Comprehensive Mental Health Nursing & Communication Strategies, mental health unit 2

FICA Tool

Spiritual assessment framework guiding holistic mental health care; F = Faith/belief/meaning, I = Importance/influence, C = Community support, A = Address in care plan.

Evidence-Based Nursing Interventions

Nursing care actions supported by research evidence, clinical expertise, and patient values.

Nursing Roles in Mental Health

Social role = advocate;

Occupational role = educator, facilitator, manager;

Therapeutic role = holistic assessment, coordination of care, encouragement, integration of modalities, reinforcement.

Therapeutic Communication

Purposeful, planned, goal-directed, client-centered communication used to build and maintain helping relationships; not social or reciprocal.

SOLER

Nonverbal communication technique—Sit squarely, Open posture, Lean toward client, Eye contact, Relax; may be modified if perceived as confrontational.

Transference

Client unconsciously transfers feelings from past relationships (e.g., parent) onto the nurse or provider.

Countertransference

Nurse or provider develops personal emotional responses to a client due to perceived similarities to significant people in their own life.

Motivational Interviewing

Client-centered communication style that elicits behavior change by helping clients explore and resolve ambivalence; stages include Engage, Focus, Evoke, Plan.

SMART Goals

Goal-setting framework—Specific, Measurable, Achievable, Relevant/Realistic, Time-bound; commonly used in psychiatric care planning.

Closed-Ended Suicide Assessment Questions

Direct safety questions used to assess risk—thoughts of harming self/others, presence of a plan, and access to means.

Suicide Risk Priority Assessment

Determining access to means (e.g., medications, firearms) is the most critical initial assessment.

Suicide Safety Interventions

Environmental room scan, one-to-one observation, family notification to remove firearms, ongoing safety assessments; restraints only if necessary.

Adaptive Coping Skills

Healthy stress-management behaviors such as exercise, mindfulness, journaling, deep breathing; smoking remains maladaptive despite reduction.

Foundational Theory

Early cognitive framework developed in childhood to explain experiences and understand the world; forms the basis for later mental health theories.

Biological Theory of Mental Illness

Focuses on brain structure, neurochemistry, genetics, and physiologic processes contributing to mental disorders.

Neurobiology

Study of the nervous system and how it influences behavior, learning, and responses.

Psychopharmacology

Use of medications to control or relieve symptoms of psychological disorders.

Central Nervous System (CNS)

Brain and spinal cord; primary site of neurotransmitter activity affecting mood, thought, and behavior.

Peripheral Nervous System (PNS)

Nerves outside the CNS that transmit sensory and motor signals.

Neurotransmitters

Chemical messengers that transmit signals across synapses in the nervous system.

Serotonin

Regulates mood, sleep, hunger, and arousal; decreased levels linked to depression.

Dopamine

Regulates movement, attention, learning, pleasure, and reward; increased levels associated with schizophrenia and mania.

Norepinephrine

Involved in arousal, alertness, learning, and mood regulation; decreased levels linked to sleepiness and depressed mood.

GABA

Primary inhibitory neurotransmitter in the brain; decreased levels associated with anxiety.

Glutamate

Major excitatory neurotransmitter involved in memory and learning; increased levels linked to psychosis and mania, decreased levels linked to psychosis.

Pharmacogenetic Testing

Genetic testing that predicts how an individual may metabolize or respond to specific medications.

Genetic Influences on Mental Health

Viral infections and environmental factors can alter genetic expression affecting mental illness risk.

St. John's Wort

Herbal antidepressant supplement; should NOT be taken with tricyclics, MAOIs, SSRIs, or SNRIs due to increased risk of serotonin syndrome.

Therapeutic Group Redirection

Technique used to preserve group process by redirecting off-topic or attention-seeking behaviors back to the group focus.

Making Observations

Therapeutic communication technique that comments on observed behaviors or affect to encourage discussion.

Restating (Reflection)

Therapeutic technique where the nurse repeats or paraphrases client statements to confirm understanding and validate feelings.

Nontherapeutic Communication - Why Questions

Use of "why" can feel judgmental and block therapeutic communication.

Trust-Building Qualities

Honesty, transparency, respect, fidelity, and understanding foster therapeutic alliance.

Barriers to Trust

Perceived differences in gender, education, language/literacy, culture, and socioeconomic status.

Professional Boundaries

Maintaining therapeutic—not personal—relationships; boundary blurring interferes with treatment goals.

Nonverbal Client Cues Requiring Clarification

Changes in affect, appearance, autonomic signs, body movements, or eye behaviors that need verbal follow-up.

Open-Ended Questions

Verbal technique that encourages clients to elaborate and keeps conversation flowing.

Affirmations

Statements conveying encouragement and support; must be sincere to be effective.

Summaries

Restating key points to transition or close an interview.

Cultural Assessment (Giger & Davidhizar)

Evaluates biologic variations, time orientation, social organization, environmental control, communication, space, pace, eye contact, and health beliefs.

Bias-Free Language

Person-first, respectful language that avoids labels, false hierarchies, and unnecessary demographic details; supports DEI.

Family System - Parentification

Dysfunctional family pattern where a child assumes adult caregiving responsibilities.

Psychosocial Risk Factors for Family Health

Factors such as inadequate childcare resources that increase risk for altered family functioning.

FICA Tool

F - Faith, belief, meaning

I - Importance and Influence

C - Community

A - Address in Care

psych closed ended questions

"do you have any thoughts about harming self or others"

"do you have a plan"

"do you have a gun? or access?"

Evidence-Based Nursing Interventions

Care actions supported by research and clinical evidence.

therapeutic role

social:

- advocate

occupational:

- educator

- facilitator

- manager

therapeutic:

- holistic assessment

- coordination of care

- encouragement

- integration of modalities

therapeutic communication

-the purposeful use of communication to build and maintain helping relationships with the client, families, and significant others

-client centered: not social or reciprocal

-purposeful, planned, and goal-directed

soler acronym nursing

-squarely";

"Open posture";

"Lean towards the other";

"Eye contact;

"Relax"

Transference

in psychoanalysis, the patient's transfer to the analyst of emotions linked with other relationships (such as love or hatred for a parent)

countertransference

Circumstances in which a psychoanalyst develops personal feelings about a client because of perceived similarity of the client to significant people in the therapist's life.

motivational interviewing

client-centered communication style for eliciting behavior change by helping clients and groups explore and resolve ambivalence to change

psychiatric SMART goals

Specific, Measurable, Achievable, Relevant, and Time-bound

Goal: "I will attend my trauma-focused therapy sessions weekly for the next 2 months and practice grounding techniques twice daily."

Specific: Attend therapy and practice grounding

Measurable: Weekly sessions + twice daily practice

Achievable: Structured schedule

Relevant: Supports trauma recovery

Time-bound: 2 months

biological theory

brain / body

neurotransmitters

CNS

PNS

psychopharmacology

the use of drugs to control or relieve the symptoms of psychological disorders

neurobiology

the study of the nervous system of living things and how it helps the living things learn and react

serotonin

Affects mood, hunger, sleep and arousal. Undersupply linked to depression.

dopamine

A neurotransmitter associated with movement, attention and learning and the brain's pleasure and reward system.

Norepinephrine

A neurotransmitter involved in arousal, as well as in learning and mood regulation

gaba

An inhibitory neurotransmitter in the brain.

a decrease -> anxiety

glutamate

A major excitatory neurotransmitter; involved in memory

increase linked to psych (mania)

increase dopamine

schizophrenia, mania

decreased norepinephrine

sleepiness, depressed mood

decreased serotonin

depression

decreased GABA

anxiety

decreased glutamate

psychosis

foundational theory

framework for initial understanding formulated by children to explain their experiences of the world

pharmacogenetic testing

a genetic test that indicates how a patient may respond to a specific drug

- viral infection can alter genetics

st. john's wart

antidepressant herbal supplement

education: do NOT take with tricyclic, MAOI, SSRI/SNRI

-> increase side effects and lead to serotonin syndrome