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NURS 3122 Final: Therapeutic strategies for Alteration in Mental Status

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NURS 3122
Robert Catena

Therapeutic strategies A. Play therapy - Play is often called the language or work of the child. - From a developmental perspective, children progressively learn to express feelings and needs through action, fantasy, and finally language. - The special quality of play buffers children against the pressures and demands of daily life. - Play facilitates mastery of developmental stages by strengthening physical and neurologic processes. - Play also assists in cognitive learning, setting the stage for problem solving and creativity. - Play therapy is a technique that reveals problems using fantasy through the use of toys, dolls, clay, art, and other creative objects. - It is often used with preschool and school-age children who are experiencing anxiety, stress, and other specific nonpsychotic mental disorders. - Play therapy encourages the child to act out feelings such as anger, hostility, sadness, and fear. - It also provides the opportunity for the therapist to help the child understand, on a conscious or unconscious level, personal responses and behavior in a safe, supportive environment. Art therapy - Children who may be apprehensive about playing can sometimes be encouraged to participate in art therapy, using brief drawing exercises. - This technique is appropriate for children of all ages, including adolescents. - The drawings can help the therapist gain information about the child, the family, and the interactions between the child and family. - However, children’s drawings should never be used solely to form a definitive diagnosis.When used in conjunction with a thorough history and appropriate psychologic testing information, art therapy can guide the child’s treatment. - These drawing exercises provide an opportunity to help in the healing process. - The therapist can assist the child to release feelings of anger, pain, or fear onto paper, where they can be examined objectively. Cognitive and behavioral therapy (CBT) - A combination of cognitive and behavioral therapy is useful in treating many mental health conditions in children. - Cognitive therapy teaches thinking patterns to change reactions to situations that cause anxiety or other undesirable conditions. - Children are taught how their brain and body are working; this understanding assists them in having control over the experience and responding with appropriate behaviors - Behavior modification is a therapeutic technique that uses stimulus and response conditioning to alter inappropriate behaviors. - It is used to reinforce desirable behaviors by helping the child to replace maladaptive behaviors with more appropriate ones. - This technique is based on the assumption that any learned behavior can be unlearned. Thus, if parents, nurses, teachers, and other adults consistently reinforce desirable behaviors, the child will eventually alter or discontinue undesirable behaviors. - Behavior modification may include (1) removing the child from the home to a more structured environment, such as a hospital, for a brief time; and (2) instructing the parents, teachers, and other appropriate adults to be agents of behavioral change. - Several ongoing sessions may be required with the adults involved, using role-play and other techniques. - Consistency is the most important principle in the successful use of behavior modification. Visualization and guided imagery - The techniques of visualization and guided imagery begin with specific directions for progressive relaxation according to the child’s ability. - These forms of therapy use the child’s own imagination and positive thinking to reduce stress and anxiety, decrease the experience of pain or discomfort, and promote healing. - The techniques are especially useful in the management of
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