MENTAL ILLNESS - PowerPoint by XhrXuQ

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									    MENTAL ILLNESS




DEFINITION: A DISTURBANCE OF
 MIND WHEREIN THE CLIENT IS
  NOT DEALING WITH REALITY
IS A CLINICAL SYNDROME:
A.   ALTERATION IN PERCEPTION
B.   DISTURBANCE IN THOUGHT
     PROCESS
C.   DISTURBANCE IN EMOTION
D.   DISTURBANCE IN BEHAVIOR
CLASSIFIED INTO 2:


   1. ORGANIC - A PSYCHOTIC
        SYMPTOMS APPEAR BECAUSE
        OF DAMAGE OF BRAIN CELLS.
   A.   Acute- called delirium; it is
        reversible
   B.   Chronic- called dementia; it is
        irreversible. Structural damage to
        the brain cells brought about by
        infection and degenerative
        changes.
2. FUNCTIONAL

No damage to the brain cells but it is
  cause by unconscious conflict.
eg. Schizoprenia
    manic- depressive disorder
    post partum blues
PRIMARY SYMPTOMS OF
    SCHIZOPRENIA

1.   ASSOCIATIVE DISTURBANCE
     OR LOOSENESS
2.   AFFECTIVE DISTURBANCES OR
     INAPPROPRIEATE MOOD
3.   AUTISM
4.   AMBIVALENCE
     SECODARY STMPTOMS
1. DELUSION
2. ILLUSION
3. HALLUCINATION
OTHERS INCLUDED:
1. LOSS OF EGO BOUNDARIES OR LOSS OF
   IDENTITY
2. INADEQUATE ABILTY, INTEREST OR DRIVE
   TO COMPLTE TASK.
3. IMPAIRED REACTION TO THE ENVIRONMENT
   RESULTING IN WITHDRAWAL
4. MOOD SWINGS
5. UNFOUNDED BODILY COMPLAINS
6. CHANANGES IN APPETITE
CHARACTERISTICS OF SCHIZOPRENIA

      POSITIVE                NEGATIVE
BEHAVIORAL:            DECREASE ACTIVITY LEVEL
                       LIMITED SPEECH;
HYPERACTIVITY          CONVERSATION DIFFICULT
BIZARRE BEHAVIOR       MINIMAL SELF- CARE
AFFECTIVE:
INAPPROPRIATE AFFECT   BLUNTED OR FLAT
OVERREACTIVE AFFECT    AFFECT
HOSTILITY              ANHEDONIA
PERCEPTUAL:
HALLUCINATION          INABILTY TO UNDERSTAND
SENSORY OVERLOAD       SENSORY INFORMATION
COGNITIVE:
DELUSIONS               CONCRETE THINKING
DISORGANIZED THINKING   ATTENTION IMPAIRMENT
LOOSE ASSOCIATION       MEMORY DEFICITS
SUSPICIOUSNESS          IMPAIRED PROBLEM SOLVING
                        LACK OF MOTIVATION

SOCIAL:
ALOOF AND STILTED       SOCIAL WITHDARWAL,
INTERACTIONS            ISOLATION, POOR
                        RAPPORT WITH OTHERS,
                        INADEQUTE SOCIAL AND
                        OCCUPATIONAL SKILLS
         SCHIZOPRENIA
1.   BLEULER
      - SCHIZIN-   SPLIT
      - PHREN-     MIND
-    A CHRONIC/ DEVASTATED DISORDER
-    DESCRIBED 4A’S (PRIMARY SYMPTOMS)
4A’S:
1.  ASSOCIATIVE LOOSENESS
    - ILLOGICAL THINKING
    - WORD SALAD
    - NEOLOGISM
2.  AFFECT IMPAIRMENT
    - APATHY
3.  AMBIVALENCE
    - PRESENCE OF 2 OPPOSITE FEELINGS
4. AUTISM
    - EXAGERATED SELF- CENTEREDNESS
    - PREOCCUPIED WITH FANTACIES
    - SELF WORLD
2. EMIL KRAEPELIN
- CALLED DEMENTIA PRAECOX

- DEMENTIA OF EARLY LIFE

- HAS EARLIEST ONSET – 13
  y.o.
     5 types of SCHIZOPRENIA
1.   DISORGANIZED OR HEBEPHRENIC
      -SYMPTOMS OCCUR BECAUSE THE
     PERSON IS UNABLE TO COMPLETE A
     TRANSITION FROM ADOLESCENCE
     TO MATURITY, THEREBY
     CONTRIBUTING TO AN EARLY
     ONSET.
CLINICAL SYMPTOMS:
1.   BLUNTED, INAPPROPRIATE, OR SILLY EMOTIONS
     SUCH AS GIGGLING OR SUPERFICIAL SADNESS.
2.   INCIHERENCE OR THE INABILITY TO MAKE SENSE
     OR BE UNDERSTOOD WHEN TALKING.


3.   WITHDRAWN AND APATHETIC
4.   HALLUCINATING AND DELUSIONS
5.   BIZZARE BEHAVIOR
eg. Masturbation in public, playing of feces and urine, squatting in the
     floor in nude.
2. Catatonic type- person is aware in his
envoronment.

Symptoms:
1.   Abnormal or catatonic posturing
2.   Catatonic stupor or withdrawing from environment.
3.   Catatonic negativism
     - the person is resistant to all instructions or attempts to be
     moved
4. Catatonic rigidity
5. Catatonic excitement
     - aggressiveness and hyperactivity
6. Waxy flexibility
     - the person will maintain the position in which he has been
     placed
7. Echolalia
     - repeats all words or phrases heard
   Echopraxia
     - mimics action of others
            PARANOID

              OVER SUSPICIOUS
  DELUSION OF PERSECUTION AND GRANDEUR
            IDEAS OF REFERENCE
         MANIPULATIVE, DEMANDING
       HOSTILITY AND AGGRESIVENESS
         ARGUMENTATIVE BEHAVIOR
JEALOUS AND STRONGLY SENSITIVE TO RELIGION
     DOUBTS ABOUT GENDER SENSITIVITY
                 2 GOALS OF CARE
1.   BUILDING TRUST
     a. PASSIVE FRIENDLYNESS
     b. HELP THEM THAT THEY ARE ACCEPTED AND SAFE
     C. HELP DEVELOP SELF- CONFIDENCE
2.   MAINTAIN TRUST
     a. SHOW RESPECT
     b. KEEP PROMISES
     C. AVOID TALKING OR LAUGHING IN FRONT OF PERSON
     d. AVOID WHISPERING
     e. ASK PERMISSION TO PARANOIDS THAT YOU COULD TALK TO
     OTHERS.
     f. AVOID ARGUING
PROBLEM #1. DELUSION OF BEING
   POISON
1. LET PERSON EAT TO ANOTHER
   PERSON EATING SAME KIND OF
   FOOD
2. LET PERSON PREPARE HIS OWN
   FOOD
3. FOOD WITH A COVER,SEAL

4. CANNED GOODS

5. NEVER MIX MEDICINES TO FOOD OR
   DRINKS
PROBLEM #2. MEDICINE
1. TRUSTED PERSON WILL GIVE THE
   MEDICINE
2. PREPARE MEDICINE INFRONT OF THE
   PATIENT
3. IDENTIFY TO PARANOID ALL HIS DRUGS
4. NEVER GIVE PLACEBO

NOTE: <0>PARANOID ARE GIVEN DRUGS IN
  LIQUID FORM
      <0> PARANOID ARE GIVEN
  PARENTERAL PRECAUTION
          SIDE EFFECTS:
1.   SKIN – ALLERGY,RASHES,DERMATITIS,
     ECZEMA, HYPERPIGMENTATION
2.   GIT - N/V, CONSTIPATION
3.   EYES – BLURRING OF VISION
4.   ENDOCRINE - MALE: ENLARGEMENT OF THE
     BREAST( GYNECOMASTIA) WOMEN :
     ENLARGEMENT OF THE BREAST
5.   ANS : LOW ACETYLCHOLINE
a.   DRYNESS OF THE MOUTH
b.   URINARY RETENTION/ CONSTIPATION
c.   LOW EPINEPHRINE – CAUSE HYPOTENSION
7.   HYPERSENSITIVE REACTION
a.   ALLERGY
b.   AGRANULOCYTOSIS – 1-3 WEEKS AFTER
     RECEIVING DRUGS
c.   SORE THROAT
d.   FEVER
e.   JAUNDICE


8. EPS  – BASAL GANGLIA
       - AFFECTED ARE VOLUNTARY
     MOVEMENTS OF THE SKELETAL
     MUSCLE
                 5 EPS:
1.   PARKINSONISM OR PARALYSIS
     AGITANS – A CHRONIC DISEASE
     CHARACTERIZED BY
     DEGENERATION OF BASAL GANGLIA
     DUE TO LOW DOPAMINE LEVEL,

        CHARACTERIZED BY TREMORS,
         RIGIDITY OF EXTREMITY
        EXPRESSIVENESS FACE, DROOLING OF
         SALIVA
        SHUFFLING GAIT
2. AKATHISIA – MOTOR
 RESTLESSNESS
   MANIFESTED BY FOOT
    TAPPING
3. AKINISIA- ABSENCE OF
   MOVEMENT, SLOWNESS OF
   MOVEMENT
4. DYSTONIA – EARLIEST EPS
   > APPEAR 2-5 DAYS AFTER
     INITIATING TREATMENT
     > SEVERE CONTRACTIONS OF
     MUSCLES
a.   EYES LOOKING UPWARD
b.   OCULO- GYRIC CRISIS – INVOLUNTARY
     ROLLING BACK OF EYEBALLS
c.   STIFFNESS OF THE NECK
d.   BODY OPISTHOTONUS –     SEVERE
     ARCHING OF BACK / ERECT POSTURE /
     ROBOT LIKE
5. TARDIVE DYSKENESIA – LATE
   APPEARING

  > IRREVERSIBLE EPS/ AFFECTS THE
  NEURO MUSCULAR SYSTEM
  > EYES INVOLUNTARY BLINKING (
  STOP DRUGS )
  > LIPS – INVOLUNTARY KISSING,
  CHEWING
  > TONGUE – WORM LIKE MOVEMENT
ANTI PARKINSONISM DRUGS
   <>REDUCE EPS EXCEPT
       TARDIVE DYSKINESIA
1.   ARTANE TRIHEZYLPHENIDYL
2.   AKINETON – BIPERIDINE HCL
3.   COGENTIN- BENZTROPINE MESYLATE
4.   BENADRYL DIPHENHYDRAMINE
5.   UNDIFFERENTIATED – UNCLASSIFIABLE,
     MIXTURE OF SYMPTOMS
6.   RESIDUAL – A STATE OF BEING PARTIAL
     REMISSION
       HAS (1) HISTORY OF ONE PREVIOUS
        SCHIZOPHRENIC EPISODE BUT NO
        LONGER EXHIBITS OBVIOUS OR
        INTENSE PSYCHOTIC SYMPTOMS.
            TREATMENT:
1.   TRANQUILIZERS
     A. MAJOR TRANQUILIZERS / NEUROLEPTICS
     OR ANTI PSYCHOTIC DRUGS
     B. ACTION:
      >IT REDUCES PSYCHOTIC SYMPTOMS
       >DECREASES DOPAMINE LEVEL, REGULATES
     SLEEP CYCLE.
       >LIMBIC SYSTEM : MAINTAINS ALERTNESS,
     STORAGE OF INFORMATION.
       >LOW DOPAMINE BASAL GANGLIA – FOR
     MUSCLE COORDINATION.
1.   THORAZINE/ SONAZINE –
     CHLORPROMAZINE
2.   HALDOL / SERENACE -
     HALOPERIDOL
3.   MELLARIL - THIORIDAZINE
4.   PROLIXIN- FLUPHENAZINE
5.   MODECATE- FLUPHENAZINE
     DECOANATE
6.   STELAZINE- TRIFLUPROMAZINE
       ELECTRO CONVULSIVE
            THERAPY

   GIVEN IF PERSON WON’T RESPOND TO
    TRANQUILIZERS
   INTRODUCED BY CERLITTI AND BINI
   AN INTRODUCTION OF ELECTRIC
    CURRENT BETWEEN 70- 150 VOLTS, 0.1 – 1
    SEC. ONLY
   THIS PRODUCES 45 SECONDS GRANDMAL
    SEIZURES
   TONIC LAST 10 SEC.
   CLONIC LAST 30 – 35 SEC.
   2 ELECTRODES APPLIED AT TEMPORAL
    LOBE
    SCHIZOPHRENICLIKE DISORDERS:
   SCHIZOAFFECTIVE DISORDERS- EXHIBITS
    SYMPTOMS OF SCHIZOPHRENIA AS WELL
    AS MAJOR AFFECTIVE DISORDERS
   SCHIZOPHRENIFORM DISORDERS –
    EXHIBITS FEATURES OF SCHIZOPHRENIA
    FOR MORE THAN 1 WEEK BUT LESS THAN
    6 MONTHS
   BRIEF REACTIVE PSYCHOSIS- EXHIBITS
    SYMPTOMS OF SCHIZOPHRENIA FOR A
    FEW HOURS BUT NOT MORE THAN 1 WEEK

   INDUCED PSYCHOTIC DISORDERS –
    DEVELOPS IN A SECOND PERSON AS A
    RESULT OF A CLOSE RELATIONSHIP WITH
    ANOTHER PERSON WHO HAS PROMINENT
    DELUSION
     TREATMENT:

   <>PSYCHOTHERAPY

  <>MILLIEU THERAPY

   <>CHEMOTHERAPY

<>SOMATIC : ECT/ INSULIN
     SHOCK THERAPY
        NURSING CARE:
   ESTABLISH A TRUSTING RELATIONSHIP BY
    COMMUNICATING A SIMPLE AND EASY TO
    UNDERSTAND TERMS
   ALLEVIATE ANXIETY
   MAINTIAN BIOLOGICAL INTEGRITY BY ASSISTING
    PATIENT IN THE PERFORMANCE OF ADL AND
    MEETING BASIC NEEDS
   PROVIDE SAFETY MEASURES TO PATIENT WHO
    DISPLAYS DESTRUCTIVE BEHAVIORS, SUICIDAL
    IDEATION, POOR JUDGEMENT OR DISORIENTATION
 ENCOURAGE PARTICIPATION OF PATIENT
              ACTIVITIES
  PROGNOSIS       FAVORABLE      UNFAVORABLE
UNFAVORABLE        SUDDEN         INSIDIOUS
PRECIPITATING    IDENTIFIABLE     UNKNOWN
                                   FACTOR
MANIFESTATION    LESS THAN 1    MORE THAN 1 YR
                    YEAR
     S.O.          MARRIED       UNMARRIED
     JOB           POSITIVE        JOBLESS

SOCIAL HISTORY    (+) SOCIAL    POOR SOCIAL / +
                 ADJUSTMENT          P.A.
MANAGEMENT       COOPERATIVE         NON-
                                 COOPERATIVE
  MOOD DISORDERS


MOOD- FEELING TONE , IT IS
       SUBJECTIVE

NORMAL MOOD – EUTHYMISM
     TYPES OF MOOD DISORDERS:
1. BIPOLAR DISORDER , MIXED -
   CHARACTERIZED BY MOOD SWING OF
   ELATION AND DEPRESSION ( SADNESS,
   HAPPINESS)
2. BIPOLAR DISORDER , MANIC – A PERSON
   IS CURRENTLY EXPERIENCING A MANIC
   EPISODE
   BIPOLAR DISORDER, DEPRESSED – A
   PERSON IS CURRENTLY EXPERIENCING A
   DEPRESSIVE EPISODE
3. INVOLUTIONAL MELANCHOLIA – A
   PSYCHOTIC REACTION COMMON AMONG
   40-60 YEARS OLD / MENOPAUSAL
   DEPRESSION
 1. MAJOR DEPRESSIVE
       DISORDER


IS A UNIPOLAR DISORDER
WHERE ONLY DEPRESSION
  IS MANIFESTED BY THE
       INDIVIDUAL.
CRITERIA FOR DIAGNOSING
  ARE THE FOLLOWING:
   INSOMNIA
   LOSS OF APPETITE
   LOSS OF INTEREST IN ACTIVITIES
   DECREASE COMMUNICATION
   PSYCHOMOTOR AGITATION AND
    SUICIDAL IDEATION MUST BE
    PRESENT ALMOST EVERYDAY
    FOR AT LEAST 2 WEEKS
   DELUSION
   HALLUCINATION
CLASSIC SIGNS OF MAJOR
     DEPRESSION:
   DEPRESSION WITHOUT APPARENT CAUSE
   WEIGHT LOSS OF 10 LBS.
   ANOREXIA
   LACK OF INTEREST IN ACTIVITIES
   DECREASED COMMUNICATION
   DOES NOT RESPOND TO EXTERNAL
    STIMULI
   SUICIDAL THOUGHTS ARE PRESENT
   CONSTIPATION
   INSOMNIA
   FATIGUE
<>PROFOUNDLY DEPRESSED
 PERSONS ARE UNABLE TO
   CARRY OUT SUICIDAL
  ATTEMPT. THE TIME OF
  GREATEST DANGER FOR
  SELF DESTRUCTION MAY
 OCCUR WHEN THE PERSON
  BEGINS TO FEEL BETTER
 BUT STILL EXPERIENCE S
PERIODS OF HELPLESSNESS
BIPOLAR DISORDER – ALSO
 KNOWN BEFORE AS MANIC-
  DEPRESSIVE PSYCHOSES.
 IT ‘S MOST OUTSTANDING
 CHARACTERISTIC IS MOOD
          SWING.
 MANIA/ MANIC PHASE –
  EXPERIENCING MANIC
     EPISODE . IT IS
CHARACTERIZED BY PERIOD
OF NORMALITY KNOWN AS “
    LUCID INTERVAL”.
      MANIC PHASE IS
    CHARACTERIZED BY:
   ELATED UNSTABLE MOOD
   PRESSURED SPEECH
   INCREASED MOTOR ACTIVITY
   INSONMIA WITHOUT FATIGUE
   FLIGHT OF IDEAS
   MANIPULATIVE AND DEMANDING
   DESTRUCTIVE AND COMBATIVE
    BEHVIOUR
   DELUSION OF GRANDEUR
   IMPAIRED JUDGEMENT SUCH AS
    HALLUCINATION AND DELUSION
DEPRESSIVE PHASE – IS
CURRENTLY
EXPERIENCING OR HAS
RECENTLY EXPERIENCED
A DEPRESSIVE PHASE.
       CLASSIFIED INTO:
1.   MILD DEPRESSION – CHARACTERIZED BY
     NORMAL FACIAL EXPRESSION, SLEEP AND
     APPETITE DISTURBANCE , WEIGHT LOSS
2.   ACUTE DEPRESSION – CHARACTERIZED BY
     BEING WITHDRAWN, SLOW SPEECH
     MOVEMENT AND SELF ACCUSATION
3.   STUPOROUS DEPRESSION – MUTENESS,
     IMMOBILITY, AND MARKED
     WITHDRAWAL
4.   MIXED TYPE – EXPERIENCES
     BOTH MANIC AND MAJOR
     DEPRESSIVE PHASE CYCLICALLY
     EVERY FEW DAYS.
MANIC DISORDER – A
 PERSON EXHIBIT S
 MANIC EPISODES AS
PERMANENT PART OF
   THE ILLNESS.
     FACTORS IN THE
  DEVELOPMENT OF MOOD
       DISORDER:
 1. BIOLOGICAL FACTOR – NOREPINEPHRINE AND
 SEROTONIN HAVE BEEN SHOWN TO REGULATE
 ONE’S MOOD.
   IF HIGH AMOUNT AT RECEPTOR SITES IN THE
   BRAIN , PATIENT BECOMES MANIC.
   IF LOW AMOUNT , PATIENT BECOMES
   DEPRESSED
2. PSYCHOANALYTIC FACTOR
CONFLICT BETWEEN THE ID AND SE
    IF ID WINS – PATIENT BECOMES MANIC
    IF SE WINS – PATIENT BECOMES
     DEPRESSED
UNWORTHINESS – LOSS SELF
  ESTEEM

3. ENVIRONMENT – FULL OF
   FRUSTRATIONS
 DIFFERNTIATION BETWEEN ELATION
        FROM DEPRESSION


       ELATION             DEPRESSION
EXAGGERATED HAPPINESS        SADNESS
ANGER TOWARDS OTHERS          SELF
   FLIGHT OF IDEAS       POVERTY OF IDEAS
DELUSION OF GRANDEUR      UNWORTHINESS/
     HYPERACTIVE             SUICIDAL
    HYPERSEXUAL             LOW LIBIDO
   WANT BEAUTIFUL          LOOKS DIRTY

TREATMENT : ANTI MANIC   ANTI DEPRESSANTS
       DRUG
TREATMENT :
ANTI MANIC DRUG
 LITHIUM CARBONATE- MOOD
 STABILIZERS
 ESKALITH
 Lithane
 Lithobid
 Lithonate
 Lithotads
NURSING RESPONSIBILITY:
1. MAINTAIN NA AND LITHIUM LEVEL
      NA LEVEL- 135- 145MEQ
      LITHIUM – 0.5- 1.5 MEQ/L
2. AVOID DIURETIC THERAPY
3. AVOID DEHYDRATION
4. GIVE IN REGULAR BASIS
5. MONITOR NA / LITHIUM LEVEL
6. ADEQUATE FLUID INTAKE
7. OBSERVE LITHIUM TOXICITY
A.GROSS TREMORS
B.MUSCLE TWITCHING
C.CONVULSIONS
D. SEVERE N/V
E.SEVERE DIARRHEA
F.OLIGURIA
G. ANURIA
SIDE EFFECTS:
   1.FINE TREMORS
   2.METALLIC TASTE
   3.POLYURIA/POLYDIPSIA
   4.MILD GIT DISCOMFORT
CONDITIONS THAT CAUSE
TOXICITY :
   1.F/E IMBALANCE( LOW NA)
   2. DIURETIC THERAPY
   3.OVERDOSAGE
MOOD ELAVATORS
1. TAD DRUGS:
          - TOFRANIL
          - ELAVIL
          - ENDEP
          - AVENTYL
TAD-Tricyclic Anti Depressant drug
MAO INHIBITORS
   MARPLAN- ( ISICARBOCID)
   NARDIL(PHENELZINE)
   PARNATE (TRANYLCYPROMINE)
   MAO-Mono-amine Oxidase inhibitor
NSG. RESP.
   1.NEVER COMBINE
   2. TAD 2-4 WKS
   3. SUICIDE ALERT
Mao Alert:
   1.AVOID FOODS TYRAMINE:CHEESE,
    YOGURT, ICE CREAM.LIVER, ORGAN
    MEATSOYA BEANS
   2. AVOID RED WINE, BEER, COFFEE
NURSING CARE FOR MANIC
PATIENT:
1.       TO PREVENT EXHAUSTION/ INJURY
        SET LIMITS ON BEHAVIOR- CONTROL THE PATIENT’S
         BEHAVIOR
          SECLUSION/ RESTRAINTS
        REDIRECT FEELINGS INTO SOCIALLY ACCEPTABLE
         BEHAVIOR AND PROVIDE ACTIVITY THAT WILL LOWER
         THE MANIA
        EG. WALKING, CARPENTRY, CLEANING THE
         ENVIRONMENT
        AVOID COMPETITIVE GAMES AND NO PHYSICAL
         CONTACTS
        AVOID ARGUING
        PROVIDE ACTIVITY WITH SHORT DURATION
2.PROVIDE PHYSICAL CARE
PROVIDE ADEQUATE NUTRITION
 -FINGER FOODS, HIGH CALORIC
   FOODS, HIGH FLUID INTAKE
-MANIC PATIENT HAS NO TIME TO EAT

3.ATTITUDE TOWARDS MANIC
 A. ACCEPTANCE, RECOGNITION – TO
  INCREASE SELF ESTEEM
 B. NO DEMAND- SETTING OFLIMITS

4.INTERACTION
A. SHORT DURATION, USE SIMPLE
  WORDS, SIMPLE EXPLANATION (
  HAVE FA)
NURSING CARE FOR DEPRESSED PATIENT:
GOAL 1: TO PREVENT SUICIDE
 -PROVIDE SAFE ENVIRONMENT
 -REMOVE ENVIRONMENTAL HAZARDS
 -MONITOR PATIENT 24 HOURS
 -DEVELOP A TRUSTING RELATIONSHIP
 - ACCEPT THE PERSON AS A WORTHY PERSON
- NURSES MUST BE AWARE OF THE CONCEPT OF
SUICIDE
  - DON’T BE JUDGMENTAL WHEN PATIENT COMMIT
SUICIDE
  - BE AWARE OF THE CUES OF SUICIDE:
        AGE: ADOLESCENT/ ELDERLY
        SEX: FEMALE ATTEPTS, MALE SUCCESSFUL
        PREVIOUS SUICIDAL ATTEMPTS
        SUDDEN CHANGE IN THE BEHAVIOR
GOAL 2: ATTITUDE TOWARDS DEPRESSED
  A. ACCEPTANCE
  B. KIND FIRMNESS
  C. EMPATHY
  D. PHYSICAL CARE/ DO COMPLETE
     CARE
  E. GROUP THERAPY – TO INCREASE
     SELF ESTEEM / TO BE RECOGNIZED
  E. MUSIC AND DANCE THERAPY
  F. BIBLIO THERAPY
  G. ART THERAPY
  H. PLAY THERAPY
  I.PSYCHODRAMA
  J. REMOTIVATIONAL THERAPY 10 – 12
     K.PATIENT WIT 1 REMOTIVATOR
Purpose:
   1. BRING PATIENT BACK TO REALITY
   2. TO DEVELOP SOCIAL SKILLS
   3. TO DEVELOP PATIENT INSIGHT

								
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