Communicating As A Mental Health Carer

The dialogue and case studies approach will help students and newly qualified practitioners to build their confidence. Dialogues provide examples of how to interact with clients in certain situations. Chapters devoted to different conditions, for example schizophrenia, depression and substance abuse, acknowledge the varying levels of care and intervention required. An appendix on the Mental Health Act and drugs unsed in psychiatry provides a practical source of reference.

PREFACE

vi

INTRODUCTION: SETTING THE SCENE

1

(19)

Mental health care settings

1

(7)

Approaches to delivery of mental health care

8

(4)

Issues around the role of the student

12

(8)

1. THE RUDIMENTS

20

(21)

1.1 Just listening

20

(1)

1.2 The importance of thoughtful communication

21

(3)

1.3 The differences between thoughtful and thoughtless communication

24

(1)

1.4 Being approachable

24

(1)

1.5 Why your self-awareness matters to others

25

(2)

1.6 Intuition

27

(1)

1.7 Starting a rapport

28

(3)

1.8 Being non-intrusive

31

(1)

1.9 Ordinariness and how it can help

32

(1)

1.10 Observation in mental health settings

33

(1)

1.11 Being optimistic

33

(1)

1.12 Being tentative

34

(1)

1.13 The myth of the magic sentence

35

(1)

1.14 Saying the wrong thing

35

(1)

1.15 Nurse or patient?

36

(1)

1.16 Self-disclosure and boundaries

37

(1)

1.17 Time and timing

38

(1)

1.18 Use of the telephone

39

(1)

1.19 When the patient is aggressive towards you

40

(1)

2. MORE COMPLEX SKILLS, TECHNIQUES AND IDEAS

41

(22)

2.1 Continually assessing

41

(1)

2.2 Intention

41

(1)

2.3 The answer to the patient's problem

42

(1)

2.4 Being consistent

43

(1)

2.5 Being persistent

44

(1)

2.6 Using activity

45

(1)

2.7 Honesty

46

(1)

2.8 Open dialogue

47

(1)

2.9 Clarifying

48

(1)

2.10 The quality of the relationship - when is it 'therapeutic' and does it need to be?

49

(1)

2.11 The therapeutic relationship: congruence, empathy, acceptance

50

(2)

2.12 When patients/clients say 'I don't know'

52

(1)

2.13 Pigeon-holing data

53

(1)

2.14 Empowering patients and clients

53

(1)

2.15 Throwaways

54

(1)

2.16 Giving feedback effectively

55

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2.17 Space and silence

57

(1)

2.18 Using touch to help

58

(1)

2.19 Measuring the patient's/client's experience

58

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2.20 Summaries (paraphrasing and summarising)

60

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2.21 Written communication

61

(1)

2.22 How to finish

62

(1)

3. EVEN MORE ADVANCED SKILLS, TECHNIQUES AND IDEAS

63

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3.1 Working with micro stories

63

(1)

3.2 Starting to think and work in an integrated way

64

(1)

3.3 Professional assertiveness

65

(2)

3.4 The idea of psychological containment

67

(1)

3.5 The observe/assess/react cycle

68

(1)

3.6 'The problem is ...'

69

(1)

3.7 Using images and imagery

70

(1)

3.8 Everything before the 'but'

70

(1)

3.9 Genograms

71

(1)

3.10 Different losses

72

(1)

3.11 When the patient finds the nurse attractive (and vice versa)

73

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3.12 Using the tray of tea

75

(1)

3.13 Cultural diversity

76

(1)

3.14 Suicide

77

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4. DISORDER-FOCUSED INTERVENTIONS

79

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4.1 People with abnormal perceptions

79

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4.2 People who are abnormally overactive

84

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4.3 People who are withdrawn/low in mood

87

(2)

4.4 People who have abnormally difficult personalities

89

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4.5 People who have organic mental illness

93

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4.6 People who have abnormal self-destructive behaviours

95

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5. ILLUSTRATIVE STORIES

98

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5.1 Mental health problems in our society - setting the scene

98

(2)

5.2 Preamble, Profile, Pathway, Prognosis

100

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5.3 Acute depression with anxiety - Joanne

102

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5.4 Longer-term depression - Jon

113

(7)

5.5 Long-term/chronic psychosis - Laura

120

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5.6 Acute psychosis - Wendy

130

(9)

5.7 Personality disorder - Denise

139

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5.8 Organic illness in the older adult - Jim

148

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5.9 Self-destructive behaviour (drugs and alcohol) - Jason

155

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5.10 'Complex needs' - Paul

160

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6. PUTTING IT ALL TOGETHER. THE COMPLETE, EFFECTIVE, PROFESSIONAL MENTAL HEALTH NURSE

167

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6.1 Leaving work behind

167

(1)

6.2 Relationships at work: up, down, across

168

(1)

6.3 You're the best nurse

169

(1)

6.4 Relatives of patients and clients

170

(1)

6.5 Being professional

170

(2)

6.6 Career or police?

172

(1)

6.7 I'm really fed up

173

(1)

6.8 It's not for me

174

(1)

6.9 Moving on to specialise

175

(1)

6.10 Supervision

176

(1)

6.11 Debriefing

176

(1)

6.12 I don't like her attitude

177

(1)

6.13 Roll on retirement

177

(1)

6.14 Summary of skills used, as a way to manage professional issues

178

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APPENDIX A. MEASURING THE PATIENT'S/CLIENT'S EXPERIENCE

179

(2)

Using a diary

179

(1)

Using a scale

179

(1)

Using a pie chart

179

(1)

Using a continuum

180

(1)

APPENDIX B. STAGES OF EGAN'S MODEL OF HELPING

181

(2)

APPENDIX C. HELP ORGANISATIONS AND NURSING UNIONS

183

(1)

REFERENCES

184

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Communicating As A Mental Health Carer

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