1. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Chapter 04Treatment of Mental Illness

2. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Reason for Treatment Treatment of mental health issues aims to reduce the symptoms of mental disorders and to allow the person with mental illness to live and function in society with improved personal and interpersonal skills

3. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Components of Mental Health Treatment Development of a treatment plan –Therapeutic milieu –Members of the treatment team –More common types of therapy

4. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Therapeutic Milieu Defined A safe and secure structured environment that facilitates therapeutic interaction between clients and members of the professional team

5. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Establishing a Therapeutic Milieu Dignity and acceptance Rules Close supervision No tolerance for aggression, violence, foul language Clients encouraged to express feelings Role model for social behaviors and communication skills –Reinforces the trusting relationship Provide support –Encouraging climate for growth and change

6. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Treatment Team Each member has a specific role in the treatment process and all have special training –Psychiatrist –Clinical psychologist – diagnostic process –Psychiatric nurse –Mental health technician Assists clients with physical and hygiene needs as needed, monitors unit activities –Social worker –Licensed professional counselor (LPC) –Case manager and outreach workers –Therapeutic support team

7. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Treatment Team (Cont.) Each team member plays a specific role Diversified client contact Collaborative team meetings held regularly Provide unbiased and nonjudgmental support for the client

8. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Role of the Nurse Caregiver –Observation of behaviors –Documents information –Provides feedback for care team –Observes response to therapy –Performs nursing interventions

9. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Role of the Nurse (Cont.) Counselor –Attitude of genuine concern –Encourages the client to express feelings and thoughts –Unconditional acceptance of the client as a person

10. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Role of the Nurse (Cont.) Educator –Verbal explanation –Demonstration –Printed materials –Evaluate the client’s understanding

11. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Role of the Nurse (Cont.) Advocate –Protect the rights of the client through acceptance and support for decisions that are made –Empathy for the client’s needs –Provide necessary resources –Compliance generally improves with empathy and positivity

12. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Pharmacologic Treatment Affects psychiatric behavior, function, or experience Aims to control symptoms Used in combination with counseling and other therapy

13. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Psychotherapy Defined as the dialogue between a mental health practitioner and the client with the goal of reducing the symptoms of the emotional disturbance or disorder and improving that individual’s personal and social well-being Aims for clients to learn about themselves Flexible approach Client–therapist relationship important

14. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Individual Therapy Psychodynamic therapy - Freudian Humanistic therapy – fosters client’s sense of worth Behavioral therapy – learning with positive reinforcement Cognitive therapy – identify and correct distorted thinking patterns Contracting – contract obligation

15. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Group Therapy Therapist leads a small group discussion –Discuss similar and common issues –Remedial group therapy –Couples therapy –Family therapy

16. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Other Types of Therapy Biomedical therapy –Application of biological and natural sciences to treat psychological disorders Electroconvulsive therapy (ECT) –Seizures are possible d/t restoration of chemical balance in the brain Agitation therapy Play therapy Pet therapy

17. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Biofeedback Training program used for specific types of anxiety that is designed to develop the client’s ability to control heart rate, muscle tension, and other autonomic or involuntary functions of the nervous system Uses monitoring devices during situations that trigger a reaction

18. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Question Tell whether the following statement is true or false. The nurse’s role as an advocate includes protecting the rights of the client.

19. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer True Rationale: As an advocate for the client, the nurse works to protect the client’s rights through acceptance and support for decisions.

20. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Question Which type of individual therapy focuses on correcting distorted thinking patterns? A. Psychodynamic B. Humanistic C. Behavioral D. Cognitive

21. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer D. Cognitive Rationale: Cognitive therapists believe that clients can change their behavior by changing their distorted thinking about themselves and their experiences.

22. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Question A behavioral technique in which the client and the therapist draw up an agreement to which both parties are obligated is called A. Therapeutic milieu B. Contracting C. Electroconvulsive therapy D. Biofeedback

23. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer B. Contracting Rationale: The client and the therapist make a contract; the contract requires the client to demonstrate specific behaviors, and in exchange, the therapist will give certain rewards. The criteria for success are outlined in the contract.

24. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins