Nursing Diagnoses in Psychiatric Nursing Care Plans and Psychotropic Medications

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facilitate change in the family structure. The therapist does this (8) societal regression. The goal is to increase the level of dif-This model uses the interactional or communications approach. The Strategic Modelturing the family.The Family as a SystemGeneral systems theory is a way of organizing thought accord-ing to the holistic perspective. A system is considered greater than the sum of its parts. A family can be viewed as a system composed of various subsystems. The systems approach to fam-ily therapy is composed of eight major concepts: (1) differentia-tion of self, (2) triangles, (3) nuclear family emotional process, (4) family projection process, (5) multigenerational transmission process, (6) sibling position profiby joining the family, evaluating the family system, and restruc-^572 ferentiation of self, while remaining in touch with the family system.The Structural ModelIn this model, the family is viewed as a social system within which the individual lives and to which the individual must adapt. The individual both contributes to and responds to stresses within the family. Major concepts include systems, subsystems, trans-actional patterns, and boundaries. The goal of therapy is to Functional families are open systems where clear and precise^ ●^ APPENDIX F les, (7) emotional cutoff, and

2 2506_Appendix_F_570-579.indd 572 506 _AppendixF 570 - 5 inconsistent and incongruent with the situation. Destructive patterns of communication tend to inhibit healthful nurtur-ing and decrease individual feelings of self-worth. Concepts of this model include double-bind communication, pseudomutual-ity and pseudohostility, marital schism, and marital skew. The goal of therapy is to create change in destructive behavior and communication patterns among family members. This is ac-complished by using paradoxical intervention (prescribing the symptom) and reframing (changing the setting or viewpoint in relation to which a situation is experienced and placing it in another more positive frame of reference).● messages, congruent with the situation, are sent and received. In psychiatry, milieu therapy, or a therapeutic community, con-stitutes a manipulation of the environment in an effort to create behavioral changes and to improve the psychological health and Healthy communication patterns promote nurturance and indi-vidual self-worth. In dysfunctional families, viewed as partially closed systems, communication is vague, and messages are often 79 .iMILIEU THERAPYndd 572 1 10/1/10 9:30:41 AM 0 / 1 / 10 9 : 30 : 41 AM
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