Psychiatric Mental Health Nursing by Videbeck

428 Unit 4 NURSINGPRACTICE FORPSYCHIATRICDISORDERS

continued from page 427

Stabilization

The client will

• Demonstrate appropriate or adequate
  social skills


• Identify social activities in drug- and
  alcohol-free environments


• Assess own strengths and weak-
  nesses realistically
  Community
  The client will


• Maintain contact or relationship
  with a professional in the community


• Verbalize plans to join a community
  support group that meets the needs
  of clients with a dual diagnosis, if
  available


• Participate in drug- and alcohol-free
  programs and activities

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IMPLEMENTATION

Nursing Interventions *denotes collaborative interventions Rationale

Encourage open expression of feelings.

Validate the client’s frustration or anger in deal-

ing with dual problems (e.g. “I know this must be

very difficult.”).

Consider alcohol or substance use as a factor that

influences the client’s ability to live in the com-

munity, as you would other factors such as taking

medications, keeping appointments, having ade-

quate eating and sleeping patterns, and so forth.

Maintain frequent contact with the client even if

it is only brief telephone calls.

Give positive feedback for abstinence on a day-by-

day basis.

Verbalizing feelings is an initial step toward deal-

ing constructively with those feelings.

Expressing feelings outwardly, especially negative

ones, may relieve some of the client’s stress and

anxiety.

For the client with a dual diagnosis, substance

use is not necessarily the major problem he or she

experiences; it may be only one of several prob-

lems. Overemphasis on any single factor, even

substance use, is not a guarantee of success.

Frequent contact decreases the length of time the

client feels “stranded” or left alone to deal with

problems.

Positive feedback reinforces abstinent behavior.