Advanced Concepts in Critical

Nursing

RESOURCE PERS
ON TEHSEENA A
KRAM
Unit-
VI:
CARE OF CLIENT
WITH
PSYCHOSOCIAL
DILEMMAS
Concept of Psychosocial:

Psychosocia refers to the close

l connection psychological
between aspects
human experience and the widerofsocial
experience.
Erikson’s Psychosocial Developmental
theory:
⚫ Erikson's model of psychosocial development
is a very significant, highly regarded and
meaningful concept.
⚫ The theory is helpful for child development,
and adults too.
⚫ Erikson's 'psychosocial' term is derived from
the two source words -namely psychological
(or the root, 'psycho' relating to the mind,
brain , personality, etc.
) and social (external relationships and
environment), both at the heart of Erikson's
theory.
 Erik
Erikson:
⚫ Erikson maintained that
predetermin
personality orderdevelops
through instages a
ed ofeight
development, from
psychosocial infancy to
adulthood.
⚫ During each stage, the person experiences a
psychosocial crisis that could positively or
negatively affect personality development.
⚫ For Erikson (1958, 1963), these crises are
psychosocial because they involve the
psychological needs of the individual (i.e.,
psycho) conflicting with the needs of society
(i.e., social).
 Continue
….
⚫ According to the theory, successful
completion of each stage results in a healthy
personality and the acquisition of basic
virtues.
⚫ Failure to complete a stage can result in a
reduced ability to complete further stages
and, therefore, a more unhealthy personality
and sense of self. These stages, however, can
be resolved successfully at a later time.
 Psychosocial
Dilemma
⚫ A conflict betweenpersonal impulse and
social impulse.
⚫ There is a conflict at each stage of
development that must be addressed.
⚫ How the conflictis managed
ultimately shape an individual’s personality.
 Erick Erikson's
Psychosocial
Dilemma
Eight Stages:
1. Trust vs. Mistrust [1st year]
2. Autonomy vs. Shame and Doubt [2-
3]
3. Initiative vs. Guilt [3-6]
4. Industry vs. Inferiority [6-12]
5. Identity vs. Rôle Confusion [12-18]
6. Intimacy vs. Isolation [Young
Adulthood]
7. Generativity vs. Stagnation [Middle
Age]
Stage 1: Trust vs. Mistrust (1st year
of Life)
⚫ Interaction with the mother.
⚫ A stage that depends on predictability and on
love & nurturance.
⚫ Children are completely dependent on others
during the first stage of life.
⚫ A basic attitude of trust (Established when babies
are given adequate warmth, touching, love, and
physical care--encouraged by the same
conditions that help babies become securely
attached to their parents) or mistrust is formed
at this time.
⚫ Mistrust is caused by inadequate or
unpredictable care and by parents who are cold,
indifferent, or rejecting.
 Stage 2: Autonomy vs. Shame and Doubt
(1 to 3 years)

⚫ Interaction with parents.

⚫ With a solid base of predictability, child moves
out to develop physically and emotionally,
and to become autonomous.
⚫ Parents provide a safe environment in
which they can have confidence in child's
ability to explore, and let go--and child needs
to know that the parents are there and that it
may return to stable place they trust.
⚫ This is where self-esteem begins.
 Con
…
⚫ This is where most language development
begins-- cognitive activity.
⚫ And real mixed messages.
⚫ "No" means they have autonomy, some
control, but may mean "yes".
⚫ A child will internalize expressions of
doubts from others.
⚫ Children's growing self-control is expressed
by climbing, touching, exploring, and a
general desire to do things for themselves.
 Con
…
⚫ Parents help foster a sense of autonomy by
encouraging children to try new skills.
⚫ Parents who ridicule their children (spilling,
falling, wetting, and other "accidents" often
result from child's crude efforts) or
overprotect them, may cause them to feel
shame and to doubt their abilities.
 Stage 3: Initiative Vs. Guilt(3 to 5
years)
⚫ Interaction with peers, pre-school.
⚫ Goal directed.
⚫ Feedback of others is a key.
⚫ Goals need to be reinforced and valued by
others.
⚫ More purposeful action, more complex,
self- direction.
⚫ Adults must gage ways to facilitate and not
stifle this important period of play activity.
⚫ The child moves from simple self-controlto
an ability to take initiative.
 Con.
.
⚫ Learns through play to plan and to undertake,
and carry out, a task.
⚫ Parents reinforce initiative by giving the child
the freedom to play, to ask questions, to use
imagination, and to choose activities.
⚫ Otherwise - if criticized severely, or prevented
from play, or discouraged - child may learn to
feel guilty about the activities s/he initiates.
 Stage Four: Industry vs.
Inferiority (6-12
Years)
⚫ Interaction at School.
⚫ Work. Responsibility.
⚫ Externally imposed structure inters in--external
expectations. Important to reinforce effort --
individual effort, not just excellence.
⚫ Acknowledgment that the child tried.
⚫ Many of the events of middle childhood are
symbolized by that fateful day when you first
entered school.
⚫ With dizzying speed your world expanded
beyond your family, and you faced a whole
series of new challenges.
 Con
…
⚫ For the first time teachers, classmates, and
adults outside the home become as important
as parents in shaping attitudes toward
oneself.

⚫ In school, children begin to learn skills

valued by society, and success or failure can
have lasting effects on their feelings of
adequacy.
 Con
…
⚫ Children learn a sense of industry if they
win praise for building, painting, cooking,
reading, studying, and other productive
activities.

⚫ If a child's efforts are regarded as messy,

childish, or inadequate, feeling of inferiority
result.
 Stage Five: Identity Versus
Role
Confusion(Adolescence)
⚫ Interaction with Peers.
⚫ The only people who count are the peers.
⚫ Transition into adulthood.
⚫ Physiological evolution--hormone storm.
⚫ The challenge of social issues and
time when there are biggest risks and
biggest price.
 Con
…
⚫ Adolescence is a turbulent time for many
persons in our culture.
⚫ Caught between childhood and adulthood, the
adolescent faces some unique problems.
⚫ Erikson considers a need to answer the
question, "Who am I?" the primary task
during this stage of life.
 Con
…
⚫ Mental and physical maturation brings
to the individual new feelings, a new
body, and new attitudes.
⚫ The adolescent must build a consistent
identity out of self-perceptions and
relationships with others.
 Con
…
⚫ Conflicting experiences as a student, friend,
athlete, worker, son or daughter, lover, and
so forth, must be integrated into a unified
sense of self.
⚫ According to Erikson, persons who fail to
develop a sense of identity suffer from role
confusion, an uncertainty about who they
are and where they are going.
 Stage Six: Intimacy Versus
Isolation (Young
Adulthood)
⚫ Individual experiences a need to achieve an
essential quality of intimacy (an ability to
care about others and to share experiences
with them)in his or her life.

⚫ After establishing a stable identity, a person is

prepared to share meaningful love or deep
friendship with others.
 Con
…
⚫ 75% of college-age men and women rank a
good marriage and family life as their
primary adult goal (Bachman & Johnson,
1979).

⚫ And yet, marriage or sexual involvement is

no guarantee that intimacy will prevail:
Many adult relationships remain superficial
and unfulfilling.
 Con
…
⚫ Failure to establish intimacy with others
leads to a deep sense of isolation.
⚫ The person feels alone and uncared for in
life.
⚫ This circumstance often sets the stage
for later difficulties.
 Stage Seven: Generativity Versus
Stagnation (Middle
Adulthood)
⚫ According to Erikson, an interest in guiding
the next generation is the main source of
balance in mature adulthood.
⚫ This quality, called generativity, is
expressed by caring about oneself, one's
children, and the future.
 Con
…
⚫ Generativity may be achieved by guiding
one's own children or by helping other
children (as a teacher, clergyman, or coach,
for example).
⚫ It may also be achieved through productive
or creative work.
 Con
…
⚫ In any case, a person's concern and energies
must be broadened to include the welfare
of others and of society as a whole .
⚫ Failure in this is marked by a stagnant
concern with one's own needs and comforts.
⚫ Life loses meaning, and the person feels
bitter, dreary, and trapped.
 Stage Eight: Integrity Versus
Despair (Late Adulthood)
⚫ Because old age is a time of reflection, a
person must be able to look back over the
events of a lifetime with a sense of
acceptance and satisfaction.
⚫ According to Erikson, the previous seven
stages of life become the basis for
successful aging.
 Con
…
⚫ The person who has lived richly and
responsibly develops a sense of integrity.
⚫ This allows the person to face aging and
death with dignity.
⚫ If previous life events are viewed with
regret, the elderly person falls into
despair.
 Con.
.
⚫ In this case, there is a feeling that life has
been a series of missed opportunities, that
one has failed, and that it is to late to
reverse what has been done.
⚫ Aging and the threat of death then become
a source of fear and depression.
 Types of psychosocial
issues:
⚫ Depression and anxiety
⚫ Grief
⚫ Financial issues and
insurance
⚫ Substance abuse
⚫ Loss of independence
⚫ Crime
⚫ Neglect
⚫ Social isolation
⚫ Negative coping behavior
⚫ Mentally disturb
⚫ Mistrust
 Psychosocial
Support(Care)
⚫ Psychosocial support is a scale of care
and support which influences both the
individual and the social environment in
which people live and ranges from care and
support offered by caregivers, family
members, friends, neighbor's,
teachers, health workers, and
community members on a daily
basis but also extends to care and support
offered by specialized psychological and
social services.
 Con
…
⚫ According to National Disaster
Authority Management psychosocial
,
disaster refers tocare in the context
comprehensive of
intervention
aimed at addressing a wide range of
psychosocial mental health problems arising
in the aftermath of disaster(NDMA)
 Importance of psychosocial care in
disaster context

⚫ Preventing long term psychiatrics

disorders in disaster affected society
⚫ Providing relief from mental
suffering and psychological distress
⚫ Provide positive mental health
⚫ Strengthening social support
network
⚫ Maintain mental well-being and
equilibrium
 Need for psychosocial
care
⚫ Strengthens resilience
⚫ Alleviates psychological stress
⚫ Mitigate effect of trauma
⚫ Re established normal development
process
Human Needs Pyramids(Maslow
Pyramid)

⚫The basis for all psychological support is

the pyramid of interventions in
emergencies, which is
primarily based upon human
needs pyramids(Maslow
Pyramid)
 Five level of Maslow
pyramids:
1. Physiological needs are biological
requirements for human survival, e.g., air, food,
drink, shelter, clothing, warmth, sex, and sleep.
2. Safety needs – people want to experience order,
predictability, and control in their lives.
3. Love and belongingness needs refers to a human
emotional need for interpersonal relationships,
affiliating, connectedness, and being part of a
group.
4. Esteem needs are the fourth level in Maslow’s
hierarchy and include self-worth, accomplishment,
and respect
5. Self-actualization needs are the highest level in
Maslow’s hierarchy, and refer to the realization of a
person’s potential, self-fulfillment, seeking personal
growth, and peak experiences.
 What is Psychological First
Aid?
⚫ Psychological First Aid (PFA) is a psychosocial
support tool that is used to help people
affected by an emergency, disaster, or
distressing event.
⚫ It is supportive humane tool that helps a
person in distress to feel heard, accepted,
enabled to manage his/her distress and to
get practical support.
 Aims
:
It aims to help people in:
⚫ Feeling safe, calm, connected and hopeful.
⚫ Accessing social, emotional and physical
support.
⚫ Feeling able to help themselves and others.
⚫ Helping them make sense of the
distressing situation
⚫ Reducing the risk that short-term
distress leads to longer-term mental health
issues
 Why is PFA
Important?
⚫ Psychological First Aid helps a person in
distress feel calm, safe, and secure.
⚫ Psychologic Firs Aid is rooted
al t in the
overwhelming
understandi experiences
tha there in life
are can
interfere
ng with at person’s
timesability to cope.
when
⚫ Thus, a person may struggle with responding
to distress and managing themselves, this is
where active listening and calm talking from
a helper is required to stabilize the person.
 For Whom(Who are exposed to
disaster)
⚫ Children
⚫ Adolescen
ts
⚫ Parents
⚫ Caretaker
s
⚫ Families
⚫ Adults
 Who delivers
it?
⚫ Mental health
workers
⚫ Nurses
⚫ Doctors
⚫ Other staff
members
 When and Where should it be
used?
⚫ In the immediate aftermath of
disaster
DIVERSE SETTINGS INCLUDES:
1. General shelter, special needs
shelter
2. Field hospital and medical triage
areas
3. Assistance centers
4. Feeding area
 General guidelines
(In delivering psychosocial care)

Professional behavior
⚫ Operate within framework of authorized
disaster response system
⚫ Model healthy response
(Calm,organized,helpful)
⚫ Be visible and available
⚫ Maintain confidentiality
 Con
…
⚫ Be polite, observe first , don’t intrude.
⚫ Initiate contact only after you have
observed the situation and the person or
the family.
⚫ Client will either avoid you with contact
⚫ Speak calmly
⚫ Speak slowly in simple and concrete
terms
⚫ Don’t use acronym
⚫ If clients wants to talk ,be prepare to
listen.
 Con
…
⚫ Remain with in your scope of practice
⚫ Referred if needed
⚫ Be cultural sensitive
⚫ Be self aware of own physical and
emotional reactions and practice self
care
 Dos and Don’ts of Psychological
First Aid

DO’S DON’T’S

Be honest and trustworthy Don’t exploit your relationship as

helper
Behave appropriately by considering Don’t force help on people, and
the don’t be
person’s culture, age and gender intrusive or pushy
Respect people’s right to make Don’t interrupt or rush someone’s
their own decisions story (e.g., don’t look at your
watch or speak too rapidly)
Provide information if you have it. Don’t share other people’s stories
Be honest about what you know
and don’t know and how you will
Follow up. “I don’t know, but I will
try to find out about that for you”.
 Core Elements of Psychological
First Aid
⚫ There are four basic sets of actions or core
elements that guide the PFA – Prepare,
Look, Listen, and Link.
⚫ These core elements define the entire
process of PFA that includes: identifying who
requires assistance (Look), listening to the
concerns and difficulties of the person
(Listen), and connecting them to sources of
information and practical help as per their
needs (Link).
Providing Psychological First Aid to
Children
⚫ PFA for children follows the same principles
as for adults, there are some key differences,
and some additional or adjusted actions that
may be required.

⚫ PFA for children not only involves providing

support to children but also providing
additional support to parents/caregivers
during and in the aftermaths of crisis, so that
they can cope better themselves and support
their children.
Approaches to Erikson’s psychosocial
Dilemma of Life Cycle
 Psychosocial Aspects of Critical
Care(Nursing)
1. Scope of critical care nursing practice:
a. The scope of practice for acute and critical
care nursing is defined by the dynamic
interaction of the acutely and critically ill
care nurse
patient, the and
acutethe
or critical car environmen
health
(American Critical-Care
e t”
Association
[AACN], of Nurses
2000)
Complexity of the psychosocial
needs of critically ill patients and
their families:
 Patient And Family Psychosocial
Assessment

1. Nursing history:
a. Patient History:

i. Identify preexisting psychiatric, psychological, and social

problems

ii. Identify coping mechanisms

[Link] sources of support (e.g., family, friends, spiritual

support, pets)

[Link] patient proxy, living will, durable power of

attorney, and so on
 Con
…
b. Family history:

Family assessment data obtained on admission or as soon

as possible

i. Health care proxy or family spokesperson

[Link] information (e.g., home and cell phone

numbers, pager numbers)

[Link] issues (culture, language, etc.) that affect the

patient and family

iv. Coping strategies

v. Family caregivers
 Con
…
[Link] systems (family, friends, church
group, other spiritual support)

[Link] family needs (e.g., young children,

handicaps, etc.)

[Link] concerns regarding this

hospitalization

ix. Best time for family to visit the patient

[Link] method of meeting and communicating

with intensive care unit (ICU) team members (e.g.,
participation in scheduled ICU rounds, scheduled
evening meetings, phone calls)
 Con
…
2. Nursing examination of
patient:
a. Physical examination

[Link] assessment (e.g., ability to concentrate,

level of judgment, presence of confusion)

[Link] assessment (sleep patterns, level of

agitation, interaction with family and staff)

[Link] of findings from other diagnostic studies

(e.g., computed tomographic [CT] scan,
electroencephalogram [EEG], etc.)
 Con
…
3. Appraisal of
patient
characteristics:
Almost all patients with a critical illness
experience some psychosocial issues during
the course of their illness.
However, each patient and family is unique
and brings a unique set of characteristics to
the care situation (Hardin and Kaplow, 2005).
 Con
…
4. Diagnostic
studies

a. Laboratory studies

b. EEG

[Link] blood flow

studies
Psychosocial care issues and their
Interventions
[Link]:

⚫ Perceived lack of control over the outcome

of a specific situation. The ability of an event
to engender a sense of powerlessness is
influenced by the individual’s self-esteem and
self-concept and where the individual is in
the life cycle.
 Signs and
symptoms:

(a) Withdrawal

(b) Aggressive behavior

(c) Demanding behavior

(d) Excessive repetition of the same

questions

(e) Placing of unrealistic demands on the

staff

(f) Blaming of the staff for the patient’s

condition
 Goals of
care:

⚫ i. Patient communicates needs and wishes

verbally or nonverbally

⚫ ii. Patient (and family as appropriate)

participates in decision making regarding
the plan of care

⚫ iii. Patient and family members do not

demonstrate signs of dysfunction associated
with powerlessness
Collaborating professionals on health
care team:
⚫ i. Nurse

⚫ ii. Physician

⚫ iii. Respiratory
therapist

⚫ iv. Physical therapist

⚫ v. Social worker

⚫ vi. Clergy

⚫ vii. Case manager

 Intervention
s:

i. Promote patient-nurse communication

⚫ (a) This intervention presents significant

challenges, particularly if the patient is intubated
or speaks a language other than English (or the
predominant language at the facility)

⚫ (b) Methods of communication should be based on

patient preferences and abilities. Common
communication techniques for use with intubated
patients include lip reading, picture or alphabet
boards, pen or pencil and paper, and computer.
 Con
…
⚫ (c) Utilize available interpreter services
for non– English speaking patients and
family members

⚫ (d) Enlist help from family members and

volunteers in the communication process
 Con
…
ii. Involve the patient and family in the
care planning process and decision
making

⚫ (a) Ask the patient (or health care proxy) what level
of involvement he or she would like in the care
planning process

⚫ (b) Encourage the patient and family members to

keep a
record of questions and concerns

⚫ (c) Provide the patient, proxy, or a family member

with daily (or more frequent) updates regarding the
 Con
…
⚫ [Link] the patient and family
members to meet with spiritual support
persons if they would find this helpful

⚫ iv. Prepare the patient for procedures:

Explain what will be happening, when it will
happen, and how the patient will be affected
 2. Sleep
deprivation:

Sleep deprivation in the critically ill patient

involves a decrease in the amount,
consistency, and/or quality of sleep that
occurs in a 24-hour period.

⚫ Sleep fragmentation occurs when the

patient fails to complete a 90-minute average
sleep cycle that includes both rapid eye
movement and non–rapid eye movement
sleep (Gawlinski and Hamwi, 1999).
 Sign and
symptoms:
(a) Altered mental status (e.g., confusion,
delusions)

(b) Decreased alertness

(c) Irritability

(d) Aggressive behavior

(e) Restlessness

(f) Anxiety

(g)Exhaustion
 Goals of
care

⚫ i. Patient has at least two 90-minute periods

of sleep in a 24-hour period

⚫ ii. Patient states that he or she feels rested

 Collaborating professionals on health
care team

⚫ i. Nurse

⚫ ii. Physician

⚫ iii. Pharmacist

⚫ iv. Respiratory
therapist
 Intervention
s:

⚫ i. Attempt to provide at least two 90-minute

periods of uninterrupted sleep in a 24-hour
period

⚫ ii. Cluster activities so that the patient is

allowed periods of rest

⚫ iii. Prioritize activities to allow a stable

patient to have periods without
unnecessary, frequent assessments
 Con
…
⚫ iv. Decrease the noise level to promote
sleep

⚫ v. Decrease overhead lighting to

promote sleep

⚫ vi. Provide adequate pain relief

⚫ vii. Teach the patient and family

relaxation techniques to promote
rest and sleep
 Con
…
⚫ viii. Administer pharmacologic
agents as needed to promote sleep
(e.g., benzodiazepines,
diphenhydramine). Note: Long-term use
of benzodiazepines can abolish stage IV
sleep.

⚫ ix. Consult with a pharmacist regarding the

best drug choices for promoting sleep,
particularly for high- risk populations such as
the elderly
 Evaluation of patient
care

⚫ i. Patient does not demonstrate signs or

symptoms of sleep deprivation

⚫ ii. Patient states that he or she feels rested

 3. Grief and
loss:

The grief reaction is the emotional response to

a loss in which something valued is changed or
altered so that it no longer has its previously
valued traits (Gawlinski and Hamwi, 1999).
 Con
…
⚫ i. Grief can be experienced during a critical
illness by both the patient and family
members

⚫ ii. Grief may result from loss (or potential

loss) of health, body image, role, and
financial security

⚫ iii. Family members experience grief

related to a patient’s death or in
anticipation of death or potential death
 Con
…
⚫ iv. Degree of grief experienced is related to
the meaning of the loss to the individual, the
adequacy of coping responses, and the
availability of support systems

⚫ v. Expressions of grief have wide variation

and are culturally determined
 Goals of
care:

⚫ i. Patient and family express feelings of grief

and loss (if they choose)

⚫ ii. Patient and family are able to state the

prognosis and current plan of care
 Collaborating professionals on health
care team

⚫ i. Nurse

⚫ ii. Clergy

⚫ iii. Social
worker

⚫ iv. Physician
 Intervention
s:
⚫ i. Appreciate cultural variation in expressions
of grief

⚫ ii. Allow the patient and family members to

express grief in their own way

⚫ iii. Provide privacy for family members and

patients
⚫ iv. Provide ongoing, honest information to the
patient and family regarding the patient’s
illness and expected recovery

⚫ v. Provide the patient and family with

teaching regarding the normal grief
response
 Evaluation of patient
care:
Patient and family express grief in a
culturally appropriate way.
 Anxiety
disorders:
It is characterized by persistent feelings of fear,
worry, or unease. Common types of anxiety
disorders include generalized anxiety disorder,
panic disorder, social anxiety disorder, and
specific phobias.
 Signs and
symptoms
⚫ Excessive worry or fear about everyday situations
or objects

⚫ Panic attacks (sudden and intense feelings of fear

or terror)

⚫ Avoidance of certain situations or objects

⚫ Difficulty concentrating or focusing on tasks

⚫ Muscle tension or physical symptoms such as

sweating, trembling, or rapid heartbeat

⚫ Irritability or restlessness
 Preventative
measures
⚫ Practice stress management techniques such
as mindfulness, meditation, or deep
breathing exercises

⚫ Maintain a healthy lifestyle with regular

exercise, a balanced diet, and adequate
sleep

⚫ Limit or avoid caffeine and alcohol, which can

exacerbate symptoms

⚫ Avoid or limit exposure to stressful situations or

triggers when possible
 Treatment
options
⚫ Therapy: Cognitive-behavioral therapy (CBT)
is a common form of therapy used to treat
anxiety disorders. CBT helps individuals
identify and change negative thought
patterns and behaviors that contribute to
anxiety symptoms.

⚫ Medications: Antidepressants, such as

selective serotonin reuptake inhibitors
(SSRIs), are commonly used to treat anxiety
disorders. Other medications, such as
benzodiazepines, may be prescribed for
short-term relief of symptoms.
 Con
…
⚫ Self-help strategies: In addition to seeking
professional help, individuals with anxiety
disorders may benefit from self-help strategies
such as exercise, relaxation techniques, and
support from friends and family.

⚫ It is important to note that treatment for anxiety

disorders can be highly individualized and may
involve a combination of different approaches.
Seeking professional help from a mental health
provider is the best way to determine an
appropriate treatment plan.
 Depressio
n:
Depression is a mental health disorder
characterized by persistent sadness, loss of
interest in activities, changes in appetite,
sleep disturbances, fatigue, feelings of guilt
or worthlessness, difficulty concentrating,
and thoughts of death or suicide.
 Signs and
symptoms
⚫ Persistent sadness, anxiousness, or
feelings of emptiness

⚫ Loss of interest or pleasure in activities

that were once enjoyed

⚫ Difficulty sleeping or oversleeping

⚫ Fatigue or decreased energy

 Con
…
⚫ Changes in appetite and weight

⚫ Difficulty concentrating, making

decisions, or remembering

⚫ Feelings of hopelessness, guilt, or

worthlessness

⚫ Recurrent thoughts of death, suicide, or

suicide attempts
 Preventio
ns
⚫ Regular exercise

⚫ Healthy diet

⚫ Adequate sleep

⚫ Limiting alcohol and drug use

⚫ Managing stress

⚫ Staying connected with family and

friends

⚫ Seeking professional help if needed

 Treatmen
ts
⚫ Therapy: Talking with a mental health
professional can help to identify and address
the underlying causes of depression, and
learn coping skills to manage symptoms.

⚫ Medication: Antidepressant medications,

such as selective serotonin reuptake
inhibitors (SSRIs), can help to regulate the
brain chemicals that affect mood.
 Con
…
⚫ Self-care: Engage in activities that bring
pleasure or relaxation, such as exercise,
yoga, meditation, or hobbies.

⚫ Support groups: Connecting with others

who have experienced depression can
provide emotional support and help to
reduce feelings of isolation.
 Obsessive-compulsive disorder
(OCD)
⚫ OCD is a disorder characterized by
recurrent, unwanted thoughts or
obsessions and repetitive behaviors or
compulsions that are performed in an
attempt to relieve anxiety or distress.
 Signs and symptoms of
OCD
⚫ Obsessive thoughts about germs, contamination,
or harm to self or others

⚫ A need for symmetry or orderliness in everyday

life

⚫ Compulsive behaviors such as repeated hand-

washing, checking and rechecking things, or
counting

⚫ A sense of anxiety or distress when compulsions

are not performed
 Preventive measures for
OCD
⚫ There is no surefire way to prevent OCD, but
early intervention and treatment can help
manage symptoms and prevent the condition
from becoming more severe.

⚫ Stress management techniques such as

meditation, yoga, or deep breathing
exercises may also help reduce anxiety
levels and prevent obsessive thoughts from
taking hold.
 Treatments for
OCD
⚫ Therapy: Cognitive-behavioral therapy (CBT)
is the most effective treatment for OCD. It
involves identifying and changing unhealthy
thought patterns and behaviors that
contribute to OCD symptoms.
⚫ Exposure and response prevention (ERP) is a
specific form of CBT that involves gradually
exposing patients to their obsessions and
teaching them to resist the urge to perform
compulsive behaviors.
 Con
…
⚫ Medications: Certain antidepressants,
particularly selective serotonin reuptake
inhibitors (SSRIs), have been shown to be
effective in treating OCD. Other
medications, such as antipsychotics, may be
used in conjunction with SSRIs for more
severe cases.
 Con
…
⚫ Deep brain stimulation (DBS): For severe
cases, a neurosurgical procedure called deep
brain stimulation (DBS) may be an option.
This involves implanting electrodes in the
brain that stimulate specific areas involved
in OCD.
 Schizophreni
a:
⚫ Schizophrenia is a severe mental illness
characterized by disordered thinking,
emotions, and behaviors.
⚫ It is a chronic condition that typically begins
in the late teenage years or early adulthood,
and it can have a profound impact on a
person’s ability to function in daily life.
 signs and symptoms of
schizophrenia
⚫ Delusions: False beliefs that are not
based in reality, such as thinking that
someone is trying to harm you or that you
have special powers.

⚫ Hallucinations: Seeing, hearing, or feeling

things that are not real, such as hearing
voices or seeing people that are not there.

⚫ Disordered thinking: Difficulty

organizing thoughts or making logical
connections between ideas.
 Con
…
⚫ Social withdrawal: A tendency to isolate
oneself and avoid social situations.

⚫ Lack of motivation: A decrease in the

ability to initiate and sustain activities or
to experience pleasure.

⚫ Emotional blunting: A decrease in the

range and intensity of emotions expressed.
 Preventio
n:
⚫ Avoiding or managing stress: Chronic
stress can be a risk factor for schizophrenia,
so managing stress through healthy coping
mechanisms such as exercise, meditation, or
therapy can be helpful.

⚫ Avoiding substance abuse: Substance

abuse, especially during adolescence, can
increase the risk of developing
schizophrenia.
⚫ Early detection and treatment:
Identifying and treating the symptoms of
schizophrenia as early as possible can lead
to better outcomes and reduce the severity
of symptoms.
 Treatment for
schizophrenia
⚫ It typically involves a combination of
medication, therapy, and support services.
Medications such as antipsychotics can
help reduce symptoms such as hallucinations
and delusions.
⚫ Therapy can include cognitive-behavioral
therapy or family therapy, which can help
patients develop coping skills and improve
communication with loved ones.
 Con
…
⚫ Support services such as case
management, vocational training, and
housing assistance can help individuals with
schizophrenia live independently and
improve their quality of life.
Coping skills and strategies for mental
conditions
⚫ Coping skills and strategies can be helpful for
individuals with mental health conditions to
manage their symptoms and improve their
overall well-being.
 Con
…
⚫ According to Mindt and Spaulding [16];
Dziegielewski, Silverman, here are some
coping skills and strategies that may be
helpful:
 COPING
STRATIGIES
⚫ Mindfulness meditation: Mindfulness
meditation can help individuals reduce
stress, anxiety, and depression symptoms. It
involves focusing on the present moment
and accepting one’s thoughts and feelings
without judgment.

⚫ Cognitive behavioral therapy (CBT): CBT

is a type of therapy that can help individuals
identify and change negative thought
patterns and behaviors that contribute to
mental health conditions.
 Con
…
⚫ Exercise: Regular exercise can help
improve mood and reduce symptoms of
anxiety and depression.

⚫ Social Support: Talking with friends, family

members, or a mental health professional can
provide emotional support and help
individuals cope with stress.
 Con
…
⚫ Self-care: Taking care of oneself by getting
enough sleep, eating a balanced diet, and
engaging in activities that bring joy can
help improve overall well-being.

⚫ Relaxation Techniques: Techniques such as

deep breathing, progressive muscle
relaxation, and guided imagery can help
reduce stress and anxiety.
 Con
…
⚫ Art Therapy: Art therapy can help
individuals express emotions and process
difficult experiences through creative
expression.

⚫ Medication: For some individuals,

medication prescribed by a mental health
professional can be an effective way to
manage symptoms of mental health
conditions.
 Conclusio
ns
⚫ Psychosocial care plays a vital role in
promoting the overall well-being and mental
health of individuals. It encompasses a range
of interventions and support services aimed
at addressing the psychological and social
aspects of a person’s life.
 key conclusions on psychosocial
care:
⚫ Holistic approach: Psychosocial care
takes a holistic approach to an individual’s
well-being, considering not only their
mental health but also their social,
emotional, and spiritual needs. It
recognizes the interconnectedness of these
factors and aims to provide
comprehensive support.
 Con
…
⚫ Mental health promotion: Psychosocial
care plays a significant role in promoting
mental health and preventing the
development or worsening of mental health
disorders. It emphasizes the importance of
early intervention, resilience-building, and
the development of coping strategies.
 Con
…
⚫ Trauma and crisis response: Psychosocial
care is essential in addressing the
psychological and emotional needs of
individuals who have experienced trauma
or crises. It helps individuals process their
experiences, manage distressing emotions,
and rebuild their lives.
 Con
…
⚫ Social support: Psychosocial care
recognizes the importance of social support
networks in promoting well-being. It involves
fostering social connections, building healthy
relationships, and providing opportunities
for community engagement, which can
enhance resilience and improve mental
health outcomes.
 Con
…
⚫ Cultural sensitivity: Effective
psychosocial care takes into account
cultural, social, and contextual factors. It
acknowledges the influence of cultural
beliefs, norms, and values on individuals’
mental health and tailors interventions
accordingly, ensuring cultural sensitivity
and respect.
 Con
…
⚫ Collaborative approach: Psychosocial care
involves collaboration among various
professionals, including psychologists,
social workers, counselors, and healthcare
providers. It emphasizes interdisciplinary
teamwork to provide comprehensive care
and support to individuals.
 Con
…
⚫ Long-term care: Psychosocial care
recognizes that mental health and
psychosocial needs may require ongoing
support. It promotes continuity of care and
ensures that individuals have access to
follow-up services and resources even after
the initial intervention.
 Con
…
⚫ Prevention and early intervention:
Psychosocial care emphasizes prevention
and early intervention strategies to address
mental health concerns before they
escalate. By promoting mental health
literacy, resilience-building, and early
identification of risk factors, it aims to
reduce the burden of mental health
disorders.
 Con
…
⚫ In conclusion, psychosocial care is an integral
part of promoting mental health and well-
being. Its holistic approach, focus on
prevention and early intervention, and
recognition of social support networks
contribute to better mental health outcomes
for individuals. Continual research and
practice advancements are essential to
further improve psychosocial care
approaches and ensure that individuals
receive the support they need.