Assess Your Knowledge
Mental Health Exam 1
Discuss prominent theories and therapeutic models
oBehavioral Therapy: attempts to correct or eliminate maladaptive (bad) behaviors/responses by rewarding & reinforcing adaptive (good) behavior. Use of Desensitization, Aversion Therapy (becoming not afraid of spiders), Biofeedback and Modeling as well as the below 3 items.
Pavlov, Watson & Skinner Pavlov: Classical Conditioning (Ex: baby cries and mom has milk “let-down” reflex).
Watson: Personality traits & responses were learned
(conscious) behavior.
Skinner: Operant Conditioning . Behaviors are learned through Positive/Negative Reinforcement (Ex:
studying hard results in good grades).
oCognitive Behavioral Therapy: combines both behavioral and cognitive theory and seeks to modify negative thoughts that lead
to dysfunctional emotions & actions. This is useful for those patients who feel incompetent, abandoned, evil or vulnerable. It is NOT the stimulus (situation/person/place/thing) that causes the response; it is the person’s evaluation & self-
thoughts about the situation that causes the negative feelings/reaction. Therapy aims to remove these negative/repetitive thoughts and replace them with rational interpretations of situations. Ex: “Matt had a car accident. He now refuses to drive and says, “I shouldn’t be allowed on the road”. (This is distorted thinking and rationalization of his car accident).
oMilieu Therapy: Creating a SAFE, structured inpatient/outpatient setting where the mentally ill can test new behaviors and coping mechanisms with others. Creating a SAFE, structured inpatient/outpatient setting where patients with mental illness can test new behaviors and interactions. Climate is essential to healing: paint color, relaxed environments are conducive to the healing process. Florence Nightingale believed that the environment helps heal
oMaslow’s Hierarchy of Needs: Basic needs on the bottom of the pyramid have to be met before the top (self-actualization) can be attained. 1.Physiological Needs – most basic needs that a human needs (food, water, O2, sleep, sex, body temperature, elimination, voiding). This level takes priority over all others. Assess Your Knowledge
Mental Health Exam 1
2.Safety Needs – security, protection, and freedom from fear/anxiousness/chaos, law, order and limitations.
3.Belonging & Love Needs – The need for love, affection, intimate relationships and belonging will see to overcome feelings of loneliness and alienation. (Having a Family and a Home is very important).
4.Esteem Needs – If this need is met, we feel confident, valued and valuable. If this need is NOT met, we feel inferior, worthless and helpless. 5.Self-Actualization – What we strive to become as humans. Fulfillment of this need brings inner piece and contentment
with ones self. Describe the role of neurotransmitters: dopamine, serotonin, and norepinephrine, GABA
Dopamine: controls emotional responses, the brain’s reward and pleasure centers, stimulates heart and increases blood flow to organs. (Haloperidol = dopamine blocker). Cocaine allows more of dopamine to stay active for longer = increased HR, etc. oEPS is the result of Dopamine blockers (Dopamine needs to get through for proper brain functioning! )
oDisorders with HIGH levels: Schizophrenia, Mania
oDisorders with LOW levels: Depression, Parkinson’s Disease
Serotonin: Regulates mood, arousal, attention, behavior, and body temperature. Most anti-depressants increase Serotonin production. Muscle Relaxants block serotonin production. Serotonin release by platelets play important role in homeostasis.
oHigh levels of Serotonin S/Sx: causes restlessness, shivering, diarrhea, muscle rigidity, fever and seizures. oDisorders with HIGH levels: Anxiety
oDisorders with LOW levels: Depression
Norepinephrine: Regulate mood. A deficiency can cause Depression and excess can cause Mania. oDisorders with HIGH levels: Mania, Anxiety, Schizophrenia
oDisorders with LOW levels: Depression
GABA: inhibitory neurotransmitter that regulates excitability and
helps treat anxiety by helping you “chill out”. Anti-Anxiety Meds help increase the effectiveness of GABA by making the receptors more responsive. oDisorders with HIGH levels: Reduction of Anxiety
oDisorders with LOW levels: Mania, Anxiety, Schizophrenia
Describe the phases of the nurse-client relationship, and what occurs during each phase (Hildegard Peplau)
1.Orientation Phase: first time the nurse & patient meet, interact according to their own backgrounds/standards/values/beliefs,