SOLUTIONS
DSM IV and DSM V - ✔✔DSM IV: Multi-axial approach
DSM V : Emphasis dimensional assessment and aligns diagnosis with ICD codes
Therapeutic communications - ✔✔Mutual, interactive, interpersonal relationship focused on the
patient's need, are goal directed, theory based and open to supervision
Transference - ✔✔Displacement of feelings by the client of someone in his or her past onto the PMHNP
in the present relationship.
Counter transference - ✔✔Represents the PMHNPs emotional reaction to the patient based on his or
her past experiences
Faces of therapeutic nurse-patient relationship - ✔✔Introduction= Orientation
Working= Identification and exploitation.
Termination= Resolution
Introduction - ✔✔Initial therapuetic stage. Creating boundaries, making plans for the length of therapy,
setting up tx goals and planning.
Working - ✔✔2nd stage of theraputuic relationship. Implementing tx plan, measuring outcomes and
evaluation of goals. This is where transference may play a role.
Termination - ✔✔This is the 3rd stage of a therapeutic relationship. Reviewing client goals and progress
towards objectives. Disengaging from the relationship. May have regression or symptoms may reappear.
, Trust v Mistrust - ✔✔0-1 year
Ability to form meaningful relationships, hope about the future, trust in others. If not achieved you show
poor relationships, lack of future hope, suspicious of others.
Autonomy v Shame and doubt - ✔✔1-3 years
Self control, self esteem, willpower. If not achieved you show poor self control, self doubt and lack of
independence.
Initiative v guilt - ✔✔3-6 years
Self directed behavior, goal formation, sense of purpose. If not achieved lack of self initiated behavior,
lack of goal orientation.
Industry v inferiority - ✔✔6-12 years
ability to work, sense of competency and achievement. If not achieved sense of inferiority, difficulty
with working and learning.
Identity v role confusion - ✔✔12-20 years
Personal sense of identity. If not achieved poor self identification in group settings and identity
confusion.
Intimacy v isolation - ✔✔20-35 years
Committed relationships, capacity to love. If not achieved Emotional isolation.
generativity v self absorption or stagnation - ✔✔35-65 years
ability to give time and talent to others, ability to grow and change. If not achieved self absorption and
inability to care for others.
integrity v despair - ✔✔> 65 years