1. Principles and Skills of Mental Health Care
Chapter 8
Principles and Skills of Mental Health Care
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2. The Mentally Healthy Adult
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?
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3. Mental Health Care Practice
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.
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4. The Seven Principles of Mental Health Care
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?
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5. Do No Harm 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.
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6. Accept Each Client as a Whole Person
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.)
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7. Develop Mutual Trust
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?
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8. Explore Behaviors and Emotions
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.
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9. Encourage Responsibility
Responsibility implies 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.
Reality Therapy—do not accept term “mental illness” but refer to responsibility or lack of responsibility
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10. Encourage Effective Adaptation
All mental health clients exhibit unsuccessful coping behaviors.
Mental health care providers encourage the following:
First, One step at a time-Do not assume, assess
Example in book—Goal is to arrive for appointment on time
How are you going to ensure that it happens?
Second—success is built on one step at a time
List the guidelines for providing safe and effective crisis intervention.

11. Encourage Effective Adaptation
Crisis intervention-Use of coping mechanisms
Priority is offering emotional support-will reduce anxiety level
Crisis-
1st- An individual matter that depends on how perceived
2nd- Can get out of hand depending on coping mechanisms used
3rd- Self limiting
4th-Affects more than one person
Perception
Denial
Disorganization phase-when client perceives crisis
Recovery phase-is when cope with crisis and ends in success
Unresolved crisis leads to maladaptive behavior
Psuedoresolution –did not learned and opportunity to grow is passed
MAIN GOAL-TO HELP WITH CRISIS/OFFER EMOTIONAL SUPPORT
List the guidelines for providing safe and effective crisis intervention.

12. Encourage Effective Adaptation
MAIN GOAL-TO HELP WITH CRISIS/OFFER EMOTIONAL SUPPORT
Guidelines set up by the National Institute for Training in Crisis Intervention
A. Care is needed immediately
B. Control
C. Assessment
D. Client’s disposition determined
E. Referral
F. Follow up
List the guidelines for providing safe and effective crisis intervention.

13. Encourage Effective Adaptation
All mental health clients exhibit unsuccessful coping behaviors.
Learning of coping mechanisms
Adaptive or Constructive mechanisms
Will show improved behavior and able to carry out daily activities
Maladaptive or Destructive mechanisms
Recovery begins when attempts to cope with the problem result in success.
List the guidelines for providing safe and effective crisis intervention.
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14. Provide Consistency
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?
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15. Skills for Mental Health Care
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.”
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16. 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
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17. The Caregiver’s Self-Awareness
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.
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18. Caring 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
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19. Advocacy The process of providing client with Information Support
Feedback
Adding the obligation to act in the client’s best interest
Remember people with mental-emotional difficulties cannot always make informed decisions
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20. Insight
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.
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21. Risk-Taking and Failure
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.
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22. Acceptance
Acceptance means receiving the entire person and the world in which he or she functions; take a holistic approach
Accepting clients does not necessarily include approving of their behaviors.
As care providers, we must accept the entire person.
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23. Boundaries and Overinvolvement
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?
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24. Commitment
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.
Keeping abreast of any new information about profession and areas working in
Explain the importance of personal and professional commitments.
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25. Positive Outlook
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, visualizations, and thoughts can act as buffers against stress and conflict.
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26. Developing a Positive Attitude
Five steps to develop a Positive Attitude
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.
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27. Nurturing Yourself Recognize and tend to your own needs.
Take pride in yourself.
Recognize limitations.
Encourage development.
Be supportive of coworkers and employer
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.
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28. Question 2
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
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