Mental Health N222 Week 3 (Answered)

Mental Health N222 Week 3 (Answered) Democratic Leadership leader facilitates much communication & interaction between members Autocratic Leadership leader controls the direction of the group, minimizing member communication Laissex-Faire Leadership leader takes a back seat, providing minimal direction, allowing the group to problem solve and progress naturally Group Process verbal & nonverbal communication in group sessions that include work progress & member interaction Group Norm the way the group behaves during sessions, and, over time, it provides structure for the group Hidden Agenda members or leader of group may have different goals that can disrupt the group process Subgroup small number of people in group who function seperately Dynamics how the group is affected if it is open (allowing new members) or closed (no new members) Homogenous Group members share certain characteristics (diagnosis or gender) Individual Therapy focus -pt. needs, problems & therapeutic relationship goals -more positive individual decisions -productive life decisions -develop a strong sense of self Family Therapy focus -needs & problems w/in family dynamic & improving function goals -cope with mental illness w/in family & improve understanding, maximizing positive interactions among family members Group Therapy focus -help individuals develop functional & satisfying relationship in group setting goals -vary depending on group -find members w/ common feelings, experiences & thoughts -positive behavioral changes resulting from group setting & feedback Children in Group Therapy in the form of play while talking about a common experience Adolescent in Group Therapy especially valuable, as this group typically has strong peer relationships Older Adults in Group Therapy helps with socialization and sharing of memories Orientation Phase of Group Development -defines purpose & goals of group -leader sets tone of respect, trust & confidentiality -members get to know eachother -discussion about termination Working Phase of Group Therapy -problem solving skills for behavioral changes -theraputic techniques to work toward goal -members promote of inhibit progress in goals -cohesivness established and leader role diminished Termination Phase of Group Development -end of group sessions -discussion of termination issues -members take many roles -feedback elicited Maintenance Role in Group Therapy members who help maintain purpose & process of group Task Role in Group Therapy members who take on various takes in group process Individual Role in Group Therapy tend to prevent teamwork due to promotion of own self agenda Group Characteristics in Acute MH Setting -members vary daily -focus of group is relief -unit acitivities impact group -leader provides structure Group Characteristics in Outpatient Setting -members often consistent -focus is on growth -external influences limited -leader allowed opportunity for member direction Nuclear Family include children who reside with married paretns Single-Parent Families include children who live with a single adult that can be related or nonrelated to the children Adoptive Families include children who live with parents who have adopted them Blended Families include children who live with one biological or adoptive parent and an nonrelated stepparent who are married Cohabitating Families include children who live with one biological parent and a nonrelated adult who are cohabitating Extended Families include children living with one biological or adoptive parent and a related adult who is not their parent (grandparent, aunt, uncle, etc.) Other Families include children living with related or nonrelated adults who are neither biological nor adoptive parents (grandparents, adult siblings, foster parents) Blaming members of family blame others to shift focus away from their own inadequacies Manipulating members of family use dishonesty to support own agenda Placating one member of family takes responsibility for all problems to keep peace at all costs Distracting a member of family inserts irrelevant information during attempts at problem solving Generalizing members of family use overall descriptions ("always" & "never") when describing family encounters Enmeshed Boundaries thoughts, roles, and feelings blend so much that individual roles in family are unclear Rigid Boundaries rules and roles are completely inflexible, these families tend to have members that isolate themselves & communication is minimal, members do not share thoughts or feelings Scapegoating member within family with little power is slammed for all the problems within the family Triangulation a third party is drawn into the relationship with two members whose relationship is unstable Multigenerational Issues emotional issues or themes within a family that continue for at least three generations (substance use or addictive behavior, dysfunctional grief, triangulation, divorce) Electroconvulsive Therapy (ECT) use of electrical current to induce brief seizure while pt. is anesthetized -exact mechanism unknown -theory that it enhances neurotransmitter effects Electroconvulsive Therapy Uses last resort treatment for serious conditions or those in need of rapid treatment -major depressive disorder -schizophrenia spectrum disorders -acute manic episodes ECT Contraindications -cardiovascular disease (due to increased heart stress from seizure activity during procedure) -cerebrovascular accident (due to increase ICP & blood flow through brain during treatment) ECT Not Successful -substance use disorders -personality disorder -dysphoric disorders ECT Procedural Care -2-3X a week for a total of 6-12 treatments -informed consent from pt. or next of kin if involuntary -chest x-ray, bloodwork, ECG pre-procedure -discontinue benzodiazepines -hypertension controlled -cardiac conditions monitored -vital signs & mental status before & after -assess pt. & family understanding -IV line inserted & maintained -ECG monitoring -100% oxygen -clients expected alertness 15min after procedure ECT Med Management before: IM injection to decrease secretions, minimizing aspirations & counteract vagal nerve stimuli (bradycardia), atropine sulfate or glycopyrrolate during: short acting anastesthia, etomidate or propofol during: muscle relaxant to prevent injury during seizures, also paralyzes respirations so pt. requires oxygen, succinylcholine ECT Memory Loss & Confusion -usually short term immediately after or for several hours -can last up to several weeks -nurse frequently orients, provides safe environment & assists w/ personal hygiene needs ECT Reactions to Anesthesia nurse provides continuous monitoring during procedure & immediate recovery phase ECT Cardiovascular Changes nurse monitors vital signs & cardiac rhythm regularly ECT Relapse of Depression -ECT is not permanent cute -weekly & monthly maintenance can decrease relapse chances Transcranial Magnetic Stimulation (TMS) -treatment for MDD in pt. not responsive to pharm treatment -noninvasive use of magnetic pulsations (MRI strength) to stimulate cerebral cortex of brain TMS Considerations -everyday for 4 to 6 weeks -outpatient procedure -lasts 30 to 40min -noninvasive magnet placed on scalp allowing magnetic pulse to pass through