NSG 526 Exam 2 | Questions and Answers (Complete Solutions)

NSG 526 Exam 2 | Questions and Answers (Complete Solutions) Which one of the following is the focus of interpersonal therapy? A) Anxiety management B) Belief systems C) Faulty cognitions D) Social interaction A patient tells the psychiatric advanced practice nurse she is going to try supplementing her selective serotonin reuptake inhibitor with St. John's wort. Which action should the psychiatric advanced practice nurse take first? a) Assess the patient for depression and risk for suicide. b) Suggest that aromatherapy may produce even better results. c) Advise her of the danger of serotonin syndrome. d) Suggest she consider decreasing the dosage of her antidepressant Which of the following is not a technique used in cognitive therapy? A) Reattribution B) Role-playing C) Abreaction D) Developing alternatives The psychiatric advanced practice nurse is developing the care plan for an 8-year-old child with intermittent explosive disorder. Based on Piaget, which of the following goals would be appropriate? The child will: a) connect consequences of his behavior with the behavior itself. b) generalize the consequences of his anger and aggression to different situations c) identify situations in which he is likely to feel abandoned. d) experience an increase in autonomous behavior. In Cognitive Behavioral Therapy, it is often helpful to view people as separate from their problems and behaviors. This empowers them to make changes in their thought patterns and behaviors. Which type of therapy would utilize this approach? A) Psychoanalysis B) Narrative Therapy C) Strategic Therapy D) Psychodynamic therapy Characteristics of cognitive-behavioral therapy include: (Select all that apply.) a) Not time limited b) Active c) Directive d) Collaborative e) Unstructured What theorist is considered the "father of CBT" Aaron Beck who developed the cognitive rational emotive theory and theory of behavior change Albert Ellis researched operant conditioning, in which voluntary behaviors are learned through consequences and behavioral responses are elicited through reinforcement, which causes a behavior to occur more frequently. Skinner in this theory, Skinner proposed: A consequence can be a positive reinforcement, such as receiving a reward (getting a 3.8 GPA after studying hard all semester), or a negative reinforcement, such as the removal of an objectionable or aversive stimulus (walking freely through a park once the vicious dog is picked up by the dogcatcher). operant conditioning who created the theory of operant conditioning Skinner Who is credited with identifying the 12 factors that make groups therapeutic? Yalom one of the 12 therapeutic factors (Yalom): The recognition of shared experiences and feelings among group members and that these may be widespread or universal human concerns, serves to remove a group member's sense of isolation, validate their experiences, and raise self-esteem. Universality One of the 12 therapeutic factors (Yalom): The group is a place where members can help each other, and the experience of being able to give something to another person can lift the member's self esteem and help develop more adaptive coping styles and interpersonal skills. Altruism one of the 12 therapeutic factors (Yalom): In a mixed group that has members at various stages of development or recovery, a member can be inspired and encouraged by another member who has overcome the problems with which they are still struggling. Instillation of hope one of the 12 therapeutic factors (Yalom): While this is not strictly speaking a psychotherapeutic process, members often report that it has been very helpful to learn factual information from other members in the group, for example, about their treatment or about access to services. Imparting information One of the 12 therapeutic factors (Yalom): Members often unconsciously identify the group therapist and other group members with their own parents and siblings in a process that is a form of transference specific to group psychotherapy. The therapist's interpretations can help group members gain understanding of the impact of childhood experiences on their personality, and they may learn to avoid unconsciously repeating unhelpful past interactive patterns in present-day relationships corrective recapitulation of primary family experience one of the 12 therapeutic factors (yalom): The group setting provides a safe and supportive environment for members to take risks by extending their repertoire of interpersonal behavior and improving their social skills. development of socializing techniques one of the 12 therapeutic techniques (Yalom): One way in which group members can develop social skills is through a modeling process, observing and imitating the therapist and other group members. For example, sharing personal feelings, showing concern, and supporting others. Imitative behavior one of the 12 therapeutic techniques (Yalom): Is the primary therapeutic factor from which all others flow. Humans are herd animals with an instinctive need to belong to groups, and personal development can only take place in an interpersonal context. A cohesive group is one in which all members feel a sense of belonging, acceptance, and validation. Cohesiveness one of the 12 therapeutic techniques (Yalom) Learning that one has to take responsibility for one's own life and the consequences of one's decisions. existential factors one of the 12 therapeutic factors (Yalom) The experience of relief from emotional distress through the free and uninhibited expression of emotion. When members tell their story to a supportive audience, they can obtain relief from chronic feelings of shame and guilt. We refer to catharsis as “getting things off our chest.” Catharsis one of the 12 therapeutic factors (Yalom): Group members achieve a greater level of self-awareness through the process of interacting with others in the group, who give feedback on the member's behavior and impact on others. interpersonal learning one of the 12 therapeutic factors (Yalom) This factor overlaps with interpersonal learning but refers to the achievement of greater levels of insight into the genesis of one's problems and the unconscious motivations that underlie one's behavior. Self-understanding what is the primary therapeutic factor of group therapy? Cohesiveness A patient in a support group says, Im tired of being sick. Everyone always helps me, but I will be glad when I can help someone else. This statement reflects: a. altruism. b. universality. c. cohesiveness. d. corrective recapitulation. Which patient would the group co-leaders determine is demonstrating the Yaloms therapeutic factor termed universality? a. Patient A, who states he realizes he is not the only person who has a problem with loneliness b. Patient B, who displays dysfunctional interaction patterns learned in his family of origin c. Patient C, who states he finally feels a strong sense of belonging d. Patient D, who openly expresses his anger about his work Today's cognitive therapy owes its origins to many great thinkers and researchers, most notably____________ and _____________, each who independently developed cognitive approaches to the treatment of psychopathology Albert Ellis and Aaron Beck ______________ developed the cognitive model of depression and the concept that cognitive processing distortions underlie psychological disorders. Aaron Beck When leading a discussion about cognitive theories of mental health, a nursing instructor would most appropriately mention the contributions of which of the following? A. Aaron Beck and Albert Ellis B. Kurt Lewin and Leon Festinger C. John Watson and Joseph Wolpe D. Alfred Adler and Carl Jung According to Beck's theory, depression can develop, persist, and recur as a result of cognitive structures called ___________ Shemas Schemas may develop in part due to childhood experiences, but may also continue to form or develop later in life. They can be adaptive or maladaptive for the individual. For example, schemas may steer an individual to attend to negative events more so than positive events and to the selective recall of negativity. According to Beck et al. (1979), depression can be understood via schemas, cognitive errors, and the __________ ___________(i.e., negative views of self, tendency toward interpreting experiences in a negative manner, and holding negative views of the future). cognitive triad what 3 things make up beck's cognitive triad? 1. View of self 2. View of world/experiences 3. View of future ____________ theories have roots in greek stoic philosophers cognitive theories ________________asserts that it is the way we think about a situation, rather than the situation itself, that leads us to feel a particular emotion and behave in a particular way. Cognitive theory ____________ developed by Aaron T. Beck, is based on the philosophy that people can learn to be their own therapist. Emphasis is on the rearrangement of a person’s maladaptive processes of thinking, perception, and attitudes utilizing an active, time-limited approach. Cognitive therapy Which of the following is a goal of cognitive rehabilitation therapy? A. To change the way the patient perceives psychotic symptoms B. To improve the patient's compliance with the medication schedule C. To improve the patient's memory and thinking D. To facilitate the patient's activities of daily living Which measure consistent with the use of cognitive therapy could the nurse incorporate into the treatment plan of a chronically depressed patient? a. Approach the patient with cheerful affect and optimistic remarks. b. Ignore the patients pessimistic statements; give attention for positive thinking. c. Identify negative evaluations and challenge pessimistic beliefs. d. Seek to uncover unconscious conflicts about significant relationships. a tool that can be used to measure maladaptive emotions and beliefs initially and at frequent intervals (developed by Beck) *measures symptoms of depression with a series of questions, gives you a score Beck's Depression Inventory [BDI] based on both cognitive psychology and behavioral theory and emphasizes the important role of thinking in how we feel and what we do. cognitive-behavioral therapy (CBT) ****Cognitive-behavioral therapists teach that when our brains are healthy, it is our thinking that causes us to feel and act the way we do. ****if we are experiencing unwanted feelings and behaviors, it is important to identify the thinking that is causing the feelings/behaviors and to learn how to replace this thinking with thoughts that lead to more desirable reactions Cognitive-behavioral therapy is based on the scientific fact that our ________ cause our feelings and behaviors, not external things, like people, situations, and events. thoughts The benefit of this fact is that we can change the way we think to feel/act better even if the situation does not change. true or false CBT is brief and time-limited. TRUE Cognitive-behavioral therapy is considered among the "fastest" in terms of results obtained. The average number of sessions clients receive (across all types of problems) is only 16. The nurse is working with a patient with an anxiety disorder whose treatment includes cognitive behavioral therapy. Which statement by the patient gives the nurse reason to assume that the patient has an understanding of the basis of this type of therapy? a. My abusive childhood has resulted in my overreaction to stress. b. My delusional thoughts of extreme anxiety are what cause my panic attacks. c. My brain chemistry causes me to overreact to common stress by getting so anxious. d. I’ve learned to react to my daily stress by having anxious thoughts and panic attacks. Long-term prognosis for eating disorders is improved dramatically when treatment includes long-term cognitive-behavioral therapy. What statement provides the best explanation to the patient for this component to the treatment plan? a. This will help you identify a healthy, weight restoration diet. b. Medication alone will not help you from relapsing back to your old habits. c. In order to manage your disorder, you have to understand the root problems. d. Prognosis has been proven to be much better with both medication and therapy. Guidelines followed by the leader of a therapeutic group include focusing on recognizing dysfunctional behavior and thinking patterns, followed by identifying and practicing more adaptive alternate behaviors and thinking. Which theory is evident by this approach? a. Behavioral b. Interpersonal c. Psychodynamic d. Cognitive-behavioral A type of CBT that views people as separate from their problems and destructive behaviors *** allows clients to get some distance from the difficulty they face; this helps them to see how it might actually be helping or protecting them, more than it is hurting them. Narrative Therapy _____________ psychotherapy is a type of therapy that primarily focuses on providing emotional support, encouragement, and validation during difficult life circumstances or psychological challenges. Supportive psychotherapy __________________ is a comprehensive cognitive behavioral treatment. It aims to treat people who see little or no improvement with other therapy models. This treatment focuses on problem-solving and acceptance-based strategies. It operates within a framework of dialectical methods Dialectical Behavioral Therapy (DBT) The family of a child diagnosed with an impulse control disorder needs help to function more adaptively. Which aspect of the child's plan of care will be provided by an advanced practice nurse rather than a staff nurse? a. Leading an activity group b. Providing positive feedback c. Formulating nursing diagnoses d. Dialectical behavioral therapy (DBT) *** Currently, DBT is used to treat people with chronic or severe mental health issues. Issues DBT treats include self-harm, eating and food issues, addiction, and posttraumatic stress, as well as borderline personality. DBT was originally designed to treat people who had chronic suicidal thoughts as a symptom of borderline personality. __________ is a cognitive behavioral therapy that is aimed at treating individuals who have been diagnosed with borderline personality disorder or individuals who deliberately partake in self-destructive behavior or have suicidal thoughts ****helps individuals regulate their emotions and take responsibility for their own behavior and problems. teaches an individual how to cope with conflict,, negative feelings, and impulsivity dialectical behavioral therapy (DBT) _________ therapy is based on the assumption that changes in maladaptive behavior can occur without insight into the underlying cause. This approach works best when it is directed at specific problems and the goals are well defined. behavioral therapy Behavioral therapy is effective in treating people with phobias, alcoholism, schizophrenia, and many other conditions What are the four types of behavioral therapy? (MOSA) 1. Modeling 2. Operant Conditioning 3. Systemic Desensitization 4. Aversion Therapy in this type of behavioral therapy, the nurse/therapist provides a role model for specific identified behaviors, and the client learns through imitation. Modeling a form of behavioral therapy - ________________ is the basis for behavior modification and uses positive reinforcement to increase desired behaviors operant conditioning a form of behavioral therapy ---- ____________ is a behavior modification therapy that involves the development of behavioral tasks customized to the client's specific fears; these tasks are presented to the client while using learned relaxation techniques. systematic desensitization in this form of therapy, the assumption is that psychiatric disorders are influenced by interpersonal interactions and the social context. The goal of __________ psychotherapy is to reduce or eliminate psychiatric symptoms (particularly depression) by improving interpersonal functioning and satisfaction with social relationships interpersonal therapy who founded interpersonal therapy Adolph Meyer and Harry Stack Sullivan what are the four identified problem areas that are investigated/treated in interpersonal therapy 1. Grief - complicated bereavement following the death or loss of a loved one 2. Role disputes - conflicts with a significant other 3. Role transition - problematic change in life status or social or vocational role 4. Interpersonal deficit - an inability to initiate or sustain close relationships _________ therapy takes naturally occurring events in the environment and uses them as rich learning opportunities for clients. mileu therapy mileu therapy. - psychotherapy in which the patient's social environment is controlled or manipulated with a view to preventing self-destructive behavior. founder of milieu therapy Bruno Bettelheim ___________________ sometimes referred to as in vivo exposure therapy, is a form of behavior therapy and desensitization. It is used to treat phobia and anxiety disorders including post-traumatic stress disorder. It works by exposing the patient to their painful memories,[1] with the goal of reintegrating their repressed emotions with their current awareness Flooding who created flooding therapy Thomas Stampfi flooding therapy A behavioral treatment for phobias that involves prolonged exposure to a feared stimulus, thereby providing maximal opportunity for the conditioned fear response to be extinguished. the primary purpose of ______________ is to facilitate changes by the patient to address identified problems. ****method where individuals with a common purpose come together and benefit by both giving and receiving feedback within the dynamic and unique context of the group group therapy in group therapy: - all that is said in the group group content in group therapy: - the dynamics of interaction among the members (ex. who talks to whom, facial expressions, and body language) group process