The document discusses therapeutic communities and milieu therapy. It defines a therapeutic community as using a patient's social environment to provide therapeutic experiences and enable them to participate actively in their own care. Key aspects of therapeutic communities include daily community meetings, a patient government, and staff meetings. The document also defines milieu therapy and therapeutic milieu, noting they refer to using a patient's entire environment and interactions to facilitate treatment.
Behavior therapy is a type of psychotherapy which is based on theories of learning and aims at changing maladaptive behavior and substituting it with adaptive behavior.
Individual psychotherapy is a one to one therapy wherein the therapist identifies the root cause of symptoms that are hidden in the subconsciousness by using the principles of psychoanalysis. The client is helped to gain insight about these represeed thoughts and feelings and thus acquiring better resolution of the mental conflicts
Behavior therapy is a type of psychotherapy which is based on theories of learning and aims at changing maladaptive behavior and substituting it with adaptive behavior.
Individual psychotherapy is a one to one therapy wherein the therapist identifies the root cause of symptoms that are hidden in the subconsciousness by using the principles of psychoanalysis. The client is helped to gain insight about these represeed thoughts and feelings and thus acquiring better resolution of the mental conflicts
It describes the commonly used terminology in mental health nursing.It forms the basic concept in the mind of students related to psychiatric nursing and psychology.
The basic about the principles of psychiatric nursing , what all are the basic we have to follow while providing care to the psychiatric patients in hospital and in the community area
It describes the commonly used terminology in mental health nursing.It forms the basic concept in the mind of students related to psychiatric nursing and psychology.
The basic about the principles of psychiatric nursing , what all are the basic we have to follow while providing care to the psychiatric patients in hospital and in the community area
INTRODUCTION TO OCCUPATIONAL THERAPY, GOALS OF OCCUPATIONAL THERAPY, THE VARIOUS CLASSIFICATION OF OCCUPATIONAL THERAPY, DIFFERENT OCCUPATIONAL THERAPIES FOR DIFFERENT MENTA DISORDERS TO TREAT THE PATIENTS EFFECTIVELY.
Therapeutic Environments - Devising space designs that provide measurable pos...bharti sharma
Threads of time and space weave human life, the pattern so weaved dictates its every aspect. If the effect of space on human mind and spirit is so intense then why not mould it to heal people. This presentation was the foundation of the graduation project of my MDes at NIFT Mumbai. It deals with the nuances of health care design unravelling the ways in which environment can act as a catalyst in the healing process.
PART 1
For the purpose of a more lucid account of my research, it has been divided into two parts. The first part i.e this presentation is the foundation of the research and deals with the objectives of the research and identification of the contemporary healthcare design pattern.
Mental Health Nursing
Psychiatric Nursing
Dr. Rahul Sharma
Associate Professor
H.O.D. of Mental Health Nursing
Ph. D Coordinator
Seedling School of Nursing,
Jaipur National University, Jaipur
Milieu therapy is the treatment of mental disorder or maladjustment by making substantial changes in a patient's immediate life circumstances and environment in a way that will enhance the effectiveness of other forms of therapy.
blue eye brown eyesblue eye brown eyesblue eye brown eyesblue eye brown eyes valora maheria unniblue eye brown eyesblue eye brown eyesblue eye brown eyesblue eye brown eyes valora maheria unni somesh black hair golden albino
Running Head BEHAVIORAL HEALTH SERVICES1BEHAVIORAL HEALTH .docxsusanschei
Running Head: BEHAVIORAL HEALTH SERVICES 1
BEHAVIORAL HEALTH SERVICES 9
The Louisiana Medicaid Program Behavioral Health services
Introduction
Louisiana Medicaid has provided health care to its members for quite some time now. Mostly, the behavioral health system has incorporated the consumers, the community and other health care providers in the process of giving efficient services to the members (Ortenberg & Roth, 2013). Their focus has been to improve access to the treatment services that have become vital to people. Additionally, the system ought to expand the services that are being provided by the Louisiana Medicaid health behavior systems. The demand for that service has grown, and it’s the duty of the system to expand the services to meet the request. Finally, it’s also the goal of the health behavior system to provide care that is accessible to all at ease.
Description of Behavioral Health Services
The following are some of the services provided at the Louisiana Medicaid behavior care
Addiction services- This includes the individual-centered outpatient services. The health care provider provides rehabilitation and recovery process to the patients. The health care provider will help in the promotion of skills that are responsible for coping with the current lifestyle. The department will assist in the elimination of substance use symptoms and behaviors that may prevent recovery.
Crisis intervention- The department is responsible for the individuals experiencing a psychiatric crisis. When a disaster occurs, victims may be affected by such occurrences may cause psychological problems. Therefore, the crisis intervention program will do a preliminary assessment then followed by a crisis resolution. After that, the medical professional will then do referral and linkage to the relevant community service for further treatment processes.
Group psychotherapy- in this section, a group of individuals with similar behavior challenges will have to sit together and share their experiences. Apparently, they share personal coping skills and practices. Typically, the session will help the patient to identify which method works for them and open up to help in the recovery process.
Psychosocial rehabilitation- The section mainly helps in the elimination of behaviors or barriers that may prevent the healing of the mental Illness. Such behaviors may be to stay away from friends who smoke if the patient if fighting an addiction of smoking.
Care conference- It involves a group of medical practitioners meeting to discuss the treatment of a crisis.
Care Advocacy
The care advocacy in this field is very active and mainly focusses of the various activities that promote all the Medicaid’s members full stabilization after an illness or the whole recovery process of the member. Apparently, the care advocacy unit is concerned with ensuring that the members fully participate in their care. Mostly, various integrated intervention methods have been created ...
Psychosocial care of coronavirus disease 2019Nursing Path
The novel Coronavirus (nCoV) epidemic in 2019 -2020 has recently emerged. The route of transmission is not totally known, although it is known that it can spread from person to person, and local health care systems may be ill-equipped to handle a large-scale outbreak.
The blood electrolytes—sodium, potassium, chloride, and bicarbonate—help regulate nerve and muscle function and maintain acid-base balance and water balance. ... Thus, having electrolytes in the right concentrations (called electrolyte balance) is important in maintaining fluid balance among the compartments
Hospital infection control programs can help healthcare organizations monitor and improve practices, identify risks and proactively establish policies to prevent the spread of infections
Outcome-based education (OBE) is an educational theory that bases each part of an educational system around goals (outcomes). By the end of the educational experience, each student should have achieved the goal.
Assessment is part of the everyday activities of nursing professionals. Assessment is the only way by which a teacher can know how successful his teaching was and what areas in teaching need improvement.
A mental health disorder characterised by feelings of worry, anxiety or fear that are strong enough to interfere with one's daily activities.
The term "anxiety disorder" refers to specific psychiatric disorders that involve extreme fear or worry, and includes generalized anxiety disorder (GAD), panic disorder and panic attacks, agoraphobia, social anxiety disorder, selective mutism, separation anxiety, and specific phobias.
Selection and organization of learning experienceNursing Path
Curriculum is the educational design of learning experiences for the students. Curricular experiences include course content as well as learning activities. The selection and organization of curricular experiences must also reflect the philosophy of the school. The identifying and organizing of curricular experiences begins with the analysis of curriculum objectives. The most commonly used approach in selecting learning experiences is the logical approach in which the process is treated as content in curriculum development.
Universal health coverage (UHC) means that all people and communities can use the promotive, preventive, curative, rehabilitative and palliative health services they need, of sufficient quality to be effective, while also ensuring that the use of these services does not expose the user to financial hardship.
Pneumonia is an inflammatory condition of the lung affecting primarily the small air sacs known as alveoli. Typically symptoms include some combination of productive or dry cough, chest pain, fever, and trouble breathing.
Swine influenza is an infection caused by any one of several types of swine influenza viruses. Swine influenza virus (SIV) or swine-origin influenza virus (S-OIV) is any strain of the influenza family of viruses that is endemic in pigs
Abortion is the ending of pregnancy by removing an embryo or fetus before it can survive outside the uterus. An abortion that occurs spontaneously is also known as a miscarriage.
The enterobacteriaceae basic properties.ppsx xNursing Path
The Enterobacteriaceae are a large family of Gram-negative bacteria that includes, along with many harmless symbionts, many of the more familiar pathogens, such as Salmonella, Escherichia coli, Yersinia pestis, Klebsiella, and Shigella.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...GL Anaacs
Contact us if you are interested:
Email / Skype : kefaya1771@gmail.com
Threema: PXHY5PDH
New BATCH Ku !!! MUCH IN DEMAND FAST SALE EVERY BATCH HAPPY GOOD EFFECT BIG BATCH !
Contact me on Threema or skype to start big business!!
Hot-sale products:
NEW HOT EUTYLONE WHITE CRYSTAL!!
5cl-adba precursor (semi finished )
5cl-adba raw materials
ADBB precursor (semi finished )
ADBB raw materials
APVP powder
5fadb/4f-adb
Jwh018 / Jwh210
Eutylone crystal
Protonitazene (hydrochloride) CAS: 119276-01-6
Flubrotizolam CAS: 57801-95-3
Metonitazene CAS: 14680-51-4
Payment terms: Western Union,MoneyGram,Bitcoin or USDT.
Deliver Time: Usually 7-15days
Shipping method: FedEx, TNT, DHL,UPS etc.Our deliveries are 100% safe, fast, reliable and discreet.
Samples will be sent for your evaluation!If you are interested in, please contact me, let's talk details.
We specializes in exporting high quality Research chemical, medical intermediate, Pharmaceutical chemicals and so on. Products are exported to USA, Canada, France, Korea, Japan,Russia, Southeast Asia and other countries.
4. The concept of therapeutic community
was first developed by Maxwell Jones
in 1953 . He wrote a book entitled
“Social Psychiatric” which was first
published in England. Later on when it
was published in the United States, its
title was changed to “Therapeutic
Community.”
JAYESH PATIDAR 4/24/2013 4
5. Stuart & Sundeen defined therapeutic
community as “a therapy in which
patient‟s social environment would be
used to provide a therapeutic
experience for the patient by involving
him as an active participant in his own
care & the daily problems of his
community.”
JAYESH PATIDAR 4/24/2013 5
6. To use patient‟s social environment to provide a
therapeutic experience for him.
To enable the patient to be an active participant
in his own care & become involved in daily
activities of his community.
To help patients to solve problems, plan activities
& to develop the necessary rules & regulations
for the community.
To increase their independence & gain control
over many of their own personal activities.
To enable the patients become aware of how
their behavior affects others.
JAYESH PATIDAR 4/24/2013 6
7. Free communication
Shared responsibilities
Active participation
Involvement in decision making
Understanding of roles,
responsibilities, limitations &
authorities.
JAYESH PATIDAR 4/24/2013 7
8. Responsibility for treatment belong to the staff
& client.
Roles of staff & clients are equalized- may
discuss either staff behavior or clients
behavior.
Democratic environment is fostered.
Open communication is encouraged
Focus is on client assets.
Peer pressure is utilized to reinforce rules &
regulations.
JAYESH PATIDAR 4/24/2013 8
9. Interpersonal interactions are utilized to improve
communication skills.
Inappropriate behavior are dealt with as they
occur.
Team approach is used.
Clients are involved in all phases of treatment
Community government is set up – Use meetings
to teach standards, values & behavior, explore
behavior, make decision, use problem solving.
Two main goals for clients – Learn to set limits,
Learn psychosocial skills
JAYESH PATIDAR 4/24/2013 9
10. 1. Daily community Meetings
2. Patient Government or Ward Council
3. Staff Meeting or Review
4. Living & Learning Opportunities
JAYESH PATIDAR 4/24/2013 10
11. These meetings are composed of 60-90
patients. All levels of unit staff are involved,
including administrative personnel. Acute
patients are involved in the meetings.
Meetings should be held regularly for 60
minutes.
Discussion should focus mainly on day-to-day
life in the unit.
During discussion patients‟ feelings & behaviors
are examined by other members.
Frank discussion are encouraged, these may take
place with much outpouring of emotions &
anger.
JAYESH PATIDAR 4/24/2013 11
12. The purpose of patient government is to deal
with practical unit details such as house-keeping
functions, activity planning & privileges.
A group of 5-6 patient will have specific
responsibilities, such as house keeping, physical
exercise, personal hygiene, meal distribution, a
group to observe suicidal patients, etc. staff
members should be available always.
All decisions should be feedback to the
community through the community meetings.
JAYESH PATIDAR 4/24/2013 12
13. A staff meeting should be held following each
community meeting (patient are excluded & only
staff are present). In this meeting the staff would
examine their own responses, expectations, &
prejudices.
4. Living & Learning Opportunities:
Learning opportunities are to be
provided within the social milieu, which should
provide realistic learning experiences for the
patients.
JAYESH PATIDAR 4/24/2013 13
15. Free communication both within & between staff
& patient group.
Communication are directed towards the
modification of patient‟s attitude, behavior & role
performance.
Atmosphere in the community will be democratic
as opposed to hierarchical, rehabilitative rather
than custodial, permissive instead of limited &
controlled.
Nurses will be more communal with the patient
instead of displaying all the time therapeutic role.
JAYESH PATIDAR 4/24/2013 15
16. Environment will be essentially permissive &
flexible.
Patient‟s activities are individualized & the role of
patients are unspecified & their participation is
completely voluntary.
A compulsory daily community meeting that all
staff members have to attend & all patients are
encouraged to attend.
The primary role of staff is to help the patients
gain new insights & test new behavioral patterns.
Problems of the patients are discussed & the
solutions are sought in the small group therapy
session following each community meeting.
JAYESH PATIDAR 4/24/2013 16
17. Patient government or ward council is to deal
with practical unit details such as privileges &
house keeping rosters. Staff member is available
to the patient government, & all decisions are
fed back to the community through the
community meetings.
Staff meeting or review is essential to on-the-
ward training. It gives opportunity for the staff
members to examine their own responses,
expectations & prejudices.
Feedback is one of the fundamental concepts in
therapeutic community practice.
JAYESH PATIDAR 4/24/2013 17
18. Patient develops harmonious
relationship with other members of the
community.
Gains self-confidence.
Develop leadership skills.
Learns to understand & solve problems
of self & others.
Become socio-centric.
JAYESH PATIDAR 4/24/2013 18
19. Learns to live & think collectively with
the members of the community.
Lastly therapeutic community provides
opportunities to participate in the
formulation of hospital rules &
regulations that affect patient‟s personal
liberties like bedtime, meal time,
weekend permission, control of radio or
TV, social activities, late night privileges
etc.
JAYESH PATIDAR 4/24/2013 19
20. Role blurring between staff & patient.
Group responsibility can easily
become nobody‟s responsibility.
Individual needs & concerns may not
be met.
Patient may find the transition to
community difficulty.
JAYESH PATIDAR 4/24/2013 20
21. Providing & maintaining a safe & conflict free
environment through role modeling & group
leadership.
Sharing of responsibilities with patients.
Encouraging patient to participate in decision-
making functions.
Assisting patients to assume leadership roles.
Giving feedback.
Carrying out supervisory functions.
JAYESH PATIDAR 4/24/2013 21
23. „Milieu‟ is a French word meaning
“Middle Place”.
In English language, milieu means
“environment” or “setting”, as used in
psychiatric mental health nursing, it
refers to the people & all other social
& physical factors in the environment
with which the client interacts.
JAYESH PATIDAR 4/24/2013 23
24. A therapeutic milieu is a 24 – hour environment
designed to provide a secure retreat for
individuals whose capacities for coping with
reality have deteriorated.
The therapeutic milieu gives them opportunities
to acquire adaptive coping skills. By offering
secure, comfortable physical facilities for
sleeping, dining, bathing & engaging in
recreational, occupational, social, psychiatric &
medical therapies, the therapeutic milieu does
many advantages.
JAYESH PATIDAR 4/24/2013 24
25. A therapeutic milieu is a “safe space,” a non-punitive
atmosphere in which caring is a basic factor.
In this environment, confrontation may be a positive
therapeutic tool that can be tolerated by the client.
Nurses & treatment team members should be aware
of their own roles in this environment, maintaining
stability & safety, but minimizing authoritarian
behavior
Clients are expected to assume responsibility for
themselves within the structure of the milieu as much
as possible.
Feedback from other clients & the sharing of tasks or
duties within the treatment program facilitate the
client‟s growth.
JAYESH PATIDAR 4/24/2013 25
26. Shelters clients physically from what they
perceive as painful, terrifying stressors.
Protects clients physically from discharges of
their own & other‟s maladaptive behaviors.
Supports the physiological existence of clients.
Provides pleasant, attractive, sensory
stimulation of clients.
Educates clients & their families about adaptive,
effective coping.
JAYESH PATIDAR 4/24/2013 26
27. 1. Maintaining Safe Environment
2. The Trust Relationship
3. Building Self-esteem
4. Limit-setting
JAYESH PATIDAR 4/24/2013 27
28. The nursing staff should follow the facility‟s
policies with regard to prevention of routine
safety hazards & supplement these policies as
necessary.
For Example;
Dispose of all needles safety & out of reach of
client.
Restrict or monitor the use of matches &
lighters.
Do not allow smoking.
JAYESH PATIDAR 4/24/2013 28
29. Remove mouthwash, aftershave lotions & so
forth, if substance abuse is suspected.
Keep sharp objects out of reach of client
Identify potential weapons & dangerous
equipment.
Do not leave medicines unattended or unlocked.
Keep keys (to unit door, medicines) on your
person at all times.
Search packages brought in by visitors, explain
the reason for such rules briefly, & do not make
any exceptions.
JAYESH PATIDAR 4/24/2013 29
30. one of the keys to a therapeutic
environment is the establishment of trust.
Both the client & the nurse must trust that
treatment is desirable & productive. Trust is
the foundation of a therapeutic relationship,
& limit-setting & consistency are its
building blocks.
JAYESH PATIDAR 4/24/2013 30
31. Strategies to help build or enhance
self-esteem must be individualized &
built on honesty & on the client‟s
strengths.
Some general suggestions are:
Set & maintain limits.
Accept the client as a person.
Be non-judgmental at all times.
Structure the client‟s time & activities.
JAYESH PATIDAR 4/24/2013 31
32. Have realistic expectations of the
client & make them clear to the client.
Initially provide the client with tasks,
responsibilities & activities that can be
easily accomplished.
Never flatter the client.
Allow the client to make his own
decisions whenever possible.
JAYESH PATIDAR 4/24/2013 32
33. Setting & maintaining limits are integral
to a trust relationship & to a
therapeutic milieu. Before stating a
limit explain the reason for limit-
setting.
Some basic guidelines for effective
using limits are:
State the expectations or the limit as
clearly, directly & simply as possible.
JAYESH PATIDAR 4/24/2013 33
34. The consequence that will follow the client‟s
exceeding the limit also must be clearly stated
at the outset.
The consequences should immediately follow
the client‟s exceeding the limit & must be
consistent, both over time (each time the limit
is exceeded) & among staff (each staff
member must enforce the limit).
Consequences are essential to setting &
maintaining limits, they are not an opportunity
to be punitive to a client.
JAYESH PATIDAR 4/24/2013 34
35. In conclusion, the nurse works with
other health professionals in an
interdisciplinary team; The
interdisciplinary team works within a
milieu that is constructed as a
therapeutic environment, with the aim
of developing a holistic view of the
client & providing effective treatment.
JAYESH PATIDAR 4/24/2013 35
36. Use nursing process to provide comprehensive
care.
Provide direct client care
Manages the day-to-day care of individual clients.
Assists the client for re-entry into the community.
Give indirect client care
Maintains on going communication with other
mental health team members.
Enforces rules, policies & regulations of therapeutic
milieu.
A schedule, assigns, manages, & evaluates clinical
work
JAYESH PATIDAR 4/24/2013 36
37. Administer medication & give medication teaching
Provide psychosocial care
Uses informal group interventions such as
community meetings & structured or unstructured
group therapy sessions to assist client with
problems in their current life situations.
Conducts brief, “on-the-spot” counseling with
clients & families.
Set limits to deal with behaviors destructive to the
self, others, or the environment.
Helps the clients use their time productively for
leisure & work.
Involves withdrawn clients in the milieu.
JAYESH PATIDAR 4/24/2013 37
38. Encourages clients who have low self-esteem to value
themselves.
Serves as a role model by demonstrating inter personal
effectiveness in relating to clients & other mental
health team members.
Conducts one-to-one therapy sessions daily with
selective clients.
Conducts group therapy on a daily basis to help clients
to gain self-awareness about how they behave in
groups
Provide mental health teaching
Psychotropic medications, methods of coping, inter
personal effectiveness (eg; assertiveness training,
communication, problem-solving skills, parenting
skills & so forth) stress management, relaxation &
physical exercise etc.
JAYESH PATIDAR 4/24/2013 38
39. Encourage clients to help & support each
other individually & as a group.
Assist clients to understand each other‟s
feelings & problems.
Conduct community meetings.
Participate freely in milieu activities (i.e,
exercise, art, craft classes, social function)
JAYESH PATIDAR 4/24/2013 39
41. Occupational therapy is the
application of goal-oriented,
purposeful activity in the assessment
& treatment of individuals with
psychological, physical or
developmental disabilities.
JAYESH PATIDAR 4/24/2013 41
42. “Any activity, which engages a
person‟s resources of time & energy &
is composed of skills & values” (Reed
& Sanderson, 1980).
“Any goal-directed activity meaningful
to the individual & providing feedback
to him about his worth & value as an
individual & about his inter-
relatedness to others”.
JAYESH PATIDAR 4/24/2013 42
43. The aim of the occupational therapist‟s
intervention is the alleviation of dysfunction &
the development of maximum functional
independence in all aspects of living. Specific
aims of occupational therapy are:
I. Promotion of recovery
II. Mobilization of total assets of the patient
III. Prevention of hospitalization.
IV. Creation of good habits of work & leisure.
V. Rehabilitation with return of self-confidence.
JAYESH PATIDAR 4/24/2013 43
44. The main goal is to enable the
patient to achieve a healthy
balance of occupations through
the development of skills that will
allow him to function at a level
satisfactory to himself & others.
JAYESH PATIDAR 4/24/2013 44
45. Occupational therapy is provided to
children, adolescents, adults & elderly
patients.
These programs are offered in psychiatric
hospitals, nursing homes, rehabilitation
centers, special schools, community group
homes, community mental health centers,
day care centers, halfway homes &
addiction centers.
JAYESH PATIDAR 4/24/2013 45
46. Helps to develop social skills &
provide an outlet for self-expression.
Strengthens ego defenses.
Develops a more realistic view of the
self in relation to other.
JAYESH PATIDAR 4/24/2013 46
47. The client should be involved as much as
possible in selecting the activity.
Select an activity that interests or has the
potential to interest him.
The activity should utilize the client‟s strengths
& abilities.
The activity should be of short duration to foster
a feeling of accomplishment.
If possible, the selected activity should provide
some new experience for the client.
JAYESH PATIDAR 4/24/2013 47
48. It consists of six stages:
1. Initial evaluation of what patient can do &
cannot do in a variety of situations over a
period of time.
2. Development of immediate & long-term goals
by the patient & therapist together. Goals
should be concrete & measurable so that it is
easy to see when they have been attained.
3. Development of therapy plan with planned
intervention.
JAYESH PATIDAR 4/24/2013 48
49. 4. Implementation of the plan &
monitoring the progress. The plan is
followed until the first evaluation. If
found satisfactory it is continued &
altered, it not.
5. Review meetings with patient & all the
staff involved in treatment.
6. Setting further goals when immediate
goals have been achieved; modifying
the treatment program as relevant.
JAYESH PATIDAR 4/24/2013 49
50. 1. Diversional activity: These activities are
used to divert one‟s thoughts from life
stresses or to fill time. For example,
organized games.
2. Therapeutic activities: These activities are
used to attain a specific care plan or goal.
For example, basket making, carpentry etc.
JAYESH PATIDAR 4/24/2013 50
51. Anxiety disorder: Simple concrete tasks with
no more than 3 or 4 steps that can be learnt
quickly. For example, kitchen tasks, washing,
sweeping, mopping, mowing lawn & wedding
gardens.
Depressive disorder: Simple concrete tasks
which are achievable; it is important for the
patient to experience success. Provide positive
reinforcement after each achievement. For
example, craft, mowing lawn, wedding
gardens.
JAYESH PATIDAR 4/24/2013 51
52. Manic disorder: Non-competitive activities that
allow to use of energy & expression of
feelings. Activities should be limited &
changed frequently. Patient needs to work in
an area away from distraction. For example,
raking, grass, sweeping, etc.
Schizophrenia (paranoid): Non- competitive,
solitary meaningful tasks that require some
degree of concentration so that less time is
available for focus on delusions. For example,
puzzles, scrabble.
JAYESH PATIDAR 4/24/2013 52
53. Schizophrenia (catatonic): Simple concrete
tasks in which patient is actively involved.
Patient needs continuous supervision & at
first works best on a one-to-one basis. For
example, metal work, molding clay, etc.
Antisocial personality: Activities that
enhance self-esteem & are expressive &
creative, but not too complicated. Patient
needs supervision to makes sure each tasks
is completed. For example, leather works,
painting, etc.
JAYESH PATIDAR 4/24/2013 53
54. Dementia: Group activities to increase feeling
of belonging & self-worth. Provide those
activities which promote familiar individual
hobbies. Activities need to be structured
requiring little time for completion & not much
concentration. Explain & demonstrate each
task, then have patient repeat the
demonstration. For example, cover making,
packing goods.
Substance abuse: Group activities in which
patient uses his talent. For example, involving
patient in planning social activities,
encouraging interaction with others etc.
JAYESH PATIDAR 4/24/2013 54
55. Childhood & Adolescent disorders:
Children: Playing, story telling, painting,
poetry, music etc
Adolescent: Creative activities such as leather
works, drawing, painting
Mental retardation: Repetitive work
assignments are ideal; positive reinforcement
after each achievement. For example, cover
making, candle making packaging goods etc.
JAYESH PATIDAR 4/24/2013 55
57. Play is a natural mode of growth &
development in children. Through play a child
learns to express his emotions & it serves as
a tool in the development of the child.
JAYESH PATIDAR 4/24/2013 57
58. It releases tension & pent-up emotions.
It allows compensation for loss & failures.
It improves emotional growth through his
relationship with other children.
It provides an opportunity to the child to act
out his fantasies & conflict, to get rid of
aggression & to learn positive qualities from
other children.
JAYESH PATIDAR 4/24/2013 58
59. Play therapy gives the therapist a chance to
explore family relationships of the child &
discover what difficulties are contributing to
the child‟s problem.
Play therapy allows studying hidden aspects
of the child‟s problems.
It is possible to obtain a good ideas of the
intelligence level of the child.
Through play inter-sibling relationships can
be adequately studied.
JAYESH PATIDAR 4/24/2013 59
60. Individual vs group play therapy: In individual
therapy the child is allowed to play by himself &
the therapist‟s attention is focused on this one
child alone. In group play therapy other children
are involved.
Free play vs controlled play therapy: In free play
the child is given freedom in deciding with what
toys he wants to play. In controlled play
therapy, the child is introduced into a scene
where the situation or setting is already
established.
JAYESH PATIDAR 4/24/2013 60
61. Structured vs unstructured play therapy:
Structured play therapy involves organizing the
situation in such a way so as to obtain more
information. In unstructured play therapy no
situation is set & no plans are followed.
Directive vs non-directive play therapy: In
directive play therapy, the therapist totally sets
the direction, whereas in non-directive play
therapy, the child receives no direction. Play
therapy is generally conducted in a playroom.
The playroom should be suitably stocked with
adequate play material, depending upon the
problems of the child.
JAYESH PATIDAR 4/24/2013 61
63. Recreation is a form of activity therapy
used in most psychiatric setting.
It is planned therapeutic activity that
enables people with limitations to
engage in recreational experiences.
JAYESH PATIDAR 4/24/2013 63
64. To encourage social interaction.
To decrease withdrawal tendencies
To provide outlet for feelings.
To promote socially acceptable
behavior
To develop skills, talents & abilities
To increase physical confidence & a
feeling of self worth.
JAYESH PATIDAR 4/24/2013 64
65. Provide a non-threatening & non-
demanding environment.
Provide activities that are relaxing &
without rigid guidelines & time-
frames.
Provide activities that are enjoyable &
self-satisfying.
JAYESH PATIDAR 4/24/2013 65
66. Motor forms: These can be further divided into
fundamental & accessory; among the
fundamental forms are such games as hockey
& football, while the accessory forms are
exemplified by play activity & dancing.
Sensory forms: These can be either visual for
example, looking at motion pictures, play, etc.,
or auditory such as listening to a concert.
Intellectual forms: These include reading,
debating & so on.
JAYESH PATIDAR 4/24/2013 66
67. Anxiety disorder: Aerobic activities like
walking, jogging, etc.
Depressive disorder: Non-competitive sports,
which provide outlet for anger, like jogging,
walking , running, etc.
Manic disorder: One-to-one basis individual
games like shuttle badminton, ball badminton,
etc.
Schizophrenia (paranoid): Activities requiring
concentration like chess, puzzles.
JAYESH PATIDAR 4/24/2013 67
68. Schizophrenia (catatonic): Social activities to give
patient contact with reality like dancing, athletics.
Dementia: Concrete, repetitious craft & projects
that breed familiarization & comfort.
Childhood & adolescent disorders: It is better to
work with the child on a one-to-one basis & give
him a feeling of importance. Employ activities
such as playing, story telling & painting.
Adolescents fare better in groups; provide gross
motor activities like sports & games to use up
excess energy.
Mental Retardation: Activities should be
according to the patient‟s level of functioning
such as walking, dancing, swimming, ball
playing. Etc.
68
JAYESH PATIDAR 4/24/2013
70. Attitude therapy is a form of milieu
therapy in which all staff members
assume a consistent, prescribed
attitude designed to be therapeutic
towards patients.
JAYESH PATIDAR 4/24/2013 70
71. i. When the patient is in the hospital for a long
time:
• The patient is interviewed to assess his
emotional state & activity level.
• Family members are interviewed to acquaint
them with the attitude therapy which will be
used for the patient.
ii. After this, a staff meeting is held in which all the
team members are present.
JAYESH PATIDAR 4/24/2013 71
72. iii. A clinical diagnosis is made by the
psychiatrist.
iv. A plan of attitude to be adopted for a
particular patient is discussed with purpose.
v. One Principal Line of Approach at a time by
all the team members.
The attitude therapy is
basically meaning to change the attitude of
the patient in specific situations. A general
attitude which the nurse needs to adopt for
psychiatric patients is kept in mind.
JAYESH PATIDAR 4/24/2013 72
73. The patient starts feeling that an
organized approach is being used for
his/her treatment.
Guesswork & haphazard plans by
individual members of the team are
reduced.
The patient‟s problems or conflict are
solved in less time.
JAYESH PATIDAR 4/24/2013 73
74. This approach also provides an
opportunity for the members to explore,
test & change the therapeutic attitude
which will bring best results in patient.
It brings members of the team together
to plan, work & evaluate each other‟s
efforts & to discover new ways of
helping the patient.
JAYESH PATIDAR 4/24/2013 74
79. It is a psychotherapeutic use of
movement, which furthers the
emotional & physical integration of
the individual.
JAYESH PATIDAR 4/24/2013 79
80. Helps to develop body awareness.
Facilitates expression of feelings.
Improves interaction & communication
Fosters integration of physical, emotional
& social experiences that results in a
sense of increased self-confidence &
contentment.
Exercise through body movement
maintains good circulation & muscle
tone.
JAYESH PATIDAR 4/24/2013 80