NUR 471 Mental Health Study Guide for Exam #2 Fall 2023
Morgan & Townsend Chapters 4, 7, 8, 14, 15 & Therapies
Correlating ATI Chapters
Chapter 4 – Psychopharmacology
• This chapter has complete info about medications talked about in other chapters.
Chapter 7– Milieu Therapy – The Therapeutic Community
• Definition & Goals
o Definition:
▪ A scientific structuring of the environment to effect behavioral changes and to
improve the psychological health and functioning of the individual”
▪ Also called…. a “therapeutic community
o Goals: to develop a greater sense of self-awareness, to learn to grow both socially and
emotionally and to begin to understand who they are and how they “fit” into their world
▪ Social learning is the backbone
• Basic Assumptions of Milieu Therapy
o The health of each individual is to be realized and encouraged to grow
▪ Identify strengths and limitations
▪ Strengths serve as a foundation for personality growth & adaptivity
o Every interaction is an opportunity for therapeutic intervention
▪ To improve communication & relationship skills
▪ Immediate feedback is key
o The client owns his or her environment
▪ Decision making in the context of the government of the unit
o Each client owns his or her behavior
▪ Must take responsibility for own behavior
▪ No “victim -mentality”!
o Peer pressure is a useful and powerful tool
▪ Used to establish group norms
▪ Feedback – direct and frequent for adaptation
o Inappropriate behaviors are dealt with as they occur
▪ Examine behaviors, affects on others & appropriate ways to behave
o Restrictions and punishment are to be avoided
▪ Inappropriate behaviors are discussed and controlled
• Conditions that Promote ta tTherapeutic tCommunity
o Basic tphysiological tneeds tare tfulfilled
o The tphysical tfacilities tare tconducive tto tachievement tof tthe tgoals tof ttherapy
▪ Homelike tatmosphere
▪ Sufficient tprivacy
▪ Group tinteractions
o A tdemocratic tform tof tself-government texists
▪ Teamwork tw/ tcommunity tmeetings tfor tdecision tmaking
▪ Total tparticipation texpected
▪ Rules tare tto tbe tfollowed
▪ Management tof tdisagreements
▪ Assignment tof tcommunity ttasks
▪ Minuets tare ttaken tfor tevidence tof tdiscussion
o Responsibilities tare tassigned taccording tto tclient tcapabilities
November 15, 2023
, ▪ To tincrease tself-esteem tto timprove tmental thealth
o A tstructured tprogram tof tsocial tand twork-related tactivities tis tscheduled tas tpart
tof
the ttreatment tprogram
▪ Individual tie: t to tmeet tpersonal tproblems
▪ Group tactivities t ie: t Management tof t: tanger, tassertiveness,
o Community tand tfamily tare tincluded tin tthe tprogram tof ttherapy tin tan teffort tto
facilitate tdischarge tfrom ttreatment
▪ To tstay tconnected
▪ Facilitate tdischarge
▪ Prevent tdependence t& tre-entry tinto tthe tprogram
• Interdisciplinary tTherapeutic tCommunity tTeam t(Program)
▪ Nursing
▪ Psychiatry, tPsychology,
▪ Social twork,
▪ Occupational ttherapy, t Recreational ttherapy,
▪ Art ttherapy, tMusic ttherapy,
▪ Dietetics, tand tChaplain’s tservice
o Nurses tRoles tin tMilieu tTherapy
▪ Manage tthe ttherapeutic tenvironment ton ta t24-hour tbasis
▪ Ensure tthat tthe tclient’s tneeds tare tmet
• Physiological t–ADLs t& tphysical thealth
• Psychological t– tReality tOrientation
▪ Provide tmedication tadministration
▪ Development tof ta tone-to-one tTRUSTING trelationship
▪ Set tlimits ton tunacceptable tbehavior
▪ Provide tClient teducation
▪ Help tthe tclients tbecome tproductive tmembers tof tsociety
▪
Chapter t8-- tIntervention tin tGroups
• Definition tof tgroup ttherapy
o A tscientific tstructuring tof tthe tenvironment tto teffect tbehavioral tchanges tand tto timprove
the tpsychological thealth tand tfunctioning tof tthe tindividual
• Functions tof ta tgroup
o Socialization:
▪ teaching/leaning tsocial tnorms;
▪ Gaining tConfidence tin tsharing
▪ Learn tto taccept tsupport tfrom tothers
o Emotional tSupport, tEmpathetic tUnderstanding t& tAuthentic tencouragement
o Task tcompletion: tResults tare tachieved tmore teffectively tas ta tteam.
o Camaraderie:
▪ Committed tattendance tis ttherapeutic:
▪ Members t“show tup” tfor tthemselves tand tothers t–
▪ Responsibility tdevelopment t& tgives tmeaning tto tlife
o Validation
▪ Learning tfrom tsharing twith teach tother
▪ Understanding tother’s tproblems t& tsolutions thelps tto tclarify tone’s town.
o Normative: tdifferent tgroups tenforce testablished tnorms tin tvarious tways
o Empowerment: tchange tcan tbe tmade tby tgroups tat ttimes twhen tindividuals talone
tare tineffective
November 15, 2023
, o Governance: tlarge torganizations toften thave tleadership tthat tis tprovided tby
tgroups trather tthan tby ta tsingle tindividual
• What tare tthe ttypes tof tgroups? t– tDefs t& tfunctions/characteristics
o Task group: a group formed to accomplish a specific outcome or task
o Teaching groups: the focus is to convey knowledge and information to a number of
individuals
o Supportive/therapeutic group: teaching effective ways of dealing with emotional stress
arising from situational or developmental crises
o Self-help groups: “Peers with similar experience groups” ie: AA, NA, etc. Either prof
or peer led; can talk about problems and get help from others
• Why tare ttherapeutic tgroups thelpful?
o What tare tthe tdifferent ttypes tof tCurative tFactors? t What tdoes tit tmean t& thow tdo tthey
apply?
▪ Instillation tof thope t– tby tobserving tthe tprogress tof tothers tin tthe tgroup
▪ Imparting tof tinformation t- tTeaching t& tlearning tfrom teach tother
▪ Altruism t- tproviding tsupport tto tothers t - tleads tto timproved tself tconcept tand
tself- testeem tand tconfidence
▪ Corrective trecapitulation tof tthe tprimary tfamily tgroup: tre-experience
tearly tfamily tconflicts tthat tremain tunresolved, tchance tfor tfeedback tand
texploration
▪ Development tof tsocializing ttechniques: tcorrect tmaladaptive tbehaviors tand
t& tdevelop tnew tsocial tskills
▪ Imitative tBehavior: tvaluable trole tmodels tfor tothers
▪ Interpersonal tlearning: tgroup toffers tvaried topportunities tfor tinteracting
twith tother tpeople
▪ Group tcohesiveness: tmembers tdevelop ta tsense tof tbelonging trather
tthan tseparating tindividual t(“I tam”) tfrom tgroup t(“we tare”)
Catharsis: within the group, members are able to express both positive and
negative feelings
▪ Existential tfactors: tthe tgroup tis table tto tassist tindividual tmembers tto
ttake tdirection tof ttheir town tlives tand tto t accept tresponsibility tfor tthe tquality
tof ttheir texistence
• corrective trecapitulation t- tWhat tare tthe tActivities, tleader texpectations t& tmember tbehaviors
o Leadership tstyles: t Autocratic, tdemocratic, tlaissez-Faire t–
Autocratic: leader focused, on whom the members are dependent for problem-
solving, decision-making, and permission to perform; production is high, but
morale is low
Democratic: focus is on members, who are encouraged to participate fully in
problem-solving of group issues, including taking action to effect change;
production is somewhat lower than with autocratic leadership, but morale is much
higher
Laissez-faire: there is no focus in this type of leadership. Goals are undefined,
and members do as they please; productivity and morale are low
o What tare tthe tdifferent t“Member tRoles” tdefinitions t?
▪ Task troles: tserving tto tcomplete tthe ttask tof tthe tgroup
▪ Maintenance troles: tmaintaining tor tenhancing tgroup tprocesses
▪ Individual t(personal) troles: tfulfilling tpersonal tor tindividual tneeds
• Family ttherapy: tDefinition, tpurpose t& tgoal; tWhat tis ta tgenogram?
o Focus tof tthe ttreatment tis ton tthe tfamily tas ta tunit
o Goal: tidentify tand tchange tproblematic, tmaladaptive, tself-defeating,
trepetitive trelationship tpatterns
November 15, 2023
Morgan & Townsend Chapters 4, 7, 8, 14, 15 & Therapies
Correlating ATI Chapters
Chapter 4 – Psychopharmacology
• This chapter has complete info about medications talked about in other chapters.
Chapter 7– Milieu Therapy – The Therapeutic Community
• Definition & Goals
o Definition:
▪ A scientific structuring of the environment to effect behavioral changes and to
improve the psychological health and functioning of the individual”
▪ Also called…. a “therapeutic community
o Goals: to develop a greater sense of self-awareness, to learn to grow both socially and
emotionally and to begin to understand who they are and how they “fit” into their world
▪ Social learning is the backbone
• Basic Assumptions of Milieu Therapy
o The health of each individual is to be realized and encouraged to grow
▪ Identify strengths and limitations
▪ Strengths serve as a foundation for personality growth & adaptivity
o Every interaction is an opportunity for therapeutic intervention
▪ To improve communication & relationship skills
▪ Immediate feedback is key
o The client owns his or her environment
▪ Decision making in the context of the government of the unit
o Each client owns his or her behavior
▪ Must take responsibility for own behavior
▪ No “victim -mentality”!
o Peer pressure is a useful and powerful tool
▪ Used to establish group norms
▪ Feedback – direct and frequent for adaptation
o Inappropriate behaviors are dealt with as they occur
▪ Examine behaviors, affects on others & appropriate ways to behave
o Restrictions and punishment are to be avoided
▪ Inappropriate behaviors are discussed and controlled
• Conditions that Promote ta tTherapeutic tCommunity
o Basic tphysiological tneeds tare tfulfilled
o The tphysical tfacilities tare tconducive tto tachievement tof tthe tgoals tof ttherapy
▪ Homelike tatmosphere
▪ Sufficient tprivacy
▪ Group tinteractions
o A tdemocratic tform tof tself-government texists
▪ Teamwork tw/ tcommunity tmeetings tfor tdecision tmaking
▪ Total tparticipation texpected
▪ Rules tare tto tbe tfollowed
▪ Management tof tdisagreements
▪ Assignment tof tcommunity ttasks
▪ Minuets tare ttaken tfor tevidence tof tdiscussion
o Responsibilities tare tassigned taccording tto tclient tcapabilities
November 15, 2023
, ▪ To tincrease tself-esteem tto timprove tmental thealth
o A tstructured tprogram tof tsocial tand twork-related tactivities tis tscheduled tas tpart
tof
the ttreatment tprogram
▪ Individual tie: t to tmeet tpersonal tproblems
▪ Group tactivities t ie: t Management tof t: tanger, tassertiveness,
o Community tand tfamily tare tincluded tin tthe tprogram tof ttherapy tin tan teffort tto
facilitate tdischarge tfrom ttreatment
▪ To tstay tconnected
▪ Facilitate tdischarge
▪ Prevent tdependence t& tre-entry tinto tthe tprogram
• Interdisciplinary tTherapeutic tCommunity tTeam t(Program)
▪ Nursing
▪ Psychiatry, tPsychology,
▪ Social twork,
▪ Occupational ttherapy, t Recreational ttherapy,
▪ Art ttherapy, tMusic ttherapy,
▪ Dietetics, tand tChaplain’s tservice
o Nurses tRoles tin tMilieu tTherapy
▪ Manage tthe ttherapeutic tenvironment ton ta t24-hour tbasis
▪ Ensure tthat tthe tclient’s tneeds tare tmet
• Physiological t–ADLs t& tphysical thealth
• Psychological t– tReality tOrientation
▪ Provide tmedication tadministration
▪ Development tof ta tone-to-one tTRUSTING trelationship
▪ Set tlimits ton tunacceptable tbehavior
▪ Provide tClient teducation
▪ Help tthe tclients tbecome tproductive tmembers tof tsociety
▪
Chapter t8-- tIntervention tin tGroups
• Definition tof tgroup ttherapy
o A tscientific tstructuring tof tthe tenvironment tto teffect tbehavioral tchanges tand tto timprove
the tpsychological thealth tand tfunctioning tof tthe tindividual
• Functions tof ta tgroup
o Socialization:
▪ teaching/leaning tsocial tnorms;
▪ Gaining tConfidence tin tsharing
▪ Learn tto taccept tsupport tfrom tothers
o Emotional tSupport, tEmpathetic tUnderstanding t& tAuthentic tencouragement
o Task tcompletion: tResults tare tachieved tmore teffectively tas ta tteam.
o Camaraderie:
▪ Committed tattendance tis ttherapeutic:
▪ Members t“show tup” tfor tthemselves tand tothers t–
▪ Responsibility tdevelopment t& tgives tmeaning tto tlife
o Validation
▪ Learning tfrom tsharing twith teach tother
▪ Understanding tother’s tproblems t& tsolutions thelps tto tclarify tone’s town.
o Normative: tdifferent tgroups tenforce testablished tnorms tin tvarious tways
o Empowerment: tchange tcan tbe tmade tby tgroups tat ttimes twhen tindividuals talone
tare tineffective
November 15, 2023
, o Governance: tlarge torganizations toften thave tleadership tthat tis tprovided tby
tgroups trather tthan tby ta tsingle tindividual
• What tare tthe ttypes tof tgroups? t– tDefs t& tfunctions/characteristics
o Task group: a group formed to accomplish a specific outcome or task
o Teaching groups: the focus is to convey knowledge and information to a number of
individuals
o Supportive/therapeutic group: teaching effective ways of dealing with emotional stress
arising from situational or developmental crises
o Self-help groups: “Peers with similar experience groups” ie: AA, NA, etc. Either prof
or peer led; can talk about problems and get help from others
• Why tare ttherapeutic tgroups thelpful?
o What tare tthe tdifferent ttypes tof tCurative tFactors? t What tdoes tit tmean t& thow tdo tthey
apply?
▪ Instillation tof thope t– tby tobserving tthe tprogress tof tothers tin tthe tgroup
▪ Imparting tof tinformation t- tTeaching t& tlearning tfrom teach tother
▪ Altruism t- tproviding tsupport tto tothers t - tleads tto timproved tself tconcept tand
tself- testeem tand tconfidence
▪ Corrective trecapitulation tof tthe tprimary tfamily tgroup: tre-experience
tearly tfamily tconflicts tthat tremain tunresolved, tchance tfor tfeedback tand
texploration
▪ Development tof tsocializing ttechniques: tcorrect tmaladaptive tbehaviors tand
t& tdevelop tnew tsocial tskills
▪ Imitative tBehavior: tvaluable trole tmodels tfor tothers
▪ Interpersonal tlearning: tgroup toffers tvaried topportunities tfor tinteracting
twith tother tpeople
▪ Group tcohesiveness: tmembers tdevelop ta tsense tof tbelonging trather
tthan tseparating tindividual t(“I tam”) tfrom tgroup t(“we tare”)
Catharsis: within the group, members are able to express both positive and
negative feelings
▪ Existential tfactors: tthe tgroup tis table tto tassist tindividual tmembers tto
ttake tdirection tof ttheir town tlives tand tto t accept tresponsibility tfor tthe tquality
tof ttheir texistence
• corrective trecapitulation t- tWhat tare tthe tActivities, tleader texpectations t& tmember tbehaviors
o Leadership tstyles: t Autocratic, tdemocratic, tlaissez-Faire t–
Autocratic: leader focused, on whom the members are dependent for problem-
solving, decision-making, and permission to perform; production is high, but
morale is low
Democratic: focus is on members, who are encouraged to participate fully in
problem-solving of group issues, including taking action to effect change;
production is somewhat lower than with autocratic leadership, but morale is much
higher
Laissez-faire: there is no focus in this type of leadership. Goals are undefined,
and members do as they please; productivity and morale are low
o What tare tthe tdifferent t“Member tRoles” tdefinitions t?
▪ Task troles: tserving tto tcomplete tthe ttask tof tthe tgroup
▪ Maintenance troles: tmaintaining tor tenhancing tgroup tprocesses
▪ Individual t(personal) troles: tfulfilling tpersonal tor tindividual tneeds
• Family ttherapy: tDefinition, tpurpose t& tgoal; tWhat tis ta tgenogram?
o Focus tof tthe ttreatment tis ton tthe tfamily tas ta tunit
o Goal: tidentify tand tchange tproblematic, tmaladaptive, tself-defeating,
trepetitive trelationship tpatterns
November 15, 2023
