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HILDEGARD PEPLAU
THERAPEUTIC NURSE-PATIENT RELATIONSHIP
ORIENTATION PHASE
IDENTIFICATION PHASE
EXPLOITATION PHASE
RESOLUTION PHASE
4 Phases of THERAPEUTIC NURSE-PATIENT RELATIONSHIP
ORIENTATION PHASE
4 Phases of THERAPEUTIC NURSE-PATIENT RELATIONSHIP: Directed by the nurse and involves engaging the client in treatment, providing explanations and information, and answering questions.
ORIENTATION PHASE
4 Phases of THERAPEUTIC NURSE-PATIENT RELATIONSHIP: The nurse conducts initial interview to find out the client's initial concern.
ORIENTATION PHASE
4 Phases of THERAPEUTIC NURSE-PATIENT RELATIONSHIP: The nurse sets limit and boundaries.
ORIENTATION PHASE
4 Phases of THERAPEUTIC NURSE-PATIENT RELATIONSHIP: Assures confidentiality with the client and establishes trust and rapport.
IDENTIFICATION PHASE
4 Phases of THERAPEUTIC NURSE-PATIENT RELATIONSHIP: Begins when the client works independently with the nurse, expresses feelings, and begins to feel stronger.
IDENTIFICATION PHASE
4 Phases of THERAPEUTIC NURSE-PATIENT RELATIONSHIP: The client feels a sense of belonging and diminishes the feeling of loneliness and hopelessness.
EXPLOITATION PHASE
4 Phases of THERAPEUTIC NURSE-PATIENT RELATIONSHIP: The client makes full use of the services offered.
EXPLOITATION PHASE
4 Phases of THERAPEUTIC NURSE-PATIENT RELATIONSHIP: The client feels that she is an integral part of the environment.
RESOLUTION PHASE
4 Phases of THERAPEUTIC NURSE-PATIENT RELATIONSHIP: The client no longer needs professional services and gives up dependent behavior. The relationship ends.
STRANGER
RESOURCE PERSON
TEACHER
LEADER
SURROGATE
COUNSELOR
ROLES OF NURSES IN THE THERAPEUTIC RELATIONSHIP
STRANGER
ROLES OF NURSES IN THE THERAPEUTIC RELATIONSHIP: Offering the client the same acceptance and courtesy that the nurse would to any stranger.
STRANGER
ROLES OF NURSES IN THE THERAPEUTIC RELATIONSHIP: The nurse provides accepting climate that builds trust.
Resource person
ROLES OF NURSES IN THE THERAPEUTIC RELATIONSHIP: Providing specific answers to questions within a larger context.
TEACHER
ROLES OF NURSES IN THE THERAPEUTIC RELATIONSHIP: Helping the client learn either formally or informally.
TEACHER
ROLES OF NURSES IN THE THERAPEUTIC RELATIONSHIP: Teach clients of different coping mechanisms.
LEADER
ROLES OF NURSES IN THE THERAPEUTIC RELATIONSHIP: Offering direction to the client or group.
LEADER
ROLES OF NURSES IN THE THERAPEUTIC RELATIONSHIP: You have the maximum responsibility of the client.
SURROGATE
ROLES OF NURSES IN THE THERAPEUTIC RELATIONSHIP: Serving as substitute for another, such as parent or sibling.
COUNSELOR
ROLES OF NURSES IN THE THERAPEUTIC RELATIONSHIP: Promoting experiences leading to health for the client, such as expression of feelings.
COUNSELOR
ROLES OF NURSES IN THE THERAPEUTIC RELATIONSHIP: Provide encouragement and guidance to your client.
MILD ANXIETY
MODERATE ANXIETY
SEVERE ANXIETY
PANIC ANXIETY
FOUR LEVELS OF ANXIETY
ANXIETY
Vague sense of impending dome. It is a psychophysiological response.
MILD ANXIETY
FOUR LEVELS OF ANXIETY: Positive state of heightened awareness and sharpened senses, allowing the person to learn new behaviors and solve problems.
MILD ANXIETY
FOUR LEVELS OF ANXIETY: The person can take in all available stimuli (perceptual field).
MILD ANXIETY
FOUR LEVELS OF ANXIETY: Very close to normal everyday stress or worries.
MILD ANXIETY
FOUR LEVELS OF ANXIETY: Performing tension-relieving behavior to remove threat or tension.
MODERATE ANXIETY
FOUR LEVELS OF ANXIETY: Involves a decreased perceptual field (focus on immediate task only)
MODERATE ANXIETY
FOUR LEVELS OF ANXIETY: the person can learn new behavior or solve problems only with assistance. Another person can redirect the person to the task.
MODERATE ANXIETY
FOUR LEVELS OF ANXIETY: Selective in attention: A person is focused on the problem/threat and only notice things if pointed out.
SEVERE ANXIETY
FOUR LEVELS OF ANXIETY: Involves feelings of dread or terror.
SEVERE ANXIETY
FOUR LEVELS OF ANXIETY: The person cannot be redirected to a task
SEVERE ANXIETY
FOUR LEVELS OF ANXIETY: he or she focuses only on scattered details and has physiologic symptoms of tachycardia, diaphoresis, and chest pain.
SEVERE ANXIETY
FOUR LEVELS OF ANXIETY: A person may go to an emergency department, believing he or she is having a heart attack.
SEVERE ANXIETY
FOUR LEVELS OF ANXIETY: Don't know what to do and what to say.
PANIC ANXIETY
FOUR LEVELS OF ANXIETY: Can involve loss of rational thought, delusions, hallucinations, and complete physical immobility and muteness.
PANIC ANXIETY
FOUR LEVELS OF ANXIETY: The person may bolt and run aimlessly, often exposing him or herself to injury
PANIC ANXIETY
FOUR LEVELS OF ANXIETY: Extreme level of anxiety.
PANIC ANXIETY
FOUR LEVELS OF ANXIETY: Client experiences loss of contact with the reality.
PANIC ANXIETY
FOUR LEVELS OF ANXIETY: Prone to suicide and experiences respiratory alkalosis.
ABRAHAM MASLOW
WHO: HIERARCHY OF NEEDS
Self-actualization
Esteem
Love and belonging
Safety needs
Physiologic needs
HIERARCHY OF NEEDS
Self-actualization
HIERARCHY OF NEEDS: Desire to become the most that one can be
Esteem
HIERARCHY OF NEEDS: respect, self-esteem, status, recognition, strength, freedom
Safety needs
HIERARCHY OF NEEDS: Personal security, employment, resources, health, property
Physiologic needs
HIERARCHY OF NEEDS: Air, water, food, shelter, sleep, clothing, reproduction
Love and belonging
HIERARCHY OF NEEDS: Friendship, intimacy, family, sense of connection
CARL ROGERS
WHO: CLIENT-CENTERED THERAPY
CLIENT-CENTERED THERAPY
The therapist must promote the client's self-esteem as much as possible through three central concepts
UNCONDITIONAL POSITIVE REGARD
GENUINENESS
EMPHATETIC UNDERSTANDING
Three concepts of CLIENT-CENTERED THERAPY
UNCONDITIONAL POSITIVE REGARD
Three concepts of CLIENT-CENTERED THERAPY: A nonjudgmental caring for the client that is not dependent on the client's behavior.
UNCONDITIONAL POSITIVE REGARD
Three concepts of CLIENT-CENTERED THERAPY: The nurse helps the client without the client feeling a sense of rejection or invalidation.
GENUINENESS
Three concepts of CLIENT-CENTERED THERAPY: Realness or congruence between what the therapist feels and what he or she says to the client.
GENUINENESS
Three concepts of CLIENT-CENTERED THERAPY: For clients to be honest and open with the nurse.
EMPHATETIC UNDERSTANDING
Three concepts of CLIENT-CENTERED THERAPY: The therapist senses the feelings and personal meaning from the client and communicates this understanding to the client.
EMPHATETIC UNDERSTANDING
Three concepts of CLIENT-CENTERED THERAPY: Helps build rapport with the therapist.
EMPHATETIC UNDERSTANDING
Three concepts of CLIENT-CENTERED THERAPY: Ensure that both the client and the nurse are fully understood.
ABRAHAM MASLOW: HIERARCHY OF NEEDS
CARL ROGERS: CLIENT-CENTERED THERAPY
HUMANISTIC THEORIES
IVAN PAVLOV
WHO: CLASSICAL CONDITIONING
Pavlov's theory of behaviorism
Rooted in the idea that behavior is the result of conditioning.
IVAN PAVLOV: CLASSICAL CONDITIONING
He believed that behavior is learned through the process of classical conditioning, where behavior is shaped through the association of stimuli in the environment.
IVAN PAVLOV: CLASSICAL CONDITIONING
All behaviors are learned and inflicted through rewards and punishment.
B.F SKINNER
WHO: OPERANT CONDITIONING
B.F SKINNER: OPERANT CONDITIONING
All behaviors can be learned and unlearned.
B.F SKINNER: OPERANT CONDITIONING
If you were given a reward, there is a repetition of action, if there is a punishment, the action will be extinct.
1 All behavior is learned.
2 Consequences result from behavior—broadly speaking, reward and punishment.
3 Behavior that is rewarded with reinforcers tends to recur.
4 Positive reinforcers that follow a behavior increase the likelihood that the behavior will recur
5 Negative reinforcers that are removed after a behavior increase the likelihood that the behavior will recur.
6 Continuous reinforcement (a reward every time the behavior occurs) is the fastest way to increase that behavior, but the behavior will not last long after the reward ceases.
7 Random intermittent reinforcement (an occasional reward for the desired behavior) is slower to produce an increase in behavior, but the behavior continues after the reward ceases.
Principles of operant conditioning:
Continuous reinforcement
Principles of operant conditioning: a reward every time the behavior occurs
Random intermittent reinforcement
Principles of operant conditioning: an occasional reward for the desired behavior
EXISTENTIAL THEORIES
Belief that we are responsible to have freedom to create our own meaning and purpose.
Rational emotive therapy
Logotherapy
Gestalt therapy
Reality therapy
EXISTENTIAL THEORIES
Albert Ellis
EXISTENTIAL THEORIES: Rational emotive therapy
Rational emotive therapy
EXISTENTIAL THEORIES: A cognitive therapy using confrontation of "irrational beliefs" that prevent the individual from accepting responsibility for self and behavior
Viktor E. Frankl
EXISTENTIAL THEORIES: Logotherapy
Logotherapy
EXISTENTIAL THEORIES: A therapy designed to help individuals assume personal responseility (the search for meaning [logos] in life is a central theme)
Frederick S. Perls
EXISTENTIAL THEORIES: Gestalt therapy
Gestalt therapy
EXISTENTIAL THEORIES: A therapy focusing on the identification of feelings in the here and now, which leads to self-acceptance
William Glasser
EXISTENTIAL THEORIES: Reality therapy
Reality therapy
EXISTENTIAL THEORIES: Therapeutic focus is need for identity through responsible behavior; individuals are challenged to examine ways in which their behavior thwarts their attempts to achieve life goals
CRISIS INTERVENTION
Caplan 1964
CAPLAN 1964
Identified the stages of crisis
1 The person is exposed to a stressor, experiences anxiety, and tries to cope in a customary manner
2 Anxiety increases when customary coping skills are ineffective
3 The person makes all possible efforts to deal with the stressor, including attempts at new methods of coping
4 When coping attempts fail, the person experiences disequilibrium and significant distress.
Stages of Crisis
Crisis
Occur in response to a variety of life situations and events.
MATURATIONAL CRISES
SITUATIONAL CRISES
ADVENTITIOUS CRISES
THREE CATEGORIES OF CRISIS
MATURATIONAL CRISES
THREE CATEGORIES OF CRISIS: Also called developmental crises
MATURATIONAL CRISES
THREE CATEGORIES OF CRISIS: Predictable events in the normal course of life, such as leaving home for the first time, getting married, having a baby, and beginning a career.
SITUATIONAL CRISES
THREE CATEGORIES OF CRISIS: Unanticipated or sudden events that threaten the individual's integrity, such as the death of a loved one, loss of a job, and physical or emotional illness in the individual or family member.
ADVENTITIOUS CRISES
THREE CATEGORIES OF CRISIS: Sometimes called social crises
ADVENTITIOUS CRISES
THREE CATEGORIES OF CRISIS: Include natural disasters like floods, earthquakes, or hurricanes, war, terrorist attacks, riots, and violent crimes such as rape or murder.
ADVENTITIOUS CRISES
THREE CATEGORIES OF CRISIS: Unforeseeable crisis
PSYCHOTHERAPY
A process in which a person enters into a contract to interact with a therapist to relieve symptoms, resolve problems in living and seek personal growth.
INDIVIDUAL THERAPY
GROUP THERAPY
FAMILY THERAPY
PLAY THERAPY
MUSICAL THERAPY
ART THERAPY
PSYCHODRAMA THERAPY
Kinds of PSYCHOTHERAPY:
INDIVIDUAL THERAPY
Kinds of PSYCHOTHERAPY: A method of bringing about change in a person by exploring his or her feelings, attitudes, thinking, and behavior.
INDIVIDUAL THERAPY
Kinds of PSYCHOTHERAPY: It involves a one-to-one confidential relationship between the therapist and the client.
hypnotherapy
Individual therapy: Technique use in therapies to have a positive outcome with the session. The client becomes submissive to commands.
INDIVIDUAL THERAPY
Kinds of PSYCHOTHERAPY: Sometimes involves hypnotherapy: technique use in therapies to have a positive outcome with the session. The client becomes submissive to commands.
GROUP THERAPY
Kinds of PSYCHOTHERAPY: clients participate in sessions with a group of people
GROUP THERAPY
Kinds of PSYCHOTHERAPY: The members share a common purpose and are expected to contribute to the group to benefit others and receive benefits from others in return.
GROUP THERAPY
Kinds of PSYCHOTHERAPY: Group rules are established, which all members must observe.
GROUP THERAPY
Kinds of PSYCHOTHERAPY: Advantage: Opportunity to help others and ability to listen with other members' feelings and experiences.
