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Emotional reactions to psychiatric patients. Analysis of a feeling checklist.

In psychodynamic milieu treatment, the relations between patients and nurses are the main tools for understanding and helping the patients. For this reason, it is important to construct methods to follow the development of relations and to study characteristics of helpful and nonhelpful relations. In this article, a checklist with feeling words given to nurses and aides in psychiatric treatment facilities is presented and its measurement properties are described. The analysis showed that the checklist as a whole measures the amount of emotional arousal in a reliable way. The individual feeling words have acceptable variance. A factor analysis gave a limited number of factors that are clinically understandable. The checklist seems to be well worth further study.

Countertransference↗

Aloneness in tenuous self-states.

This article describes the inner world of severely impaired clients who operate within a behavioral mode of violence and manipulation. Clients who employ such tactics are attempting to exert control over an internal environment that threatens their sense of self-cohesion. While descriptive labels of "uncooperative" and "manipulative" may be apt, these terms are used pejoratively all too often. This article outlines nursing approaches that assist these clients to achieve greater self-cohesion.

Adolescent↗

A self-psychology approach to narcissistic personality disorder: a nursing reflection.

TOPIC: The use of Heinz Kohut's self-psychology perspective in understanding and providing care for patients with narcissistic personality disorder (NPD). PURPOSE: To describe how nurses can apply the self-psychology perspective as a way to understand the development of self for individuals with NPD and to enhance the therapeutic relationship between the nurse and patient with NPD. SOURCES: Theoretical literature; the author's clinical experience. CONCLUSIONS: Self-psychology provides nurses with a theoretical perspective that can enhance the interpersonal relationship between the nurse and patient with NPD.

Adult↗

Advanced practice psychiatric mental health nursing, finding our core: the therapeutic relationship in 21st century.

TOPIC: Increasingly, students from various professional backgrounds are enrolling in Psychiatric Mental Health (PMH) Nursing graduate programs, especially at the post-master's level. Faculty must educate these students to provide increasingly complex care while socializing them as PMH advanced practitioners. PURPOSE: To present how one online program is addressing these issues by reasserting the centrality of the relationship and by assuring it has at least equal footing with the application of a burgeoning knowledge base of neurobiology of mental illness. SOURCES: Published literature from nursing and psychology. CONCLUSIONS: The PMH graduate faculty believes that they have developed strategies to meet this challenge and to help build a PMH workforce that will maintain the centrality of the relationship in PMH practice.

Clinical Competence↗

Suicide: what is in the clinician's mind?

The assessment and treatment of the suicidal patient challenge all clinicians, regardless of training or theoretical orientation, to draw upon their knowledge and judgment to formulate the best treatment plan possible. As great as the influence of demographics, genetics, and psychobiology are, what is in the mind of the clinician, whether it is anxiety, confidence, knowledge, or uncertainty, will determine the fate of the suicidal patient.

Countertransference↗

Examining the multifaceted notion of isomorphism in marriage and family therapy supervision: a quest for conceptual clarity.

The notion of isomorphism has been recommended as a conceptual framework to guide the practice of marriage and family therapy (MFT) supervision. The term is frequently cited in the MFT training literature but is often used in different ways. A panel of MFT supervisors rated the importance and relevance to both therapy and supervision of a large pool of variables. The majority of variables were found to be equally relevant or isomorphic to the domains of MFT and MFT supervision. A qualitative interview with a small subset of the panelists suggested that the concept, to varying degrees, has influenced their work as supervisors. The implications of the results for theory development, research and supervisory practice are discussed.

Adult↗

Counter-transference and counter-experience in the treatment of violence prone youth.

The constant confrontation inherent in therapeutic intervention with violence prone children, some of whome have committed homicide, is explored. Problems unique to work with these youths are discussed in terms of counter-transference issues for clinicians and counter-experience of teachers and child care workers. Suggestions for training and supervision are offered.

Adolescent↗

Crisis in psychotherapy: principles of emergency consultation and intervention.

A surprisingly large number of visits to a crisis intervention service are made by patients engaged in ongoing psychotherapy elsewhere. Data are presented from patients and their therapists that support the concept of a psychotherapy crisis as a major precipient of such visits. A typology for the therapy crisis is elaborated, and guidelines for the crisis worker's assessment and intervention are suggested.

Adolescent↗