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NSG 526 Exam 2 Study Guide & Nursing Exam Review

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NSG 526 Exam 2 Study Guide & Nursing Exam Review

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Exam Two

Here is the breakdown of the test questions:

Group Therapy 3 21

(Highlight) The primary purpose of group therapy is to facilitate changes by the patient to
address identified problems.

Examples: A technique for dealing with an over-talkative client and silence from other
participants in a group during therapy is to make an observation about the group’s silence and
invite the others to comment. During group members sharing methods they personally use for
dealing with problems are using the technique of <Information Giver=

Group psychotherapy or group therapy is a method whereby individuals with a common purpose
come together and benefit by both giving and receiving feedback within the dynamic and unique
context of group life.

The basic premises of group therapy are: (1) that human beings are social animals, and (2) that
we heal in community. This is why group therapy is so efficacious. This correlated to Maslow’s
third level in his hierarchy of needs; the need for love and belonging. Group therapy provides a
valuable form of social support.

Cognitive/Cognitive Behavioral/DBT 3 16

(Highlights) Cognitive Behavioral Therapy consists of active questioning, homework
assignments, and dream survey. The therapist helps the patient consider personal ideas and
beliefs in order to increase the patient's realization about how thoughts influence behaviors.

Cognitive Therapy: Cognitive Therapy is a form of psychotherapy based on the
theory that pathological information processing is linked to emotional reactions and
dysfunctional behavioral patterns. The goals of cognitive therapy are to establish a
nurse-patient therapeutic relationship. Complete a full assessment of the patient (via
intake interview), Set an agenda for therapy sessions. Give constructive feedback to
direct the course of the therapy.
Cognitive therapy focuses on helping the individual to alter mood by changing
the way he or she thinks. The individual is taught to control negative thought
distortions that lead to pessimism, lethargy, procrastination, and low self-esteem.
DBT: (Dialectical Behavior Therapy) DBT is a treatment designed specifically for
individuals with self-harm behaviors, such as self-cutting, suicide thoughts, urges to
suicide, and suicide attempts
Three Modes of DBT include:
1. Individual therapy (once a week for an hour utilizing cognitive-behavioral techniques)
2. Skills group - 2-hour weekly skills group; 4 sets of skills:
Mindfulness
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Interpersonal effectiveness (IE)
Emotion regulation (ER)
Distress tolerance (DT)
3. Telephone Crises Management - Contract to call therapist for suicide or self-harm
behaviors.



Attachment 3 2

(Highlights) Attempts to explain the dynamics of interpersonal relationships between humans. A
child needs to form a relationship between at least one primary caregiver.

Attachment Theory: Attachment can be defined as the emotional tone between children and
their caregivers, as seen within the 1st month. Originated by John Bowlby. He stressed the
following:

- Attachment constituted a central motivational force and that mother/infant was an
essential medium of human interaction which has important consequences for later
development and personality functioning.
- Can form attachments to more than one person, develops gradually
- It results in the infant wanting to be with the person who is perceived as stronger, wiser,
able to reduce stress and anxiety.
- Gives the infant a feeling of security
- The amount of time spent together is less important than the amount of activity between
the two.
- Harry Harlow was able to show with monkeys: Isolating monkeys from birth led to
behaviors that were withdrawn, unable to relate to peers, unable to mate, and incapable
of caring for their offspring.
- PHASES OF ATTACHMENT: <Pre-attachment stage= (birth to 8-12 wks)- babies orient to
their mothers, follow them with their eyes over a 180 degree range, and turn towards
mothers voice. Next is <Attachment in the Making= is 8-12 wks - 6 months. Infants
become more attached to one or more persons in the environment. Finally the <Clear cut
attachment= is 6-24 months. Infants show signs of distress when separated from
caretaker or mother. Can occur as early as 3 months.
- Mary Ainsworth - Described 3 types of insecure attachment (More examples noted later
in diagram) 1. Insecure-avoidant - Tends to avoid close contact with people andlingers
near caregivers rather than approaching them directly. Insecure-ambivalent- Child finds
exploratory play difficult, even in the absence of danger, clings to his or her inconsistent
parents. - and Insecure-disorganized - Children in this case have parents who are
emotionally absent with a parental history of abuse in their childhood,

Milieu 3 2

(Highlight) Milieu therapy requires consideration of the client’s social, economic, and cultural
status.

Complementary Alternative Medicine 3 9
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(Highlight) The major difference between Western medicine and complementary and alternative
therapies (CAM) is Western medicine focuses on what is done to the patient whereas CAM
focuses on mind-body interactions.

Know the following Theorists and basic assumptions:

Beck: Dissatisfied with the psychoanalytic orientation in which he was trained, Beck
developed the cognitive model of depression and the concept that cognitive processing
distortions underlie psychological disorders. Beck’s work on the theory of depression
became the catalyst for much of what is construed to be cognitive therapy today. Beck
emphasized the role of cognitive structures in depression. According to his theory,
depression can develop, persist, and recur as a result of cognitive structures called
<schemas=. Cognitive therapy, developed by Aaron T. Beck, is based on the philosophy
that people can learn to be their own therapists. Emphasis is on the rearrangement of a
person’s maladaptive processes o\f thinking, perception, and attitudes utilizing an active,
time-limited approach. ASSUMPTION: Distorted thinking contributes to and
maintains behavior (symptoms)

Ellis: Rational emotive therapy (RET), a form of CBT developed by Albert Ellis in the
mid-1950s, is a psychotherapeutic approach which proposes that unrealistic and
irrational beliefs cause many emotional problems. The purpose of RET is to identify an
irrational belief and dispute it through active, philosophical, confrontational therapy.

Key concepts of Albert Ellis’ Rational Emotive Therapy include:

People control their own destinies and interpret events according to their own
values and beliefs.

A-B-C theory: Activating event, belief, consequences (emotional and/or
behavioral)

Forms of irrational beliefs: Something should be different/Something is awful or
terrible/One cannot tolerate something/Something or someone is damned or cursed.

<Musturbatory” ideologies have 3 forms: I must do well and win approval or I
am a rotten person/You must act kindly toward me or you are a rotten person/My life
must remain comfortable or life hardly seems worth living.

Therapy consists of detecting and eradication irrational beliefs: Disputing:
Detecting irrationalities, debating them, discriminating between logical and illogical
thinking, and defining what helps create new beliefs. Debating: Questioning and
disputing the irrational beliefs. Discriminating: Distinguishing between wants and needs,
desires and demands, and rational and irrational ideas. Defining: Defining words and
redefining beliefs.

ASSUMPTION: People make themselves sick anytime they escalate a desire or
preference into a demand or absolute must. (People become who they become based
on their beliefs).
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Krieger:




Ecosocial theory: is a broad and complex theory with the purpose of describing and
explaining causal relationships in disease distribution. While it incorporates biological
and psychosocial influences on disease occurrence, the theory is also suited to analyse
the relationships between social factors and disease development in public health
research.

Key constructs include

1. Embodiment-describes the literal physical incorporation of the social and
biological world into an individual's body.
2. Pathways to embodiment-describes the various ways that social, biological, and
environmental forces may interact with an individual's body in context.
3. The cumulative interplay of exposure, susceptibility, and resistance-describes
how patterns of disease occur within a social, ecological, and biological context.
It emphasizes how individuals in different socio-economic positions have different
exposures, susceptibilities, and resistance (both biological and political) to
disease, based on their unique histories and experiences over the lifecourse,
based on spatio-temporal factors and the interaction with groups, power
structures, discrimination, and inequality.
4. Agency and accountability- claims that the State is a responsible agent in the
patterns of disease distribution in a given society

Paiget: 4 Jean Piaget's theory of cognitive development suggests that children move
through four different stages of mental development. His theory focuses not only on
understanding how children acquire knowledge but also on understanding the nature of
intelligence.
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