Patients undergoing mental health problems and personal recovery require help and guidance from various health care professionals. This assignment will focus on different strategies that mental health nurse can implement with Ban who is recovering from drug-induced psychosis.
According to (Influence on recovery) one of the most important factors that facilitates recovery in patients following a first episode of psychosis is social support. Family and parents in particular are the biggest influences on recovery. It is also states that the ability of family members to understand patient’s limitations, while still believing in patient’s capacity to recover was highly beneficial (influence on recovery). Such support enchased a sense of agency,
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which is an important part of individual recovery. Thus, it is important that the mental health nurse facilitates family therapy with Ben. According to (the role of family) there are a number of challenges for the implementation of family intervention in clinical settings. They include transportation, motivation, energy and time. Stigma might also be a reason for family to quit. It is also stated by (2 in the role of family) that the social and emotional implications for families and patients with psychosis are harmful, resulting in impairment of social and occupational functioning. In such stressful environment parents can use “expressed emotions” (EE) such as over-involvement, hostility, and criticism toward the patient. EE has been shown to be related to worse prognosis of the ilness( the role of family).
Consequentially, it can lead to limitation of contact between Ban and his family.( Family intervention). Usually family therapies include psychoeducation, stress reduction, emotional processing, cognitive reappraisal, and structured problem solving.( the role of family) Intervention is also aiming to develop a collaborative relationship between patient’s family and treatment team by combining different psychotherapeutic strategies to help patient to achieve full recovery. (The role of family) Psychoeducation is considered to be an important part of family therapy. It is suggested that mental health nurses should routinely provide education to relatives. (The role of family). (60 in the role of family) reports that psychoeducation improves the adherence to medications, reduce recurrence, help families to increase their knowledge and coping strategies. It also may help to reduce levels of EE and improve quality of life in both patients and their families (2 in the role of family). Current family therapies programs focus not only on providing information about the problem and management but also on promoting positive attitudes such as empathy, effective support and changing communication between family members. (The role of family) Overall, …show more content…
family therapy is reported to have positive impact on patient’s recovery. It improves their social functioning and also reduces the possibility of relapse.(55 in the role of family). However, effective treatment for psychosis requires more help from mental health professionals. ( The role of family) Another therapy a mental health nurse can implement with Ban is mindfulness based cognition therapy. Mindfulness is “paying attention to relevant aspects of experience in a non- judgmental manner” ( 4 in Valk). According to (influences on reco) participants that took part in the trial stated that making sense of their psychotic experience and accepting the illness are highly important for recovery process. Practice of mindfulness is associated with reduction of stress and emotional distress and more positive state of mind.(Valk) As patients who has been diagnosed with psychosis have high levels of stress, and stress is one of the most common factors that can lead to relapse, people with psychosis can benefit from mindfulness based cognitive therapy. Studies identify three main stages in MBT. The first stage is about becoming aware of psychosis or psychotic symptoms. Second focuses on letting voices, thought or images to come and go without reacting or struggling. And the third is about accepting the illness and self. Mindfulness based therapy does not focus on controlling psychotic symptoms but on ease the distress associated with them.(valk) However, the research by (Randal) shows that there were little or no positive results in people who attended MBT. Five main hypotheses were addressed. The first hypothesis would measure the distance between “self” and “ideal self”. No changes in that distance were presented. It means that participants did not perceive themselves becoming better selves after MBT. The second hypothesis would address the ability of people to cope with their illness. There was no distance change between “ self” and “self as a coper”. Which indicates that participant did not feel as a “coper” after therapy. However, the distance between “self” and “self as not coping” became bigger. It means that patients view themselves moving further from not coping. In contrast to the third hypothesis the participant’s idea of “ideal self” and “self as recovered from psychosis” became more similar following mindfulness behavior therapy. It may indicate that patient’s desire to fully recover from psychosis has increased. The possible explanation to that increased similarity might be that participants were able to reflect on their selves, realizing that they want to recover and identifying their goals in life. However, there was no changes in distance between “self” and “self as recovered from psychosis” It means that even though participants want to recover, they don’t see themselves achieving that goal. In support of the fourth hypothesis there was a tightening of patients’ construing. Which indicates increased correlation between constructs, in that patient’s construing became less flexible and more concrete. Finally, in contrast to fifth hypothesis the salience of “self” was slightly increased. It indicates that the patient’s view of their selves became less vague and they developed a better understanding of it. ( Randal) The research shows that mindfulness behavioral therapy does not have any harmful effect on patients and can be beneficial for people recovering from psychosis if tailored to their specific needs. (valk). Since Ban is a compulsory client in acute adult mental health setting there might be a number of challenges in providing psychological interventions.
Such as unpredictable length of stay, limited availability of trained stuff and high level of distress. (bjc) Acute settings usually do not have the conditions to implement many standard therapy conventions like taking detailed history of life events or providing room for reflection and collaboration. In addition, patients in acute mental health setting usually have a range of psychiatric diagnosis.(bjc) In that case Ban might encounter post- psychotic experience that includes major external threats such as bullying voices, traumatic memories and self attacking but also severe stress, anxiety or other psychological issues(CFG). It is getting clearer that people with a number of mental health problems have common features such as low self –esteem, high levels of shame and self-criticism. (bjc) Compassion – focused therapy not only can be cost – beneficial way to address the challenges listed above but is designed to help people with severe mental health disorders that are often associated with high levels of self-shame and criticism. (bjc) According to (Lurte and Gorten in bjc) after compassion – focused group therapy there were reductions in shame, self-hatred, depression and stress. Increases in self-reassurance, overall wellbeing and social functioning were shown as well.(Bjc) In addition it appeared that having nurses
included in the therapy was highly beneficial. (bjc) Taking into consideration that therapeutic alliances play important role in mental health therapies (ther. Allia.) and limited availability of trained stuff in acute mental health setting(bjc), CFT might not be beneficial. According to (ther. Allia) in order for patients to benefit from psychotherapies a good therapeutic alliance should be established. It is also not acceptable if alliance is poor and mental health stuff persistently trying to engage clients in psychotherapy. Methods that maximize the alliance should be considered and in case of poor therapeutic alliance the treatment should be discontinued. (Ther Allia). An important implication is that mental health stuff may be able to improve the outcomes from therapies, in that case form compassion – focused therapy, by improving the quality of therapeutic relationship and develop more person- based approach in which the interventions are tailored to client’s needs. If all challenges have been resolved group compassion – based therapy is a promising intervention that helps with emotional recovery from psychosis that can be performed on Ban and his family (CFG). Even though mental health nurses try to move from medical model in process of recovery from psychosis towards the concept of self-identified personal recovery, antipsychotic medications still play an important role in patients recovering from psychosis. (Bressington). It has been stated that receiving the right drug was highly beneficial (influence of rec). Medications has been describes as essential part of recovery as they help to get symptoms under control and provide a base for building a meaningful life (medication). Additionally some patients described the realizing the need for medication as an important part of accepting being ill (influence on rec). However, medication therapies have been associated with trails, errors and negative experience with side effects and adherence. (medication) According to (medication) patients state that problems associated with side effects usually outweigh any benefits and could potentially have negative influence on recovery, particularly on social recovery and sense of self (influence on rec). Others state that lack of information and choice of medication lead to feeling of powerlessness and can be traumatic. (medication) Antipsychotic drugs are also accosted with the development and escalation of many physical health problems (Bressington). There is a certain link between the use of antipsychotic drugs and health issues such as weight gain, type 2 diabetes mellitus, lipid abnormalities and hypertension. These disorders can lead to cardiovascular disease and can significantly shorten the lifespan in people with severe mental illness. (Bressington). Another complication that can affect the recovery is nonadherence to the medication. (Med adh) states that even mild nonadherence was associated with an increased of escalation of psychotic symptoms. In case of Ban who is now recovering from drug induced psychosis adherence to medications outside the clinical environment cab be an issue. If Ban will continue substance abuse, the chance that he will be taking his medications as prescribed is unlikely. It can have a negative influence on his recovery. (mea adh.) It is also reported that discontinuation of antipsychotic drugs within first two years increase levels of relapse and readmission (Bressington). According to (Bressington) it is possible that people can fully recover from psychosis without using antipsychotic medications. Howerver, it is important to take into consideration that people with more severe symptoms and worth coping recourses might need to use medical therapies to facilitate recovery. (Bressington). It also should be noted that there is a big number of evidences from antipsychotic drugs trials that indicate the high effectiveness of drugs over placebo. Mental health nurses should be involved in process of helping people during their recovery. It is vital to share all the facts and have open discussions about available approaches. (Bressington) If treatment is tailored to Ban’s needs and concerns and mental health stuff is fully involved, personal recovery will be beneficial and he is most likely to have a full recovery from drug induced psychosis.
Mental illness can have a tremendous effect on not only the individual suffering, but to their family. "Mental illness often has a ‘ripple effect’ on families, creating tension, uncertainty, troubled emotions and big changes in how people live their lives" ("Families and friends"). A family member who suffers from a mental illness can have a great impact on numerous physical, psychological and social aspects of the family. Creating nursing priorities can help to create developmental and behavioral functions of a family to help the family bond and cope with a mental illness. The film “What’s Eating Gilbert Grape” by Lasse Hallstrom, portrays a family who struggle to cope with the enormous impact that a mentally challenged child “Arnie” can have on a family. Although the whole family is involved in Arnie’s care, it is clear that Gilbert, Arnie’s older brother, takes on the primary giver role. Throughout the movie, many scenes tend to dramatically show the amount of stress, frustration, aggression, and separation on the family that is ultimately created from Arnies mental illness. In this paper we are going to discuss the impact of chronic illness on the grape family, two family centered priorities we have chosen using the Calgary Family Assessment Model and one nursing intervention for each priority using the Calgary Family Intervention Model.
Varcarolis, E. M., Carson, V. B., & Shoemaker, N. C. (2006). In Foundations of Psychiatric Mental Health Nursing (p. 283). St. Louis: Elsevier Inc.
Schizophrenia is a major psychiatric disorder, or cluster of disorders, characterised by psychotic symptoms that alter a person’s perception, thoughts, affect and behaviour (NICE, 2009). Tai and Turkington (2009) define Cognitive Behaviour Therapy (CBT) as an evidence-based talking therapy that attempts cognitive and behavioural change based on an individualised formulation of a client’s personal history, problems and world views. CBT as a treatment for schizophrenia can be understood within a wider framework of CBT as applied to a range of mental disorders such as anxiety, post traumatic stress disorder (PTSD), and depression (Tai and Turkington, 2009). CBT was built on behavioural principles that emphasised clear relationships between cognition, physiology and emotion (Beck, 1952). This essay will analyse CBT as a therapy for individual suffering from schizophrenia. It will discuss briefly the historical background and the development of CBT, the aims and principles, the evidence base of the strengths and weaknesses of the therapy. It will discuss as well the implication to mental health nursing practice. The focus of this essay is on intervention and psychosocial in nature which will be brought together in the conclusion.
Chien, W. (2010). Stress of Family Members in Caring for a Relative with Schizophrenia. New York: Nova Science Publishers.
The purpose of this assignment is to demonstrate my reflection and understanding in the Role of the Mental Health Nurse in an episode of care supporting and promoting the recovery of service users. According to the National institute for Mental Health (2004) recovery is a process to restore something or return to a state of wellness, is an achievement of quality of life that is acceptable to the person (Ryan 2012).
The first one is the acute phase in which the patient may be hyperactive and wander, the patient is at risk for injury and the nurse should manage medications, increase food and fluid intake and ensure that they get enough sleep. Second phase is the continuation phase that lasts for 4 to 9 months in which the nurse’s interventions should be focused on relapse prevention, in this time patient should be educated in the diagnosis and medications that should be administered, and the patient’s cognition should be evaluated. The third phase is the maintenance phase in which the nurse’s intervention should still be focused on relapse prevention, during this phase the nurse should encourage the patient to attend to psychotherapy or groups and the patient’s family and social life should be evaluated so difficulties during this time may be
By writing this paper, I hope to help caregivers and doctors who work with psychologically distressed patients, along with family members who live with a patient who has Schizophrenia or Psychosis . By finding what symptoms are heightened, doctors can better treat their patients’ symptoms to help lessen, or eventually cure, the symptom caused by a patient’s childhood trauma. . Caregivers can better understand how to care for their psychologically disordered patients depending on each of the individual patient’s history...
One in five Americans, approximately 60 million people, have a mental illnesses (Muhlbauer, 2002).The recovery model, also referred to as recovery oriented practice, is generally understood to be defined as an approach that supports and emphasizes an individual’s potential for recovery. When discussing recovery in this approach, it is generally seen as a journey that is personal as opposed to having a set outcome. This involves hope, meaning, coping skills, supportive relationships, sense of the self, a secure base, social inclusion and many other factors. There has been an ongoing debate in theory and in practice about what constitutes ‘recovery’ or a recovery model. The major difference that should be recognized between the recovery model and the medical model is as follows: the medical model locates the abnormal behavior within an individual claiming a factor that is assumed to cause the behavior problems whereas, the recovery model tends to place stress on peer support and empowerment (Conrad and Schneider, 2009). This essay will demonstrate that the recovery model has come a long way in theory and practice and therefore, psychological well-being is achievable through this model.
It requires ongoing treatment, and those treatments vary from patient to patient. Mental conditions can be treated with one or a combination of treatments such as medication, psychotherapy, hospital treatment, and group therapy (Medicine Net). While medication does not completely cure mental illness, it does help control the symptoms of said mental problem. Psychotherapy is performed by a trained mental health professional who studies the patient’s emotions, thoughts, and behaviors to assess what is best for the individual’s health. The most effective way to treat mental illness is a combination of psychotherapy with medication. The need for hospitalization is rare among mental health cases; it is only necessary for patients who need to be monitored closely because they are a danger to themselves or society. Group therapies, also referred to as support groups, are meetings where members help guide each other towards their shared goal of recovery (Mental Health America). Support groups are beneficial because it comprises of peers who are going through the same experiences and
Giving verbal instructions, guidance and reassurance to mental health patients is essential for nurses. Teaching patients how to cope with their mental disorders helps them feel more empowered and in control, in a situation where they have very little control over their
Stuart, G. W. (2009). Principles and Practice of Psychiatric Nursing (9th ed. pp 561). St. Louis, MO: Elsevier Mosby.
Although about 450 million people in the world currently are suffering from a mental illness, many untreated, the topic still remains taboo in modern society (Mental Health). For years, people with mental illnesses have been shut away or institutionalized, and despite cultural progression in many areas, mental illnesses are still shamed and rarely brought to light outside of the psychiatric community. The many different forms in which mental illness can occur are incredibly prevalent in the world today, and there is a substantial debate about the way that they should be handled. Some people are of the opinion that mental illness is merely a variance in perception and that it either can be fixed through therapy or should not be treated at all, and that treatment can have negative side effects. Other groups of people believe that mental illness is a very serious affliction and should be treated as a disease through a combination of counselling and medication because people suffering from an untreated mental illness are a danger to themselves and society as a whole. This debate is a popular one, discussed everywhere from the medical field to the dinner table, and it is such because of the numerous lives it affects on the well-being of fellow members of society and the economy. People suffering from mental illnesses are afflicted with anything from delusions, to manic periods, to periods of deep emotional darkness due to experiences and brain chemistry (Johnson). Due to the negative effects untreated mental illness has been proven to have on the human well-being and society as a whole, medication should most certainly be seen as a valid and sometimes necessary way to treat those who suffer from mental illnesses.
My experience in mental health clinical was very different from any other clinical I had before. In a mental health clinical setting, I am not only treating client’s mental illnesses, I am also treating their medical problems such as COPD, diabetes, chronic renal failure, etc. Therefore, it is important to prepare for the unexpected events. In this mental health clinical, I learned that the importance of checking on my clients and making sure that they are doing fine by performing a quick head-to toes assessment at the beginning of my shift. I had also learned that client’s mental health illness had a huge impact on their current medical illness.
Schizophrenia is affecting people more now than a few decades ago. This illness is across the US and is present in every culture. People are now aware and understand how the illness can be devastating to one’s life. Schizophrenia is a mental disorder of the brain but it is highly treatable. In the US the total amount of people affected with the illness is about 2.2 % of the adult population. The average number of people affected per 1000 total population is 7.2 % per 1000, which means a city that is consists of 3 million people will have approxiamately 21,000 people suffering from schizophrenia. People with mental illness should seek early treatment to be stabilized with medications. During a 10 year period 25% of schizophrenics completely recovered, and another 25% much improved and become independent, while 15% were hospitalized and unimproved, and 10% die due to suicide. Since most schizophrenics recover from the illness and lives independently, some are not so fortunate. Where are some of the people with schizophrenia? Its about 6% are homeless and lives in shelters, another 6% lives in jails or prisons and 5 to 6% lives in hospitals, while 25% lives with family members, 28% are living independently and 20% lives in supervised housing or group homes. The aim of this research paper is t o discover and explore how schizophrenics lives on a daily bases with mental illness and how the effects can be devastating to themselves and family members. According to researchers, schizophrenia can be cured through extensive treatment, family support, medications and constant psychiatric evaluations. My findings also have proven the researchers to be accurate on their analysis. The results are overwhelming for schizophrenia patients ...
However, recovery is based on core aspects such as hope and meaning whereby an individual tries to overcome discrimination, stigma and trauma attributed to the diagnosis of a mental illness. Also, it requires a person to assume the control over his or her life and empowered to make his or her own decision in full engagement. There are two types of recovery, i.e. clinical recovery and personal recovery. Therefore, it is vital for an individual to have a clear understanding of the two as well as identify the differences since recovery is considered to have a medical meaning. According to Rethinks, clinical recovery is a treatment outcome emerged from the designated experts of mental health professionals which encompasses the restoration of social functioning and getting rid of symptoms, hence making an individual to get back to normal. (Unger,