2010

What is clinical recovery?

Reduction of symptoms and improvement in functioning or clinical stability.

What is personal recovery?

An individual process of building a meaningful and satisfying life, with or without ongoing symptoms.

Why is the distinction between clinical and personal recovery important?

Recovery should reflect the person's own goals and meaning, not just symptom reduction.

What is a psychotherapeutic approach?

Using psychological principles and therapeutic interactions to help people understand distress, develop coping strategies and work towards recovery.

What is cognitive behavioural therapy (CBT)?

A therapy that explores and changes unhelpful thought and behaviour patterns.

What is solution-focused therapy (SFT)?

A therapy that focuses on strengths, hopes, resources and achievable future goals.

What is reflective practice?

Critically examining experiences, decisions and reactions to improve future practice.

How does reflective practice improve nursing?

Identifies strengths, learning needs, biases and emotional responses; improves judgement, communication and accountability.

What is the therapeutic use of self?

Intentionally using self-awareness, communication and interpersonal skills to support a therapeutic relationship.

What supports the therapeutic use of self?

Active listening, empathy, trust, respect, self-reflection, appropriate communication and professional boundaries.

What are the main components of a mental health assessment?

Presenting concerns, history, MSE, risk and safety, physical health, social context, strengths and the person's perspective.

What is a mental state examination (MSE)?

Assessment of appearance, behaviour, speech, mood and affect, thought, perception, cognition, insight and judgement.

Why include the person's perspective in assessment?

To understand their experiences, priorities, preferences and interpretation of their difficulties.

What should a mental health risk assessment consider?

Relevant suicidal thoughts, self-harm, risk to others, vulnerability, protective factors and immediate safety.

What is a clinical formulation?

An individualised explanation of a person's difficulties, context, contributing factors and strengths.

What is the purpose of formulation?

To understand distress, identify maintaining and protective factors, and guide individualised interventions.

What are the 5Ps of formulation?

Presenting, predisposing, precipitating, perpetuating and protective factors.

What are presenting factors?

The person's current difficulties and reasons for seeking care.

What are predisposing factors?

Experiences or circumstances that may have increased vulnerability to difficulties.

What are precipitating factors?

Events or changes that contributed to the onset or worsening of current difficulties.

What are perpetuating factors?

Factors that maintain or worsen current difficulties.

What are protective factors?

Strengths, relationships and resources that support coping and recovery.

What is the purpose of a formulation's sixth P, when used?

To include the person's perspective, understanding or other additional context specified by the framework.

How should a formulation be written?

Gather information, organise it into a framework, connect factors, identify strengths and interventions, and review collaboratively.

Why is formulation considered a working hypothesis?

It may change as new information emerges and the person's circumstances or understanding develops.

How can formulation be person-centred?

Use the person's own perspective, strengths, culture, preferences and goals; develop and revise it collaboratively.

What is the difference between diagnosis and formulation?

Diagnosis classifies symptoms; formulation explains how difficulties may relate to the individual's experiences and circumstances.

What is the purpose of a nursing care plan?

To translate assessment and formulation into goals, interventions and evaluation.

What should a nursing care plan include?

Needs, collaborative goals, interventions, rationale, responsibilities, timeframes, safety planning and evaluation.

What makes a care-plan goal useful?

It is clear, realistic, meaningful to the person and developed collaboratively.

What are key principles of clinical documentation?

Be accurate, timely, factual, clear, respectful and relevant.

How should nurses document subjective and objective information?

Distinguish what the person reports from what the nurse observes.

What safety information should be documented?

Relevant risks, assessments, actions, consultations, escalation and the person's response to care.

What does it mean to humanise mental health care?

Treating each person with dignity and individuality rather than reducing them to a diagnosis or risk category.

How can nurses humanise care?

Listen, communicate compassionately, explain treatment, respect autonomy and challenge stigma and assumptions.

What ethical challenges arise in mental health care?

Autonomy versus safety, consent and capacity, confidentiality, coercion, power imbalances, stigma and professional boundaries.

How can nurses advocate for consumers?

Explain rights, include their preferences, challenge unsafe or discriminatory care and support access to services.

How can nurses advocate for themselves professionally?

Know their scope, seek supervision, raise concerns appropriately, document and maintain boundaries.

Why are professional boundaries important?

They protect consumers, maintain trust, clarify roles and keep care focused on the person's needs.

What are examples of boundary violations?

Exploitation, inappropriate personal relationships, excessive self-disclosure, misuse of power, favouritism and inappropriate contact.

How should nurses respond to boundary concerns?

Reflect on motivations, seek supervision, follow policy and maintain the professional role.

Why is understanding different perspectives on suicide important?

It helps nurses understand the person's suffering, avoid judgement and provide compassionate, collaborative care.

How can nurses explore a person's experience of suicidality?

Ask directly, listen without judgement, explore distress and triggers, and identify coping strategies and supports.

What should suicide assessment explore?

Thoughts, frequency, plans, intent, access to means, previous behaviour, current stressors, protective factors and immediate safety.

Why should suicidality not be reduced to a risk checklist?

The person's suffering and circumstances are complex and require individualised understanding and care.

How can services improve responses to suicidality?

Train staff, improve access, support therapeutic engagement, coordinate care, provide safety planning and ensure follow-up.

What is a collaborative response to suicidality?

Working with the person to understand suffering, plan safety, identify supports and explore ways to reduce distress.

What should a suicide safety plan include?

Warning signs, coping strategies, supportive people, services, means-safety steps and escalation arrangements.

How should nurses communicate with someone experiencing suicidal thoughts?

Ask directly, validate distress, listen actively, avoid judgement and collaborate on safety and support.

Why is a person's desire for relief important when discussing suicidality?

Understanding what the person wants to escape or relieve can help identify meaningful alternatives and support.

What is trauma-informed care?

Care that recognises trauma's potential effects and prioritises safety, choice, trust, empowerment and collaboration.

What are core principles of trauma-informed care?

Safety, choice, empowerment, collaboration, trust and transparency, and avoiding re-traumatisation.

How can nurses enact trauma-informed care?

Explain procedures, ask permission, offer choices, communicate predictably and respect the person's control and preferences.

What is re-traumatisation?

Care or interactions that recreate or intensify feelings of threat, powerlessness or loss of control.

What is vicarious trauma?

The potential psychological impact of repeated exposure to other people's traumatic experiences through caring work.

What are possible signs of vicarious trauma?

Emotional exhaustion, distress, intrusive thoughts, altered beliefs about safety, reduced empathy or emotional distancing.

How can nurses manage vicarious trauma?

Use supervision, peer support, reflection, boundaries, restorative activities and professional support when needed.

What is the window of tolerance?

The range of arousal in which a person can regulate emotions and engage with thinking and relationships.

What is hyperarousal?

A heightened state of arousal, potentially involving panic, agitation, anger or fight-or-flight responses.

What is hypoarousal?

A lowered state of arousal, potentially involving shutdown, numbness, disconnection or reduced responsiveness.

What is distress tolerance?

The ability to experience difficult emotions or situations without becoming overwhelmed or relying on harmful responses.

How can nurses support regulation?

Reduce stimulation, communicate calmly, offer grounding and choices, support coping strategies and recognise early warning signs.

Why should nurses consider regulation before problem-solving?

A highly distressed or dysregulated person may struggle to process information or engage in complex discussion.

What are key human rights principles in mental health care?

Rights are universal, inherent, inalienable and interdependent.

How can nurses uphold human rights in daily practice?

Respect dignity, privacy, autonomy, consent, participation and equitable access; challenge discrimination and degrading treatment.

What should nurses consider when using restrictive practices?

Legal and professional requirements, safety, rights and the need to avoid unnecessary restriction.

What is the nursing role in forensic or custodial settings?

Provide assessment, therapeutic care, medication monitoring, crisis response, advocacy and care coordination.

What should mental health nurses consider when caring for incarcerated people?

Trauma, loss of freedom, structural disadvantage, stigma, access to care and continuity after release.

Why is continuity of care important after release from custody?

People may face increased vulnerability through housing instability, unemployment, substance-related harms and suicide risk.

What is shame-sensitive practice?

Care that recognises fear of judgement or humiliation and protects dignity, safety and trust.

How can shame affect mental health care?

It may contribute to withdrawal, concealment, defensiveness, anger, distrust or reluctance to seek help.

How can nurses navigate awkward conversations?

Explain why questions matter, ask respectfully, use neutral language, allow time and protect privacy.

What should nurses avoid in shame-sensitive practice?

Blame, humiliation, judgement, stereotypes and unnecessary confrontation.

What are similarities between structured psychotherapies?

They aim to reduce distress or support change and usually rely on collaboration, goals and a therapeutic relationship.

How does CBT differ from psychodynamic therapy?

CBT focuses on thoughts and behaviours; psychodynamic therapy explores underlying emotional patterns and motivations.

What do behavioural approaches focus on?

Learning, changing or unlearning behaviours.

What do interpersonal approaches focus on?

Relationships and interpersonal difficulties.

What is an integrative psychotherapy approach?

Combining elements of different therapeutic approaches according to the person's needs.

What can influence psychotherapy outcomes besides technique?

The therapeutic alliance, expectations, opportunities to practise new behaviours and therapist qualities.

What should nurses consider when using therapeutic activities?

The person's goals, preferences, consent, readiness, culture, safety and the nurse's skills.

What are examples of therapeutic activities nurses can use?

Therapeutic conversations, goal-setting, coping strategies, early-warning-sign planning, problem-solving and meaningful activities.

What is attachment?

The emotional bond between an infant and caregiver.

How can nurses support secure attachment?

Encourage responsive caregiving, help caregivers recognise infant cues and support safe, positive interaction.

What is infant mental health?

An infant's social and emotional wellbeing and developing ability to form relationships, regulate distress and engage with their environment.

What might indicate infant mental health concerns?

Persistent difficulties with settling, feeding, sleep, regulation, interaction or caregiver-infant relationships.

What are examples of perinatal mental health conditions?

Perinatal depression, anxiety, bipolar disorder and postpartum psychosis.

What are priorities in perinatal mental health nursing?

Assess wellbeing and safety, provide non-judgemental support, support parent-infant relationships and coordinate care.

Why is postpartum psychosis urgent?

It can involve rapid deterioration, psychotic symptoms, confusion or marked mood disturbance and requires urgent specialist assessment.

What are common antidepressant side effects?

Nausea, gastrointestinal changes, headache, sleep disturbance and sexual side effects.

What are common antipsychotic side effects?

Sedation, dizziness, weight gain, metabolic changes and movement-related effects.

What are possible effects of anxiolytics and sedatives?

Drowsiness, impaired coordination and, for some medications, tolerance or dependence.

What monitoring may mood stabilisers require?

Monitoring depends on the medication; lithium requires serum levels, renal function and thyroid function monitoring.

What is electroconvulsive therapy (ECT)?

A treatment using brief electrical stimulation under general anaesthesia and muscle relaxation to produce a controlled seizure.

When may ECT be used?

For severe depression or bipolar disorder when medication is ineffective, and in some urgent or specific presentations such as catatonia.

What are potential ECT adverse effects?

Memory impairment, temporary confusion, headache, muscle soreness and anaesthesia-related risks.

What is the nursing role before and after ECT?

Explain and support consent, prepare the person, follow fasting requirements, monitor recovery and report adverse effects.

How should nurses support a person who wants to reduce psychotropic medication?

Listen to concerns, support informed discussion, collaborate with the prescriber and arrange monitoring and follow-up.

Why should psychotropic medication not be stopped abruptly without advice?

Stopping may cause withdrawal effects or relapse; reduction should be clinically supported and individualised.

What should be monitored during medication reduction?

Mental state, functioning, sleep, withdrawal effects, relapse indicators and safety.

What is relational recovery?

Recovery understood as occurring within relationships and social contexts, including connection, belonging and support.