact of childhood experiences on their personality, and they may learn to avoid unconsciously repeating unhelpful past interactive patterns in present-day relationships.

Corrective recapitulation of primary family experience

----------- therapy is a growing field that includes therapies originating from many parts of the world. It is based on the belief that nonphysical bioenergy forces pervade the universe and people. Some cultures believe this comes from GOD Use hands to direct --------, one example is -------------

Energy energy/reiki

Therapeutic Factors Universality Altruism Instillation of hope Imparting information Corrective recapitulation of primary family experience Development of socializing techniques Imitative behavior Cohesiveness Existential factors Catharsis Interpersonal learning Self-Understanding Which one Group members achieve a greater level of self-awareness through the process of interacting with others in the group, who give feedback on the member's behavior and impact on others

Interpersonal learning

Therapeutic Factors Universality Altruism Instillation of hope Imparting information Corrective recapitulation of primary family experience Development of socializing techniques Imitative behavior Cohesiveness Existential factors Catharsis Interpersonal learning Self-Understanding were all created by ------------------------

Irvin Yalom

Dialectical Behavior Therapy (DBT) as an alternative to CBT: Founded by Marsha M. ---------to treat ---------- Personality Disorder spin off of CBT. Difference in DBT is related to the use of M------------, M--------- and E---------- Regulation in the DBT approach.

Linehan Borderline Mindfulness, Meditation and Emotional

CBT Techniques -Validity Testing -Cognitive Rehearsal -Guided Discovery -Writing in a journal -Homework -Modeling -Systematic positive reinforcement -Aversive conditioning Which one........... The therapist conducts role playing exercises to demonstrate appropriate reactions to different situation.

Modeling

A sound therapeutic relationship is necessary for effective therapy, but not the--------- Some forms of therapy assume that the main reason people get better in therapy is because of the positive relationship between the therapist and client. Cognitive-behavioral therapists believe it is important to have a good, trusting relationship, but that is not enough. CBT therapists believe that the clients change when they learn to ------ differently; therefore, CBT therapists focus on teaching rational ----------counseling skills.

NOT the focus. think self (basically relationship with therapist is not as important as the patient changing their thinking)

Ivan Pavlov John Watson F. Skinner Which one.................... Classical Conditioning Theory-when a neutral stimulus (a bell) was repeatedly paired with another stimulus (food that triggered salivation), eventually the sound of the bell alone could elicit salivation in the dogs. It is important to recognize that classical conditioned responses are ---------------

Pavlov/involuntary

------------ is a form of bodywork that focuses primarily on the feet. Each foot contains more than 7,000 nerve endings. The belief is that areas on the feet and hands that correspond to specific organs, glands, and other parts of the body. Used to treat: Stress and stress-related conditions Tension headaches D--------- disorders Arthritis I-------------- H----------- imbalances Sports injuries M------------ disorders, such as premenstrual syndrome (PMS) Digestive problems, such as --------------- Back pain

Reflexology Digestive Insomnia Hormonal Menstrual constipation

Therapeutic Factors Universality Altruism Instillation of hope Imparting information Corrective recapitulation of primary family experience Development of socializing techniques Imitative behavior Cohesiveness Existential factors Catharsis Interpersonal learning Self-Understanding Which one This factor overlaps with interpersonal learning but refers to the achievement of greater levels of insight into the genesis of one's problems and the unconscious motivations that underlie one's behavior.

Self-understanding

Ivan Pavlov John Watson F. Skinner Which one.................... Operant Conditioning Theory-voluntary behaviors are learned through consequences, and behavioral responses are elicited through reinforcement, which causes a behavior to occur more frequently. ------------- or rewards Teachers employ this strategy in the classroom when they ignore acting-out behavior that had previously been rewarded by more attention. ----------------behavior model provides a concrete method for modifying or replacing behaviors.

Skinner/consequences Skinner's

Ivan Pavlov John Watson F. Skinner Which one.................... Behaviorism Theory-stood behind Little Albert, a 9-month-old who like animals, and made a loud noise with a hammer every time the infant reached for a white rat. After this experiment, Little Albert became terrified at the sight of white fur or hair, even in the absence of a loud noise. Concluded that behavior could be molded by controlling the -------------- and that anyone could be trained.

Watson/controlling the ENVIRONMENT

CBT Techniques -Validity Testing -Cognitive Rehearsal -Guided Discovery -Writing in a journal -Homework -Modeling -Systematic positive reinforcement -Aversive conditioning Which one........... The client keeps a journal about day to day interactions. The therapist ------------ the journal with the client to discover maladaptive behaviors and to then discover how these thoughts impact behavior.

Writing in a journal reviews

Milieu Therapy for Schizophrenia: When the potential for violence exists, measures to protect the client and others become the priority. Interventions include increasing staff supervision, reducing stimulation (e.g., noise, crowds), ----------- paranoia and other contributing symptoms, providing constructive diversion and outlets for physical energy, teaching and practicing coping skills, implementing cognitive-behavioral approaches (to correct unrealistic expectations or selectively extinguish aggression), de-escalating tension verbally, and when necessary, using seclusion or chemical (medication) or physical restraints.

addressing

The classic descriptive categories for these roles are task, maintenance, and individual roles mix and match -have nothing to do with helping the group but instead relate to specific personalities, personal agendas, and a desire to have needs met by shifting the group's focus to them. -serve to keep the group focused on its main purpose and get the work done. -function to keep the group together, help each other person feel worthwhile, and create a sense of group cohesion.

i t m

Before initiating any aversive (punishment) protocol, the nurse/therapist, treatment team, or society must answer the following questions: Is this therapy in the best interest of the client? Does its use violate the client's ------------? Is it in the best interest of society?

rights?

Rational-Emotive Therapy (RET); Exposure Therapy for Anxiety (Albert Ellis) ASSUMPTION: People make themselves sick anytime they escalate a desire or preference into a --------- or absolute must. (People become who they become based on their beliefs). CHARACTERISTICS & PRINCIPLES: -People are born with the ability to be rational or ----------- -People have a tendency toward --------- thinking, self-damaging habits, wishful thinking and intolerance which is frequently exaggerated by family and ---------- -Humans tend to perceive, think and emote simultaneously -All emotional problems stem from --------- empirically invalidated thinking ------------- often do not lead to major personality change since at best they help people to see emotional problems without changing behavior

demand irrational irrational culture magical INSIGHTS often DO NOT lead to major personality changes

Today's COGNITIVE therapy owes its origins to many great thinkers and researchers, most notably Aaron ---------- and Albert ----------, each who independently developed cognitive approaches to the treatment of psychopatholog

beck/ellis

Do most people breathe too fast or slow? ----------- problem with this is it ------------ carbon dioxide

fast expells

Rational-Emotive Therapy (RET); Exposure Therapy for Anxiety (Albert Ellis) TECHNIQUE: -RET uses -------- playing, a-------- training, de---------, h-------, operant conditioning, suggestion, support, etc. (too elegant or inelegant? -------------) therapy teaches behavior change almost synonymous with cognitive behavior therapy (CBT) -(too elegant or inelegant? -------------)therapy emphasizes general RET techniques combining cognitive or philosophical restructuring striving for the most elegant solution possible - it is not content with symptom relief

role, assertion, desensitization, humor inelegant too elegant/not content with symptom relief

Group Leader Activities May or may not be defined, may ----------- among members Role is often more -----------oriented

rotate task

Milieu Therapy for Anxiety Disorders: Most clients who demonstrate anxiety disorders can be treated successfully as outpatients. Hospital admission is necessary only if ----------- anxiety or symptoms interfere with the individual's health or if the individual is suicidal. When hospitalization is necessary, the following features of the therapeutic milieu can be especially helpful to the client: -S----------- the daily routine to offer physical safety and predictability, thus reducing anxiety over the unknown -Providing daily ----------- to promote sharing and cooperation -Providing therapeutic --------------s, including one-on-one nursing care and behavior contracts -Including the client in ------------ about his or her own care

severe Structuring activities interactions decisions

Behavioral therapy is effective in treating people with phobias, alcoholism, schizophrenia, and many other conditions. Let's examine four types of behavioral therapy. -Modeling -Operant Conditioning -Systematic Desensitization -Aversion Therapy Systematic desensitization is another form of behavior modification therapy that involves the development of behavioral tasks customized to the client's specific fears; these tasks are presented to the client while using learned relaxation techniques. The process involves four steps: -The client's fear is broken down into its components by exploring the particular -------------- cues to which the client reacts. -The client is incrementally exposed to the -------------- -The client is instructed in how to design a ------------ of fears. -The client practices these techniques every --------------

stimulus fear. hierarchy every day

CBT Techniques -Validity Testing -Cognitive Rehearsal -Guided Discovery -Writing in a journal -Homework -Modeling -Systematic positive reinforcement -Aversive conditioning Which one........... The therapist asks the client questions designed to guide the client towards the reasons for the cognitive distortion.

Guided Discovery

CBT Techniques -Validity Testing -Cognitive Rehearsal -Guided Discovery -Writing in a journal -Homework -Modeling -Systematic positive reinforcement -Aversive conditioning Which one........... The goal of this technique is to bring to light new solutions to behavior and thinking distortions discovered and applying newly learned strategies and coping skills.

Homework

H---------- is a central feature of CBT.

Homework

Cognitive therapy, developed by Aaron T. ---------, is based on the philosophy that people can learn to be their own therapist. The client needs to learn the following: -Monitor his/her negative, automatic thoughts (cognitions) -Recognize the connections between cognition, a------- and b------- -Examine the --------- for and against his/her distorted automatic thoughts -Substitute more -----------oriented interpretations for these biased cognitions -Identify and alter d---------- beliefs which predispose them to distort his/her experiences

Beck affect, and behavior evidence reality -dysfunctional

-------------- have no concern with inner conflicts but argue that personality simply consists of learned behaviors. They were created in a response to Freud's belief that our destiny is already carved for us

Behaviorists

In 1948, Bruno ---------- (as cited in Almond, 1974) coined the term MILIEU therapy to describe his use of the total environment to treat disturbed children In 1953, Maxwell --------- in Great Britain wrote the book The Therapeutic Community. This book both laid the groundwork for the milieu therapy movement in the United States and defined the nurse's role in this therapy. Hildegard ----------(1989) advocated for the milieu as a therapeutic modality on inpatient units.

Bettelheim Jones Peplau

Mind-Body (MB) Approaches -Guided Imagery -Biofeedback -Hypnosis and Therapeutic Suggestion -Meditation -Deep Breathing Exercises -Prayer/Spiritual Practices This process enables the person to begin to voluntarily control reactions that were previously outside conscious awareness.---------------------

Biofeedback

CBT is s----------- and d-------------- Cognitive-behavioral therapists have a specific agenda for each session. Specific techniques/concepts are taught during each session. CBT focuses on helping the client achieve the goals they have set. CBT is ---------- in that respect. However, CBT therapists do not tell their clients what to do -- rather, they teach their clients ------- to do.

CBT is structured and directive. directive how

Therapeutic Factors Universality Altruism Instillation of hope Imparting information Corrective recapitulation of primary family experience Development of socializing techniques Imitative behavior Cohesiveness Existential factors Catharsis Interpersonal learning Self-Understanding Which one The experience of relief from emotional distress through the free and uninhibited expression of emotion. When members tell their story to a supportive audience, they can obtain relief from chronic feelings of shame and guilt. We refer to ----------as "getting things off our chest."

Catharsis

Therapeutic Factors Universality Altruism Instillation of hope Imparting information Corrective recapitulation of primary family experience Development of socializing techniques Imitative behavior Cohesiveness Existential factors Catharsis Interpersonal learning Self-Understanding Which one The group setting provides a safe and supportive environment for members to take risks by extending their repertoire of interpersonal behavior and improving their social skills.

Development of socializing techniques

Rational-Emotive Therapy (RET); Exposure Therapy for Anxiety (Albert Ellis) STEPS: -Identify the irrational belief -D---------- the irrational belief -Work with ----------------- thinking patterns and tendencies that distort reality -Teach s---------- problem solving skills -Teach appropriate rational self statements -In-vivo behavioral rehearsal and p--------

Dispute illogical social practice.

Rational emotive therapy (RET), a form of CBT developed by Albert ---------- in the mid-1950s, is a psychotherapeutic approach which proposes that unrealistic and ------------ beliefs cause many emotional problems. The purpose of RET is to identify an irrational belief and dispute it through a--------, philosophical, con------therapy.

Ellis irrational active, philosophical, confrontational therapy.

Therapeutic Factors Universality Altruism Instillation of hope Imparting information Corrective recapitulation of primary family experience Development of socializing techniques Imitative behavior Cohesiveness Existential factors Catharsis Interpersonal learning Self-Understanding Which one One way in which group members can develop social skills is through a modeling process, observing and imitating the therapist and other group members. For example, sharing personal feelings, showing concern, and supporting others.

Imitative behavior

Therapeutic Factors Universality Altruism Instillation of hope Imparting information Corrective recapitulation of primary family experience Development of socializing techniques Imitative behavior Cohesiveness Existential factors Catharsis Interpersonal learning Self-Understanding Which one While this is not strictly speaking a psychotherapeutic process, members often report that it has been very helpful to learn factual information from other members in the group, for example, about their treatment or about access to services.

Imparting Information

Phases of Group Development Orientation Working Termination Mix and match: -Through successful resolution of conflicts, group members are empowered to develop confidence in their problem-solving abilities and better support one another in their individual efforts to grow and change. -Initially, members may be overly silent or overbearing because they have not yet established trust with one another. -Therapeutic interaction is supported when the group leader points out similarities between members, encourages them to talk directly to each rather than to the leader, and reminds members about ground rules for respectful interaction -It is important to openly address such feelings as part of the group's work toward successful termination. -the group leader's role is to encourage focus on problem solving consistent with the purpose of the group. -It is important for the leader to guide and support conflict resolution.

Orientation -Which one group leader's role is to structure an atmosphere of respect, confidentiality, and trust. -The purpose of the group is stated, and members are encouraged to get to know one another. -Initially, members may be overly silent or overbearing because they have not yet established trust with one another. -Therapeutic interaction is supported when the group leader points out similarities between members, encourages them to talk directly to each rather than to the leader, and reminds members about ground rules for respectful interaction Working -the group leader's role is to encourage focus on problem solving consistent with the purpose of the group. -As group members begin to feel safe within the group, conflicts may be expressed, which should be viewed by the group leader as a positive opportunity for group growth. -It is important for the leader to guide and support conflict resolution. -Through successful resolution of conflicts, group members are empowered to develop confidence in their problem-solving abilities and better support one another in their individual efforts to grow and change. Termination -the group leader's role is to encourage members to reflect on progress they have made and identify post-termination goals. -Members may experience feelings of loss or anger about the group ending; at times, these feelings can be directed toward other group members or the leader. -It is important to openly address such feelings as part of the group's work toward successful termination.

To develop a successful group, planning should include a description of specific characteristics, including: Name and objectives of the group Types of clients or diagnoses of members Group size *Small *Large mix and match >10people 8 to 10 people Cohesive Cost-effective Richer interpersonal experience Open-ended, ongoing Leaders (1 or 2) Ideal for complex individual issues Either way Use --------------- seating without barriers (tables)

Small 8 to 10 people Cohesive Richer interpersonal experience Leaders (1 or 2) Ideal for complex individual issues Large >10 members More cost-effective Open-ended, ongoing circle (nobody should sit outside of circle)

CBT uses the ----------- method. Cognitive-behavioral therapists want to gain a very good understanding of their clients' concerns. That's why they often askquestions. They also encourage their clients to ask ---------- of themselves, like, "How do I really know that those people are laughing at me?" "Could they be laughing about something else?" CBT theory and techniques rely on the ------------ method. A central aspect of Rational thinking is that it is based on ---------, not simply our assumptions made. Often, we upset ourselves about things when, in fact, the situation isn't like we think it is. If we knew that, we would not waste our time upsetting ourselves. Therefore, the inductive method encourages us to look at our thoughts as being hypotheses that can be questioned and tested. If we find that our hypotheses are incorrect (because we have new information), then we can change our thinking to be in line wi

Socratic questions inductive fact

CBT Techniques -Validity Testing -Cognitive Rehearsal -Guided Discovery -Writing in a journal -Homework -Modeling -Systematic positive reinforcement -Aversive conditioning Which one........... This technique is based largely on behaviorism. Tokens for example are used to note a reward; accumulated tokens are then rewarded with an established reward. Positive behavior is rewarded and motivated. Rules are established by the therapist that specifies behaviors to be rewarded.

Systematic positive reinforcement

------------- touch is a modality developed in the 1970s by Dolores Krieger, a nursing professor at New York University, and Dora Kunz, a Canadian healer. Practitioners then assess the energy field, clear and balance it through hand movements, and/or direct energy in a specific region of the body. The therapist ------------ physically touch the client. After undergoing a session of therapeutic touch, clients report a sense of deep relaxation.

Therapeutic does not

Therapeutic Factors Universality Altruism Instillation of hope Imparting information Corrective recapitulation of primary family experience Development of socializing techniques Imitative behavior Cohesiveness Existential factors Catharsis Interpersonal learning Self-Understanding Which one The recognition of shared experiences and feelings among group members and that these may be widespread or ------------ human concerns, serves to remove a group member's sense of isolation, v----------- their experiences, and raise self-----------

Universality/universal validate self-esteem

CBT Techniques -Validity Testing -Cognitive Rehearsal -Guided Discovery -Writing in a journal -Homework -Modeling -Systematic positive reinforcement -Aversive conditioning Which one........... The therapist asks the client to defend his or her thinking. It the client is unable to substantiate the beliefs, then the therapist points out the error in the clients thinking.

Validity Testing

Cognitive Therapy (BECK) STEPS: -Recognize your own automatic thoughts whenever you feel anxious. -Keep track of these in a ---------- (they are time limited). -Develop and carry out strategies for ---------- your thoughts and beliefs about what might happen. ------------ your results. ------------ play (practice).

notebook testing discuss role

see spreadsheet for Informal Roles of Group Members

ok

Recreational activities such as picnics and outings to stores and restaurants are not simply diversions; they teach constructive leisure skills, increase social comfort, facilitate growth in social concern and interactional skills, and enhance the ability to develop -----------and set limits on self and others.

boundaries

CBT is ---------- and time-limited. Cognitive-behavioral therapy is considered among the "----------" in terms of results obtained. The average number of sessions clients receive (across all types of problems) is only -------- sessions. Other forms of therapy, like psychoanalysis, can take years. What enables CBT to be brief is its highly instructional nature and the fact that it makes use of ------------- assignments.

brief fastest 16 homework

Contemporary ------------- medicine continues to be based on the theory that energy flows from the brain to all parts of the body through the spinal cord and spinal nerves

chiropractic

Goal of --------------is to limit the severity and debilitating aspects of symptoms.

cognitive therapy (BECK)

Milieu Therapy for Bipolar Disorders: Control of hyperactive behaviors during the acute phase of bipolar disorder almost always includes immediate treatment with an -------------. However, when a client is dangerously out of control, use of the ----------- room or restraints may be indicated. The seclusion room provides comfort and relief to many clients who can no longer control their own behavior. Seclusion serves the following purposes: -Reduces overwhelming environmental ----------- -Protects a client form injuring self, others, or staff -Prevents destruction of personal property or property of others Seclusion is warranted when documented data collected by the nursing and medical staff reflect the following points: -Substantial risk of harm to others or self is clear. -The client is unable to ---------- his or her actions. -Problematic behavior has been sustained (---------- or escalates despite other measure

antipsychotic drug seclusion stimuli control continues failed

Diet, herbs, and ----------- are types of Biologically Based Therapies It is recommended that clients with mood disorders, impulse-control disorders, and psychotic disorders consume at least 1 gram of --------- fatty acids a day

aromatherapy omega-3 (mood/impulse/psychosis)

Behavioral therapy is effective in treating people with phobias, alcoholism, schizophrenia, and many other conditions. Let's examine four types of behavioral therapy. -Modeling -Operant Conditioning -Systematic Desensitization -Aversion Therapy Which one akin to punishment, is used widely today to treat behaviors such as alcoholism, sexual deviation, shoplifting, hallucinations, violent and aggressive behavior, and self mutilation? *Pairing of a maladaptive behavior with a ---------------- stimulus (e.g., pairing the sight and smell of alcohol with electric shock), so that anxiety or fear becomes associated with the once-pleasurable stimulus *Punishment (e.g., punishment applied after the client has had an alcohol drink) *----------------- training (e.g., client avoids punishment by pushing a glass of alcohol away within a certain lime limit)

aversion noxious Avoidance

Mind-Body (MB) Approaches -Guided Imagery phenomenon as a "multidimensional mental representation of reality and fantasy that includes not only visual pictures, but also remembrance of situations and experiences such as sound, smell, touch, movement and taste" be----------- rehearsal imagery, (2) im---------- imagery, (3) bio--------- based imagery, and (4) sy--------- and metaphoric imagery. Imagery is used as a therapeutic tool for treating a--------, p---------, psychological trauma, and P----------. Imagery may be combined with cognitive-behavioral therapy to help w------ veterans and people who have survived natural disasters.

behavioral impromptu biologically symbolic anxiety, pain, psychological trauma, and PTSD

Cognitions include such factors as thoughts, beliefs, attitudes, a--------, expectations, s----------, images, g-------, memories, and p---------

beliefs, attitudes, assumptions, expectations, standards, images, goals, memories, and perceptions

Seclusions: The use of seclusion or restraints is associated with complex therapeutic, ethical, and legal issues. Most state laws prohibit the use of unnecessary physical restraint or isolation. Barring an emergency, the use of seclusion and restraints warrants the client's ------------- Careful and precise documentation is a legal necessity. Documentation includes the following: -The behavior leading up to the seclusion or restraint -The ----------- taken to provide the least restrictive alternative -The ---------- the client was placed in seclusion -Every ---------- minutes, the client's behavior, needs, nursing care, and vital signs -The ----------- and type of medications given and their effects on the client

consent. actions time 15 minutes time

Complementary and Alternative Medicine (CAM) supplements and approaches may prove effective and less ---------than prescription drugs that produce similar results; however, it is imperative that data be available to identify the desired and adverse effects of these treatments. --------------- for Some health insurance companies include coverage for certain modalities, particularly chiropractic medicine, nutritional care, massage, mind-body approaches, and acupuncture (Dumoff, 2004). The covered benefits are quite narrowly defined, however. For instance, acupuncture can be used in some plans only as an alternative to anesthesia

costly REIMBURSEMENT for massage/acupuncture

There are three main styles of group leadership, and a leader selects the style hat is best suited to the therapeutic needs of a particular group. -autocratic leader -democratic leader -laissez-faire leader mix and match -supports extensive group interaction in the process of problem solving. Psychotherapy groups most often employ this leadership style. -allows the group members to behave in any way they choose and does not attempt to control the direction of the group. In a creative group, such as an art group, the leader may choose this style of leadership, giving minimal direction to allow for a variety of responses. -exerts control over the group and does not encourage much interaction among members. For example, staff leading a community meeting with a fixed, time-limited agenda may tend to be more -------------

d-psychotherapy l-art therapy a-meeting with time limits

CBT is based on an e----------- model. CBT is based on the scientifically supported assumption that most emotional and behavioral reactions are learned. Therefore, the goal of therapy is to help clients unlearn their unwanted reactions and to learn a new way of reacting. While CBT therapists do not present themselves as "know-it-alls", the assumption is that if clients knew what the therapist had to teach them, clients would not have the emotional / behavioral problems they are experiencing. Therefore, CBT has nothing to do with "just talking". People can "just talk" with anyone. The educational emphasis of CBT has an additional benefit -- it leads to long term results. When people understand how and why they are doing well, they can continue doing what they are doing to make themselves well.

educational

Massage: effleurage pétrissage vibration and percussion mix and match (kneading of the muscles to increase circulation) (a series of fine or brisk movements that stimulate circulation and relaxation), and friction (which is decreased with the use of massage oils). (long, gliding strokes over the skin)

effleurage (long, gliding strokes over the skin) pétrissage (kneading of the muscles to increase circulation) vibration and percussion (a series of fine or brisk movements that stimulate circulation and relaxation), and friction (which is decreased with the use of massage oils).

CBT is based on the cognitive model of ------------ response. Cognitive-behavioral therapy is based on the scientific fact that our thoughts cause our feelings and behaviors, not ---------- things, like people, situations, and events. The benefit of this fact is that we can change the way we think to feel/act better even if the situation does not change.

emotional NOT external

Therapeutic Factors Universality Altruism Instillation of hope Imparting information Corrective recapitulation of primary family experience Development of socializing techniques Imitative behavior Cohesiveness Existential factors Catharsis Interpersonal learning Self-Understanding Which one Learning that one has to take responsibility for one's own life and the consequences of one's decisions.

existential factors

Suicide risk is highest in the ---------- of admission and during times of staff ------------

first few days rotation

Yalom (2005) describes two popular types of groups, the agenda group and the focus group -which one There is more pathology in the room and the clients require more individual attention and direction. -This type of group provides human contact in a safe, structured, secure environment.

focus

The US Food and Drug Administration (FDA; 2009) offers seven warning signs of fraud: The product is advertised as a quick and effective --------- for a wide range of ailments. The promoters use words like "scientific breakthrough, miraculous cure, exclusive product, secret ingredient, or -------- remedy." The text is written using impressive terminology to disguise lack of good science. The promoter claims the government, the medical profession, or research scientists have conspired to ---------- the product. The advertisement includes ----------- case histories claiming amazing results. The product is advertised as available from only one source, and payment is required in ------------· The promoter promises a "no-risk, ----------- guarantee."

fraud: -cure-all -ancient -suppress -undocumented -advance. -money-back

(BECK) Cognitive Therapy Measure maladaptive emotions and beliefs initially and at ------ intervals (e.g., Beck's Depression Inventory [BDI] - a copy of the BDI can be found at https://www.ismanet.org/doctoryourspirit/pdfs/Beck-Depression-Inventory-BDI.pdf -Teach client new methods of discovering what types of thinking make them feel -Have clients test their thoughts (experiment) out in the --------- -Prepare for provocation through the development of self-statements in -----------. Thinking ahead strategies Self instructional training through the use of specific self-verbalizations as guidelines. Reinforcing self-statements Provide "----------" feedback through the use of measurement tools.

frequent real world. advance objective

If a pharmaceutical company studies and patents a drug, it can reap considerable financial return; however, an ----------- cannot be patented and exclusively marketed, so there is little incentive to invest in researching its uses and effects.

herb

Yalom (2005) describes two popular types of groups, the agenda group and the focus group Agenda group is for: ------------------- functioning clients -group size 6 to ---------- clients -group runs usually ---- to ---- hours Each individual states an agenda for that day's session and is asked if he or she wants time to work during the session or not. Then members work ----------- at a time. -Will all members work each session? ---------------- At the end of the group, all members share what the work done that day has brought up for them and how it ties in with their particular agenda for that day. This is not advice, but rather a -------------- on how the issues discussed related to their own life issues.

higher 12 1-1.5 one at a time no not advice but a reflection

Consumers and Integrative Care Consumers are attracted to integrative care for a variety of reasons, including: A desire to be an active participant in one's health care and engage in ---------- practices that can promote health and healing A desire to find therapeutic approaches that seem to carry --------- risks than medications A desire to find less ------------ alternatives to high-cost conventional care Positive experiences with holistic, integrative CAM practitioners, who tend to spend more --------- with and learn about their clients as a whole Dissatisfaction with the practice style of conventional medicine (e.g., rushed office visits, short hospital stays) A need to find modalities and remedies that provide comfort for chronic conditions for which no conventional medical cure exists, such as anxiety, chronic pain, and depression

holistic lower less expensive time

Mind-Body (MB) Approaches -Guided Imagery -Biofeedback -Hypnosis and Therapeutic Suggestion -Meditation -Deep Breathing Exercises -Prayer/Spiritual Practices In stress states, people are more susceptible to suggestion because their focus of attention is narrowed. People who dissociate in traumatic situations are in a trance-like state. When we use relaxation and imagery techniques, individuals frequently will enter a similarly altered state of awareness, or trance-like state.

hypnosis

Behavioral therapy is effective in treating people with phobias, alcoholism, schizophrenia, and many other conditions. Let's examine four types of behavioral therapy. -Modeling -Operant Conditioning -Systematic Desensitization -Aversion Therapy In modeling, the nurse/therapist provides a role model for specific identified behaviors, and the client learns through -------------. The nurse/therapist may do the modeling, provide another person to model the behaviors, or present a ------------ for the purpose. Bandura, Blahard, and Ritter (1969) were able to help people reduce their phobias about nonpoisonous snakes by having them first view close-ups of filmed encounters between people and snakes that resulted in successful outcomes, and then view live encounters between people and snakes that also had successful outcomes. In a similar fashion, some behavioral therapists use role playing in the consulting room. They de

imitation video

Milieu Therapy for Sexual Disorders: When the client who has a gender identity disorder or a paraphilias is in a crisis that requires hospitalization, providing a safe environment is fundamental. All clients on a psychiatric inpatient unit should be informed on admission about unit rules regarding personal contact between clients and between clients and staff. Limit setting is done consistently when it is needed. Individuals with paraphilias tend to ---------- themselves. The unit environment may be a challenge. Sharing meals with others may result in -----------, and the client might wonder what other people know about him or her.

isolate discomfort,

The four cardinal values of Stoic philosophy were wisdom, courage, j----------- and t-----------

justice, and temperance (moderation)

CBT is a collaborative effort between the therapist and the client. Cognitive-behavioral therapists seek to learn what their clients want out of life (their goals) and then help their clients achieve those goals. The therapist's role is to l----------, teach, and e---------, while the client's roles is to express concerns, learn, and implement that learning.

listen, teach, encourage

Yalom (2005) describes two popular types of groups, the agenda group and the focus group Focus group is for: ------------------- functioning clients -group size 4 to -------------clients -These clients may be actively psychotic or severely depressed or anxious. They are usually ---------------- -The goal is to make this a successful, --------------producing experience so that the client begins to feel comfortable coming to group therapy. -usually around ------------ minutes -there should be a --------------- leader who can be -------------- Such things as drawing a picture or sharing a recent non-threatening event, like a -------------, might be done. Positive reinforcement should be used generously.

lower 7 inpatients non-anxiety 45 consistent/flexible focus-drawing or MEAL

Mind-Body (MB) Approaches -Guided Imagery -Biofeedback -Hypnosis and Therapeutic Suggestion -Meditation -Deep Breathing Exercises -Prayer/Spiritual Practices practices include such simple behaviors as consciously breathing and focusing attention while walking. ---------------

meditation

Behavioral therapy is effective in treating people with phobias, alcoholism, schizophrenia, and many other conditions. Let's examine four types of behavioral therapy. -Modeling -Operant Conditioning -Systematic Desensitization -Aversion Therapy were able to help people reduce their phobias about nonpoisonous snakes by having them first view close-ups of filmed encounters between people and snakes that resulted in successful outcomes, and then view live encounters between people and snakes that also had successful outcomes is an example of which --------------------

modeling

Deep breathing: we suck in our bellies and raise our shoulders, is that good? ----------- why or why not? ------------ When we breathe fully and deeply, the diaphragm moves farther ---------- into the abdomen and our lungs are able to expand more completely into the chest cavity.

no it's shallow breathing down

May need 1:1 if: Client is currently verbalizing a clear intent to harm self. Client is unwilling to make a ---------- contract. Client shows no ---------- into existing problems. Client has poor impulse control. Client has already attempted suicide in the recent past by a particularly lethal method (e.g., hanging, gun, CO poisoning). RN should: Chart client's whereabouts and record mood, verbatim statements, and behavior every ---- to ----- minutes as per protocol. During observation when client is sleeping, hands should always be in view, not under the ------------

no-suicide insight attempted 15-30 bedcovers.

Behavioral therapy is effective in treating people with phobias, alcoholism, schizophrenia, and many other conditions. Let's examine four types of behavioral therapy. -Modeling -Operant Conditioning -Systematic Desensitization -Aversion Therapy -------------------is the basis for behavior modification and uses positive reinforcement to increase desired behaviors. For example, when desired goals are achieved or behaviors are performed, clients might be rewarded with tokens. These tokens can be exchanged for food, small luxuries, or privileges. This reward system is known as a ---------- economy.

operant conditioning token economy

orientation, working, termination The leader is often most directive in the ------------------ phase of the group.

orientation

Megavitamin therapy, also called ortho--------- therapy, is a nutritional therapy that involves taking large amounts of vitamins, minerals, and amino acids. The theory is that the inability to absorb nutrients from a proper diet alone may lead to the development of different illnesses. The earliest use of megavitamin therapy was for the treatment of schizophrenia, for which n--------- was recommended.

orthomolecular niacin

Of all the spiritual healing practices, ----------- is the one most commonly used.

prayer

Structured aspects of the milieu include activities, unit rules, ---------orientation practices, and unit ------------ In addition to the structured components of the milieu, Peplau (1989) described other less tangible factors of the milieu, such as the ------------- that occur among clients and staff, clients and clients, clients and visitors, as so forth.

reality environment. interactions

CBT is based on ---------- philosophy CBT -------- tell people how they should feel. However, most people seeking therapy do not want to feel they way they do. CBT teaches the benefits of feeling, at worst, calm when confronted with undesirable situations. It also emphasizes the fact that we have our undesirable situations whether we are upset about them or not. If we are upset about our problems, we have two problems -- the problem, and our being upset about it. Most sane people want to have the fewest number of problems possible.

stoic -DOES NOT tell people how they should feel

Milieu Therapy for Schizophrenia: Effective inpatient care provides (1) protection from stressful or disruptive environments and (2) structure. Clients in the acute phase of schizophrenia show greater improvement in a structured or open milieu? ----------- The milieu also provides guidance, supportive peer contact, and opportunities for practicing conflict resolution, s---------- reduction techniques, and dealing with -------------

structured conflict resolution/stress reduction/symptoms.

Milieu Therapy for Depressive Disorders: When a person has acute and severe depression, admission to an inpatient setting may be indicated. The client with depression needs protection from ----------- acts and a supervised environment for regulating treatments. Often, being removed from a stressful interpersonal situation increases therapeutic value. Hospitals have protocols regarding the care and protection of the suicidal client.

suicidal

orientation, working, termination mix and match -the leader ensures that each member summarizes individual accomplishments and gives positive and negative feedback regarding the group experience. -the leader facilitates communication and ensures that meetings begin and end on time. -During this phase, the structure, size, composition, purpose, and timing of the group are defined. Task and maintenance functions may be discussed and demonstrated

t w o