Name
Chamberlain University
NR-326: Mental Health Nursing
Prof. Name
Date
Psychotherapy plays a vital role in mental health nursing, aiming to promote emotional and behavioral change. It incorporates several therapeutic approaches, such as cognitive therapy, behavioral therapy, and integrative methods like cognitive-behavioral therapy (CBT) and dialectical behavior therapy (DBT). These strategies help individuals manage psychological disorders by addressing thoughts, emotions, and behaviors in a structured manner.
Cognitive therapy is based on the principle that thoughts significantly influence emotions and behaviors. The therapy focuses on identifying and modifying distorted thinking patterns that contribute to distress. It is especially useful in treating depression, anxiety disorders, and eating disorders. Clients are encouraged to reassess and reinterpret their life events to reduce emotional suffering (Beck, 2011).
Behavioral therapy contrasts with psychoanalysis by emphasizing that behaviors are learned and can be unlearned. Theorists like Pavlov, Watson, and Skinner argued that maladaptive behaviors arise from negative experiences and can be changed through reinforcement and structured interventions.
| Technique | Description | Application in Mental Health |
|---|---|---|
| Modeling | Learning through imitation of role models | Enhances interpersonal skills in clinical settings |
| Systematic Desensitization | Gradual exposure to anxiety-inducing stimuli with relaxation | Effective for phobias and anxiety disorders |
| Aversion Therapy | Linking undesirable behaviors with unpleasant stimuli | Applied in substance use or aggression management |
| Flooding | Intense exposure to feared situations | Reduces anxiety in phobias (e.g., claustrophobia) |
| Response Prevention | Blocking compulsive behaviors | Common in treating OCD |
| Thought Stopping | Interrupting negative thinking with cues | Improves control over intrusive thoughts |
| Time-Out | Temporary removal from reinforcing environments | Behavior modification in both children and adults |
| Validation Therapy | Affirming feelings regardless of factual accuracy | Helpful in neurocognitive disorders |
CBT combines cognitive and behavioral approaches to highlight how thoughts, emotions, and behaviors interact. DBT, a specialized form of CBT, is particularly effective for personality disorders. It emphasizes mindfulness, distress tolerance, and emotional regulation.
Dissociative disorders involve disruptions in identity, memory, or consciousness, usually resulting from trauma or stress.
| Disorder | Characteristics |
|---|---|
| Dissociative Identity Disorder | Two or more personality states; often linked to childhood trauma |
| Depersonalization-Derealization | Feelings of detachment from self or surroundings, altering perception |
| Dissociative Amnesia | Inability to recall important personal information, usually related to trauma |
Predisposing factors include severe psychological trauma, abuse, and overwhelming stress. Treatment focuses on strengthening coping skills and restoring reality orientation (APA, 2013).
Somatic symptom disorders manifest as physical complaints without medical explanations, often leading to significant emotional distress.
This condition includes multiple unexplained physical complaints that disrupt functioning. The PHQ-15 is used to assess severity, covering symptoms such as pain, dizziness, fatigue, and gastrointestinal problems.
Characterized by preoccupation with having a serious illness despite reassurance, individuals may frequently seek medical care (care-seeking) or avoid it altogether (care-avoidant). Childhood abuse and comorbid psychiatric illnesses are common risk factors.
This disorder involves neurological symptoms such as blindness or paralysis without an underlying medical cause. Symptoms often emerge following stress. A subtype, pseudocyesis, manifests as false pregnancy after emotional trauma.
In factitious disorder, individuals deliberately fabricate symptoms to assume a sick role. This may be self-imposed or projected onto another person (previously referred to as Munchausen syndrome by proxy).
Grief is a highly individualized process that may occur before a loss (anticipatory grief) or extend beyond typical patterns. The Kübler-Ross model identifies five stages: denial, anger, bargaining, depression, and acceptance. Maladaptive grief occurs when individuals remain stuck in certain stages, often resulting in prolonged distress and impaired recovery.
NCDs involve progressive cognitive decline that interferes with daily living, classified as mild or major.
| Feature | Delirium (Acute Confusion) | Major NCD (Dementia) |
|---|---|---|
| Onset | Sudden | Gradual |
| Duration | Short-term, reversible | Chronic, progressive |
| Causes | Infection, dehydration, drugs | Alzheimer’s, vascular disease |
| Subtype | Cause |
|---|---|
| Alzheimer’s | Neurodegeneration |
| Vascular NCD | Stroke-related damage |
| Lewy Body Dementia | Protein deposits in the brain |
| Parkinson’s Disease | Dopaminergic degeneration |
| Huntington’s Disease | Genetic defect |
| HIV-related NCD | Neurological impact of HIV |
Defense mechanisms include denial, confabulation, and perseveration, which are often used to maintain self-esteem.
Suicide is an intentional act of self-harm, most commonly associated with psychiatric illnesses such as major depression. Over 90% of individuals who die by suicide have a diagnosable mental disorder. Risk factors include hopelessness, isolation, trauma, and guilt.
| Assessment Criteria | Key Focus Areas |
|---|---|
| Suicidal Ideation | Presence of thoughts, plans, past attempts |
| Psychiatric/Medical | History of depression, substance use, chronic illness |
| Social Connections | Availability of interpersonal support |
| Symptoms and Diagnosis | Current psychiatric or medical conditions |
| Risk Indicators | Warning signs, access to means, presence of concrete suicide plans |
| Risk Factor Type | Examples |
|---|---|
| Gender & Age | Males, especially older adults |
| Identity/Occupation | LGBTQ+, military veterans |
| Comorbid Conditions | Depression, substance use, bipolar disorder, schizophrenia |
| Life Events | Job loss, bereavement, declining health |
| Biological | Family history, chronic illnesses |
| Psychosocial | Hopelessness, trauma, interpersonal issues |
| Cultural | High rates in American Indian and Alaskan Native groups |
| Environmental | Firearm access, unemployment, poor access to care |
| Medication Class | Examples | Indications |
|---|---|---|
| SSRIs | Citalopram, Fluoxetine, Sertraline | Depression, suicidal ideation |
| Benzodiazepines | Diazepam, Lorazepam | Anxiety, panic disorders |
| Mood Stabilizers | Lithium | Bipolar disorder |
| Second-Gen Antipsychotics | Risperidone, Olanzapine | Schizophrenia, bipolar disorder, depression adjunct |
ECT is considered when other interventions are ineffective, particularly in severe depression, schizophrenia, or mania. Electrical stimulation under anesthesia induces controlled seizures that alleviate symptoms.
| Component | Purpose |
|---|---|
| Anticholinergics | Reduce secretions |
| Anesthetics | Prevent discomfort |
| Methohexital/Propofol | Induce muscle relaxation |
Clients and families should be educated on pre- and post-procedure care, including side effects like confusion, headaches, and temporary memory impairment.
| Disorder Type | Characteristics |
|---|---|
| Major Depressive Disorder | Persistent low mood >2 weeks, no mania |
| Dysthymia | Chronic low-grade depression >2 years |
| Postpartum Depression | Irritability, fatigue, poor sleep, concern about infant care |
Risk factors include hormonal imbalances, neurological changes, medication effects, and learned helplessness.
| Type | Description |
|---|---|
| Bipolar I | Manic episodes, may alternate with depression |
| Bipolar II | Hypomanic episodes alternating with major depression |
| Cyclothymic | Chronic mood fluctuations not meeting criteria for bipolar disorder |
Manic episodes include impulsivity and hyperactivity, while depressive phases are marked by hopelessness and suicidal ideation.
| Disorder | Key Features |
|---|---|
| PTSD | Flashbacks, avoidance, hyperarousal, risk of long-term disability |
| Acute Stress Disorder | Symptoms similar to PTSD but lasting only 3 days–1 month |
Nursing care emphasizes suicide risk assessment, empathy, and access to therapy and medical treatment.
| Disorder Type | Characteristics |
|---|---|
| Phobias | Irrational fears leading to avoidance |
| Panic Disorder | Sudden episodes with chest pain, palpitations |
| Generalized Anxiety | Excessive worry >6 months, fatigue, poor concentration |
| Body Dysmorphic Disorder | Obsessive focus on perceived flaws |
OCD involves intrusive thoughts (obsessions) and ritualistic actions (compulsions) designed to reduce distress. Both psychotherapy and pharmacological interventions, particularly SSRIs, are commonly used.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).
American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). Washington, DC: Author.
ATI Nursing Education. (2020). Mental health nursing review module (10th ed.). Assessment Technologies Institute.
Beck, J. S. (2011). Cognitive behavior therapy: Basics and beyond (2nd ed.). Guilford Press.
Centers for Disease Control and Prevention. (2022). Preventing suicide. https://www.cdc.gov/suicide/index.html
Townsend, M. C. (2020). Psychiatric mental health nursing: Concepts of care in evidence-based practice (9th & 10th eds.). F.A. Davis.
U.S. Department of Health & Human Services. (2022). Suicide prevention. National Institute of Mental Health. https://www.nimh.nih.gov/health/topics/suicide-prevention
