Psychiatric Therapies

MSH College
Brgy. San Miguel, Iligan City

THERAPIES USED IN PSYCHIATRIC
MENTAL HEALTH NURSING
In partial Fulfillment of the Requirements
for the Degree BSN
Submitte by!
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TABLE OF CONTENTS
1 | P a g e T H E R A P I E S U S E D I N P S Y C H I AT R I C M E N T A L H E A LT H N U R S I N G
THERAPY: ASSERTIVENESS TRAINING .......................................................................................................................................................................................................... )
THERAPY: CRISIS INTERVENTION .............................................................................................................................................................................................................. *
THERAPY: BEHAVIOR MODIFICATION ................................................................................................................................................................................................ +
THERAPY: MILIEU THERAPY .............................................................................................................................................................................................................................. 11
THERAPY: THERAPEUTIC COMMUNITY .................................................................................................................................................................................................... '&
THERAPY: GROUP THERAPY ...................................................................................................................................................................................................................... ')
THERAPY: FAMILY THERAPY ............................................................................................................................................................................................................................. ',
THERAPY: MARITAL OR COUPLE THERAPY ..................................................................................................................................................................................... '*
THERAPY: INDIVIDUAL THERAPY............................................................................................................................................................................................................. &(
THERAPY: HYNOPSIS ........................................................................................................................................................................................................................................ &&
THERAPY: PLAY THERAPY .................................................................................................................................................................................................................................. &-
THERAPY: REALITY ORIENTATION THERAPY.................................................................................................................................................................................. &+
THERAPY: REALITY THERAPY........................................................................................................................................................................................................................... .&
THERAPY: RELAXATION THERAPY................................................................................................................................................................................................................ ./
THERAPY: REMINISCENCE THERAPY ...................................................................................................................................................................................................... )(
THERAPY: REMOTIVATION THERAPY ............................................................................................................................................................................................................. ).
THERAPY: SEX THERAPY .................................................................................................................................................................................................................................. ),
THERAPY: PAIN MANAGEMENT ....................................................................................................................................................................................................................... )+
THERAPY: MUSIC THERAPY ......................................................................................................................................................................................................................... -,
THERAPY: ART THERAPY .......................................................................................................................................................................................................................... -*
THERAPY: PSYCHODRAMA THERAPY ......................................................................................................................................................................................... ,(
THERAPY: DANCE THERAPY .................................................................................................................................................................................................. ,.
THERAPY: DANCE THERAPY ............................................................................................................................................................................................................................. ,.
THERAPY: ELECTROCONVULSIVE THERAPY ........................................................................................................................................................................................ ,-
THERAPY: INDOKLON INHALATION THERAPY ............................................................................................................................................................................... ,/
THERAPY: INSULINCOMA AND METRAZOLINDUCED CONVULSION THERAPY ............................................................................................................................/(
THERAPY: NARCOTHERAPY ........................................................................................................................................................................................................................ /&
THERAPY: PSYCHOSURGERY THERAPY ......................................................................................................................................................................................................... /.
THERAPY: RECREATIONAL THERAPY ............................................................................................................................................................................................................. /-
THERAPY PURPOSED/
OBJECTIVE
MATERIALS NEEDED INDICATION MECHANIC/PROCEDURE ADVANTAGES DISADVANTAGES
ASSERTIVENES
S TRAINING
0o ha1e self"
respe2t be2ause
integrity has been
uphel by
staning up for a
person3s o4n
rights 4ithout
abusing others
rights.
Clarify 4hat a
person 4ants an
e2iing if those
4ants are
teasible.
5oals neee to
be realisti2 an
a2hie1able 4ithin
a short perio of
time.
eye 2onta2t!
emonstrates interest,
sho4s sin2erity
boy posture!
2ongruent boy
language 4ill impro1e
the signifi2an2e of the
message
gestures! appropriate
gestures help to a
emphasis
1oi2e! a le1el, 4ell
moulate tone is more
2on1in2ing an
a22eptable, an is not
intimiating
timing! use your
6ugment to ma7imi8e
re2epti1ity an impa2t
2ontent! ho4, 4here
an 4hen you 2hoose
to 2omment is probably
more important than
9H:0 you say
0he importan2e of ;I;
statements
<art of being asserti1e
in1ol1es the ability to
=a2>ing the
ability to openly
or ire2tly
e7press your
emotions.
%7pressing your
opinion an then
4orrying
e72essi1ely
after4ar.
:greeing 4ith
others to a1oi
2onfli2t or
;ro2>ing the
boat?;
:1oiing @an
unable to as>
forA help from
others.
Silently 2arrying
a sa2> fille
4ith
resentments on
your ba2>.
'. 9hen approa2hing
someone about beha1ior
you3 li>e to see 2hange,
sti2> to fa2tual
es2riptions of 4hat
they31e one that3s upset
you, rather than labels or
6ugments.
Here3s an e7ample!
Situation!
Bour frien, 4ho
habitually arri1es late for
your plans, has sho4n up
t4enty minutes late for a
lun2h ate.
Inappropriate! ;Bou3re so
rueC Bou3re al4ays late.;
:sserti1e Communi2ation!
;9e 4ere suppose to
meet at ''!.(, but no4 it3s
''!-(.;
&. 0he same shoul be
one if es2ribing the
effe2ts of their beha1ior.
Don3t e7aggerate, label or
6ugeD 6ust es2ribe!
Inappropriate! ENo4 lun2h
is ruine.F
Feel better about
yourself
Feel more 2onfient
Feel more rela7e
Ha1e a greater
a4areness of your o4n
nees an ho4 to meet
them
Be able to 2reate
personal an
professional goals
instea of putting other
peopleGs nees or
4ishes first
Be able to 4or>
effe2ti1ely in
partnership 4ith others
<arti2ipate in honest,
2onstru2ti1e
relationships 4here you
an others 2an e1elop
unerstaning an
respe2t an sol1e
problems together
#thers may not
appro1e of this style of
2ommuni2ation, or
may not appro1e of the
1ie4s you e7press.
:lso, ha1ing a healthy
regar for another
personGs rights means
that you 4onGt al4ays
get 4hat B#H 4ant.
Bou may also fin out
that you 4ere 4rong
about a 1ie4point that
you hel. But most
importantly, as
mentione earlier, it
in1ol1es the ris> that
others may not
unerstan an
therefore not a22ept
this style of
2ommuni2ation.
appropriately e7press
your nees an
feelings. Bou 2an
a22omplish this by
using ;I; statements.
0hese ini2ate
o4nership, o not
attribute blame, fo2uses
on beha1ior, ientifies
the effe2t of beha1ior,
is ire2t an honest,
an 2ontributes to the
gro4th of your
relationship 4ith ea2h
other.
Strong ;I; statements
ha1e three spe2ifi2
elements!
:sserti1e Communi2ation!
ENo4 I ha1e less time to
spen lun2hing be2ause I
still nee to be ba2> to
4or> by 'pm.F
.. Hse EI MessagesF.
Simply put, if you start a
senten2e off 4ith EBouF, it
2omes off as more of a
6ugment or atta2>, an
puts people on the
efensi1e. If you start 4ith
EIF, the fo2us is more on
ho4 you are feeling an
ho4 you are affe2te by
their beha1ior. :lso, it
sho4s more o4nership of
your rea2tions, an less
blame.
For e7ample!
IBou Message3! EBou nee
to stop thatCF
II Message3! EI3 li>e it if
you3 stop that.F
). Here3s a great formula
that puts it all together!
E9hen you Jtheir
beha1iorK, I feel Jyour
feelingsK.F
9hen use 4ith fa2tual
statements, rather than
6ugments or labels, this
formula pro1ies a ire2t,
non"atta2>ing, more
responsible 4ay of letting
people >no4 ho4 their
beha1ior affe2ts you. For
e7ample!
E9hen you yell, I feel
atta2>e.F
-. : more a1an2e
1ariation of this formula
in2lues the results of their
beha1ior @again, put into
fa2tual termsA, an loo>s
li>e this!
E9hen you Jtheir
beha1iorK, then Jresults of
their beha1iorK, an I feel
Jho4 you feelK.F
Here are some e7amples!
E9hen you arri1e late, I
ha1e to 4ait, an I feel
frustrate.F
E9hen you tell the >is
they 2an o something that
I31e alreay forbien,
some of my authority as a
parent is ta>en a4ay, an I
feel unermine.F
THERAPY PURPOSED/
OBJECTIVE
CRISIS
INTERVENTION
0o help the 2lient
resol1e the problem
an return to his
pre2risis le1el of
fun2tioning or to a
higher le1el of
fun2tioning in a
short perio of time.
Boo>s an referen2es
0herapeuti2 approa2h
<lanne a2ti1ities
<eople 4ho
e7perien2e a
traumati2 e1ent
often be2ome 4orse
if they o not
re2ei1e help or
support.
'. Introu2tory remar>s! team
sets the tone an rules for the
is2ussion, en2ourages
parti2ipant 2ooperation.
&. Fa2t phase! parti2ipants
es2ribe 4hat happene uring
the in2ient.
.. 0hought phase! parti2ipants
state the first or main thoughts
4hile going through the
in2ient.
). Rea2tion phase! parti2ipants
is2uss the elements of the
situation that 4ere 4orst.
-. Symptom phase! parti2ipants
es2ribe the symptoms of
istress e7perien2e uring or
after the in2ient.
,. 0ea2hing phase! team
pro1ies information an
suggestions that 2an be use to
reu2e the impa2t of stress.
/. Re"entry phase! team
ans4ers parti2ipantsG questions
an ma>es summary 2omments.
: 2risis inter1ention
2ounselor 2an offer short"
term help to reu2e the
emotional, mental, an
physi2al impa2t that a 2risis
has on a person
Rea
Inability to fo2us on
one patient3s problems
L suggestions of
malaapti1e or
estru2ti1e 2oping
methos by group
members.
THERAPY PURPOSED/
OBJECTIVE
BEHAVIOR
MODIFICAT
ION
0o ientify the
beha1ior to be
2hange, moifie or
e1elope.
Determine in 4hi2h
settings the beha1ior
is eli2ite.
Determine ho4 the
beha1ior is
maintaine.
Ientify things that
2an be use as
positi1e reinfor2ers
@re4arA an things
that 2an be use as
negati1e reinfor2ers
@punishmentA
<rint the beha1ior
management
assessment 2harts an
obser1ation forms from
the Relate Sites for
help in assessing an
e1aluating patient
beha1ior.
Buy boo>s on beha1ior
moifi2ation plans an
systems so that you 4ill
ha1e a 1ariety of
methos from 4hi2h to
2hoose.
Consier a re4ar or
self"e1aluation system
to monitor an
reinfor2e stuent
beha1ior.
9hen using a re4ar
system, in2lue
instru2tions on ho4 to
appropriately e7press
feelings of frustration
an the nee for
attention.
:22ess the Relate
Chemi2al
Depenen2y @e.g
. 0oba22o abuseA
B:0H%
0e2hnique
0herapy an 2onsultation
2annot be effe2ti1e unless the
beha1iors to be 2hange are
unerstoo 4ithin a spe2ifi2
2onte7t. 0he pro2ess of
unerstaning beha1ior in
2onte7t is 2alle
FUNCTIONAL
BEHAVIORAL
ASSESSMENT. 0herefore, a
fun2tional beha1ioral
assessment is neee before
performing beha1ior
moifi2ation. #ne of the most
simple yet effe2ti1e methos of
fun2tional beha1ioral
assessment is 2alle the
"ABC" !!"#$%, 4here
obser1ations are mae
on A&'($()(&'*+ B(%,-#"*+
&) C#&*(./(&$(*. In other
4ors, ;9hat 2omes ire2tly
before the beha1ior?;, ;9hat
oes the beha1ior loo> li>e?;,
an ;9hat 2omes ire2tly after
the beha1ior?; #n2e enough
obser1ations are mae, the ata
are analy8e an patterns are
R(0") S1*'(2
States that 4hen oing
beha1ior moifi2ation, a
Re4ar system is use
4here the patient re2ei1es
tangible re4ars for
positi1e beha1iors.
L("&()
C#&*(./(&$(*
0he patient also learns
2onsequen2es 4hen he a2ts
inappropriately, 4hi2h
is2ourages the negati1e
beha1ior. 0his 2an be an
important lesson for the
2hil, espe2ially if he i
not re2ei1e any
2onsequen2es for his
beha1iors before the
therapy began.
I2!"#,(2(&' #3
B(%,-#" &)
E2#'-#&*
0he o1erall benefit of
beha1ior moifi2ation is an
Diffi2ulty 4ith
reasoning, thin>ing or
logi2
M Diffi2ulty 4ith
fo2using an paying
attention
M Slo4er at responing,
rea2ting an
2ompleting tas>s
M Inappropriate so2ial
beha1iors
M Diffi2ulty
remembering
M <hysi2al limitations
M Diffi2ulty learning
M #ften 2onfuse 4ith
4or> that is in their
grae le1el
M Some 4ill ha1e
language an spee2h
problems
Sites for a more
etaile e7planation
ientifie. If there are
2onsistent ante2eents anNor
2onsequen2es, an inter1ention
shoul target those to in2rease
or e2rease the target beha1ior.
0his metho forms the 2ore
of positi1e beha1ior support for
s2hool2hilren in both regular
an spe2ial eu2ation.
impro1ement of beha1ior.
<ositi1e beha1iors are
introu2e, taught an
reinfor2e through a re4ar
system.
Inappropriate beha1iors are
is2ourage by not
re4aring them, an by
tea2hing 2onsequen2es.
0his helps the patient
fun2tion normally an learn
that a2ting out is not
a22eptable. Beha1ior
moifi2ation 2an also help
impro1e emotional
responses, su2h as helping
the patient get o1er a
spe2ifi2 fear.
THERAPY PURPOSED/
OBJECTIVE
MILIEU
THERAPY
0o in2rease responsibility
for therapy on the part of
both 2lient an staff. 0his
is best a2hie1e through a
2ons2iously in2orporate
plan. Hltimately, 2lient
autonomy is the goal.
<lanne a2ti1ities.
O an : for the
spe2ifi2 2lient3s
problems.
=a2>ing the ability
to openly or ire2tly
e7press your
emotions.
=a2> of positi1e
so2ial support an
mental health
problems @e.g.,
epression, an7iety,
posttraumati2 stress
isorer, an
antiso2ial an other
personality
isorersA.
D-*'"-4/'-#& #3 !#0("
0he milieu therapy
approa2h in1ol1es
EflatteningF the 2ontrol
hierar2hy so all
parti2ipants ha1e a
1oi2e in e2ision
ma>ing.
O!(& $#22/&-$'-#&!
:lthough the
importan2e of open
2ommuni2ation has
been 4iely re2ogni8e
in literature, it is still
not a reality in many
settings.
Milieu therapy 2reates a
ifferent type of attitue
an beha1iour in the patient
be2ause the en1ironment is
li>e home.
Instea of aopting a si2>
role, the patient ma>es
e2isions in the 4ar
management an 2ares for
other patients. In other
4ors, he be2omes less
epenent an passi1e.
0he patient learns to aopt
a beha1iour 4hi2h is
a22eptable in the
therapeuti2 en1ironment
li>e learns to 2ontrol
hostility.
0he patient learns to ma>e
e2isions 4hi2h impro1e
his self 2onfien2e.
Milieu in2lues safe
physi2al surrounings, al
the treatment team
Role blurring
bet4een staff an
patient.
5roup
responsibility 2an
easily be2ome
noboy3s
responsibility.
Ini1iual nees
an 2on2erns may
not be met.
<atient may fin
the transition to
2ommunity
iffi2ult.
Milieu therapy is
S'"/$'/"() -&'("$'-#&*
P.: Menninger
pioneere the 2on2ept
of stru2ture intera2tion
patterns in the form of
attitue therapy.
5#"6 "(7'() $'-,-'-(*:
9or> uner realisti2
2ir2umstan2es an for
appropriate re4ars is probably
the best 2entral a2ti1ity for all
2lients. Se1eral fa2tors
2ontribute to effe2ti1e 4or>
therapy programs.
C#22/&-'1 &) 32-71
-&,#7,(2(&':
:s a result of more
effe2ti1e mei2ations
an humane treatment
philosophies,
2ommunity mental
health 2enters emerge.
A)!''-#& #3 '%(
(&,-"#&2(&' '# 2((' '%(
members, an other 2lients,
4hi2h is supporte by 2lear
an 2onsistently maintaine
limits an beha1ioural
e7pe2tations.
: therapeuti2 milieu is a
safe spa2e, a non puniti1e
atmosphere, 4hi2h
minimi8e the en1ironmental
stress an pro1ies a
2han2e for rest an
nurturan2e of self, a time to
fo2us on the e1elopments
of strengths, an an
opportunity to learn to
ientify alternati1es or
solutions to problems an
to learn about the
psy2hoynami2s of those
problems.
<atient e1elops
harmonious relationships
4ith other members of the
2ommunity.
De1elops leaership s>ills.
Be2omes so2io 2entri2.
=earns to li1e an thin>
2olle2ti1ely 4ith the
members of the 2ommunity.
limite to only
hospitali8e
patients.
Confli2t
resolution is
neee as part of
the staff3s s>ills.
=o4 2lient" to"
staff ratio.
Requires
2ontinuous open
2ommuni2ation
among all staff
an 2lients.
)(,(7#!2(&'7 &(()*:
0o e1elop his full
potential an ini1iual
must ha1e an
en1ironment aapte to
his 2urrent nees.
THERAPY PURPOSED/
OBJECTIVE
THERAPEUTIC
COMMUNITY
0o fa2ilitate so2ial
learning by
en2ouraging staff
an 2lient to
2onfront one
another about their
beha1ior.
Trainers Manual,
participants Manual that
2an be photo2opie for ea2h
training parti2ipant, an
moule <o4er<oint
presentations. 0he
<o4er<oint slies also 2an
be printe an 2opie onto
o1erhea transparen2ies.
Multiple rug
ai2tions,
in1ol1ement 4ith
the 2riminal 6usti2e
system.
=a2> of positi1e
so2ial support an
mental health
problems @e.g.,
epression, an7iety,
posttraumati2 stress
isorer, an
antiso2ial an other
personality
isorersA.
TC '"('2(&' $& 4( )-,-)()
-&'# '%"(( 28#" *'9(*
S'9( 1.
I&)/$'-#& &) ("71
'"('2(&'! 0his phase typi2ally
o22urs uring the first .( ays
to assimilate the ini1iual into
the 0C.
S'9( :.
P"-2"1 '"('2(&t
In <hase t4o the resient is
e7pe2te to ta>e on more
<atient e1elops
harmonious
relationships 4ith other
members of the
2ommunity
5ains self Q2onfien2e
De1elops leaership
s>ills
=earns to unerstan
an sol1e problems of
self an others
Role blurring
bet4een staff an
patient
5roup
responsibility 2an
easily be2ome
noboy3s
responsibility
Ini1iual nees
an 2on2erns may
not be met
<atient fin the
transition to
responsibility for the 4elfare of
others, parti2ularly ne42omers.
S'9( ;
%ntry into phase three normally
begins 4hen the resient has
applie for, an has been
a22epte to train in a 1o2ational
area on a full"time basis, 4ith
the intention of 2ompleting a
2ertifi2ate in the program or
trae, an fining relate 4or>
outsie of the fa2ility after
lea1ing.
S'9( <
R(=(&'"1 :t this point resients
typi2ally share a22ommoations
an bathrooms 4ith a smaller
number of resients in a more
home li>e setting.
Be2omes so2io"2entri2
=earns to li1e an thin>
2olle2ti1ely 4ith the
members of the
2ommunity
It pro1ies opportunity
to parti2ipate in the
formulation of hospital
rules an regulations
that affe2t patient3s
personal liberties li>e
betime, meal time,
4ee>en permission,
an 2ontrol of raio or
0.$, so2ial a2ti1ities,
late night pri1ileges.
2ommunity
iffi2ult
THERAPY PURPOSED/
OBJECTIVE
GROUP
THERAPY
Determine by the
nees of the group!
may in2lueD
a. Re2onstru2tio
n of the
personality as
in
psy2hoanalyti
2al an
transa2tional
analysis
groups.
b. :4areness of
feelings an
beha1ior of
self an others
as in 5estalt
groups.
Colle2te the best tools li>e
free e"boo>s, 6ournals,
patient eu2ation
hanoutsR an other peer
re1ie4e referen2e.
<roblems 4ith
interpersonal
relationship,
an7iety, epression,
berea1e parents,
se7ually abuse
4omenNmen.
F-"*' *'9( Q 0he group
members try to epen on the
therapist, see>ing e7pert a1i2e
about their problems an about
the 4ay they shoul beha1e in
the group. In this first stage
some members may lea1e the
group ue to an7iety in tal>ing
in the group or the therapistsG
refusal to sol1e their problem.
S($#&) *'9( Q 0he remaining
members begin to >no4 ea2h
other better, they is2uss their
problems an try to see>
the0he group therapy is able to
gi1e support, offer
alternati1es, an 2omfort
members in su2h a 4ay that
these iffi2ulties be2ome
resol1e an alternati1e
beha1iors are learne.
&. 0he group also allo4s a
person to e1elop ne4
4ays of relating to people.
.. During group therapy,
people begin to see that
they are not alone an that
Not suitable 4hen
patient suffers
from se1ere
epression an
sui2ie is a ris>.
Similarly, mani2
patients are
iffi2ult to
manage in the
group setting.
0hey ten to
isplay e72essi1e
elation,
tal>ati1eness an
irritability 4hi2h
are often iffi2ult
2. Impro1e
2ommuni2atio
n an
interpersonal
relationships
as 2ouple
groups.
ans4ers to their problems.
During this perio ma7imum
2hange 2an be e7pe2te. 0he
therapist en2ourages loo>ing
into 2urrent problems an
relationships.
T%-") S'9( Q 0he group in
this stage 2an be2ome
ominate by the resiual
problems of the members 4ho
ha1e mae least progress an
sho4s most epenen2y. 0hese
points are is2usse before
ening the group.
there is hope an help. It is
2omforting to hear that
other people ha1e a similar
iffi2ulty, or ha1e alreay
4or>e through a problem
that eeply isturbs another
group member.
). :nother reason for the
su22ess of group therapy is
that people feel free to 2are
about ea2h other be2ause of
the 2limate of trust in a
group.
-. :s the group members begin
to feel more 2omfortable,
you 4ill be able to spea>
freely. 0he psy2hologi2al
safety of the group 4ill
allo4 the e7pression of
those feelings 4hi2h are
often iffi2ult to e7press
outsie of group. Bou 4ill
begin to as> for the support
you nee. Bou 4ill be
en2ourage tell people 4hat
you e7pe2t of them.
to 2ontrol.
<atients 4ith sub"
normal
intelle2tual le1el
may not get
aequate benefit
from the group
situation
THERAPY PURPOSED/
OBJECTIVE
FAMILY
THERAPY
0o remo1e family
system pathologi2al
fa2tors an to impro1e
the fun2tioning of the
family as an
interepenent group.
0his is a22omplishe
a22oring to the
theoreti2al orientation
of the therapist,
beha1ioral,
2ommuni2ation,
intera2tional or
stru2tural.
E)/$'-#& &)
(>!("-(&$(. 9hat is your
eu2ational an training
ba2>groun? :re you
li2ense by the state? :re
you 2reentiale by the
::MF0? 9hat is your
e7perien2e 4ith my
familyGs type of problem?
L#9-*'-$*. 9here is
your offi2e? 9hat are your
offi2e hours? :re you
a1ailable in 2ase of
emergen2y?
T"('2(&'
!7&. Ho4 long is ea2h
session? Ho4 often are
sessions s2heule? Ho4
S$!(9#'-&9
32-7-(*
" "S2apegoating
system is 4here one
family member is
labele si2> or ba
an is 2arrying the
buren for other
members.
E&2(*%() 32-7-(*
==
In enmeshe
families there is
e7treme bounary
an role iffusionD
Communi2ations
may be 2ontinuously
interfere 4ith an
ini1iuals are not
felt to spea> for
#ne of the first things that I o
4hen 4or>ing 4ith ne4 2lients
is to establish a sense of rapport
or relationship. If I am 4or>ing
4ith 2hilren or aoles2ents I
li>e to fin out 4hat3s of
interest to her an 4hat she
1alues. 9hat hobbies oes he
en6oy? Fa1orite t.1. sho4s? I
4ant to 2onne2t 4ith her as a
person, not 6ust fo2us on 4hat3s
not 4or>ing in her life at the
moment.
Bou 2an use family therapy
to aress many spe2ifi2
issues, su2h as marital an
finan2ial problems, 2onfli2t
bet4een parents an
2hilren, an the effe2ts of
substan2e abuse an
epression on the entire
family.
Family therapy may help
you ientify your familyGs
strengths, su2h as 2aring for
one another, an
4ea>nesses, su2h as
iffi2ulty 2onfiing in one
another.
0here is iffi2ulty in
engaging the
family an 4here
some family members
are un4illing to
parti2ipate
many sessions shoul I
e7pe2t to ha1e? 9hat is
your poli2y on 2an2ele
sessions?
F((* &)
-&*/"&$(. Ho4 mu2h o
you 2harge for ea2h
session? :re your ser1i2es
2o1ere by my health
insuran2e plan? 9ill I nee
to pay the full fee upfront?
themsel1es.
P"&#-)=*$%-?#-)
32-7-(*
""
sees as an
unifferentiate
ego mass 4here
feeling parts of the
self are pro6e2te on
to others so that
ea2h ini1iual only
2arries a parti2ular
part of the family3s
range of
feelings an role
fun2tions.
C"-*-* *-'/'-#&*
==
Fourthly, there are
families unergoing
a 2urrent share
family 2risis
su2h as
berea1ement. Su2h
situations are so 4ell
>no4n that no
e7ample is
gi1en.
THERAPY PURPOSED/
OBJECTIVE
MARITAL
OR COUPLE
THERAPY
0o ientify marital
2onfli2ts.
0o fa2ilitate open
2ommuni2ation
patterns.
0o use problem"
sol1ing te2hniques
to resol1e
2onfli2ts.
E)/$'-#& &)
(>!("-(&$(. 9hat is your
eu2ational an training
ba2>groun? :re you
li2ense by the state? :re
you 2reentiale by the
::MF0? 9hat is your
e7perien2e 4ith my type of
issue?
L#9-*'-$*. 9here is
your offi2e? 9hat are your
offi2e hours? :re you
a1ailable in 2ase of
emergen2y?
T"('2(&'
!7&. Ho4 long is ea2h
session? Ho4 often are
sessions s2heule? Ho4
:ll psy2hologi2al
problems, an all
psy2hologi2al
2hanges, in1ol1e
both ini1iual
symptoms @beha1ior,
emotions, 2onfli2ts,
thought pro2essesA
an 2hanges in
interpersonal
relationships.
S'(! O&(: I&'6(
It is useful to 2olle2t some basi2
information at the start of the
first session, su2h as the
number of years the 2ouple has
been together, the 2urrent li1ing
situation, spe2ial health issues,
prior 2ounseling e7perien2es,
employment, an spe2ial
interests.
Step Two: Goals and Why
Therapists Are Not Referees
Couples often arri1e at the
session belie1ing that ea2h
partner 4ill be laying out his or
her EpositionF an the therapist
4ill a2t as a referee to e2ie
4ho is right. 0he therapist
shoul inform them that it is not
a matter of one person being
Couples therapy is relief
from symptomati2
beha1iors that 2ause marital
is2ourse, istress, an
iffi2ulties. 0he 2ouple is
restore to healthier
intera2tions an beha1iors
are a6uste to prou2e a
happier balan2e of mutually
appropriate intera2tions.
<atients 4ho are sin2ere
an reasonable 4ith a
4illingness to 2hange ten
to prou2e better out2omes.
<atients usually e1elop
s>ills an in2rease
a4areness that promotes
healthier relationship
intera2tions.
0he ma6or ris> of
2ouples therapy is
la2> of impro1ement
or return to
ysfun2tional
beha1iors. 0hese ten
not to o22ur unless
there is a brea>o4n
in s>ills learne an
e1elope uring
treatment, or a person
is resistant to long"
term 2hange.
many sessions shoul I
e7pe2t to ha1e? 9hat is
your poli2y on 2an2ele
sessions?
F((* &)
-&*/"&$(. Ho4 mu2h o
you 2harge for ea2h
session? :re your ser1i2es
2o1ere by my health
insuran2e plan? 9ill I nee
to pay the full fee upfront?
right or 4rong, sin2e both
partners ma>e sense from their
perspe2ti1e.
Step Three: How Our Brain
Impacts the ishwasher
0al>ing to the 2ouple about
basi2 brain fun2tions an ho4
the '(( billion neurons in their
brains ma>e e2isions helps
them to thin> of therapy as a
2ons2ious e7er2ise.
Step !our: The Sun
:ppre2iations are to a
relationship as the sun an rain
are to a flo4er. 0hey trigger the
happy neurons in the limbi2
system an bring 2ouples 2loser
together.
THERAPY PURPOSED/
OBJECTIVE
INDIVIDUAL
THERAPY
0o relie1e painful
symptoms an to feel
in2rease satisfa2tion
in life.
%u2ation an
e7perien2e
=ogisti2s
0reatment plan
Fees an insuran2e
@'A0he patient has
suffere traumati2
separationsD @&A
separate help is
as>e forD @.A the
therapist 2onsiers
ini1iuation
ne2essary an @)A
unusual life
e7perien2e.
Belo4 are a fe4 of the spe2ifi2
theoriesNte2hniques I may
employ uring our 4or>
together!
BEHAVIORAL THERAPY
Beha1ioral therapies use
learning prin2iples
@e7amples gi1en belo4A
to eliminate or reu2e
un4ante rea2tions to
e7ternal situations,
one3s one thoughts an
feelings, an boily
sensations or fun2tions.
E>!#*/"( T%("!1
Instea of trying to a1oi or
o1er2oming epression,
an7iety, stress
2reating intima2y an
trust
strengthening self"
esteem
e1eloping healthy
bounaries
ealing 4ith grief, loss,
loneliness
lo1ing 4ithout
ai2tion
<atients 2an tal> but
not ma>e any real
2hanges.
<atients on3t ha1e the
1erbal s>ills to benefit.
<atients on3t ha1e
interest in tal>ing about
their problems.
<atients may not
pro1ie enough help
for the se1erity of the
problems
epening on
2ir2umstan2es,
ini1iual therapy may
be more 2ostly than
other options su2h as
es2ape upsetting e7perien2es S
4hi2h 2an bring short"term
relief, but in the longer run
usually prolong or 4orsen one3s
1ulnerability S 2lients
1oluntarily e7pose themsel1es
to the e7perien2es 4hile in a
rela7e state.
B(%,-#"7 A$'-,'-#&
0his is a metho 2ommonly
use in treating epression. It
in1ol1es e1eloping a list of
a2ti1ities the 2lient is li>ely to
en6oy, or nees to engage in as
part of a normal an satisfying
life.
COGNITIVE THERAPY
Cogniti1e therapies rely on
other, largely 1erbal, learning
prin2iples Snamely, those that
in1ol1e 2ognition @per2eption,
thin>ing, reasoning, attention
an 6ugmentA.
resol1ing 2areer
2onfli2ts
o1er2oming
2oepenen2y
resol1ing se7ual
iffi2ulties
healing 2hilhoo
4ouns relate to
al2oholism, in2est, an
other traumas
in2orporating therapy
into your '&"step
program
learning effe2ti1e
2ommuni2ation an
anger release
e1eloping your ability
to e7press healthy
emotions
o1er2oming money an
po4er struggles
hanling ai2tions an
group therapy
2ompulsi1e beha1iors
4or>ing through
milife 2risis
e7ploring purpose,
meaning, spiritual
gro4th
2larifying 2ommitments
freeing 2reati1ity,
spontaneity an 6oy
THERAPY PURPOSED/
OBJECTIVE
MATERIALS
NEEDED
INDICATION MECHANIC/
PROCEDURE
ADVANTAGES DISADVANTAGES
HYNOPSIS: 0o relie1e pain
0o reu2e
an7iety
0o 2hange
unesirable
beha1iorNhabits
@smo>ing,
eating, phobiasA
0o 2hange
physiologi2al
me2hanism
@bloo pressureA
0o in2rease
re2all
In the therapeuti2
setting hypnosis is
inu2e in one person
by another through
te2hniques esigne to
pro1ie a graual
transition from our
usual generalise
reality orientation to the
fo2use orientation
2hara2teristi2 of
hypnosis. During
inu2tion an
throughout the perio
hypnosis is maintaine,
P-&
H4-' D-*#")("*
N/*( &)
#'%(" C#&)-'-#&*
-& P"(9&&$1
R(7>'-#&
A&>-('1 *''(*:
I&'(""/!'-#& #3
*'"#&9 (2#'-#&7
*''(
P*1$%#'-$
D-*#")("*
P*1$%#'%("!1
H1!&#'%("!1 -*
'"('2(&' 2#)7-'1 0-'%
*!($-3-$ '%("!(/'-$ -2*
&) *!($-3-$ '($%&-./(*
/'-7-*() 0%-7*' '%( */48($'
-* -& *''( #3 %1!&#*-*.
5%(& $$(** '# '%(
S/4$#&*$-#/* -* 9-&()
'%"#/9% /*( #3 %1!&#*-*+
2#"( !"#3#/&) 7(,(7 #3
"(7>'-#& 0-'%
$#&$#2-'&' "()/$'-#& -&
*'"(** 7(,(7* -* $%-(,()
0%-$% -)* -& "('"-(,7+
"(*#7/'-#& &) "(=
Hypnotherapy is
one of the
safest, qui2>est
an most
effe2ti1e forms
of treatment for
the ma6ority of
psy2hologi2al
an emotional
problems 4ith
fe4 ris>s an
sie effe2ts.
Hypnotherapy
Be2ause there is no
statutory regulation
of the profession,
thereGs al4ays the
ris> of running into
someboy 4ho
la2>s the right
training.
Hypnotherapy is
not re2ommene
for people 4ith
post"traumati2
stress, epilepsy, an
serious
suggestions gi1en are
more reaily a22epte,
an a2te upon more
po4erfully than 4hen
sub6e2t is in the 4a>ing
state, pro1iing of
2ourse, that the
suggestions gi1en are
a22eptable to sub6e2tGs
o4n moral 2oe.
9hilst it is re2ognise
that the follo4ing
ingreients i.e.
Misire2te attention T
belief T e7pe2tation T
imagination U 0he
Hypnoti2 State, other
G %ssential
<rerequisitesG ne2essary
for the su22essful
inu2tion of hypnosis
in one ini1iual by
another are!
aA <ositi1e Rapport an
0rust
bA Strong Moti1ation
for Change on ClientGs
<art
During hypnosis
the Cons2ious Min ,
i.e. the =eft
()/$'-#& #3 #7) #/')'()
2(2#"-(*+ '"/2*+
&(9'-,( &) )-*'"(**-&9
(2#'-#&*
0he tran2e state maybe
inu2e by a s>ille
therapist, or it may be self"
inu2e through a
prelearne methos. 0hen
patient is2o1er the 2riti2al
e7perien2es in their
ba2>groun that ha1e been
responsible for their present
istress. 0hese e7perien2es
are then reframing is
2hanging the frame in
4hi2h a person per2ei1es
e1ent in orer to 2hange the
meaning. 9hen the
meaning 2hanges, the
person3s responses an
beha1ior 2hange
fosters an
attitue of
inepenen2e
an mastery in
2oping 4ith
problems an
2an also
a22elerate the
healing pro2ess
in many
physiologi2al
problems.
<ositi1e aspe2ts
of hypnosis
in2lue the
prou2tion of a
mu2h more
profoun le1el
of rela7ation
4ith a
2on2omitant
reu2tion in
stress le1els.
Do2tors are
be2oming
in2reasingly
supporti1e of
hypnotherapy as
an ai to better
health. It is a
non"in1asi1e
psy2hologi2al
isorers @su2h as
split personality,
borerline
psy2hosis, an
epressionA.
0he pro2ess ta>es
4or>. Many
patients unergo
hypnotherapy in
the hopes of
fining a mira2le
2ure an get
isappointe 4hen
the therapist
mentions iet an
e7er2ise.
It may not 4or> for
e1eryboy. ;Some
2lients 4ill not fin
their remey or
solution in
Hypnotherapy for
all >ins of
reasons,; says
$a>nin. ;Most 4ill,
but some 4ill not.;
Hemisphere of the
Brain, 4hi2h is
asso2iate 4ith su2h
fun2tions as =ogi2,
Reasoning, =anguage
an the po4er of
Criti2ism is suppresse
or rela7e. 0his allo4s
in2rease a22ess to
the Sub2ons2ious
Min , i.e. the Right
Brain, 4hose fun2tions
are 2on2erne 4ith
%motions, $isual
Impressions, Imagery,
et2., as 4ell as being
the seat of all our
Memories, <ast
%7perien2es an
=earnings. 0he egree
of a22ess to the
Sub2ons2ious ho4e1er,
is relate to the egree
of suppression of the
Cons2ious Min i.e.
Criti2al Min. 0his in
turn is relate to le1el
of hypnosis obtaine by
sub6e2t.
=e1els of Hypnosis !
" =ight Meium Deep N
Somnambulism
therapy,
2omplementary
to orthoo7
mei2ine.
@:ppro7imatelyA +(V
/("/-V '-"&(V
THERAPY PURPOSED/
OBJECTIVE
MATERIALS
NEEDED
PROCEDURE
PLAY
THERAPY
P/"!#*(:
0o ser1e as a tool for
gro4th an
maturation an to
help etermine the
2hil3s beha1ioral
problem an 4ays it
is interfering 4ith
e1elopment
M:0%RI:=S!
Crayons
Bon
paperN2artolina
S2issors
Colore papers
P71 '%("!1 is
generally employe
4ith 2hilren age .
through '' an
pro1ies a 4ay for
them to e7press their
e7perien2es an
feelings through a
natural, self"guie,
self"healing pro2ess.
: play therapist obser1es a
2lient playing 4ith toys
@play"houses, pets, olls,
et2.A to etermine the 2ause
of the isturbe beha1ior.
0he ob6e2ts an patterns of
play, as 4ell as the
4illingness to intera2t 4ith
the therapist, 2an be use to
unerstan the unerlying
rationale for beha1ior both
<lay therapy is a
methoology
use to help
trouble
2hilren 2ope
4ith traumati2
or istressing
situations.
<lay is use as a
meium of
2ommuni2ation
<lay therapy is not
ire2tly ealing
4ith the abuse.
<lay therapy 2an be
seen as a
istra2tion to the
a2tual problem.
0his type of
therapy has
positi1e short term
effe2ts, but it may
O48($'-,(*:
0o 4or> out
problem
situations
0o learn to trust
0o learn to
2ompete,
2ooperate an
2ollaborate
0o gain mastery
o1er ne4
e7perien2es
0o play
2reati1ely
<aste
<en2ils
Colore pens
Story boo>s
<uppet
insie an outsie the
session.
:22oring to
the psy2hoynami2 1ie4,
people @espe2ially 2hilrenA
4ill engage in play
beha1ior in orer to 4or>
through their
interior obfus2ations an an
7ieties. In this 4ay, play
therapy 2an be use as a
self"help me2hanism, as
long as 2hilren are allo4e
time for ;free play; or
;unstru2ture play.; From a
e1elopmental point of
1ie4, play has been
etermine to be an
essential 2omponent of
healthy 2hil e1elopment.
<lay has been ire2tly
lin>e to 2ogniti1e
e1elopment.
#ne approa2h to treatment
is for play therapists use a
type of
systemati2 esensiti8ation o
r relearning therapy to
2hange isturbing beha1ior,
either systemati2ally or in
4hi2h enables
the 2hil to
re2ognise an
separate their
role in
situations.
0hrough play
therapy
ultimately the
2hil is able to
internalise their
role 4ithin the
istressing
situation, to
ha1e a 2lear
unerstaning
that they are not
to blame for the
e1ents an help
them to
unerstan an
ma>e 2onta2t
4ith the 4ier
en1ironment.
be harer for the
abuse 1i2tim later
on in life. 0he
1i2tim may
suppress the abuse
using play therapy
but e1entually the
memories 4ill
2ome ba2> as they
gro4 oler
less formal so2ial settings.
0hese pro2esses are
normally use 4ith
2hilren, but are also
applie 4ith other pre"
1erbal, non"1erbal, or
1erbally"impaire persons,
su2h as slo4"learners, or
brain"in6ure or rug"
affe2te persons. Mature
aults usually nee mu2h
;group permission; before
inulging in the rela7e
spontaneity of play therapy,
so a 1ery s>ille group
4or>er is neee to eal
4ith su2h guare
ini1iuals.
0here are . types of
imaginati1e play 4hi2h 2an
ma>e up a play therapy
session. %mboiment play
in1ol1es e7ploring the
4orl through use of the
sense an 2an in2lue
playing 4ith 2lay or paint.
0his type of play allo4s a
2hil to e7pan their
physi2al 4orl an is2o1er
4here their boy begins
an ens.
<ro6e2ti1e play ta>es pla2e
4hen a 2hil is2o1ers the
4orl outsie themsel1es
through toys. Storyma>ing
is a part of pro6e2ti1e play
an the ob6e2tsNtoys
in1ol1e ten to ha1e
alternati1e meanings. 0his
type of play assists 4ith the
e7ternalisation of trauma
an helps to e7pan a
2hilGs perspe2ti1es.
Role play is 4hen the 2hil
pretens to be someone
else, usually the ault@sA
in1ol1e in the abuse or
trauma.
THERAPY PURPOSED/
OBJECTIVE
MATERIALS
NEEDED
PROCEDURE
REALITY
ORIENTATION
0he primary
goal of R# is to
reu2e
2onfusion. In its
initial
2on2eptuali8atio
n R# 4as
belie1e to
a22omplish this
goal through
three
2omponents.
0he first
2omponent 4as
staff
maintenan2e of
0he use of props or
en1ironmental 2ues 4as
en2ourage, in2luing
signs, 2lo2>s, 2alenars,
reality orientation
boars @information
about lo2ation, ate,
ay, 4eather, holiays,
et2.A, ne4spapers,
tele1ision, pi2tures, an
personal belongings.
Classes 4ere small
groups 4ith an optimal
si8e of three to si7
R# 4as e1elope for
reu2ing 2onfusion in
institutionali8e
ini1iuals. 0he
sour2e of 2onfusion
2oul be any of
1arious 2onitions
@e.g., stro>e, ementia,
psy2hiatri2 isorerA.
Ho4e1er, little
2onsieration has been
gi1en to 4hether there
shoul be ifferen2es
in R# a22oring to the
'. Reality orientation
is a te2hnique use by
2aregi1ers
an family members of
people 4ho suffer from
se1ere memory loss, su2h
as patients 4ith :l8heimerGs
Disease. 0his te2hnique
in1ol1es surrouning the
patient 4ith items an
2on1ersation intene to
remin her of etails of her
reality su2h as the ate, the
9or>s 4ell 4ith
person 4ho is
EtemporarilyF
2onfuse
Delirium @a2ute
2onfusionA
Disorientation
ue to
relo2ation
5entle,
E2on1ersational
F orientation
useful 4ith
2hroni2ally
2onfuse
Disa1antages
<erson 4ith
progressi1e
memory loss not
able to retain
information
Contrai2tion of
their reality
fun2tions as
negati1e an
restri2ti1e feeba2>
In2reases
frustration, an7iety,
anger Reu2es self
esteem Can feel
li>e Ebeing teste
a spe2ifi2
attitue to4ar
the patient,
usually one of
IIa2ti1e33 or
IIpassi1e33
frienliness
@Folsom, '+,*A.
0his 2omponent
has been
referre to as
attitue therapy.
0he se2on
2omponent
in1ol1e staff3s !
@aA presentation of
basi2 orienting
information uring
intera2tions 4ith
2onfuse patients
@e.g., remining
patients of 4ho an
4here they areA an
@bA in1ol1ement of
patients in their
en1ironment, by
2ommenting on
4hat 4as happening
in the en1ironment
at that time an by
reinfor2ing
ini1iuals3
a4areness of an
interest in their
en1ironment.
0he thir
ini1iuals meeting
4ith one or t4o staff
members @9oos,
'++&A. 0he se2on an
thir 2omponents ma>e
up, respe2ti1ely, 4hat is
no4 >no4n as t4enty"
four"hour reality
orientation an
2lassroom reality
orientation.
reason for 2onfusion.
In pra2ti2e, R# is use
most 2ommonly 4ith
patients 4ith
ementia, but fe4
attempts ha1e been
mae to e7plain the
4ay in 4hi2h
ementia might affe2t
the ini1iual3s ability
to benefit from R#..
4eather an people she
>no4s.
R(7-'1 B#")
&. #ne tool in reality
orientation is a reality
boar. 0his is usually a ry
erase boar hung on the
4all of the patientGs li1ing
spa2e 4here the patient 4ill
see it often. %a2h ay the
2aregi1er an the patient
4rite information on the
boar in2luing the ate,
the ay of the 4ee> an the
4eather. 0he patient is
en2ourage to remember
an 4rite as mu2h of the
information as possible.
C#&,("*'-#&
.. :n important part
of reality orientation is
2on1ersation. : 2aregi1er
shoul spea> to patients
about 4hat she is oing an
4hy, e1en if there is little or
no response from the
patient. 0he 2aregi1er
2omponent
entaile the use
of basi2 an
a1an2e
2lasses in
orientation as an
a6un2t to the
se2on
2omponent.
shoul mention etails
about the ate, the time an
the lo2ation of the patient
as often as possible uring
2on1ersation.
P-$'/"(*+ C7#$6* &)
C7(&)"*
). : patient
unergoing reality
orientation 4ill ha1e many
items intene to 6og his
memory. <la2e pi2tures of
friens an family
throughout the patientGs
li1ing spa2e, an 2aregi1ers
shoul 2omment on the
pi2tures an use the names
of the people in the
pi2tures. Calenars an
2lo2>s shoul also be in the
patientGs li1ing spa2e, an
2aregi1ers shoul use these
items to remin the patient
of the ate an time.
THERAPY PURPOSED/
OBJECTIVE
MATERIALS
NEEDED
PROCEDURE
REALITY
THERAPY
0he Reality 0herapy
approa2h to
2ounseling an
problem"sol1ing
fo2uses on the here"
an"no4 of the
2lient an ho4 to
2reate a better
future, instea of
2on2entrating at
length on the past. It
emphasi8es ma>ing
e2isions, an ta>ing
a2tion an 2ontrol of
0he psy2hotherapist
must fo2us the 2lient on
2urrent beha1ior rather
than past e7perien2es.
0he therapist as>s the
2lient to ma>e a 1alue
6ugement about his
2urrent beha1ior @4hi2h
presumably is not
benefi2ial, other4ise
the 2lient may not ha1e
negati1e 2onsequen2es
from beha1ior
Reality therapy is
more than a
2ounseling te2hnique.
Reality therapy is a
problem sol1ing
metho that 4or>s
4ell 4ith people 4ho
are e7perien2ing
problems they 4ant
help sol1ing, as 4ell
as those 4ho are
ha1ing problems an
Reality therapy pro1ies a
moel of builing
relationships by instru2ting
helpers to 2reate a nee"
satisfying 2ounseling
en1ironment. 0he fi1e basi2
nees of all humans are
sur1i1alD lo1e an
belongingD po4erD freeom
an fun. So, in a helping
relationship, the helper
must 2reate an en1ironment
Reality therapy
fun2tions as
both a
pre1enti1e an a
remeial
program by
attempting to
2hange beha1ior
before an after
it o22urs. Many
times, the
alternati1e
solutions 4ill
also apply to
#ften the effe2ts
an pro2eures of
the therapy are
limite to 1erbal
stuents.
0he therapy
in2lues no
suggestions for
systemati2ally
monitoring
beha1iors.
Many times it is
iffi2ult to initiate
the questioning
oneGs o4n life.
0ypi2ally, 2lients
see> to is2o1er
4hat they really
4ant an 4hether
4hat they are
2urrently oing
@ho4 they are
2hoosing to beha1eA
is a2tually bringing
them nearer to, or
further a4ay from,
that goal.
Reality 0herapy is a
2onsiere a
2ogniti1e"
beha1ioural
approa2h to therapyD
that is, it fo2uses on
fa2ilitating the 2lient
to be2ome a4are of,
an if ne2essary,
2hange, hisNher
thoughts an
a2tions.
moti1ating enough to
see> therapyA. In many
2ases the therapist must
press the 2lient to
e7amine the effe2ts of
his beha1ior, but it is
important that the
6ugment be mae by
the 2lient an not the
therapist.
appear to not 4ant any
assistan2e. Reality
therapy also pro1ies
an e72ellent moel for
helping ini1iuals
sol1e their o4n
problems ob6e2ti1ely
an ser1es as the ieal
questioning series
uring 2oa2hing
sessions.
0he unerlying >ey to
reality therapy is the
relationship that is
establishe 4ith the
person 4ho nees the
help. 0his is most
2riti2al 4hen you are
attempting to help
someone 4ho oesn3t
really 4ant your help,
su2h as a non"
1oluntary 2lient, a
resistant stuent or
sometimes e1en your
o4n 2hil. 9ithout a
positi1e relationship,
you ha1e no influen2e.
4here it is possible for the
person being helpe to feel
safeD to feel 2onne2te to
the helper in some 4ayD to
be listene to an
respe2teD to ha1e some
2hoi2esD an to ha1e some
fun or learning 4ith the
helper. :fter 2reating this
nee"satisfying
en1ironment an 4or>ing
har to maintain it
throughout the relationship,
the helper 2an mo1e on to
the a2tual problem.
:fter hearing the person3s
story, the helper nees to
etermine 4hat the ieal
solution 4oul loo> li>e
from the other person3s
point of 1ie4. So, for
e7ample, if the person 4ere
2omplaining about a fight
he ha 4ith his girlfrien,
as> the question, E9hat o
you 4ant to happen? Ho4
o you 4ant this to 4or>
out?F It is 2riti2al to get a
spe2ifi2 pi2ture of 4hat the
ieal solution 4ill loo> li>e
from the perspe2ti1e of the
other beha1iors.
Beha1ior is
e1aluate in
terms of
so2ietyGs
guielinesD
e72uses are not
allo4e if the
plan is not
follo4e, 6ust
be2ause the
stuent is
e72eptional.
:llo4an2e oes
nee to be mae
for the
ini1iual
uring the
2reation of the
planD but, on2e
the stuent has
mae the
2ommitment
an the plan is
eeme
appropriate, the
e72eptional
stuent nee not
be allo4e any
e72uses. #ften
stuents 4ith
problem
beha1iors use
spe2ial
eu2ation
;labels; as
immeiatelyD for
e7ample, the
inappropriate
beha1ior may o22ur
4hen the tea2her is
presenting a group
lesson. 0he time
fa2tor thus may
2lou the 2larity of
the es2ription.
0he te2hnique of
the 2lass meeting is
unfamiliar to many
tea2hers, sin2e
most of them are
not traine in
2ounseling types of
group intera2tions.
person e7perien2ing the
problem. 0he helper is
leaing him or her a4ay
from the problem an into a
problem"solution moe. In
this 4ay, the fo2us is off the
past an the problem,
4hi2h 2annot be 2hange.
0he fo2us instea is on the
beha1ior the person 2an
2reate to mo1e himself in
the ire2tion of the solution
he 4ants.
0he ne7t step is to ta>e an
in1entory of all the things
the person is oing to get
the situation to 4or> out the
4ay they 4ant. 0he helper
as>s the person to list the
steps theyGre ta>ing to rea2h
their goal. 0ypi2ally, the
person 4ill only list
positi1e things, but the
helper must as> them to
2onsier e1erything that is
both helping an hinering
progress. 0he helper may
a obser1ations of their
o4n. 0he point is to get as
2omplete a pi2ture as
possible. In aition to
e72uses to a1oi
tas>s. 0his
program oes
not allo4 that.
0he program
tens to tea2h
stuents
e2ision"ma>ing
s>ills ne2essary
for ault life.
0ea2hers are
mae a4are that
is2ipline an
2aring are
2ompatible.

2onsiering one3s out4ar
beha1ior, as> about their
thoughts, feelings an
physiology @if appropriateA,
as 4ell.
0he ne7t step is the most
2ru2ial in the entire pro2ess.
0he helper as>s helpees if
their 2urrent beha1ior is
li>ely to get them 4hat they
say they 4ant. If the person
is alreay a4are 4hat
theyGre oing is not
4or>ing, theyGre alreay in
istress an reay to try
something ifferent. 0he
helper assists the 2lient by
helping them fin a
solution.
#n the other han, if the
person is una4are they
nee help, this self"
e1aluation step helps the
2lient e1aluate their
beha1ior an re2ogni8e the
nee to o things
ifferently. It generally
2reates enough is2omfort
to at least loo> at
alternati1es.
0he final step in the reality
therapy pro2ess is to help
the helpee 2ome up 4ith a
plan to o something more
effe2ti1e. 0his is best
a22omplishe by helping
the person fo2us on those
things 4ithin their 2ontrol
Stheir o4n thoughts an
a2tions. 9e on3t help a
epresse person by simply
saying, ECheer upCF <eople
2annot ire2tly 2ontrol their
feelings but they 2an
ire2tly 2ontrol their
a2tions an thin>ing.
Similarly, people li>e to
fo2us their time an
attention on 4hat others
2oul an shoul o to gi1e
them 4hat they 4ant, but
attempting to 2ontrol others
is generally a fruitless
a2ti1ity. Helping people to
fo2us on 2hanging their
o4n beha1ior an thoughts
is generally the goal of
reality therapy.
THERAPY PURPOSED/
OBJECTIVE
MATERIALS
NEEDED
PROCEDURE
RELAXATION
THERAPY
0o
o1er2ome an7iet
y, phobias ,
or pani2
atta2>s it is of
paramount
importan2e to
learn ho4 to
rela7. It is
impossible to
feel rela7e an
tense at the
same time.
<eople 4ho li1e
<rogressi1e Mus2le
Rela7ation is a
te2hnique for a2hie1ing
a eep state of
rela7ation. 0ensing a
mus2le an holing it
for a fe4 se2ons, then
releasing that tension
4ill prou2e a eep
sense of rela7ation, an
4ill ri the boy of the
built up tension from
li1ing 4ith high le1els
of an7iety on a aily
Rela7ation
0herapy for
:n7iety Disorers
Helpful for
epression, but
oes not 4or> as
4ell as
psy2hologi2al
treatments.
<rogressi1e mus2le
rela7ation is a te2hnique
4here you tense an rela7
one at a time, all the ma6or
mus2le groups of the boy.
0he iea is to tense ea2h
mus2le group har for
about '( se2ons, an then
to let go of it suenly. Bou
then gi1e yourself '-"&(
se2ons to rela7 an
be2ome a4are of the
2ontrast bet4een the feeling
of rela7ation to ho4 it felt
Regular, aily
pra2ti2e
of rela7ation
te2hniques 4ill
assist you in
relie1ing mus2le
tension, greatly
impro1e your
o1erall feeling of
4ellbeing an
reu2e your an7iety.
Deep rela7ation
in1ol1es a number
of physiologi2al
Not for e1eryone.
Some people 4ho are
1ery epresse or
an7ious or 4ho ha1e
other types of mental
health problems fin
that rela7ation oesn3t
help. It might e1en
ma>e them feel 4orse.
4ith high le1els
of an7iety often
o not >no4
ho4 to rela7 or
to release the
tension store in
their mus2les
that is
2ontributing to
the e7perien2e
of an7iety.
0he aim of
rela7ation
therapy is to
quiet the minD
to allo4
thoughts to flo4
in a smooth,
le1el rhythm,
an inu2e the
rela7ation
response. 0his
mental quiet
allo4s for rest
an re6u1enation
that oes not
al4ays o22ur,
e1en uring
sleep.
basis.
Guidelines
<ra2ti2e for at least
&( minutes per ay
Fin a quiet
lo2ation free from
istra2tion
%nsure the room
temperature is
2omfortable " not
too hot, an not too
2ol
<ra2ti2e at regular
times Q on
a4a>ening or
before retiring or
before meals
:ssume a
2omfortable
position Q your
entire boy nees
to be supporte
=oosen any tight
2lothing an ta>e
off shoes
Ma>e a e2ision
not to 4orry about
anything " if you
ha1e any other
thought 2ome into
your min, 6ust let
4hen tense. Bou then
mo1e onto the ne7t mus2le
group until you ha1e
4or>e your 4ay through
your 4hole boy. #ften it is
helpful to ha1e some quiet,
gentle musi2 in the
ba2>groun.
2hanges in2luing!
De2reases in
heart rate
De2rease in
respiration rate
De2rease in
bloo pressure
De2reases in
s>eletal mus2le
tension
De2rease in
metaboli2 rate
an o7ygen
2onsumption
De2rease in
analyti2al
thin>ing
In2rease in s>in
resistan2e
Reu2tion
of generali8e
an7iety
Reu2tion of
frequen2y an
se1erity of pani2
atta2>s
<re1ention of
stress be2oming
2umulati1e
In2rease
energy an
them go an bring
your attention ba2>
to your rela7ation
:ssume a passi1e,
eta2he attitue
prou2ti1ity.
Impro1e
2on2entration
an memory
In2rease
in ability to
fo2us
Reu2tion of
insomnia an
fatigue
Deeper an
souner sleep
<re1ention an
or reu2tion of
psy2hosomati2
isorers su2h
as hypertension,
migraines,
heaa2hes,
asthma, ul2ers
et2.
In2rease self
2onfien2e an
reu2e self
blame
In2rease
a1ailability of
feelings. Mus2le
tension is one of
the 2hief
impeiments to
an a4areness of
your feelings.
THERAPY PURPOSED/
OBJECTIVE
MATERIALS
NEEDED
PROCEDURE
REMINISCENCE
THERAPY
R(2-&-*$(&$(
'%("!1 is use
to 2ounsel an
support oler
people, an is an
inter1ention
te2hnique
4ith brain"
in6ure patients.
0his form of
therapeuti2
inter1ention
respe2ts the life
an e7perien2es
of the ini1iual
D-33("(&' M()-/2*
/*() 3#" R(2-&-*$(&$(
T%("!1 &)
A$'-,-'-(*
: 1ariety of meiums
2an assist the a2t of
remembering that use
ifferent senses. It
means that people 4ho
ha1e iffi2ulty
2ommuni2ating
1erbally 2an ha1e the
opportunity to o so in
other 4ays.
%stablishing ientity
4ith or 4ithout 4ors
is a goo e7ample of
Reminis2en2e
0herapy is a form
of therapy that 2an
be useful an
helpful to oler
people 4ith
memory problems.
Reminis2en2e 2an be use
as ini1iual, group or
family sessions an is
generally 2ategorise in
three main types!
Simple reminis2en2e.
Here the iea is to
refle2t on the past in an
informati1e an
en6oyable 4ay.
%1aluati1e
reminis2en2e is more of
a therapy an may, for
e7ample, be use as a
life re1ie4ing or
Regular, aily
pra2ti2e
of rela7ation
te2hniques 4ill
assist you in
relie1ing mus2le
tension, greatly
impro1e your
o1erall feeling of
4ellbeing an
reu2e your an7iety.
Deep rela7ation
in1ol1es a number
of physiologi2al
2hanges in2luing!
None >no4n
4ith the aim to
help the patient
maintain goo
mental health.
ho4 4e ha1e to aapt,
gi1ing a 1aluable
opportunity to a2quire
an use ne4 s>ills of
2ommuni2ation.
$isually!
photographs, slies.
<ainting pi2tures,
loo>ing at ob6e2ts
of autobiographi2al
meaning.
Musi2! using
familiar tunes from
the raio, C.Ds, or
ma>ing musi2
using 1arious
instruments.
Smell or taste!
using smell >its,
ifferent foos
0a2tile! tou2hing
ob6e2ts, feeling
te7tures, painting
an pottery.
sometimes 2onfli2t
resol1ing approa2h.
#22asionally,
unpleasant an stressful
information is re2alle
an this has been 2alle
offensi1e"efensi1e
reminis2en2e. It 2an be
the either the 2ause or
the result of beha1ioral
an emotional issues.
Dealing 4ith them 2an
pro1ie resolution " a
2oming to terms 4ith
life e1ents an possible
2losure.
I&$7/*-#& #3 C"(9-,("*+
F"-(&)* &) R(7'-,(* -&
R(2-&-*$(&$( A$'-,-'1
In a 2are fa2ility, or in a
professional setting, the 2o"
operation an in2lusion of
relati1es an friens 2an
enhan2e the reminis2en2e
time for all parties. 0hey
may be able to pro1ie
photos or remember
in2ients in the person3s life
that 2an in2rease the
pleasure an engage a
person 4ith :l8heimer3s
attention more fully.
Friens an relati1es 2an
also pro1ie 1aluable
De2reases in
heart rate
De2rease in
respiration rate
De2rease in
bloo pressure
De2reases in
s>eletal mus2le
tension
De2rease in
metaboli2 rate
an o7ygen
2onsumption
De2rease in
analyti2al
thin>ing
In2rease in s>in
resistan2e
Reu2tion
of generali8e
an7iety
Reu2tion of
frequen2y an
se1erity of pani2
atta2>s
<re1ention of
stress be2oming
2umulati1e
In2rease
energy an
prou2ti1ity.
Impro1e
information on any sub6e2t
that a person may fin
istressing or upsetting that
require in2rease support.
2on2entration
an memory
In2rease
in ability to
fo2us
Reu2tion of
insomnia an
fatigue
Deeper an
souner sleep
<re1ention an
or reu2tion of
psy2hosomati2
isorers su2h
as hypertension,
migraines,
heaa2hes,
asthma, ul2ers
et2.
In2rease self
2onfien2e an
reu2e self
blame
In2rease
a1ailability of
feelings. Mus2le
tension is one of
the 2hief
impeiments to
an a4areness of
your feelings.
THERAPY PURPOSED/
OBJECTIVE
MATERIALS
NEEDED
PROCEDURE
REMOTIVATION
THERAPY
<urpose!
Hse to orient to
reality for
2ommunity
li1ing. 0he fo2us
is present
oriente.
Remoti1ation
therapy is useful
for the long"
term 2hroni2ally
ill psy2hiatri2 in
a nursing home
or e7tene 2are
fa2ility.
V7/(* #3 '%( !'-(&'
Stimulate patient to
thin> about
something L tal>
about himself
5i1es him reason
to 1alue himself L
in2rease his self"
respe2t.
0a>es him out of
the ar>ness of the
4orl life
Ma>es him part of
the group
0a>e the patient out
of the 1egetable
: simple group
therapy 4hi2h
aims to brige the
fantasy" 4orl of
the <sy2hoti2s to
the real 4orl
'.Climate :22eptan2e
@-minA
a.0he leaer 4ho is at the
2enter of the group
introu2es him L the rest of
the group.
b.=eaer must as> the
patient to introu2e
themsel1es.
2.:fter the intro., the leaer
may 2omment on the
4eather, the patient3s
appearan2e or may gi1e a
pleasant 2ompliment
.0he ob6e2ti1e! Create a
pleasant L rela7e
atmosphere
&.Brige to Reality @'-minA
a.:s> boun2e questions.
1ery useful in
group settings
an 4ith
non2ommuni2at
i1e 2lients as a
a4ay of
preparing them
for more
a1an2e
therapies.
None >no4n
#b6e2ti1es!
0o fo2us on
the 4orl
outsie
0o assist in
2oping 4ith
the present
situation
0o pro1ie
some
uni1ersity
@holiay,
homes,
reamsA
0o stimulate
sensory
input
@feeling,
seeing,
tou2hing,
hearing,
tastingA
0o stimulate
latent
abilities
0o pro1ie
sense of
meaning or
purpose
2lass
D/"'-#&: <@=AB
2-&/'(* =<@ 2-& 1
%#/" 3#" #&$( #" '0-$(
!(" 0((6
N#. #3 *(**-#&* C
E,7/'-#&=1: *(**-#&*
$#&*-*'* *("-(*. T%(
*'/)(&' (,7/'(* '%(
!'-(&'D* "($'-#&*
0-'% '%( 9/-)&$( #3
'%( CI=E,7/'-#&
"(!#"' -* ''$%() '#
'%(-" "(*!($'-,( $%-"
#3 '%( !%1*-$-&* '#
&#'(
S/48($' '# 4(
$#&*-)("()
'.5eography
&.History
..S2ien2e
).=iterature
-.Inustry
,.Sports
Ouestion sho4e be short
L easy to ans4er.
b.0hen as> for anyboy
4ho >no4s a poem about
the topi2 of is2ussion
2.Ouestions are from
general"spe2ifi2
.0ry to rea your poetry to
the group L later as> the
patients to rea it. Sho4
your 1isual ai
..Sharing the 4orl 4e li1e
in @'-minA
a.Stimulating question
leaing to the topi2
b.=eaer shoul try to
e7plore the topi2 uner
is2ussion
).:ppre2iation of the 4or>s
of the 4orl @'-minA
a.0he step is blene 4ith
step .
b.Be sure to relate the
patient so he 4ill be able to
thin> of himself in relation
/.Hobbies
*.Nature
S/48($' NOT '# 4(
$#&*-)("()
'.Religion
&.<oliti2s
..=o1e
).Se7
-.Family <roblem
into 2ertain 6ob
-.Climate of :ppre2iation
@'-minA
a.=eaer shoul try to as> a
summary about the topi2
4N2 has is2usse
b.%7press your appre2iation
to the patient for 2oming to
the sessions L tell them
about the ne7t session L
4hat topi2 to be is2usse
: 2limate or 4arm
frienliness an a22eptan2e
are essential. Reaing,
poetry, an 2urrent e1ents
from briges to reality.
<rops are use to promote
is2ussion of topi2s. :n
:ppre2iation of the 2lient3s
4or> in the past is
emphasi8e.
R#7(* #3 '%( N/"*(:
0o introu2e members
0o establish rituals
0o e7plain the spe2ifi2
fo2us of the group
0o introu2e sub6e2t
0o eli2it members
2omments about the
sub6e2t
0o summari8e 4hat has
been learne an share
THERAPY PURPOSED/
OBJECTIVE
MATERIALS
NEEDED
PROCEDURE
SEX
THERAPY
Se7 therapy is your
4ay out 4hen you
fin your
relationship faltering
on the physi2al
satisfa2tion front.
Se7ual therapy is
ho4e1er not at all
restri2te to sorting
out the problems of
2ouples. It basi2ally
eals 4ith pro1iing
solutions to a host of
se7"relate problems
that 2an span i1erse
Se7 therapy is usually
pro1ie by
psy2hologists,
physi2ians or li2ense
therapists 4ho ha1e
spe2ial training in
issues relate to se7
an relationships.
Certifie se7 therapists
ha1e grauate egrees
an 2an emonstrate
their 2ompeten2e in se7
therapy by be2oming
2reentiale by the
:meri2an :sso2iation
of Se7uality %u2ators,
Counselors an
S(> '%("!1 is the
treatment of se7ual
ysfun2tion, su2h as
non"2onsummation,
premature
e6a2ulation or ere2tile
ysfun2tion,
lo4 libio,
un4ante se7ual
fetishes, se7ual
ai2tion,painful se7,
or a la2> of se7ual
2onfien2e, assisting
people 4ho are
re2o1ering
Se7 therapy is typi2ally a
short term @, to '- 4ee>sA
solution fo2use
inter1ention. Solution
fo2use means that there
are 2on2rete goals 4ith
4hi2h to gauge progress,
that there is a 2ons2ious
utili8ation of 2lient3s
strengths, an that
home4or> assignments are
utili8e to en2ourage a2ti1e
steps to4ar one3s goals.
9hile more general
Se7 0herapy is a
professional an
ethi2al treatment
approa2h to
problems of se7ual
fun2tion an
e7pression. It
refle2ts the
re2ognition that
se7uality is of
legitimate 2on2ern
to professionals an
that it is the right of
ini1iuals to e7pert
assistan2e 4ith their
:s 4ith any therapy for
personal or beha1ioural
iffi2ulties, se7 therapy
has its limitations.
:lthough usually brief
an effe2ti1e 4ith most
se7ual 2on2erns, se7
therapy oes not offer a
mira2le 2ure for all
interpersonal problems.
Su22ess of treatment
epens upon many
fa2tors, not the least of
4hi2h are the nature of
the problem, the
moti1ation of the
li1es
e7 therapy eals
4ith the follo4ing
>ins of problems!
Non"
2onsummation""
its possible
2auses an the
remeies
<remature
e6a2ulation an
problems 4ith
ere2tion that
pre1ent you an
also your partner
from attaining
that moment of
i1ine bliss
=o4 se7ual
esires that 2an
lea to feelings
of frustration
an epression
Se7ual fetishes
or fi7ations 4ith
ob6e2ts
Se7 mania that
almost borers
on per1ersion
In2onfien2e
0herapists @::S%C0A.
Se7 therapy is usually
short term. 0he spe2ifi2
treatment plan epens
on the issues to be
aresse.
from se7ual assault,
problems 2ommonly
2ause by stress,
tireness an other
en1ironmental an
relationship fa2tors.
Se7 therapists assist
those e7perien2ing
problems in
o1er2oming them, in
oing so possibly
regaining an a2ti1e se7
life
relationship issues are an
integral part of se7 therapy,
they are not the primary
issue. Se7 therapists treat
the se7ual problem ire2tly
as oppose to assuming that
if a 2ouple resol1es their
other relationship issues,
their se7ual fun2tioning
4ill e1entually impro1e.
Sin2e relationship issues
are an integral part of se7
therapy, an often one of
the ynami2s that
perpetuates the se7ual
problem, 2ouples 4ho meet
their goals in se7 therapy
in1ariably impro1e
fun2tioning in other areas
of their relationship as 4ell.
9hen relationship issues
are the primary problem
@iffi2ulty negotiating
2onfli2t, iffi2ulty
negotiating 1alue systems,
ifferen2e in atta2hment
styles, et2.A, then more
traitional 2ouples therapy
is more appropriate.
Se7 therapy is a pro2ess
se7ual iffi2ulties.
Se7 therapy, then, is
the fo2using of
spe2iali8e 2lini2al
s>ills on helping
men an 4omen as
ini1iuals anNor as
2ouples to eal more
effe2ti1ely 4ith
their se7ual
e7pression.
patient, the therapeuti2
goals an the therapistGs
s>ills. 0he moti1ate
prospe2ti1e patient
anNor 2ouple shoul
2hoose a therapist
2arefully an establish
realisti2 goals early in
the 2ounselling.
4ith se7ual a2ts
%7perien2ing
pain or se1ere
is2omfort
4hile engaging
in se7ual
inter2ourse
groune in the s2ien2e of
se7uality, 2alle se7ology,
not in the ieology or
morality of our 2ulture. #ur
4orl is fille 4ith
6ugments about 4hat
se7ual beha1ior is EnormalF
or a22eptable. :s long as
noboy3s basi2 rights are
being 1iolate, a se7
therapist stri1es to be
non6ugmental, 4ith the
intent of helping a 2ouple
meet their goals from
4ithin their o4n 1alue
system. : se7 therapist 2an
pro1ie information about
4hat beha1iors are
statisti2ally 2ommon an
un2ommon, an 2an help a
2lient e7plore their o4n
1alue system, but 2annot
e2ie for the 2lient 4hat
beha1iors are morally
a22eptable.
THERAPY PURPOSED/
OBJECTIVE
MATERIALS
NEEDED
PROCEDURE
PAIN
MANAGEMENT
reu2ing or
eliminating
pain
using
mei2ines
that are
appropriate,
pro1ie
sustaine
benefits, ha1e
tolerable sie
effe2ts, an
support the
fun2tional
goals of the
patient
0he treatment of pain is
guie by the history of
the pain, its intensity,
uration, aggra1ating
an relie1ing
2onitions, an
stru2tures in1ol1e in
2ausing the pain. In
orer for a stru2ture to
2ause pain, it must ha1e
a ner1e supply, be
sus2eptible to in6ury,
an stimulation of the
stru2ture shoul 2ause
pain. 0he 2on2ept
behin most
<ain management 2an
be simple or 2omple7,
epening on the
2ause of the pain. :n
e7ample of pain that is
typi2ally less 2omple7
4oul be ner1e root
irritation from
a herniate is2 4ith
pain raiating o4n
the leg. 0his 2onition
2an often be alle1iate
4ith an epiural
steroi
in6e2tion anphysi2al
therapy. Sometimes,
ho4e1er, the pain oes
M-&)=B#)1 T%("!-(*
Min"boy therapies are
treatments that are meant to
help the min3s ability to
affe2t the fun2tions an
symptoms of the boy.
Min"boy therapies use
1arious approa2hes
in2luing rela7ation
te2hniques, meitation,
guie imagery,
biofeeba2>, an hypnosis.
Rela7ation te2hniques 2an
help alle1iate is2omfort
relate to 2hroni2 pain.
Mei2ine treats
in6ury an pathology
to support an spee
healingD an treats
istressing
symptoms su2h as
pain to
relie1e suffering ur
ing treatment an
healing. 9hen a
painful in6ury or
pathology is
resistant to
treatment an
persists, 4hen pain
persists after the
None >no4n
reu2ing
istress an
enhan2ing
2omfort,
pea2e of
min an
quality of life
impro1ing
the
unerstanin
g of the role
of emotions,
beha1ior an
attitues in
pain
impro1ing
the ability to
fun2tion
physi2ally
an perform
a2ti1ities of
aily li1ing
impro1ing
the ability to
fun2tion in
so2ial an
family roles
supporting
the patientGs
ability to
return to
4or> an
inter1entional
pro2eures for treating
pain is that there is a
spe2ifi2 stru2ture in the
boy 4ith ner1es of
sensation that is
generating the pain.
<ain management has a
role in ientifying the
pre2ise sour2e of the
problem an isolating
the optimal treatment.
not go a4ay. 0his 2an
require a 4ie 1ariety
of s>ills an
te2hniques to treat the
pain. 0hese s>ills an
te2hniques in2lue!
Inter1entional
pro2eures
Mei2ation
management
<hysi2al
therapy
or 2hiropra2ti2
therapy
<sy2hologi2al
2ounseling an
support
:2upun2ture an

other alternati1e
therapiesD an
Referral to
other mei2al
spe2ialists
:ll of these s>ills an
ser1i2es are ne2essary
be2ause pain 2an
in1ol1e many aspe2ts
of a personGs aily life
A$/!/&$'/"(
:lthough the 9orl Health
#rgani8ation 2urrently
re2ogni8es more than .(
iseases or 2onitions that
2an be helpe by
a2upun2ture treatment, one
of the main uses of
a2upun2ture is for pain
relief.
Si7teenth 2entury Chinese
o2tors belie1e that illness
4as ue to an imbalan2e of
energy in the boy. In
a2upun2ture, isposable,
stainless steel neeles are
use to stimulate the boyGs
') ma6or meriians, or
energy"2arrying 2hannels,
to resist or o1er2ome
illnesses an 2onitions by
2orre2ting these
imbalan2es.
:2upun2ture is also thought
to e2rease pain by
in2reasing the release of
2hemi2als that blo2> pain,
2alle enorphins. Many
a2u"points are near ner1es.
9hen stimulate, these
ner1es 2ause a ull a2he or
feeling of fullness in the
mus2le. 0he stimulate
in6ury or pathology
has heale, an
4hen mei2al
s2ien2e 2annot
ientify the 2ause of
pain, the tas> of
mei2ine is to
relie1e suffering.
0reatment
approa2hes to long
term pain
in2lue pharma2olo
gi2 measures, su2h
as analgesi2s, tri2y2l
i2
antiepressants an
anti2on1ulsants,
inter1entional
pro2eures, physi2al
therapy, physi2al
e7er2ise, appli2ation
of i2e anNor heat,
an psy2hologi2al m
easures, su2h
as biofeeba2> an
2ogniti1e beha1ioral
therapy.
fun2tion on
the 6ob
eu2ating
patients in
4ays to
maintain
rehabilitation
gains an
a1oi re"
in6ury
empo4ering
patients to
a2ti1ely
parti2ipate in
pain 2ontrol
strategies
promoting
a4areness
an
unerstanin
g of the
fa2tors that
2ontribute to
physi2al an
emotional
istress
relate to
pain
e1eloping
the s>ills an
>no4lege
neee to
mus2le sens a message to
the 2entral ner1ous system
@the brain an spinal 2orA,
2ausing the release of
enorphins @morphine"li>e
2hemi2als prou2e in our
o4n boies uring times of
pain or stressA. %norphins,
along 4ith other
neurotransmitters @boy
2hemi2als that moify
ner1e impulsesA, blo2> the
message of pain from being
eli1ere up to the brain
:2upun2ture may be useful
as an a22ompanying
treatment for many pain"
relate 2onitions,
in2luing! heaa2he, lo4
ba2> pain, menstrual
2ramps, 2arpal tunnel
synrome, tennis
elbo4, fibromyalgia, osteoa
rthritis an myofas2ial pain.
:2upun2ture also may be
an a22eptable alternati1e to
or may be in2lue as part
of a 2omprehensi1e pain
management program.
C%-"#!"$'-$ T"('2(&'
&) M**9(
Chiropra2ti2 treatment is
the most 2ommon non"
in2rease the
patientGs
sense of
2ontrol o1er
pain
surgi2al treatment for ba2>
pain. Impro1ements of
people unergoing
2hiropra2ti2 manipulations
4ere note in some trials.
Ho4e1er, the treatments
effe2ti1eness in treating
ba2> an ne2> pain has not
been supporte by
2ompelling e1ien2e from
the ma6ority of 2lini2al
trials. Further stuies are
2urrently assessing the
effe2ti1eness of
2hiropra2ti2 2are for pain
management.
Massage is being
in2reasingly use by people
suffering from pain, mostly
to manage 2hroni2 ba2> an
ne2> problems. Massage
2an reu2e stress an
relie1e tension by
enhan2ing bloo flo4. 0his
treatment also 2an reu2e
the presen2e of substan2es
that may generate an
sustain pain. :1ailable ata
suggest that massage
therapy, li>e 2hiropra2ti2
manipulations, hols
2onsierable promise for
managing ba2> pain.
T%("!(/'-$ T#/$% &)
R(-6- H(7-&9
0herapeuti2 tou2h an rei>i
healing are thought to help
a2ti1ate the self"healing
pro2esses of an ini1iual
an therefore reu2e pain.
:lthough these so 2alle
;energy"base; te2hniques
o not require a2tual
physi2al 2onta2t, they o
in1ol1e 2lose physi2al
pro7imity bet4een
pra2titioner an patient.
In the past fe4 years,
se1eral re1ie4s e1aluate
publishe stuies on the
effi2a2y of these healing
approa2hes to ease pain an
an7iety an impro1e health.
:lthough benefi2ial effe2ts
4ith no signifi2ant a1erse
sie effe2ts 4ere reporte
in se1eral stuies, the
limitations of some of these
stuies ma>e it iffi2ult to
ra4 efiniti1e
2on2lusions. Further stuies
are neee before the
e1ien2e"base
re2ommenation for using
these approa2hes for pain
treatment 2an be mae.
D-('"1 A!!"#$%(* '#
T"('-&9 P-&
Some people belie1e that
2hanging ietary fat inta>e
anNor 2onsuming plant
foos that 2ontain anti"
inflammatory agents 2an
help ease pain by limiting
inflammation.
: mostly ra4 1egetarian
iet 4as foun helpful for
some people
4ith fibromyalgia, but this
stuy 4as not ranomi8e
an 4as 4ithout a 2ontrol
group. #ne stuy of 4omen
4ith premenstrual
symptoms suggeste that a
lo4"fat 1egetarian iet 4as
asso2iate 4ith e2rease
pain intensity an uration.
9eight loss a2hie1e by a
2ombination of ietary
2hanges an in2rease
physi2al a2ti1ity has been
sho4n to be helpful for
people suffering from
osteoarthritis.
Still, further resear2h is
neee to etermine the
effe2ti1eness of ietary
moifi2ations as a pain
treatment.
N/'"-'-#&7 S/!!7(2(&'*
0here is soli e1ien2e
ini2ating that glu2osamine
sulfate an 2honroitin
sulfate are effe2ti1e for
>nee osteoarthritis. 0hese
natural 2ompouns 4ere
foun to e2rease pain an
in2rease mobility of the
>nee an 4ere 4ell
tolerate an safe.
#ther ietary supplements,
su2h as fish oils, also sho4
some e1ien2e of benefit,
although more resear2h is
neee.
H("47 R(2()-(*
It has been iffi2ult to ra4
2on2lusions about the
effe2ti1eness of herbs. If
you e2ie to use herbal
preparations to better
manage your pain, it is of
2riti2al importan2e to share
this information 4ith your
o2tor. Some herbs may
intera2t 4ith rugs you are
re2ei1ing for pain or other
2onitions an may harm
your health.
THERAPY PURPOSE/
OBJECTIVE
MATERIALS
NEEDED
PROCEDURE
MUSIC
THERAPY
Musi2 therapists
primarily help
2lients impro1e their
obser1able le1el of
fun2tioning an self"
reporte quality of
life in 1arious
omains @e.g.,
2ogniti1e
fun2tioning, motor
s>ills, emotional an
affe2ti1e
M'("-7*:
CassetteNs
CDNs
0apeNs
StereoNs
.
Musi2 therapy is most
frequently use to help
the mentally or
physi2ally isable.
For e7ample is a
patient suffering from
spee2h iffi2ulties or
autism, may be
enable to e7press
themsel1es more
effe2ti1ely by ma>ing
musi2al souns an
Hse of musi2 as an aition
to rela7ation therapy or in
psy2hotherapy to eli2it
e7pressions of suppresse
emotions by prompting
patients to an2e, shout,
laugh or 2ry in response.
musi2 therapists
suggest that the
soun of musi2 that
is soothing an
2omfortable!
=o4ers
2ortisol, a stress
hormone, as
mu2h as &- V
Boosts
enorphins, the
boyGs natural
None >no4n
e1elopment,
beha1ior an so2ial
s>illsA by using
musi2 e7perien2es
@e.g., singing,
song4riting,
listening to an
is2ussing musi2,
mo1ing to musi2A to
a2hie1e measurable
treatment goals an
ob6e2ti1es
musi2 2an help people
4ith physi2al
isabilities to e1elop
better motor 2ontrol.
opiates or feel"
goo rugs.
Reu2es
pain after
surgery an
reu2es the nee
for seati1es
an pain
relie1ers
Ma>e
patients re2o1er
from surgery
faster an 4ith
less pain
May
pre1ent 2ols
Raises
bloo le1els of
Immunoglobin
:@immune
system fighterA
to a 4hopping
').' V
%ases labor
4ithout rugs
Helps
preemies in
intensi1e 2are
May
stimulate neural
2onne2tions in
the brain an
promote spatial
ability an
memory in
2hilren
=o4ers
bloo pressure
as mu2h as -
points, reu2es
heart rate,
impro1es
2aria2 output,
rela7es mus2le
tension
Manages
nonpharma2olo
gi2ally pain an
is2omfort
.
THERAPY PURPOSE/
OBJECTIVE
MATERIALS
NEEDED
PROCEDURE
ART
THERAPY
Musi2 therapists
primarily help
M'("-7*: :rt therapy pra2ti2e is
base on >no4lege
:rt therapy is efine as a
human ser1i2e profession
musi2 therapists
suggest that the
None >no4n
2lients impro1e their
obser1able le1el of
fun2tioning an self"
reporte quality of
life in 1arious
omains @e.g.,
2ogniti1e
fun2tioning, motor
s>ills, emotional an
affe2ti1e
e1elopment,
beha1ior an so2ial
s>illsA by using
musi2 e7perien2es
@e.g., singing,
song4riting,
listening to an
is2ussing musi2,
mo1ing to musi2A to
a2hie1e measurable
treatment goals an
ob6e2ti1es
Crayon
s
Bon
papers
9ater
2olors
<astels
S2issor
s
.
of human
e1elopmental an
psy2hologi2al theories
4hi2h are
implemente in the
full spe2trum of
moels of assessment
an treatment
in2luing eu2ational,
psy2hoynami2,
2ogniti1e,
transpersonal, an
other therapeuti2
means of re2on2iling
emotional 2onfli2ts,
fostering self"
a4areness, e1eloping
so2ial s>ills, managing
beha1ior, sol1ing
problems, reu2ing
an7iety, aiing reality
orientation, an
in2reasing self"esteem.
0his therapy is
an effe2ti1e treatment
for the
e1elopmentally,
mei2ally,
eu2ationally, so2ially,
or psy2hologi2ally
impaire an is
that uses art meia, images,
the 2reati1e pro2ess, an
patientN2lient responses to
the 2reate prou2ts as
refle2tions of an
ini1iual3s e1elopment,
abilities, personality,
interests, 2on2erns an
2onfli2ts.
0heories from
psy2hoanalysis an art
eu2ation are the
founations for the t4o
poles of the fiel, 4hi2h are
terme art psy2hotherapy
an art as therapy. 9hether
the therapeuti2 pro2ess is
inherent in tal>ing about a
4or> of art an in
e7pressing oneself or in the
spe2ifi2 a2t of 2reation has
been a sub6e2t of
2onsierable ebate. Most
art therapists fin that they
ra4 from both approa2hes,
moifying 4hat they o or
emphasi8e a22oring to the
population 4ith 4hi2h they
are 4or>ing.
soun of musi2 that
is soothing an
2omfortable!
=o4ers
2ortisol, a stress
hormone, as
mu2h as &- V
Boosts
enorphins, the
boyGs natural
opiates or feel"
goo rugs.
Reu2es
pain after
surgery an
reu2es the nee
for seati1es
an pain
relie1ers
Ma>e
patients re2o1er
from surgery
faster an 4ith
less pain
May
pre1ent 2ols
Raises
bloo le1els of
Immunoglobin
:@immune
system fighterA
pra2ti2e in mental
health, rehabilitation,
mei2al, eu2ational
an forensi2
institutions. :rt
therapists in
ini1iual, 2ouples,
family an group
therapy formats ser1e
populations of all
ages, ra2es, an
ethni2s ba2>grouns.
. to a 4hopping
').' V
%ases labor
4ithout rugs
Helps
preemies in
intensi1e 2are
May
stimulate neural
2onne2tions in
the brain an
promote spatial
ability an
memory in
2hilren
=o4ers
bloo pressure
as mu2h as -
points, reu2es
heart rate,
impro1es
2aria2 output,
rela7es mus2le
tension
Manages
nonpharma2olo
gi2ally pain an
is2omfort
.
THERAPY PURPOSE/
OBJECTIVE
MATERIALS
NEEDED
PROCEDURE
PSYCHODRAMA
THERAPY
P*1$%#)"2
is metho
of psy2hothera
py in 4hi2h
2lients are
en2ourage to
2ontinue an
2omplete their
a2tions
through
ramati8ation,
role
playingan
ramati2 self"
presentation
Both 1erbal an non"
1erbal 2ommuni2ations
are utili8e. : number
of s2enes are ena2te,
epi2ting, for e7ample
memories of spe2ifi2
happenings in the past,
unfinishe situations,
inner ramas,
fantasies, reams,
preparations for future
ris>"ta>ing situations,
or unrehearse
e7pressions of mental
states in the here an
no4. 0hese s2enes
either appro7imate real"
life situations or are
e7ternali8ations of
inner mental pro2esses.
If require, other roles
may be ta>en by group
<sy2horama is a
therapeuti2 is2ipline,
4hi2h uses a2tion
methos so2iometry,
role training, an
group ynami2s to
fa2ilitate 2onstru2ti1e
2hange in the li1es of
parti2ipants. <sy2ho"
ramatists pro1ie
ser1i2es to i1erse
groups from 2hilren
to the elerly, an
from the 2hroni2ally
mentally ill to those
see>ing unerstaning
an learning in their
4or> settings.
By 2losely appro7imating
life situations in stru2ture
en1ironment, the
parti2ipant is able to
re2reate an ena2t s2enes in
a 4ay, 4hi2h allo4s both
insight an an opportunity
to pra2ti2e ne4 life s>ills.
In psy2horama, the 2lient
fo2uses on a spe2ifi2
situation to be ena2te.
#ther members of the
group a2t as au7iliaries,
supporting the protagonist
in his or her 4or>, by
ta>ing the parts or roles of
signifi2ant others in the
s2ene. 0his en2ourages the
group as a 4hole to parta>e
in the therapeuti2 po4er of
the rama. 0he traine
ire2tor helps to re2reate
:lthough a primary
appli2ation of
psy2horama has
traitionally been as
a form of group
psy2hotherapy, an
psy2horama often
gets efine as ;a
metho of group
psy2hotherapy,; this
oes a isser1i2e to
the many other uses
or fun2tions of the
metho. More
a22urately
psy2horama is
efine as ;a
metho of
2ommuni2ation in
4hi2h the
2ommuni2atorJsK
e7presses
himNherNthemsel1es
in a2tion.; 0he
psy2horamati2
metho is an
None >no4n
members or by
inanimate ob6e2ts.
In psy2horama,
parti2ipants e7plore
internal 2onfli2ts throug
h a2ting out their
emotions an
interpersonal
intera2tions on stage. :
gi1en psy2horama
session @typi2ally +(
minutes to & hoursA
fo2uses prin2ipally on a
single parti2ipant,
>no4n as
the protagonist.
<rotagonists e7amine
their relationships by
intera2ting 4ith the
other a2tors an the
leaer, >no4n as
the director. 0his is
one using spe2ifi2
te2hniques,
in2luing oubling
@psy2horamaA, role
re1ersals, mirrors, solil
oquy, an
applie so2iometry.
<sy2horama attempts
s2enes that might other4ise
not be possible. 0he
psy2horama then be2omes
an opportunity to pra2ti2e
ne4 an more appropriate
beha1iors, an e1aluate its
effe2ti1eness 4ithin the
supporti1e atmosphere of
the group. Be2ause the
imension of a2tion is
present, psy2horama is
often empo4ering in a 4ay
that e72ees the more
traitional 1erbal therapies.
0here are se1eral
aitional bran2hes of
psy2horama. So2iometry
is the stuy an measures
of so2ial 2hoi2es 4ithin a
group. So2iometry helps to
bring the surfa2e patterns of
a22eptan2e or re6e2tion an
fosters in2rease group
2ohesion. 0his surfa2ing of
the 1alue systems an
norms of a group allo4s for
restru2turing that 4ill lo4er
2onfli2ts an foster
synergisti2 relationships.
So2iometry has been use
in s2hools an 2orporations
important sour2e of
the role"playing 4i
ely use in business
an inustry.
<sy2horama offers
a po4erful approa2h
to tea2hing an
learning, as 4ell as
to training
interrelationship
s>ills. 0he a2tion
te2hniques of
psy2horama also
offer a means of
is2o1ering an
2ommuni2ating
information
2on2erning e1ents
an situations in
4hi2h the
2ommuni2ator has
been in1ol1e.
to 2reate an internal
restru2turing of
ysfun2tional minsets
4ith other people, an
it 2hallenges the
parti2ipants to is2o1er
ne4 ans4ers to some
situations an be2ome
more spontaneous an
inepenent. 0here are
o1er '(,(((
pra2titioners
internationally.
as 4ell as 4ithin the mental
health fiel. So2iorama is
a form of psy2horama that
aresses the group3s
per2eption in so2ial issues.
Rather then being the
rama of a single
protagonist, this is a
pro2ess that slo4s the
group as a 4hole to safely
e7plore 1arious
per2eptions. Members
might aress problems
su2h as teenage pregnan2y
or rug abuse, an together
arri1e at unerstaning an
inno1ati1e responses to
these iffi2ult issues.
<sy2horama see>s
to use a person3s 2reati1ity
an spontaneity to rea2h his
or highest human potential.
9ith its perspe2ti1e on the
so2ial net4or> in 4hi2h an
ini1iual li1es, it promotes
mutual support an
unerstaning. In
e7plaining his 4or>, Dr.
Moreno state
psy2horama3s goal!
E2annot ha1e less an
ob6e2ti1e than the 4hole of
man>in.F
THERAPY PURPOSE/
OBJECTIVE
MATERIALS
NEEDED
PROCEDURE
DANCE
THERAPY
D&$( '%("!1,
or )&$( 2#,(2(&'
'%("!1 is
the psy2hotherapeuti
2 use of mo1ement
an an2e for
emotional, 2ogniti1e
, so2ial, beha1ioral
an physi2al 2oniti
ons
K
. Dan2e
mo1ement therapy
strengthens
the boyNmin 2onn
e2tion through boy
mo1ements to
impro1e both the
mental an
physi2al 4ell"being
of ini1iuals. :s a
form of e7pressi1e
therapy, DM0 is
foune on the basis
that mo1ement an
0he 2reati1e pro2ess
has four stages, 4hi2h
o22ur uring DM0.
%a2h stage 2ontains a
smaller set of goals
4hi2h 2orrelate to the
larger purpose of DM0.
0he stages an goals of
DM0 1ary 4ith ea2h
ini1iual. :lthough
the stages are
progressi1e, the stages
are usually re1isite
se1eral times
throughout the entire
DM0 pro2ess. 0he four
stages are!
<reparation! the 4arm"
up stage, safety is
establishe
In2ubation! rela7e, let
Dan2e therapy is
base on the premise
that the boy an min
are interrelate. Dan2e
therapists belie1e that
mental an emotional
problems are often
hel in the boy in the
form of mus2le
tension an
2onstraine mo1ement
patterns. Con1ersely,
they belie1e that the
state of the boy 2an
affe2t attitue an
feelings, both
positi1ely an
negati1ely.
4or> settings.
Dan2e mo1ements promote
healing in a number of
4ays. Mo1ing as a group
brings people out of
isolation, 2reates po4erful
so2ial an emotional bons,
an generates the goo
feelings that 2ome from
being 4ith others. Mo1ing
rhythmi2ally eases
mus2ular rigiity,
iminishes an7iety, an
in2reases energy. Mo1ing
spontaneously helps people
learn to re2ogni8e an trust
their impulses, an to a2t on
or 2ontain them as they
2hoose. Mo1ing 2reati1ely
en2ourages self"e7pression
an opens up ne4 4ays of
thin>ing an oing.
#n a purely
%7amples of these
in2lue!
:utism! therapists
2onne2t on a
sensory"motor le1el,
pro1ies a sense of
a22eptan2e an
e7pans s>ills an
2ogniti1e abilities,
in2reases maturity
=earning
Disabilities!
e1elops better
organi8ational s>ills,
learnsNe7perien2es
2ontrol an 2hoi2e,
higher self
2onfien2e, ne4
inspirations to learn
Mental Retaration!
None >no4n
emotion are ire2tly
relate. 0he ultimate
purpose of DM0 is
to fin a healthy
balan2e an sense of
4holeness.
go of 2ons2ious 2ontrol,
mo1ements be2ome
symboli2
Illumination! meanings
be2ome apparent, 2an
ha1e positi1e an
negati1e effe2ts
%1aluation! is2uss
signifi2an2e of the
pro2ess, prepare to en
therapy
physi2al le1el, an2e
therapy pro1ies the
benefits of e7er2ise,
impro1e health, 4ell"
being, 2oorination, an
mus2le tone. #n an
emotional le1el, it helps
people feel more 6oyful an
2onfient, an allo4s them
to e7plore su2h issues as
anger, frustration, an loss
that may be too iffi2ult to
e7plore 1erbally. #n a
mental le1el, an2e therapy
see>s to enhan2e 2ogniti1e
s>ills, moti1ation an
memory.
Bour an2e
therapist 2an also aress
spe2ifi2 problems in
spe2ifi2 4ays. For e7ample,
to help a patient reu2e
stress, a an2e therapist
4oul first ientify ho4 the
person3s boy rea2ts to
stress, an then e7plore
spe2ifi2 mo1ement
te2hniques to in2rease
2ir2ulation, eepen
breathing, an reu2e
mus2le tension.
impro1es boy
image, so2ial s>ills,
2oorination, an
motor s>ills,
promotes
2ommuni2ation
Deaf an Hearing
Impaire! reu2es
feelings of isolation,
pro1ies inspiration
for relationships
Blin an $isually
Impaire! impro1es
boy image, motor
s>ills, an personal
a4areness
<hysi2ally
Hani2appe!
impro1es motor
s>ills an boy
image, pro1ies a
4ay to 2ommuni2ate
an e7press
emotions
%lerly! pro1ies
so2ial intera2tion,
e7pression, an
e7er2ise, alle1iates
fears of loneliness
an isolation
THERAPY PURPOSE/
OBJECTIVE
MATERIALS
NEEDED
PROCEDURE
ELECTRO=
CONVULSI
VE
THERAPY
%le2tro2on1ulsi1e
therapy @%C0A,
pre1iously >no4n as
ele2trosho2>, is a
4ell"establishe,
albeit 2ontro1ersial,
psy2hiatri2 treatment
in 4hi2h sei8ures are
ele2tri2ally inu2e
in anestheti8e
patients for
therapeuti2 effe2t.
0oay, %C0 is most
often use as a
treatment for se1ere
ma6or epression
4hi2h has not
respone to other
treatment, an is
also use in the
treatment of mania
@often in bipolar
P"(!"'-#&!
M 0he patient has
a pretreatment
e1aluation in2luing
physi2al e7amination,
lab 4or> @CBC, Bloo
2hemistry, HN:A an
baseline memory
abilities.
M : 2onsent form
must be signe be2ause
%C0 is often gi1en as a
treatment of last resort,
some patient3s are so
profounly epresse
by the %C0 is orere
that a truly informe
2onsent is almost a
2ontraini2ation in
terms. In su2h 2ases,
:lthough %C0 4as
originally e1elope
for s2hi8ophrenia it3s
primary ini2ation
soon shifte to
patients 4ho 4ere
se1erely epresse
parti2ularly those
manifesting elusion
an psy2homotor
retaration.
M Ma6or
epression! %C0 is
appropriate treatment
4hen asso2iate 4ith
'. Non response
to an aequate trial of
anti epressant
&. High sui2ial
<ro2eure!
M :n intra1enous line
is inserte
M %le2troes are
atta2he to the proper pla2e
on the hea. %le2troes are
typi2ally hel 4ith a rubber
strap
M 0he bite blo2> is
inserte
M Methohelital other
short a2ting barbiturates is
gi1en intra1enously the
barbiturates 2auses
immeiately anesthesia
preempting the an7iety
asso2iate 4ith 4aiting for
the 6olt to bit an the
an7iety 2ause by
%7amples of these
in2lue!
:utism! therapists
2onne2t on a
pro1ies a sense of
a22eptan2e an
e7pans s>ills an
in2reases maturity
=earning
Disabilities!
e1elops better
learnsNe7perien2es
2ontrol an 2hoi2e,
higher self
2onfien2e, ne4
Contraini2ation!
Coffey an 9einer
@'++(A state that there
are no absolute
2ontraini2ations for
%C0. Wiring @'++(A
suggest that %C0
shoul be 1ie4e
similarly to May life"
sa1ing surgeries. 0hat
is, although there may
be 2onitions that pla2e
an %C0 re2ipient at
ris>, the ris> may be
4arrante if the
patient3s 2onition3s is
se1ere @e.g., se1ere
epression, a2ti1e
sui2ial ieation3sA
isorerA, an
2atatonia
family members an
fa2ility legal staff
shoul be in1ol1e.
M 0he routine use
of ben8oia8epines
barbiturates for
nighttime seation
shoul be eliminate
be2ause of their ability
to raise sei8ure
threshol.
M : traine
ele2trotherapist an an
anesthesiologist shoul
be a1ailable
potential
.. Dehyration
). Depressi1e
stupor
-. Catatonia
,. Delusions
M <rophyla7is of
re2urrent ma6or
epression i.e.
maintenan2e %C0
M Se1ere mania
Q not 2ontrolle by
mei2ation
M <ost"partum
psy2hosis after non
response to anti
epressant
M S2hi8ophrenia
Q 2atatoni2 type 4hen
non responsi1e to
mei2ations
M Mo1ement
isorer refra2tory to
treatment e.g.
<ar>inson3s iseases,
su22inyl2holine.
@Su22nyl2holine 2auses but
nit seation thereby lea1ing
the patient 2ons2ious but
unable to breathe.
N/"*-&9 "(*!#&*-4-7-'-(*
3'(" $"(
M 0he nurse or
anesthesiologist
me2hani2ally 1entilates the
patient 4ith '((V o7ygen
until the patient 2an breathe
unassiste.
M 0he nurse monitors
for respiratory problems
M %C0 2auses
2onfusion
M :n isorientation
it is important to help 4ith
reorientation as the patient
energies from this groggy
state. Sin2e appropriately
-(V to '((V of these
patient3s a4a>e agitate,
the nurse may nee to
aminister a prn
ben8oia8epine
M #bser1ations are
ne2essary until the patient
is oriente an steay
:ll aspe2t of the treatment
shoul be 2arefully
o2umente for the
patient3s re2or
Mental Retaration!
impro1es boy
2oorination, an
motor s>ills,
promotes
2ommuni2ation
Deaf an Hearing
Impaire! reu2es
pro1ies inspiration
for relationships
Blin an $isually
Impaire! impro1es
boy image, motor
s>ills, an personal
a4areness
<hysi2ally
Hani2appe!
impro1es motor
s>ills an boy
image, pro1ies a
4ay to 2ommuni2ate
an e7press
emotions
%lerly! pro1ies
so2ial intera2tion,
e7pression, an
fears of loneliness
neurolepti2 malignant
synrome tar2line
ys>inesia
an isolation
THERAPY PURPOSE/
OBJECTIVE
MATERIALS
NEEDED
PROCEDURE
INDOKLON
INHALATI
ON
THERAPY
use in some
hospitals for the
treatment of
mentally ill patients
in 4hom 2on1ulsi1e
therapy is ini2ate
P"(!"'-#&:
Ino>lon therapy is
gi1en only after the
requires physi2al
e7amination, laboratory
test, X"rays are
2omplete for the
purpose of ruling out
2ontraini2ations
similar to those for
ele2trotherapy. 0he
patient3s 1ital signs are
2he2>e t4i2e a ay for
t4o ays before
treatment. 0he patient
is not permitte to
ingest anything by
mouth on the morning
go treatment.
Ino>lon @FlurothylA, a
2olorless, 1olatile
liqui that is
aministere 4ith
o7ygen inhalation, is
being use in some
hospitals for the
treatment of mentally
ill patients in 4hom
2on1ulsi1e therapy is
ini2ate. 0he
te2hnique may be use
but itself therapy. It is
a treatment that, on2e
starte, may be gi1en
aily 4ithout
interruption, 4hen the
patient3s 2onition is
satisfa2tory, until a
series of eight to
fifteen treatments is
2ompli2ate. For those
: -"liter bag atta2he to an
o7ygen supply tan> is
2onne2te to the ino>lon
1apori8er. 0he 1apori8er is
2onne2te to the fa2emas>.
:bout (.- 22 of ino>lon is
put into the 1apori8er of the
bag is partially is
maintaine uring therapy.
Some physi2ians aminister
ino>lon therapy 4ithout
gi1ing the patient
premeitation others prefer
to pres2ribe atropine sulfate
'N,( grains by hypoermi2
in6e2tion ' hour before
treatment ignore to ry
se2retions an to pre1ent
1agal stimulations of the
heart. 0he alternati1e may
be to gi1e atropine sulfate
'N/- grains intra1enously as
%7amples of these
in2lue!
:utism! therapists
2onne2t on a
pro1ies a sense of
a22eptan2e an
e7pans s>ills an
in2reases maturity
=earning
Disabilities!
e1elops better
learnsNe7perien2es
2ontrol an 2hoi2e,
higher self
2onfien2e, ne4
No >no4n
patient3s 4ho fear
ele2trotherapy?
Ino>lon as usually a
more a22eptable
alternati1e. 0he most
benefi2ial results ha1e
been a2hie1e in
psy2hoti2 epresse
persons. :lthough the
sei8ures inu2e by
ino>lon are similar to
those prou2e by the
2lassi2al type of
ele2trotherapy, this
onset is appro7imately
one minute. Sin2e only
minimal amnesia may
be e1elop after
treatment. Ino>lon
may be useful in
outpatient fa2ilities.
treatment is starte. :n
intra1enous in6e2tion of '
per2ent bre1ital soium in
an a1erage ose of * to '(
22 is immeiately by small
ose of ane2tine
@su22inyl2holine 2hlorieA.
0he amount use epens
upon the mus2ular
e1elopment of the patient
an may 1ary from '- to &(
mg. For a 4oman of
a1erage 4eight to &( to )(
mg. For a man of a1erage
4eight. Separate syringe
are use for ea2h rug
aministere. :n ault
rubber 5ueel oral,
pharyngeal air4ay is then
inserte through the
patient3s smooth.
0he fa2emas> is pla2e
tightly on the patient3s fa2e
an the bag is squee8e
gently, for2ing the o7ygen"
ino>lon mi7ture into the
lungs at the rate of the
inhalation require to 2ause
a 2on1ulsion may 1ary from
three to si7. : sei8ure
usually o22urs 4ithin )(
Mental Retaration!
impro1es boy
2oorination, an
motor s>ills,
promotes
2ommuni2ation
Deaf an Hearing
Impaire! reu2es
pro1ies inspiration
for relationships
Blin an $isually
Impaire! impro1es
boy image, motor
s>ills, an personal
a4areness
<hysi2ally
Hani2appe!
impro1es motor
s>ills an boy
image, pro1ies a
4ay to 2ommuni2ate
an e7press
emotions
%lerly! pro1ies
so2ial intera2tion,
e7pression, an
fears of loneliness
se2ons. In mossy patient3s
respiration starts the
termination of the 2loni2
phase, as the patient is, in
effe2t, being resus2itate
uring the inhalation. Some
in1estigators ha1e foun it
unne2essary to 2ontinue
resus2itation until the
effe2ts of the :ne2tine
@su22inyl2holine 2hlorieA
has 2ompletely
isappeare. Ino>lon is
eliminate from the boy
through the lungs.
#bser1ation of the patient
follo4ing treatment is the
same as that follo4ing
ele2trotherapy.
A3'(" C"(:
M Release restraints
e1ery & hours an o range
of motion e7er2ises.
M <ro1ie hygiene
measures
M <a restraints an
2he2> 2ir2ulation. Che2>
1ital signs e1ery hour
M Reassure 2lients
allo4 e7pression of feelings
an isolation
THERAPY PURPOSE/
OBJECTIVE
MATERIALS
NEEDED
PROCEDURE
INSULIN
COMA AND
METRAZO
L
INDUCED
CONVULSI
ON
use in the treatment
of s2hi8ophreni2
patients
P"(!"'-#&:
Dresse in sleeping
attire, the patient is
ta>en to the insulin
treatment epartment in
the early morning.
Brea>fast is omitte.
He is put to be an the
nurse 2he2>s his
temperature, pulse,
respirations an bloo
pressure. 0he patient
1ois before re2ei1ing a
eep intramas2ular
in6e2tion of insulin.
Ini2ation!
M%ating an 4eight
problems
MSe1ere agitation
M<sy2hoti2 2lients
MS2hi8ophreni2 2lients.
P"#$()/"(:
0he initial ose is small an
1aries usually from - '(
units of insulin, epenent
upon the person3s age,
4eight an physi2al
2onition. 9hen the first
in6e2tion is gi1en 2areful
obser1ation is mae for
signs of hypersensiti1ity or
allergi2 rea2tions to the
rug. Raise 4elts aroun
the in6e2tion site or an
it2hing sensation
e7perien2e by the patient
an s2rat2hing of the
affe2te area ini2ations to
terminate treatment for the
ay. :nother bran or type
of insulin obtaine from a
sensiti1e to all types of
insulin, an antihistamine
rug is gi1en in
Su22essful in the
treatment of
s2hi8ophreni2
patients
No >no4n
2ombination 4ith the
insulin. Hyluroniase is
sometimes in6e2te in
2on6un2tion 4ith insulin to
fa2ilitate the rate of insulin
absorption by the boy,
ma>ing it possible to reu2e
osage.
:fter 2are!
MMonitor patient 2onition
2losely
M<ro1ie hygiene measures
M<as restraints an 2he2>
2ir2ulation. Che2> 1ital
signs e1ery hour
MReassure 2lient3s, allo4
e7pression of feelings
THERAPY PURPOSE/
OBJECTIVE
MATERIALS
NEEDED
PROCEDURE
NARCOTHERAPY Is the intravenous
administration of
sedatives or
stimulants to
produce a
physiological
state conductive
to therapeutic
change
M'("-7*:
EDrugs! Soium
<enthotal,
:mbarbital,
Methylpheniate
MNeele an
syringe
Nar2otherapy is a
form of therapy
originating in China
that isables the boy
or one part
temporarily by rugs
or a22upun2ture,
4hi2h is usually use
insurgi2al operations
An intravenous infusion of a
5% dextrose solution in
water is started to make a
vein accessible for
injection. A physician
administers the drug in the
amount required to facilitate
the clients responsiveness
to interview. !uring the
procedure traumatic events
are experienced" and the
unconscious emotions
associated with the events
are the treatment team as
they formulate appropriate
intervention strategies
0reatment of post
traumati2 stress
None >no4n
THERAPY PURPOSE/
OBJECTIVE
MATERIALS
NEEDED
PROCEDURE
PSYCHOSURGERY <sy2hosurgery,
also 2alle
neurosurgery for
mental isorer
@NMDA, is the
neurosurgi2al
treatment of
mental isorer.
<sy2hosurgery is
a 2ollaboration
bet4een
psy2hiatrists an
neurosurgeons.
During the
operation, 4hi2h
is 2arrie out
uner a general
anaestheti2 an
using stereota2ti2
methos, a small
pie2e of brain is
estroye or
remo1e. 0he
P"(!"'-#& 3#"
*/"9("1 -*
"(./-"()
#nly patients 4ith
se1ere, 2hroni2,
isabling an
refra2tory psy2hiatri2
isorers shoul be
2onsiere for
<sy2hosurgery. It is
helpful for the
follo4ing mental
isorer if or 4hen
traitional treatments
ha1e faile.
MDepression an
an7iety
MDepression Q relate
pain
M#bsessi1e Q
Compulsi1e isorers
M:ggression.
=obotomy is a
psy2hosurgi2al pro2eure
in1ol1ing estru2tion of
2onne2ti1e ner1e fibers or
tissue. It is performe on
the frontal lobe of the brain
an its purpose is to
alle1iate mental illness an
2hroni2 pain symptoms.
A3'(" C"(:
#ngoing beha1ioral an
mei2ation is after require
in #CD patient3s 4ho
unergo 2irgo2atomy. :ll
psy2hosurgery patients
shoul remain uner a
psy2hiatri2 2are for follo4"
up, e1aluation an
treatments.
No one a1o2ates
the use of 2lassi2al
lobotomies toay as
a treatment for
mental isorers.
Ho4e1er, a small
minority of
neurologists
a1o2ates the use of
1ery pre2ise surgi2al
te2hniques to
prou2e small
lesions in efine
areas of the brain to
treat rare 2ases of
se1ere mental illness
su2h as life"
threatening
epression or
in2apa2itating
an7iety or
obsessions.
Ho4e1er, there is
little nee for su2h
pro2eures toay.
:ntipsy2hoti2 an
antiepressant
mei2ations are the
Sie %ffe2t!
M Callus
MNo feeling tone
most 2ommon
types of
psy2hosurgery in
2urrent or re2ent
use are
2apsulotomy,
2ingulotomy,
sub2auate
tra2totomy an
limbi2
leu2otomy.
=esions are mae
by raiation,
thermo"
2oagulation,
free8ing or
2utting.
treatments of 2hoi2e
for treating mental
isorers.
THERAPY PURPOSE/
OBJECTIVE
MATERIALS
NEEDED
PROCEDURE
RECREATIONAL
THERAPY
O48($'-,(*:
M0o pro1ie an
a2ti1ity 4hi2h is
ifferent an
pro1ies a
2hange from the
patient3s usual
routine.
M 0o re1itali8e the
patient3s interest
an helps him to
re2reate feel
refreshe.
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21 )(!(&)* '##.
Re2reational therapy,
also referre to as
re2reation therapy an
therapeuti2 re2reation,
is a treatment ser1i2e
esigne to restore,
remeiate an
rehabilitate a person3s
le1el of fun2tioning
an inepenen2e in
life a2ti1ities, to
promote health an
4ellness as 4ell as
reu2e or eliminate the
a2ti1ity limitations an
restri2tions to
parti2ipation in life
situations 2ause by
an illness or isabling
2onition
D(!(&)(&' /!#& '%(
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0o restore,
remeiate an
rehabilitate a
person3s le1el of
fun2tioning an
inepenen2e in life
a2ti1ities, to
promote health an
4ellness as 4ell as
reu2e or eliminate
the a2ti1ity
limitations an
restri2tions to
parti2ipation in life
situations 2ause by
an illness or
isabling 2onition
D(*-9&-&9
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C"3'*
D"(**26-&9
5##)$"3'*

Psychiatric Therapies

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Psychiatric Therapies

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MSH College

Brgy. San Miguel, Iligan City

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