Psych Milieu Therapy – Flashcards
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milieu also means
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"environment" or "therapeutic community"
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goal of the milieu
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-structure -to manipulate the environment so that all aspects of the patients hospital experience is therapeutic
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intent of structuring the environment
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-affect behavioral changes -improve psychological health and functioning
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learning expectations for pt within milieu
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-adaptive coping -appropriate interaction -establish positive relationships
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basic expectations
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-growth -interaction -owning environment -behavior -peer pressure -inappropriate behavior examined -punishments avoided
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growth
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health is realized and encouraged to grow -strengths and limits
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interaction
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every interaction is an opportunity for therapeutic intervention -immediate feedback facilitates learning
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owning environment
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client makes decisions and solves problems
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behavior
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client responsible for own behavior
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peer pressure
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useful and powerful determining group norms
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inappropriate behavior examined
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dealt with as they occur, examines how it affects others
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punishments avoided
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should be resolved within group "quiet area"
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6 conditions that promote therapeutic community
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-Maslow -physical -self government -responsibilities -activities -community
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maslow
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-basic physiologic needs are met
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physical
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facilities are conducive to achievement of the goals of therapy
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self government
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-community meeting, unit roles, patient participation
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responsibilities
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based on pts capabilities -client chooses task, provides self esteem
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activities
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structured program of social and work related activities scheduled as part of program
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community/family
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included in an effort to facilitate discharge
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IDT
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interdisciplinary (multidisiplinary) treatment team
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possible members of IDT
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-psychiatrist -clinical psychiatrist -psych clinical nurse specialist -psych nurse -mental health tech -psych social worker -occupational therapist -recreational therapist -art therapist -music therapist -psychodramatist -dietician -chaplan
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role of nurse
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-24 hour management of therapeutic env -day to day activities -ensure pts psychological needs are met -must not overlook physical status
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objects can assist disoriented or disorganized pts
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-large clock -bulletin board -calendar -ID on doors -written schedules
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major focus of the milieu env
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establish a one on one relationship
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ways to establish one on one relationship
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-meals -limits of acceptable behaviors -patient education
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nursing responsibility in milieu
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-med admin -one on one relationship -setting limits on unacceptable behavior -pt education
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questions asked to assess learning readiness
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-do you want to learn? -what is your level of anxiety? -what is your level of ability in understanding the info being presented?
