Exam 1 Mental Health Chapter 22

Chapter 22 Therapeutic Environment in Various Treatment Settings Inpatient!Settings! 1. Occupational therapy >functional abilities of patients, their capacity to work & perform ADLs; master skills for self care; work; play 2. Recreational therapy >assist patietns to find activites that balance work & play; exercise group 3. Psychoeducation >educating patietns & families regarding mental illness from a multidimensional viewpoint; provide social support; share information to assist adaptation to living with a chronic illness; prepare for discharge 4. Group therapy >an opportunity to get input from others, can work with a large number of patients, and is economical; gain new insight, knowledge, and perspective; feeling of acceptance & belonging; accountable to group of people with similar struggles; type of group therapy depending on purpose intended 5. Spirituality groups >instilling hope & encouraging patients to look at faith or spirituality as resources for recovery; run by chaplain or mental health treatment team professionals; focus on forgiveness, grief, meaning in life 6. Community meetings >addressing daily needs associated with community living; inpatient or community setting -Recognizing signs of relapse -Using public transportation -Talking with your therapist, c worker, & psychiatrist -Coping with stress -Managing your medications -Coping with symptoms -Knowing when to call your physician -Getting along with family members -Returning to work -Anger management -Interpersonal skills -Living skills -Cognitive behavioral -Psychodynamic -Gestalt -Attachment based -Interpersonal -Family systems 1. Intensive care or acute psychiatric units (locked units) >24hr structure inpaitent treatment within a locked setting; treatment emphasis on short term, intense therapeutic interventions to provide rapid evaluation & stabilization of symptoms; criteria for admission is danger to self or others or gravely disabled; can be voluntary or involuntary; severity of illness is high, requiring close supervision and intervention by nursing staff >presenting problems: acute & persistent mental illness, organic brain syndrome, detox from alcohol or drugs, acute situational or emotional distress, suicide threats or attempts, medication adjustment 2. Child-adolescent inpatient unit >offer comprehensive psychiatric assessment stabilization, and short stay treatment; child and family centered care is essential; schoolwork; play with peers; behavior management; time out; skills training groups >common conditions: severe depression, bipolar disorders, impulse control disorders, phobias, anxiety disorders, schizophrenia, eating disorders 3. Acute substance abuse treatment centers >provide detoxification and acute inpatient medical & psychiatric stabilization and treatment who are seeking help with an identified drug or alcohol problem; dual diagnosis unit focuses on co-occurring disorders of substance abuse and mental illness in a psychiatric hospital setting; resolution of medical & psychological crisis; psychotherapy & group activities 4. Co-occurring disorders inpatient units >focus on treatment of substance abuse and mental illness; address the patient substance abuse or dependence, psychiatric illness, & the relationship between the two -Dietiticans -Educators -Nurses -OT -Pediatric mental health specialists -Physicians -Pscyhologists -Social workers -Speech & language disorders specialists Medical-Psychiatric!Hospital!Units! -Specially designed for mentally ill patients with coexisting medical problems who are in need of hospi 1. Geropsychiatric units >provides care to patients who have a psychiatric disorder, one or more acute or chronic health cond & normal age related physical changes >most common occurring disorders: Alzheimer’s, dementia, schizophrenia, fall prevention 2. State psychiatric hospitals >long term treatment of severely psychotic patients and forensic individuals; highly restrictive; treat providing rehabilitation and recovery; skills based relapse prevention program; cognitive-behavi programs to reduce symptom severity; psychoeducational meetings; daily & weekly activities 3. State forensics hospital >patient has been convicted by the court of a criminal offense and has a diagnosed mental illness; m restrictive; patients charged with criminal offense and too dangerous to reside in the community; rules and regulations to ensure safety; correctional officers, controlled doors, metal detectors, ch staff must maintain respect and be aware of patient’s feelings Community!Treatment!settings 1. Group homes ! >6-12 bed program located in a neighborhood setting staffed with non clinical paraprofessionals who specialized 24/7 homelike milieu; structured program creating a physically, emotionally, psycholo environment for children, adolescents, or adults with moderate psychological needs; psychoeduca individual & group therapy, and medication management 2. Partial hospitalization >short-term, ambulatory treatment program for attends transitioning from acute psychiatric inpatient reduce rehospitalizaion; successful integration into community setting; skull day psychiatric reha services; psychoeducation; psychiatric medication evaluation and monitoring; individual and grou 3. Day treatment >patient stabilization, rehabilitation, and recovery in a community outpatient setting; maintain or enh current level of functioning; maintain community living; develop self-awareness; scheduled activ recovery model, a process, attitude of hope, sense of control over life