Course Name: CARE OF CLIENTS WITH MALADAPTIVE PATTERNS OF BEHAVIOR

Course Code: NCM 105

Course Description:The course is designed to focus on health and illness across the lifespan of clients,

population group with acute and chronic psychosocial difficulties and psychiatric illnesses.

Course Credit: 4units lecture; 2units RLE (2units Clinical)Contact Hours/Semester: 72 Lecture hours; 102 RLE hoursPrerequisite: General Psychology, NCM 103Co-requisite: NCM 104Placement: 3rd Year; 2nd semester

Course Objectives:At the end of the course, and given actual clients with maladaptive patterns of behavior,

the student shall be able to:1. Utilize the nursing process in the care of individuals, families in community and hospital settings.

- assess client/s with his/her/their condition through mental status examination, physical examination, interpretation of diagnostic procedures- identify actual and potential nursing diagnosis- plans appropriate nursing interventions with client/s and family for identified nursing diagnosis- Implement plan of care with client/s and family- Evaluate the progress of his/her/their client’s condition and outcomes of care

2. Apply knowledge and understanding of maladaptive patterns of behavior in providing safe and quality care to clients.3. Increase self-awareness and therapeutic use of self in the care of clients4. Ensure a well organized and accurate documentation system5. Relate with client/s and their family and the health team appropriately6. Observe bioethical concepts/ principles, core values and nursing standards in the care of clients7. Promote personal and professional growth of self and others

Course Outline:

I. Overview of Psychiatric NursingA. Evolution of Mental Health-Psychiatric Nursing PracticeB. The Mental Health Nurse

• Role• Essential qualities

C. Interdisciplinary TeamThe Mental Health Illness Continuum

II. Mental Health-Psychiatric Nursing Practice

A. Personality Theories and Determinants of Psychopathology: Implications for Mental Health-Psychiatric Nursing Practice

a. Psychoanalyticb. Behavioralc. Interpersonald. Cognitivee. Humanisticf. Psychobiologicg. Cognitiveh. Psychosociali. Psychospiritualj. Eclectic

B. General Assessment Considerations1. Principles and Techniques of Mental Health-Psychiatric Nursing Interview2. Mental Status Examination3. Diagnostic Examinations Specific to Psychiatric Patients

C. Building Nurse-Client Relationship1. Nurse-Client Interaction vs. Nurse-Client Relationship2. Therapeutic Use of Self3. Therapeutic Communication

a. Characteristicsb. Techniques

4. Goals in the One-to-One Relationship5. Phases in the Development of Nurse-Client Relationship

D. Documentation in Psychiatric Nursing Practice1. Problem Oriented Recording

a. SOAP2. Narrative Recording3. Process Recording

E. Therapeutic Modalities, Psychosocial Skills and Nursing Strategies1. Biophysical /Somatic Interventions

a. Electroconvulsive and Other Somatic Therapiesb. Psychopharmacology

2. Supportive Psychotherapya. Nurse-Patient Relationship Therapyb. Group therapyc. Family therapy

3. Counseling4. Mental Health Teaching/Client Education5. Self-Enhancement, Growth/Therapeutic Groups6. Assertiveness Training7. Stress Management8. Behavior Modification9. Cognitive Restructuring10. Milleu Therapy11. Play Therapy

12. Psychosocial Support Interventions13. Psychospiritual Interventions14. Alternative Medicine/Therapies

F. Concept of Anxiety1. Defining characteristics of Anxiety2. Levels of Anxiety3. Manifestations of Levels of Anxiety

3.1. Physiologic3.2. Psychologic

4. Ego Defense Mechanisms4.1. Four levels of Defense

G. Crisis1. Types of crisis2. Phases of Crisis Development3. Characteristics of Crisis4. Crisis Intervention

III. Care of clients with maladaptive patterns of behavior across the lifespan (childhood, adolescent, adulthood)A. The Nursing Process applied to Psychiatric Nursing Practice:

1. Assessing human response to the different maladaptive patterns of behaviora. Self-awareness and Use of Selfb. Bio-Psycho-Social and Behavioral data

2. Nursing Diagnosis and Outcome identification3. Planning and implementing nursing intervention

a. Biologicalb. Psychosocial

4. Evaluation and treatment outcomesB. Maladaptive Patterns of Behavior

1. Age-Related Maladaptive Patterns: Disorders Across the Lifespan2. Anxiety-Related Disorders

a. Anxiety disorders across the lifespan Panic Disorder Phobias Post traumatic stress disorder Acute Stress disorder Obsessive-compulsive disorder Generalized Anxiety Disorder

b. Somatoform disorders Somatization disorder Conversion disorder Hypochondriasis Pain disorder Body Dysmorphic disorder

c. Dissociative disorders Depersonalization

Psychogenic Amnesia Psychogenic Fugue Dissociative Identity Disorder/ Multiple Personality disorder

3. Psychophysiologic Response and Sleep4. Personality Disorders

a. Childhood Personality disorders Conduct disorder Oppositional Defiant Behavior

b. Odd/ eccentric behaviours Paranoid personality disorder Schizoid personality disorder Schizotypal personality disorder

c. Dramatic, emotional, erratic behaviours Antisocial personality disorder Borderline personality disorder Narsicistic personality disorder Histrionic personality disorder

d. Anxious, fearful behaviors Obsessive compulsive personality disorder Dependent personality disorder Avoidant personality disorder

e. Passive aggressive5. Substance-Related Disorders: Substance Abuse, Dependence, Intoxication, Withdrawal and Polysubstance dependence

a. Central Nervous System Depressants Alcohol Sedatives-Hypnotics and Anxiolytics Opioids

b. Central Nervous System Stimulants Caffeine Nicotine Amphetamine and Cocaine

c. Hallucinogensd. Cannabise. Inhalantsf. Nursing Issues

6. Mood Disordersa. Reactive Attachment disorderb. Bipolar I disorderc. Bipolar II disorderd. Cyclothymic disordere. Dysthymic disorderf. Major Depressive Disorderg. Clients at risk for suicidal and self-destructive behavior

7.Schizophrenia and other Psychosesa. Schizophrenia

Catatonic type Paranoid type Undifferentiated type Disorganized type Residual type

b. Other Psychotic Disorders Schizophreniform d. Schizoaffective d. Delusional disorder Brief Psychotic disorder Shared Psychotic disorder

8.Cognitive Disordersa. Fetal Alcohol Syndromeb. Attention deficit hyperactive disorderc. Autismd. Deliriume. Dementiaf. Alzheimer’s Diseaseg. Diffuse Lewy Body diseaseh. Korsakoff’s Diseasei. Huntington’s Diseasej. Pick’s Diseasek.Vascular and Multi-infarct Dementia

9.Eating disordersa. Picab. Ruminationc. Feeding disordersd. Anorexia Nervosae. Bulimia Nervosa

10. Psychosexual Disordersa. Gender Identity Disorderb. Sexual Dysfunctionsc. Paraphilias

11. Abuse and Violencea. Victims of violent behavior

Child Spouse Elderly

b. Torture and ritual abusec. Rape and Sexual Assault

C. Legal issues affecting mental health nursingD. Future trends and issues in mental health nursing practiceE. Community-Based mental health programs

Guide for RLEProvide opportunities to care for actual clients in the hospital and community to ensure

competencies are developed.