Treatment medalities

1. Treatment
modalities and nursing
roles
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2. Treatment modalities
physical
Psychopharmacology
Nutritional therapy
Electroconvulsive Therapy
psychological
Art , Play, music , dance
therapy
community Therapy
individual Therapy
Cognitive. and Behavioral
Therapy
Therapeutic Groups
Intervention with Families
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3. ELECTROCONVULSIVE THERAPY
• An electrical current (70-150 v) passes thru electrodes
applied to the patient’s temple to induce a
generalized tonic-clonic seizure (or Grand Mal) and
unconsciousness;
• Is use when other traditional therapies failed;
• Length of application: 0.5 - 2 secs;
• Length of seizure: 30 - 60 secs;
• The cumulative effect of ECT is approx 220 - 250 secs.
• Used to treat patients with depression, bipolar
disorders, manic, and psychotic symptoms;
• The exact action of ECT remains unknown;
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4. ∞Nursing Interventions:
• Obtain an informed consent from the patient, family, or
legal representative of the patient;
• Teach the family and the patient about the treatment and
what to expect like:
– Short-term memory loss – resolve after 4-8 weeks;
– Disorientation
– Confusion
– Respiratory depression
• NPO post-midnight to prevent aspiration and vomiting; at
least 8 hrs.
• Remove all prostheses including hairpins and dentures;
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5. • Administer all preop meds as indicated like:
1. AtSO4 – to decrease oral and nasal secretions*;
2. Succinylcholine – muscle relaxant;
3. Short-acting barbiturates*
– Does not affect seizure threshold
– Ex. Methohexital
• Vital signs must be monitored before and after the
procedures;
• Tongue guard is inserted to prevent tongue injury during
seizure;
• Monitor heart rate and rhythm, blood pressure, and EEG;
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6. – Diet and nutritional needs are integral to
traditional and alternative therapies.
– Foods high in TYRAMINE:
• A – cheese
• B – bananas
• C – chocolate, coffee, chicken and pork liver
• D – dried and preserved foods (pickles)
• E – etc (yogurt, sausage)
Nutritional therapy
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7. Therapeutic Groups
Therapeutic groups Focus is on group relations, interactions
between group members, and the consideration of a
selected issue.
Functions of a Group
• Socialization.
• Support.
• Task completion.
• Camaraderie.
• Informational.
• Normative.
• Empowerment.
• Governance.
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8. Types of Therapeutic Groups
• Task groups. to accomplish a specific outcome.
• Teaching groups. to convey knowledge and information to a
number of individuals.
• Supportive/therapeutic groups. to prevent possible future
upsets by teaching effective ways of dealing with emotional
stress.
• Self-help groups: composed of individuals with a similar
problem Serve to reduce the possibilities of further emotional
distress leading to pathology and necessary treatment. May or
may not have a professional leader. Run by members, and
leadership often rotates from member to member
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9. The Role of the Nurse in Group
Therapy
• Guidelines set forth by the American Nurses
Association specify that nurses who serve as
group psychotherapists should have a
minimum of a master’s degree in psychiatric
nursing.
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10. Phases of Group Development
Initial or Orientation Phase
• Leader and members work together to establish rules and goals for the group.
• Leader promotes trust and ensures that rules do not interfere with fulfillment of
the goals.
• Members are superficial and overly polite. Trust has not yet been established.
Middle or Working Phase
• Productive work toward completion of the task is undertaken.
• Leader role diminishes and becomes more one of facilitator.
• Trust has been established between the members, and cohesiveness exists.
• Conflict is managed by the group members themselves.
Final or Termination Phase
• A sense of loss, precipitating the grief process, may be experienced by group
members.
• The leader encourages the group members to discuss these feelings of loss and
to reminisce about the accomplishments of the group.
• Feelings of abandonment may be experienced by some members. Grief for
previous losses may be triggered.
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11. Family Therapy
Family Functioning
1. Communication
2. Self-concept Reinforcement
3. Family Members’ Expectations
4. Handling Differences
5. Family Interactional Patterns
6. Family Climate
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12. The Therapeutic Community
• therapeutic community, is defined as “a
scientific structuring of the environment to
effect behavioral changes and to improve the
psychological health and functioning of the
individual.”
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13. Role of the Nurse
• Through use of the nursing process, nurses manage the
therapeutic environment on a 24-hour basis.
• Nurses have the responsibility for ensuring that the
client’s physiological and psychological needs are met.
• Nurses are also responsible for
– Medication administration
– Development of a one-to-one relationship
– Setting limits on unacceptable behavior
– Client education
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14. Play Art , music , dance therapy
• Play techniques are use to understand the child thoughts and
feelings and to promote communication. Is techniques release
energy could include running or working with modeling clay and
help children to express themselves such as drawing pictures
themselves
• Art therapy :. The use of the creative art process for
psychotherapy and rehabilitation.
• Music therapy:. The use of music in the accomplishment of
therapeutic aims :.the restaration ,maintenance ,and
improvement of mental and physical health.
• Dance therapy:. Use of movement as a process that furthers the
emotional ,cognitive and physical integration of the individual.
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15. • A behavior is considered to be maladaptive when it:
- Is age-inappropriate
- Interferes with adaptive functioning
- Is misunderstood by cultural inappropriateness
• The behavioral approach to therapy is that people have
become what they are through learning processes or
through the interaction of the environment
• The basic assumption is that problematic behaviors
occur when there has been inadequate learning
Behavior Therapy
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16. Techniques for Modifying Client
Behavior
• Shaping.
• Modeling.
• Premark principle.
• Extinction.
• Contingency contracting.
• Token economy.
• Time out.
• Reciprocal inhibition.
• Overt sensitization.
• Covert sensitization.
• Systematic desensitization.
• Flooding.
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17. Cognitive Therapy
• The foundation on which cognitive therapy is
established can be identified by the
statement, “Men are disturbed not by things
but by the views which they take of them.”
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18. Indications for Cognitive Therapy
• Depression
• Panic disorder
• Generalized anxiety
disorder
• Social phobia
• Obsessive-compulsive
disorder
• Posttraumatic stress
disorder
• Substance abuse
• Personality disorders
• Schizophrenia
• Couple’s problems
• Bipolar disorder
• Hypochondriasis
• Somatoform disorder
• Eating disorders
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