Question

cluster 3. While working in a psy chiatric mental health facility, you are assigned to Kenny, a 34-year- old man who has just been diagnosed with a personality disorder. Kenny says to you, "can't they just give me a pill so that I can feel betterimoki 6 What are the different treatment options that are available for a client with a personality a. disorder? b. treatmentis believed to help the disorder Identify what treatment modality is best for each personality disorder and how the 4. You have been a psychiatric nurse for 10 years working with children Fou are being transferred to the adult unit where you will be working with clients with Personality Disorders and y ou have no experience in this area a. Why is self care important for the nurse when working with patients with this diagnosis? b. What self care activities will you employ and why? Discussion Topics, Mohr Chapter 27, Depresive Disorders 1. Depression is often feferred to as the commen cold of mental ilness because it affectss 31

mental health nursing q 3 and 4

Answer 1

3 a

An essential element of the diagnosis is that the symptoms of personality disorders are fixed and long lasting.Even with treatment it is not possible to completely change someones personality.However it is possible to help people with personality disorders improve the quality of their lives.Treatment can lead to significant improvement in the symptoms,distress and general functioning of patients with personality disorders.Persons with personality disorder come to treatment for help with depression,anxiety ,alcoholism or difficulties in work or personal relationships,not to have their personalities changed.The focus of therapy is to help patients change the maladaptive thinking and behaviour that result from personality traits and to treat any comorbid conditions.Various behavioural strategies can help decrease antisocial behaviour.These can include social skills training and anger management .A specific form of cognitive behavioural therapy called dialectical behaviour therapy (DBT)is an empirically validated treatment approach for patients with borderline personality disorder.DBT uses behavioural and cognitive techniques that include psychological education ,problem solving,training in social skills,excercising in monitoring moods ,modeling by the therapist,homework assignments and meditation.it is based on the assumption that temperament and an unresponsive environment have made patients unable to trust their own emotional response or soothe themselves.Medications have only limited role in the treatment of personality disorders.

b

Paranoid personality disorder-Supportive psychotherapy,antidepressants,antipsychotic for depressive as well as acute psychotic symptoms.

Schizoid personality disorder-supportive psychotherapy,antipsychotics for thought disorder and acute psychotic symptoms.

Schizotypal personality disorder-supportive psychotherapy,antipsychotics for thought disorder and acute psychotic symptoms.

Antisocial personality-Psychotherapy-group therapy and medications.

Histrionic personality-positive reinforcement and group therapy.

Obsessive Compulsive personality - antianxiety agents.

Dependent personality disorder-Antidepressants and anti-anxiety agents

Avoidant personality disorder-Group therapy,social skills training and anti-anxiety medicines.

4 a The deliberate self destructive or self-mutilating behaviour of the borderline patient is very difficult to treat .often the nursing staff must observe the patient constantly to prevent physical harm.The challenges to nurses are to maintain the patients safety ,facilitate the patients participation in care,select the least restrictive intervention,facilitate behavioural change and help the patient assume responsibility for behaviours.

b Talking to colleagues about feelings of frustration will help the nurse deal with emotional responses,so the nurse can be more effective with clients.Clear ,frequent communication with other health-care providers can help to diminish the clients manipulation.Set realistic goals and remember that behaviour changes in clients with personality disorders take a long time.