Exam 1 Mental Health Chapter 10

Chapter 10 Working with a group of patients Purpose!of!Groups -Deal with current here & now issues -Patients gain awareness and knowledge about their maladaptive behaviors and thoughts -Assist in decision making and problem solving -Educational and skill development groups -Family groups learn about mental illness and assist with coping with the family member Benefits!of!Groups!to!Patients! -Gain knowledge about relating & communicating -Gain acceptance, reassurance, and support -Gain hope and efficacy -Have opportunity to test new behaviors -Can share feelings and problems in a safe setting -Obtain reaffirmation of strengths & increased self esteem -Feel increased self worth and importance Therapeutic!Factors! -Irving Yalom is “father of group therapy” -Developed 11 therapeutic factors that help patietns feel accepted and heard Patients receive hope from observing others who have benefited from g experience Patietns experience relief in knowing they are not alone & unique but that other experience similar problems, feelings, & concerns Patients learn or are provided information about areas related to needs Patients experience themselves as helpful or useful to others Patients review previou dysfunctional family Patient is taught ways to express feelings appropriately patterns & learn that Patietns selectively model healthy behaviors these patterns can be of the leader & other group members changed to meet their present needs Patients taught social skills Patients share feelings about “ultimate concerns” of existence, such a death or isolation, & learn to accept that there is a limit to their co Patients experience feelings of being accepted, valued, & part of group experie Patients learn how their behaviors affect others & more appropria ways of relating in the supportive atmosphere Types!of!Groups! -Typically deal with medication, dynamics & management of illness, problem solving, stress manageme management, social skills, basic living skills, & relapse prevention -Nurse teaches patient & families the content -Adminster medication r/t dynamics of illness, symptoms, signs of -Assess symptoms and side effects relapse, management of illness, & dealing -Explain type & purpose of medication, dosage, therapeu with crises effects, and side effects -Provide support measures to prevent relapse -Help identify and describe current problems, discuss & develop solutions and their effects, -Teach & facilitate adaptive coping behaviors decide on an alternative method & how to try it -Evaluate & choose new method, if necessary -Teach, develop, & practice skills to enhance interaction with others; focus on realistic, day to day patient nee -Provides support -Reinforce or maintain existing strengths -Patient can be acutely or chronically ill -May need a lot of reassurance & emotional support during stay -Reduce anxiety -Reality orientation -Members share a common problem >weight loss, anorexia, child abuse, anxiety, heart disease, DM -Members feel accepted and understood -Goals are to help patients increase self esteem, expr feelings, & social interaction -The activity is a means to facilitate self expression o positive & negative feelings, patient interaction, & enjoyment -Exercise or recreation groups -Support for families (ALANON) >information about illness, medication benefits, & S >communication with ill family member >ways to manage crisis situations Group!Management!Issues -Nurses engage in spontaneous, informal interactions with groups of patients in the day area -Formal groups are planned & structured -Nurse uses group leadership skills to meet patient’s interpersonal needs in a therapeutic milieu -Use effective communication throughout the shift -Facilitative communication -Physical setting -Role modeling -Confidentiality -Norms -Nurse must be active, empathic, & able to provide structure -Groups are goal directed -Focus on here and now -Leader states the group’s purpose at the beginning of the session -Final 5 to 10 minutes summarize and close session -Summarize positive feedback to group Types!of!Patients!in!Groups! -May monopolize the entire group session to the extent that other patients might believe they don’t have the opportunity to participate -Use gate keeping techniques -Support the patient by relating that each individual is important and capable of helping others -Use respect & recognition -Hostility might mask a patients fear, unreso anger, or hurt toward others -Directly confront patient in a supportive ma -Reassure the patient’s emotion and then return to the topic of discussion -Use empathy, focus on the underlying need an present reality, and refocus the group