Skills and Principles of Mental Health Care Chapter 8 Skills and Principles of Mental Health Care Copyright ©2013 by Elsevier Inc. All rights reserved.

Copyright ©2013 by Elsevier Inc. All rights reserved. Learning Objectives Describe three characteristics of a mentally healthy adult. Explain how the phrase “do no harm” applies to mental health care. Apply the seven principles of mental health care to client care. Identify the four components of any behavior. Copyright ©2013 by Elsevier Inc. All rights reserved.

Copyright ©2013 by Elsevier Inc. All rights reserved. Learning Objectives Summarize the primary purpose and six guidelines for providing safe and effective crisis intervention. Illustrate how setting limits helps to provide consistency for mental health clients. Describe how failure contributes to the development of insight. Identify three ways to prevent overinvolvement and codependency. Copyright ©2013 by Elsevier Inc. All rights reserved.

Copyright ©2013 by Elsevier Inc. All rights reserved. Learning Objectives Discuss the importance of personal and professional commitments. Describe four techniques for developing a positive mental attitude. List ten principles for nurturing yourself and other caregivers. Copyright ©2013 by Elsevier Inc. All rights reserved.

The Mentally Healthy Adult (p. 79) Health is a changing state that is influenced by genetics, behavior, and the environment. Mental health reflects changing status as the stresses of life are encountered. Mentally healthy adults are content with who they are and where they are in life. Mentally healthy adults are persons who can cope with and adjust in an acceptable way to the recurrent stresses of daily living. List three characteristics exhibited by a mentally healthy adult. As students, you have many demands placed on you. As you progress through these demands, you rally to adjust. How do you adapt to these stressors? Copyright ©2013 by Elsevier Inc. All rights reserved.

Mental Health Care Practice (p. 80) Practicing the principles of mental health care is the responsibility of all health care providers. Every caregiver helps clients cope with their problems. No matter how casual a client may appear, a heightened stress level is present every time interactions with health care providers take place. Copyright ©2013 by Elsevier Inc. All rights reserved.

The Seven Principles of Mental Health Care (p. 80) Do NO harm. Accept each client as a whole person. Develop a mutual trust. Explore behaviors and emotions. Encourage responsibility. Encourage effective adaptation. Provide consistency. How do we as caregivers exhibit the “do no harm” principle of mental health care? Copyright ©2013 by Elsevier Inc. All rights reserved.

Copyright ©2013 by Elsevier Inc. All rights reserved. Do No Harm (p. 80) The care provider has a responsibility to protect clients. No matter what the circumstances, avoid any action that may result in harm to your client. The “do no harm” principle also relates to the “reasonable and prudent nurse (caregiver)” concept found in U.S. law. Copyright ©2013 by Elsevier Inc. All rights reserved.

Accept Each Client as a Whole Person (p. 80) Differences do not have to be understood, but they must be accepted. Holistic health care is based on the concept of “whole.” Viewing clients holistically also involves acceptance of their lifestyles, attitudes, social interactions, and living conditions. Provide examples of how to accept each client as a whole person. (One example is providing the client with an environment that includes caring and openness.) Copyright ©2013 by Elsevier Inc. All rights reserved.

Develop Mutual Trust (p. 81) Trust implies cooperation, support, and willingness to work together. For care providers, the concept of trust holds much importance. Trust is the foundation of therapeutic relationships. Trust between client and caregiver involves three concepts: caring, empathy, and advocacy. How is trust developed in the therapeutic relationship? Copyright ©2013 by Elsevier Inc. All rights reserved.

Explore Behaviors and Emotions (p. 81) Every behavior serves a purpose and has meaning. “Behavior consists of perceptions, thoughts, feelings, and actions.” By sharing perceptions, the health care provider can help clients see how their behavioral messages are being received by other people. List and identify the four components of any behavior. Clients are willing to share their experiences with others when they trust the health care provider and when they know he or she is willing to take time to listen. Copyright ©2013 by Elsevier Inc. All rights reserved.

Encourage Responsibility (p. 82) Responsibility infers that a person is able to exercise capability and accountability. Encouraging responsibility helps build self-worth, dignity, and confidence, and assists clients in learning more successful coping behaviors. Nurses and other professionals plan and implement specific interventions designed to help clients achieve their highest possible level of responsibility. Copyright ©2013 by Elsevier Inc. All rights reserved.

Encourage Effective Adaptation (p. 83) All mental health clients exhibit unsuccessful coping behaviors. Mental health care providers encourage the following: One step at a time Crisis intervention Learning of coping mechanisms Recovery begins when attempts to cope with the problem result in success. List the guidelines for providing safe and effective crisis intervention. Copyright ©2013 by Elsevier Inc. All rights reserved.

Provide Consistency (p. 85) Consistency of a behavior implies being steady, regular, and dependable. Consistency usually is addressed in the client’s plan of care. Guidelines for providing consistency involve setting limits and focusing on the positive changes that clients are making. How does setting limits help to provide consistency for mental health clients? Setting Limits Case Study: A client in the psychiatric facility is scheduled for a group therapy session on Wednesday. She refuses to go to the session. The nurse says she must attend or she will not be granted time to see her family that weekend. The nurse adds that this is the institution’s policy. Explain what type of an impact setting limits will have on this client. If the client is granted permission to skip the session, what impact will this action have on the client’s care? Copyright ©2013 by Elsevier Inc. All rights reserved.

Skills for Mental Health Care (p. 86) Caregivers act as role models for good mental and physical health; they serve as therapeutic instruments. The caregiver’s approach to clients must be monitored and adjusted continually. The caregiver must convey “a consistent, thoughtful effort directed toward developing an awareness of self and others.” Copyright ©2013 by Elsevier Inc. All rights reserved.

The Caregiver’s Self-Awareness (p. 86) Self-awareness is the ability to objectively look within. Allows individuals to direct and mold the pattern of their lives To be in charge of their own growth and development The caregiver who encourages self-awareness must practice self-awareness. Copyright ©2013 by Elsevier Inc. All rights reserved.

Copyright ©2013 by Elsevier Inc. All rights reserved. Caring (p. 86) Caring is concern for the well-being of another person. Empathy is the ability to recognize and share the emotions of another person without actually experiencing them. Behaviors associated with caring include the following: Accepting Comforting Being honest Listening attentively Having sensitivity Copyright ©2013 by Elsevier Inc. All rights reserved.

Copyright ©2013 by Elsevier Inc. All rights reserved. Insight (p. 87) Insight is the ability to see clearly and understand the nature of things; it relies on common sense, good judgment, and prudence. Self-awareness is developed through the practice of introspection. Knowledge breeds competence, and from competence grows confidence to provide the best possible care. Copyright ©2013 by Elsevier Inc. All rights reserved.

Risk Taking and Failure (p. 87) Risk taking implies the possibility of failure. Failure provides the opportunity for change. We grow from our failures. One fails only when one refuses to grow from the experience. Identify how a failure in your life became a positive experience. Copyright ©2013 by Elsevier Inc. All rights reserved.

Copyright ©2013 by Elsevier Inc. All rights reserved. Acceptance (p. 87) Acceptance means receiving the entire person and the world in which he or she functions. Accepting clients does not necessarily include approving of their behaviors. As care providers, we must accept the entire person. Copyright ©2013 by Elsevier Inc. All rights reserved.

Boundaries and Overinvolvement (p. 88) Professional boundaries Must be defined by caregivers Are crossed when caregivers become too helpful or controlling Must be balanced because one cannot focus on the client and the self at the same time Compassion, empathy, and acceptance are vital elements of health care, but they must be balanced by professionalism, judgment, and therapeutic actions that meet client needs. How can caregivers prevent overinvolvement and codependency? How will the health care provider feel if there is a crossover of professional boundaries? How will the client feel if there is a crossover of professional boundaries? Copyright ©2013 by Elsevier Inc. All rights reserved.

Copyright ©2013 by Elsevier Inc. All rights reserved. Commitment (p. 89) Caregivers must be committed to providing competent health care, no matter what the setting or circumstances. Self-commitment involves a promise to do the best you can in every situation and to be the best that you can be. Explain the importance of personal and professional commitments. Copyright ©2013 by Elsevier Inc. All rights reserved.

Copyright ©2013 by Elsevier Inc. All rights reserved. Positive Outlook (p. 89) Focusing on the positive aspects of a situation leads to a greater chance of success. One tool for developing self-awareness is a positive or optimistic attitude. Positive attitudes and thoughts can act as buffers against stress and conflict. Copyright ©2013 by Elsevier Inc. All rights reserved.

Developing a Positive Attitude (p. 89) Listen to your self-talk. Change recurrent negative themes. Be your own cheerleader. Visualize future successes. Act the part. List and describe the techniques for developing a positive mental attitude. Copyright ©2013 by Elsevier Inc. All rights reserved.

Nurturing Yourself (p. 90) Recognize and tend to your own needs. Encourage development. To effectively care for your clients, you first must nurture yourself. What are the principles for nurturing yourself and other caregivers? Nurturing allows for encouragement and self development. Identify how you nurture yourself to prevent burnout in your job or in your everyday life. Copyright ©2013 by Elsevier Inc. All rights reserved.

Copyright ©2013 by Elsevier Inc. All rights reserved. Question 1 Which of the following is not a principle of mental health care? Do no harm. Accept each client as a whole. Develop mutual trust. Explore defense mechanisms. Correct Answer: 4 Copyright ©2013 by Elsevier Inc. All rights reserved.

Copyright ©2013 by Elsevier Inc. All rights reserved. Question 2 Behavior consists of four components. Which of the following is not one of them? Perception Feelings Actions Attitude Correct Answer: 4 Copyright ©2013 by Elsevier Inc. All rights reserved.

Copyright ©2013 by Elsevier Inc. All rights reserved. Question 3 The nurse works in a crisis intervention area. She realizes that the goal of crisis intervention is to offer immediate emotional support. Procedures for crisis intervention focus on all of the following except: Concepts of immediacy Control Assessment Protection Correct Answer: 4 Copyright ©2013 by Elsevier Inc. All rights reserved.

Copyright ©2013 by Elsevier Inc. All rights reserved. Question 4 The nurse realizes that when working in a crisis intervention area, it is important to maintain a positive attitude. A positive mental attitude is developed by all of the following except: Listening to your self-talk Changing recurrent negative themes Treating yourself to something special Being your own cheerleader Correct Answer: 3 Copyright ©2013 by Elsevier Inc. All rights reserved.

Copyright ©2013 by Elsevier Inc. All rights reserved. Question 5 Which of the following is not a principle for nurturing yourself? Be knowledgeable. Value each individual. Treat yourself to new things. Be open to new ideas. Correct Answer: 3 Copyright ©2013 by Elsevier Inc. All rights reserved.