Therapeutic Communication
Techniques
• Open ended questions
• Exploring, focusing, restating.
• Some promote discussion of feelings or concerns in more depth
• Other techniques useful in focusing or clarifying what is being said
check restraints when??
every 15-30 min
veracity
Honesty
nontherapeutic techniques
• Advising, belittling, challenging, probing, reassuring
Release from Hospital
Release from the hospital
• Voluntary hospitalization: right to request discharge at any time
• Release unless danger to self or others; if such danger present, then
commitment proceedings instituted
• Committed client may:
• Take medication and improve rapidly
• Become dangerous again if medication ceased after release
• Mental health clinicians can be held liable for criminal actions of
client.
Autonomy
self rights
Secondary prevention: early identification of mental health problems
early identification of mental health problems
Clinical practice issues such as:
Clinical practice issues such as substance abuse, domestic violence,
child abuse, grief, depression, and many others
Therapeutic Milieu Therapy
• Structured Environment
• Scheduled activities
• Therapy: Individual, group
• Medications
• Meals
• Safe Space
• Safe to be self
• Must take responsibility for own actions
• Multidisciplinary Support
• Support for psycho-social and spiritual needs
• Focus on recovery
• Learning effective coping skills
• Identifying triggers
• Setting goals
• Improving communication and relationship skills
Assault
Touch without consent
Beneficence
duty to benefit others or promote good
Fidelity
obligation to honor commitments and contract
Milieu therapy=
safe physical setting with defined rules and boundaries; appropriate activities
offered
An example of Negligence
Not putting side rails up
Nom-Maleficence
Do no harm
Psychosocial Nursing in Public
Health and Home Care
Primary prevention:
stress management education
battery
Harmful contact resulting in injury
Tertiary prevention:
monitoring and coordinating psychiatric
rehabilitation services
Legal and Ethical Issues
Mental Health
• CLIENT’S RIGHTS: based on Patients’ Bill of Rights & HIPAA
• Right to Confidentiality
• Right to Informed Consent
• ECT- Electroconvulsive therapy
• Right to refuse treatment
• Right to receive treatment in the least restrictive form
• ADMISSION TO A MENTAL HEALTH FACILITY
• Standard criteria: threat to self or others
• Health care professionals have a duty to warn and protect third party individuals who may be in
danger due to the client’s threats of harm.
• Voluntary: client chooses admission to mental health facility in order to obtain treatment