Centro Escolar university

College of Nursing
Mendiola, Manila

In Partial Fulfillment of the requirement in

Nursing care Management 104
(National Center for Mental Health)

Submitted by:
Acosta, Edward Joseph P.
BSN3D/D0

Submitted to:
Ms. Dovie Brabante R.N,M.A.N
Clinical Instructor

December 3, 2010

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Table of contents
Chapter 1
Introduction - pg 4
Theoretical framework - pg 6
Personal data -pg23
Chapter 2
Mse -pg26
Chapter 3
Predisposing factor and psychodynamic -ph44
Psychopatology -pg45
Related literature -pg47
Drugstudy - -pg49
Chapter 4
Npi -pg51
Prio -pg68
Ncp -pg69
Chapter 5
psychotherapy Tegerapy -pg74
appendices -pg88

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CHAPTER
I

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 Introduction
Mental Health and Mental Illness are to difficult to define precisely. People who can carry

out their roles in society and whose behavior is appropriate and adaptive are viewed as

healthy . Conversely those who fail to fulfill roles and carry out responsibilities or whose

behavior is inappropriate are viewed as mentally ill. The culture of any societies strongly

influences its values and beliefs, and this in turn affects how that society defines health and

illness. What one society may view as acceptable and appropriate, another society may see

as maladaptive or inappropriate.

The world Health Organization Defines health as a state of emotional, psychological and

social wellness evidenced by satisfying interpersonal relationships, effective behavior and

coping, Positive self-concept and emotional stability.

Mental disorder Is a clinically significant behavioral or psychological syndrome or pattern

that occurs in an individual and that is associated with present distress (e.g. a painful

symptom) or disability (Re-Impairement in one or more important areas of functioning) or

with a significantly increased risk of suffering death, pain, disability or an important loss of

freedom. General criteria to diagnose mental disorder include dissatisfaction with one’s

characteristics, abilities, and accomplishment; Ineffective coping with life events;

ineffective or non-satisfying relationships; dissatisfaction with one’s place in the world;

Ineffective coping with life events; and lack of personal. In addition, the person’s behavior

must not be culturally expected or sanctioned, nor does deviant behavior necessarily

indicate a mental disorder. Schizophrenia causes distorted and bizarre thoughts,

Perceptions, emotions, movements and behavior. It cannot be defined as a single illness;

rather schizophrenia is thought of as a syndrome or disease process with many different

varieties and symptoms, much like the varieties of cancer

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Sigmund Freud

Freud theoryTo understand the conscious and unconscious forces guiding an individual’s

behavior, Freud developed a personality model. He divided the personality into three elements:

the id, the ego and the superego. These elements are not physical structures found in the brain,

instead they represent a general model of personality that describesThe id refers to the raw,

unorganized, inherited part of the personality. Its main goal is to reduce tension created by our

primitive drives which are related to hunger, sex, aggression and irrational impulses. The id

operates according to the pleasure principle, in which its goal is immediate gratification and

reduction of tension. In most people, reality prevents the id’s instant demands from being

fulfilled. We cannot always eat when we are hungry, and we can act on sexual drives only in the

right place and time.

The ego is the buffer between the id and the world’s realities. The ego operates on the reality

principle. In this principle, instinctual energy is restrained in order to maintain the safety of the

individual and help integrate the person into society. The ego is sometimes called “the

executive” of an individual’s personality. The ego makes the decisions, controls actions and

allows for a higher capability of problem solving. The id is not capable of such higher level of

thinking. The ego is responsible for the higher cognitive functions such as intelligence,

thoughtfulness and learning.

The superego is the final element of Freud’s model of personality. It is similar to the id in that it

is somewhat unrealistic. The superego represents the rights and wrongs of the society as handed

down to an individual over their lifetime. The superego has two subparts: the conscience and the

ego-ideal. The conscience prevents us from doing morally bad things. The ego-ideal motivates us

to do what is morally proper. The superego helps to control the id’s impulses, making them less

selfish and more morally correct.

It is the ego that compromises between the demands of the id and superego, permitting a person

to obtain some of the gratification of the id while maintaining the superego, which would prevent

such gratification.

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Stages of Development

Freud proposed that there were 5 stages of development. Freud believed that few people

successfully completed all 5 of the stages. Instead, he felt that most people tied up their libido at

one of the stages, which prevented them from using that energy at a later stage.

ORAL Stage This occurs from birth to about 1 year, and the libido is focused on the mouth. The

individual may be frustrated by having to wait on another person, being dependent on another

person. Being fixated at this stage may mean an excessive use of oral stimulation, such as

cigarettes, drinking or eating.

ANAL Stage This period occurs about age 2 and 3 yrs. Here individuals have their first

encounter with rules and regulations, as they have to learn to be toilet trained. This encounter

with rules and regulations will dictate the later behavior with rules and regulations. The libido is

focused anally, and frustration may arise from having to learn a somewhat complex cognitive

and motor response. Being fixated at this stage can result in stinginess, stubbornness, or

orderliness, as well as messiness. Essentially, behavior related to retention and expulsion may be

related to experiences at this stage.

LATENCY Stage This period occurs after the Oedipus conflict has been resolved and the

feelings that were aroused during that time have subsided. This lasts from about the age of 7 until

puberty, and this is a period of rest where there are no developmental events

GENITAL Stage Begins at puberty involves the development of the genitals, and libido begins

to be used in its sexual role. However, those feelings for the opposite sex are a source of anxiety,

because they are reminders of the feelings for the parents and the trauma that resulted from all

that.

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Erick Erickson

Infancy (birth to 18 months)

Trust vs. Mistrust

Feeding

Children develop a sense of trust when caregivers provide reliability, care, and affection. A lack

of this will lead to mistrust.

Early Childhood (2 to 3 years)

Autonomy vs. Shame and Doubt

Toilet Training

Children need to develop a sense of personal control over physical skills and a sense of

independence. Success leads to feelings of autonomy, failure results in feelings of shame and

doubt.

Preschool (3 to 5 years)

Initiative vs. Guilt

Exploration

Children need to begin asserting control and power over the environment. Success in this stage

leads to a sense of purpose. Children who try to exert too much power experience disapproval,

resulting in a sense of guilt.

School Age (6 to 11 years)

Industry vs. Inferiority

School

Children need to cope with new social and academic demands. Success leads to a sense of

competence, while failure results in feelings of inferiority.

Adolescence (12 to 18 years)

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Identity vs. Role Confusion

Social Relationships

Teens need to develop a sense of self and personal identity. Success leads to an ability to stay

true to you, while failure leads to role confusion and a weak sense of self.

Young Adulthood (19 to 40 years)

Intimacy vs. Isolation

Relationships

Young adults need to form intimate, loving relationships with other people. Success leads to

strong relationships, while failure results in loneliness and isolation.

Middle Adulthood (40 to 65 years)

Generativity vs. Stagnation

Work and Parenthood

Adults need to create or nurture things that will outlast them, often by having children or creating

a positive change that benefits other people. Success leads to feelings of usefulness and

accomplishment, while failure results in shallow involvement in the world.

Maturity (65 to death)

Ego Integrity vs. Despair

Reflection on Life

Older adults need to look back on life and feel a sense of fulfillment. Success at this stage leads

to feelings of wisdom, while failure results in regret, bitterness, and despair.

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Jean Piaget

Child psychologist Jean Piaget described the mechanism by which the mind processes new

information. He said that a person understands whatever information fits into his established

view of the world. When information does not fit, the person must reexamine and adjust his

thinking to accommodate the new information. Piaget described four stages of cognitive

development and relates them to a person's ability to understand and assimilate new information.

Sensorimotor: (birth to about age 2)

During this stage, the child learns about himself and his environment through motor and reflex

actions. Thought derives from sensation and movement. The child learns that he is separate from

his environment and that aspects of his environment -- his parents or favorite toy -- continue to

exist even though they may be outside the reach of his senses. Teaching for a child in this stage

should be geared to the sensorimotor system. You can modify behavior by using the senses: a

frown, a stern or soothing voice -- all serve as appropriate techniques.

Preoperational: (begins about the time the child starts to talk to about age 7)

Applying his new knowledge of language, the child begins to use symbols to represent objects.

Early in this stage he also personifies objects. He is now better able to think about things and

events that aren't immediately present. Oriented to the present, the child has difficulty

conceptualizing time. His thinking is influenced by fantasy -- the way he'd like things to be --

and he assumes that others see situations from his viewpoint. He takes in information and then

changes it in his mind to fit his ideas. Teaching must take into account the child's vivid fantasies

and undeveloped sense of time. Using neutral words, body outlines and equipment a child can

touch gives him an active role in learning.

Concrete: (about first grade to early adolescence)

During this stage, accommodation increases. The child develops an ability to think abstractly and

to make rational judgements about concrete or observable phenomena, which in the past he

needed to manipulate physically to understand. In teaching this child, giving him the opportunity

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to ask questions and to explain things back to you allows him to mentally manipulate

information.

Formal Operations: (adolescence)

This stage brings cognition to its final form. This person no longer requires concrete objects to

make rational judgments. At his point, he is capable of hypothetical and deductive reasoning.

Teaching for the adolescent may be wide-ranging because he'll be able to consider many

possibilities from several perspectives.

Sullivan Theory Developmental Epochs

Infancy 

Age birth to 1 year

From birth to about age one, the child begins the process of developing, but Sullivan did not

emphasize the younger years to near the importance as Freud.

Childhood

Ages 1 to 5

The development of speech and improved communication is key in this stage of development.

Juvenile

Ages 6 to 8

The main focus as a juvenile is the need for playmates and the beginning of healthy socialization

Pre adolescence

Ages 9 to 12

During this stage, the child's ability to form a close relationship with a peer is the major focus. 

This relationship will later assist the child in feeling worthy and likable.  Without this ability,

forming the intimate relationships in late adolescence and adulthood will be difficult.

Early Adolescence

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Ages 13 to 17

The onset of puberty changes this need for friendship to a need for sexual expression.  Self worth

will often become synonymous with sexual attractiveness and acceptance by opposite sex peers.

Late Adolescence

Ages 18 to 22 or 23

The need for friendship and need for sexual expression get combined during late adolescence.  In

this stage a long term relationship becomes the primary focus.  Conflicts between parental

control and self-expression are commonplace and the overuse of selective inattention in previous

stages can result in a skewed perception of the self and the world.

Adulthood

Ages 23 on

The struggles of adulthood include financial security, career, and family.  With success during

previous stages, especially those in the adolescent years, adult relationships and much needed

socialization become easier to attain.  Without a solid background, interpersonal conflicts that

result in anxiety become more commonplace

Carl Jung

 Carl Jung first developed the theory that individuals each had a psychological type. He believed

that there were two basic kinds of "functions" which humans used in their lives: how we take in

information (how we "perceive" things), and how we make decisions. He believed that within

these two categories, there were two opposite ways of functioning. We can perceive information

via 1) our senses, or 2) our intuition. We can make decisions based on 1) objective logic, or 2)

subjective feelings. Jung believed that we all use these four functions in our lives, but that each

individual uses the different functions with a varying amount of success and frequency. He

believed that we could identify an order of preference for these functions within individuals. The

function which someone uses most frequently is their "dominant" function. The dominant

function is supported by an auxiliary (2nd) function, tertiary (3rd) function, and inferior (4th)

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function. He asserted that individuals either "extraverted" or "introverted" their dominant

function. He felt that the dominant function was so important, that it overshadowed all of the

other functions in terms of defining personality type. Therefore, Jung defined eight personality

types:

 Extroverted Thinking – Jung theorized that people understand the world through a mix of

concrete ideas and abstract ones, but the abstract concepts are ones passed down from other

people. Extroverted thinkers are often found working in the research sciences and mathematics.

 Introverted Thinking – These individuals interpret stimuli in the environment through a

subjective and creative way. The interpretations are informed by internal knowledge and

understanding. Philosophers and theoretical scientists are often introverted thinking-oriented

people.

 Extroverted Feeling – These people judge the value of things based on objective fact.

Comfortable in social situations, they form their opinions based on socially accepted values and

majority beliefs. They are often found working in business and politics.

 Introverted Feeling – These people make judgments based on subjective ideas and on

internally established beliefs. Oftentimes they ignore prevailing attitudes and defy social norms

of thinking. Introverted feeling people thrive in careers as art critics.

 Extroverted Sensing – These people perceive the world as it really exists. Their perceptions

are not colored by any pre-existing beliefs. Jobs that require objective review, like wine tasters

and proofreaders, are best filled by extroverted sensing people.

 Introverted Sensing – These individuals interpret the world through the lens of subjective

attitudes and rarely see something for only what it is. They make sense of the environment by

giving it meaning based on internal reflection. Introverted sensing people often turn to various

arts, including portrait painting and classical music.

 Extroverted Intuitive – These people prefer to understand the meanings of things through

subliminally perceived objective fact rather than incoming sensory information. They rely on

hunches and often disregard what they perceive directly from their senses. Inventors that come

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upon their invention via a stroke of insight and some religious reformers are characterized by the

extraverted intuitive type.

 Introverted Intuitive – These individuals, Jung thought, are profoundly influenced by their
internal motivations even though they do not completely understand them. They find meaning
through unconscious, subjective ideas about the world. Introverted intuitive people comprise a
significant portion of mystics, surrealistic artists, and religious fanatics.

Peplau Theory inter personal relations

theory
ORIENTATION PHASE

Get acquainted phase of the nurse-patient relationship

Preconceptions are worked through

Parameters are established and met

Early levels of trust are developed

Roles begin to be understood

IDENTIFICATION PHASE

The client begins to identify problems to be worked on within relationship

The goal of the nurse: help the patient to recognize his/her own interdependent/participation role

and promote responsibility

EXPLOITATION PHASE

Client’s trust of nurse reached full potential

Client making full use of nursing services

Solving immediate problems

Identifying and orienting self to [discharge] goals

RESOLUTION PHASE

Final phase of nurse-patient relationship

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Sense of security is found as patient has less reliance and identification upon nurse helper

Client has increased self-reliance to deal with his/her problem

Carl Roger

Actualizing Tendency

Rogers maintains that the human "organism" has an underlying "actualizing tendency", which

aims to develop all capacities in ways that maintain or enhance the organism and move it toward

autonomy. This tendency is directional, constructive and present in all living things. The

actualizing tendency can be suppressed but can never be destroyed without the destruction of the

organism. The concept of the actualizing tendency is the only motive force in the theory. It

encompasses all motivations; tension, need, or drive reductions; and creative as well as pleasure-

seeking tendencies Only the organism as a whole has this tendency, parts of it (such as the self)

do not. Person thus has a fundamental mandate to fulfill their potential.

Self

The human organism's "phenomenal field" includes all experiences available at a given moment,

both conscious and unconscious. As development occurs, a portion of this field becomes

differentiated and this becomes the person's "self” The "self" is a central construct in this theory.

It develops through interactions with others and involves awareness of being and functioning.

The self-concept is "the organized set of characteristics that the individual perceives as peculiar

to himself/herself” It is based largely on the social evaluations he/she has experienced.

Self-Actualizing Tendency

A distinctly psychological form of the actualizing tendency related to this "self" is the "self-

actualizing tendency". It involves the actualization of that portion of experience symbolized in

the self (Rogers, 1959). It can be seen as a push to experience oneself in a way that is consistent

with one's conscious view of what one is Connected to the development of the self-concept and

self-actualization are secondary needs (assumed to likely be learned in childhood): the "need for

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positive regard from others" and "the need for positive self-regard", an internalized version of the

previous. These lead to the favoring of behavior that is consistent with the person's self-concept

Organismic Valuing and Conditions of Worth

When significant others in the person's world (usually parents) provide positive regard that is

conditional, rather than unconditional, the person introjects the desired values, making them

his/her own, and acquires "conditions of worth" (Rogers, 1959). The self-concept then becomes

based on these standards of value rather than on organismic evaluation. These conditions of

worth disturb the "organismic valuing process", which is a fluid, ongoing process whereby

experiences are accurately symbolized and valued according to optimal enhancement of the

organism and self (Rogers, 1959). The need for positive self-regard leads to a selective

perception of experience in terms of the conditions of worth that now exist.

Fully Functioning Person and the Self

Theoretically, an individual may develop optimally and avoid the previously described outcomes

if they experience only "unconditional positive regard" and no conditions of worth develop. The

needs for positive regard from others and positive self-regard would match organismic

evaluation and there would be congruence between self and experience, with full psychological

adjustment as a result "The good life is a process not a state of being. It is a direction, not a

destination. For the vast majority of persons who do not have an optimal childhood there is hope

for change and development toward psychological maturity via therapy, in which the aim is to

dissolve the conditions of worth, achieve a self congruent with experience and restore the

organismic valuing process

the organized, consistent, conceptual gestalt composed of perceptions of the characteristics of the

"I" or "me" and the perceptions of the relationships of the "I" or "me" to others and to various

aspects of life, together with the values attached to these perceptions.

This gestalt is a fluid and changing process, available to awareness. By using the term "gestalt",

Rogers points to the possibility of change describing it as "a configuration in which the alteration

of one minor aspect could possibly alter the whole picture"

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The "maladjusted person" is the polar opposite of the fully functioning individual (who was

introduced early in this essay). The maladjusted individual is defensive, maintains rather than

enhances his/her life, lives according to a preconceived plan, feels manipulated rather than free,

and is common and conforming rather than creative The fully functioning person, in contrast, is

completely defense-free, open to experience, creative and able to live "the good life". Empirical

support for the fully functioning person is somewhat mixed. The openness to experience

characteristic has been supported However, some studies have found that openness to

experience and organismic trusting did not intercorrelate, contrary to expectations notes that

some studies have found non-defensive people are more accepting of others and Madd cites

numerous studies that indicate self-accepting people also appear to be more accepting of others.

Horney Theory

Horney thought it a mistake to think that neuroses in adults are caused by abuse or neglect in

one's childhood. She, instead, named parental indifference the true culprit behind neurosis. The

key to understanding this phenomenon is the child's perception, rather than the parent's

intentions, she said. A child may feel a lack of warmth and affection if a parent, who is otherwise

occupied or neurotic themselves, makes fun of their child's thinking or neglects to fulfill

promises, for example.

Using her clinical experience, Horney named ten particular patterns of neurotic needs. They are

based on things that all humans need, but that are distorted in some because of difficulties within

their lives. As she investigated them further, she found that she could clump the ten into three

broad coping strategies.

The first strategy is compliance, also known as the moving-toward strategy or the self- effacing

solution. Most children facing parental indifference use this strategy. They often have a fear of

helplessness and abandonment, or what Horney referred to as basic anxiety. This strategy

includes the first three needs: the need for affection and approval, which is the indiscriminate

need to both please others and be liked by them; the neurotic need for a partner, for someone else

to take over one's life, encompassing the idea that love will solve all of one's problems; and the

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neurotic need to restrict one's life into narrow boarders, including being undemanding, satisfied

with little, inconspicuous.

Horney's second broad coping strategy is aggression, also called the moving-against and the

expansive solution. Here, children's first reaction to parental indifference is anger, or basic

hostility. Needs four through eight fall under this category. The fourth need is for power, for

control over others, and for a facade of omnipotence. Fifth is the neurotic need to exploit others

and to get the better of them. Another need is for social recognition and prestige, with the need

for personal admiration falling along the same lines. The eighth neurotic need is for personal

achievement.

The final coping strategy is withdrawal, often labeled the moving-away-from or resigning

solution. When neither aggression nor compliance eliminate the parental indifference, Horney

recognized that children attempt to solve the problem by becoming self- sufficient. This includes

the neurotic needs for self sufficiency and independence and those for perfection and

unassailability.

Adler Theory

Adler stressed a positive view of human nature. He believed that individuals can control their

fate. They can do this in part by trying to help others (social interest). How they do this can be

understood through analyzing their lifestyle. Early interactions with family members, peers, and

teachers help to determine the role of inferiority and superiority in their lives.

Although all neurosis is, for Adler, a matter of insufficient social interest, he did note that three

types could be distinguished based on the different levels of energy they involved:

The first is the ruling type. They are, from childhood on, characterized by a tendency to be

rather aggressive and dominant over others. Their energy -- the strength of their striving after

personal power -- is so great that they tend to push over anything or anybody who gets in their

way. The most energetic of them are bullies and sadists; somewhat less energetic ones hurt

others by hurting themselves, and include alcoholics, drug addicts, and suicides.

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The second is the leaning type. They are sensitive people who have developed a shell around

themselves which protects them, but they must rely on others to carry them through life's

difficulties. They have low energy levels and so become dependent. When overwhelmed, they

develop what we typically think of as neurotic symptoms: phobias, obsessions and compulsions,

general anxiety, hysteria, amnesias, and so on, depending on individual details of their lifestyle.

The third type is the avoiding type. These have the lowest levels of energy and only survive by

essentially avoiding life -- especially other people. When pushed to the limits, they tend to

become psychotic, retreating finally into their own personal worlds.

There is a fourth type as well: the socially useful type. This is the healthy person, one who has

both social interest and energy. Note that without energy, you can't really have social interest,

since you wouldn't be able to actually do anything for anyone

Superiority

The drive to become superior allows individuals to become skilled, competent, and creative.

Superiority Complex:

a means of masking feelings of inferiority by displaying boastful, self-centered, or arrogant

superiority in order to overcome feelings of inferiority.

Inferiority:

Feelings of inadequacy and incompetence that develop during infancy and serve as the basis to

strive for superiority in order to overcome feelings of inferiority

Inferiority complex:

A strong and pervasive belief that one is not as good as other people. It is usually an exaggerated

sense of feelings of inadequacy and insecurity that may result in being defensive or anxious

Birth order:

The idea that place in the family constellation (such as being the youngest child) can have an

impact on one's later personality and functioning.

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Abraham Maslow

Maslow has set up a hierarchy of five levels of basic needs. Beyond these needs, higher levels of

needs exist. These include needs for understanding, esthetic appreciation and purely spiritual

needs. In the levels of the five basic needs, the person does not feel the second need until the

demands of the first have been satisfied, nor the third until the second has been satisfied, and so

on. Maslow's basic needs are as follows:

Physiological Needs

These are biological needs. They consist of needs for oxygen, food, water, and a relatively

constant body temperature. They are the strongest needs because if a person were deprived of all

needs, the physiological ones would come first in the person's search for satisfaction.

Safety Needs

When all physiological needs are satisfied and are no longer controlling thoughts and behaviors,

the needs for security can become active. Adults have little awareness of their security needs

except in times of emergency or periods of disorganization in the social structure (such as

widespread rioting). Children often display the signs of insecurity and the need to be safe.

Needs of Love, Affection and Belongingness

When the needs for safety and for physiological well-being are satisfied, the next class of needs

for love, affection and belongingness can emerge. Maslow states that people seek to overcome

feelings of loneliness and alienation. This involves both giving and receiving love, affection and

the sense of belonging.

Needs for Esteem

When the first three classes of needs are satisfied, the needs for esteem can become dominant.

These involve needs for both self-esteem and for the esteem a person gets from others. Humans

have a need for a stable, firmly based, high level of self-respect, and respect from others. When

these needs are satisfied, the person feels self-confident and valuable as a person in the world.

When these needs are frustrated, the person feels inferior, weak, helpless and worthless.

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Needs for Self-Actualization

When all of the foregoing needs are satisfied, then and only then are the needs for self-

actualization activated. Maslow describes self-actualization as a person's need to be and do that

which the person was "born to do." "A musician must make music, an artist must paint, and a

poet must write." These needs make themselves felt in signs of restlessness. The person feels on

edge, tense, lacking something, in short, restless. If a person is hungry, unsafe, not loved or

accepted, or lacking self-esteem, it is very easy to know what the person is restless about. It is

not always clear what a person wants when there is a need for self-actualization.

Glaser Theory

Choice theory

The term choice theory is the work of William Glasser, MD, author of the book so named, and is

the culmination of some 50 years of theory and practice in psychology and counseling. Choice

Theory posits that behavior is central to our existence and is driven by five genetically driven

needs, similar to those of Abraham Maslow:

Survival (food, clothing, shelter, breathing, personal safety and others)

and four fundamental psychological needs:

Belonging/connecting/love

Power/significance/competence

Freedom/responsibility, and

Fun/learning

Choice Theory posits the existence of a "Quality World." The phrase "Quality World," represents

a person's total outlook and understanding of the world around them as it relations to people,

possessions, beliefs, etc. Starting from birth and continuing throughout our lives we place the

people who are important to us, things we prize, and systems of belief (religion, cultural values,

and icons, etc.) within the framework of our "Quality World." Glasser also posits a "Comparing

Place" in which we compare and contrast our real world experiences against our Quality World

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perspective. We behave to achieve as best we can a real world experience consistent with our

Quality World.

Behavior ("Total Behavior" in Glasser's terms) is made up of these four

components: acting, thinking, feeling and physiology. Glasser suggests that we have

considerable control or choice over the first two of these, and little ability to directly choose the

latter two. As these four components are closely intertwined, the choices we make in our

thinking and acting greatly affect our feeling and physiology.

The source of much unhappiness are the failing or failed relationships with those who are

important to us: spouses, parents, children, friends & colleagues. The symptoms of unhappiness

are widely variable and are often seen as mental illness. Glasser believes that "pleasure" and

"happiness" are related but are far from synonymous. Sex, for example, is a "pleasure" but may

well be divorced from a "satisfactory relationship" which is a precondition for lasting

"happiness" in life. Hence the intense focus on the improvement of relationships in counselling

with Choice Theory—the "new Reality Therapy".

Choice Theory posits that most mental illness is, in fact, an expression of unhappiness and that

we are able to learn how to choose alternate behaviors that will result in greater

satisfaction. Reality Therapy is the Choice Theory-based counseling process focussed on helping

clients to learn to make those choices.

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Fowler's stages of faith development

A series of stages of faith development was proposed by Professor James W. Fowler,

a developmental psychologist at Candler School of Theology, in the book Stages of Faith. This

book-length study contains a framework and ideas, which have generated a good deal of

response from those interested in religion.

Faith is seen as a holistic orientation, and is concerned with the individual's relatedness to the

universal:

Stage 0 – "Primal or Undifferentiated" faith (birth to 2 years), is characterized by an early

learning of the safety of their environment (i.e. warm, safe and secure vs. hurt, neglect and

abuse). If consistent nurture is experienced, one will develop a sense of trust and safety about the

universe and the divine. Conversely, negative experiences will cause one to develop distrust with

the universe and the divine. Transition to the next stage begins with integration of thought and

languages which facilitates the use of symbols in speech and play.

Stage 1 – "Intuitive-Projective" faith (ages of three to seven), is characterized by the psyche's

unprotected exposure to the Unconscious.

Stage 2 – "Mythic-Literal" faith (mostly in school children), stage two persons have a strong

belief in the justice and reciprocity of the universe, and their deities are almost

alwaysanthropomorphic.

Stage 3 – "Synthetic-Conventional" faith (arising in adolescence) characterized by conformity

Stage 4 – "Individuative-Reflective" faith (usually mid-twenties to late thirties) a stage

of angst and struggle. The individual takes personal responsibility for their beliefs and feelings.

Stage 5 – "Conjunctive" faith (mid-life crisis) acknowledges paradox and transcendence relating

reality behind the symbols of inherited systems

22
PERSONAL DATA

Patient name is RU he is 29 years old male Filipino he was born on cavite, has finished up to 3rd
year highschool and his occupation was janitor, his wife name was RU his hiegt was 5’7

Date of admission : april 18 2010

Pav/Ward :pavilion 1,ward 9

CHIEF COMPLAINT
According to his sister he assaulted their mother by punching her especially in her face, and also
he assaulted kids, talking to himself and having a tantrums

HISTORY OF PRESENT ILLNESS

16 months prior to the admission when he experience difficulty of sleeping accompanied by
apathetic behavior, took time to respond simple question and exhibit violent behavior.

14 monts prior to admission the patient become worst and started cursing other people and his
family lock him in his room

5months prior to admission he refused to take a bath,cursing his father

1day prior to the admission he punched his father and hurt his mother who was trying to stop
him.

PREVIOUS ILLNESS

The client had a chickenpox before.

PAST PERSONAL HISTORY

He was a planned wanted pregnancy, and he has no history of thumbsucking when he

was a baby. In his middle childhood he loose to draw and play outside. He enjoy the company of

friends, he also play basketball. In his late childhood he has many friends and he was popular

among his peers and group activity. He enjoy playing basketball, he has a good grade, very

responsible and hardworking

But he stop at 3rd year highschool, When he stop schooling he started to drink with his peers and

they use marijuana, His leisure time that time was listening to music. He has no suicidal attempt,

he has three girlfriends and this time he has his first sexual encounter.

In his adulthood he said that he want to be a policeman, but he cannot afford to schooling, he

worked at a hotel being a waiter, He married his girlfriend and have a son,He became a good

23
father but after 2 years they broke up because of financial problem, He doubt if his kid is the

source of argumentation. His sister finished vocational course and their financial source was his

brother

FAMILY HISTORY

The patient family was consisted of ten members, He was second to the youngest. He has no

other siblings except them. His father was the head of the family, he disciplined his children

properly without hurting them. Her mother was a good person, she has no job but she do many

house chores. There are no family history of diabetes and hypertension.

24
CHAPTER
II

25
Mental status evaluation

General 1 2 3
appearance
Facial expression
*Animated X X X
*Fixed or Immobile / X X
*Sad or Depressed X X X
*Angry X X X
*Pale X X X
*Reddened X X X
Posture
* Slouched X X X
*Stooped / / /
*Upright / / /
*Stiff X X X
Gait
*Smooth Rhythmic / / /
*Shuffling X X X
*Stagerring X X X
Clothes
*Appropriately Dressed X X X
*Inappropriately X X X
Dressed
*Pressed X X X
*Wrinkled / / /
Grooming
*Well Groomed X X X
*Unkempt / / /
Hygiene
*Clean X X X
*Untidy / / /
Odor(body/breathe)
*None X X X
*Alcohol X X X
*Acetone X X X
*Pungent / / /
*Cigarette Smoke X X X
*Foul Smelling / / /
Physical deformity X X X
Specify _____________
Eye Contact
*Maintains Good Eye / / /
Contact
*Poor Eye Contact X X X
(Lacks Eye Contact)
*Eye Cast(Client Squints X X X
his eyes, Pupils dilated)

Legend

Observed :/

Not observed : X

26
Day 1

Interpretation

My Patient on the first day of meeting was wearing clean but wrinkled clothes. He’s posture was

upright stooped. He has body odor, he has no facial expression when I met him, and he has eye

contact when we were talking

Analysis

According to the theory of giligan, the stage 1 caring for oneself the person is connected with

caring of oneself but because of this mental illness he cant achive overcoming this stage

One of the outstanding symptoms of mental illness is the diminishing interest of the patient in

personal appearance and hygiene, Body odor, lifeless expression, dull hair, unattractive nails and

foul breathe may be observed. The clothing of the patient may be poorly kempt and soiled and

improperly fitted. Some of the symptoms above describe by manfreda and krampritz were

evident to my patient. He has body odor, unattractive nails and wears poorly kempt clothes.

Facial expression frequently reflects mood and attitude.

Day2

Interpretation

According to the theory of giligan, the stage 1 caring for oneself the person is connected with

caring of oneself but because of this mental illness he cant achive overcoming this stage

On the second day he wore clean but wrinked clothes,he still have body odor he has long pale

finger nails, he has dirty toe nails still have no facial expression,he has eye contact while we

were talking

Analysis

27
According to the theory of giligan, the stage 1 caring for oneself the person is connected with

caring of oneself but because of this mental illness he cant achive overcoming this stage

A mentally ill patient has an apparent lack of energy or ability to cope with usual everyday

practice of personal hygiene. These signs are usually evident during the onset and progressive

stage of mental disorder. As for the case of my patient, he manifest some of the symptoms,

hestill have wrinkled clothes nails long and dirty but he also perform personal hygiene in

morning

Day 3

Interpration

My patient was wearing clean but wrinkled clothes. He has upright stooped [Link] has body

[Link] has dirty nails. He was slight happy cheerful and smiling when we talk to each other.

And he has eye contact while we were talking.

Analysis

According to the theory of giligan, the stage 1 caring for oneself the person is connected with

caring of oneself but because of this mental illness he cant achive overcoming this stage

Facial expression frequently reflects moods and attitudes. The expression of the mouth may be

indicated by relaxed or firmed lips. Lips may be curled in resentment or relaxed in a pleasant

smile. The patient was smiling during the interaction, he was happy, he has a good eye contact

which mean he is sincere.

28
 Motor Behavior 1 2 3
Purposeful and / / /
coordinated movement
Catatonia / / /
Echopraxia x x x
Tics x x x
Spasm x x x
Compulsive x x x
Waxy flexibility x x x
Parkinson-like x x x
symptoms
Akathesia x x x
Dyskinesia x x x
Apraxia x x x
Catatonic stupor x x x
Catatonic Excitement x x x
Hyperkinesia x x x
Catalepsy x x x
Cataplexy x x x

Day 1

Interpretation

The patient was observe to have a catatonic movement but with out other problem

Analysis

Choice theory of glasser posits that most mental illness is in fact the expression of unhappiness

and that we are able to learn how to choose alternate behavior that will result in greater reaction

Schizophrenic patient motor behavior may appear odd. The patient may be restless and unable to

sit still, exhibit agitation and pacing or appear unmoving. On my patient case he has catatonia

meaning a psychological induced immobility occasionally marked by period of agitation or

excitement, the client appear seems motionless

Day 2

Interpretation

On the second day the patient was observe again to have a catatonic movement but without

other problem

29
Analysis

Choice theory of glasser posits that most mental illness is in fact the expression of unhappiness

and that we are able to learn how to choose alternate behavior that will result in greater reaction

Schizophrenic patient motor behavior may appear odd. The patient may be restless and unable to

sit still, exhibit agitation and pacing or appear unmoving. On my patient case he has catatonia

meaning a psychological induced immobility occasionally marked by period of agitation or

excitement, the client appear seems motionless

Day 3

Interpretation

On the 3rd day The patient was observe again to have a catatonic movement but without other

problem

Analysis

Choice theory of glasser posits that most mental illness is in fact the expression of unhappiness

and that we are able to learn how to choose alternate behavior that will result in greater reaction

Schizophrenic patient motor behavior may appear odd. The patient may be restless and unable to

sit still, exhibit agitation and pacing or appear unmoving. On my patient case he has catatonia

meaning a psychological induced immobility occasionally marked by period of agitation or

excitement, the client appears seems motionless

[Link] and cognition 1st day 2nd day 3rd day

[Link]   /

[Link]  / /

3. Concentration  / /

[Link] x x /

Day 1

30
Interpretation

The patient was conscious he still has memory of the reent past, recent and has immediate

retention. He can also recall except the event that lead him or the reason why heis in the

hospital. He was oriented in time,place and person. He was concentrated on what we are thinking

Analysis

Choice theory of glasser posits that most mental illness is in fact the expression of unhappiness

and that we are able to learn how to choose alternate behavior that will result in greater reaction

The conscious portion of the mind is the part which functions when the person is awake, causing

the individual to be aware of himself, his thoughts, feelings, perceptions and what was going in

the environment. Orientation is being aware of the correct time, date, place etc. when the patient

becomes unaware of the three spheres (time, place, person) he is disoriented. Concentration was

greatly influenced by distractibility. The interference of anxiety and environmental stimuli with

ones ability to focus attention upon communication and occurrences

My patient was conscious and oriented with time place and person. He has memory of the past

except the reason why he was here. He concentrates with what which are talking and is not easily

distracted

Day 2

Interpretation

He was conscious. He still has memory of the recent past, recent and has immediate retention.

He can also recall except the event that lead him or the reason why he is in the hospital and the

the time when he experienced ondoy. He was oriented in time, place and person. He was

concentrated on what we are talking and doing

Analysis

31
Choice theory of glasser posits that most mental illness is in fact the expression of unhappiness

and that we are able to learn how to choose alternate behavior that will result in greater reaction

The conscious portion of the mind is the part which functions when the person is awake, causing

the individual to be aware of himself, his thoughts, feelings, perceptions and what was going in

the environment. Orientation is being aware of the correct time, date, place etc. when the patient

becomes unaware of the three spheres (time, place, person) he is disoriented. Concentration was

greatly influenced by distractibility. The interference of anxiety and environmental stimuli with

ones ability to focus attention upon communication and occurrences

My patient was conscious and oriented with time place and person. He has memory of the past

except the reason why he was here. He concentrates with what which are talking and is not

easily distracted

Day 3

Interpretation

RU was conscious; he still has memory of the recent past, recent and has immediate retention.

He can also recall except the event that lead him or the reason why he is in the hospital. He was

oriented in time, place and person. He was concentrated on what we are talking.

Analysis

Choice theory of glasser posits that most mental illness is in fact the expression of unhappiness

and that we are able to learn how to choose alternate behavior that will result in greater reaction

The conscious portion of the mind is the part which functions when the person is awake, causing

the individual to be aware of himself, his thoughts, feelings, perceptions and what was going in

the environment. Orientation is being aware of the correct time, date, place etc. when the patient

becomes unaware of the three spheres (time, place, person) he is disoriented. Concentration was

greatly influenced by distractibility. The interference of anxiety and environmental stimuli with

ones ability to focus attention upon communication and occurrences

32
My patient was conscious and oriented with time place and person. He has memory of the past

except the reason why he was here. He concentrates with what which are talking and is not easily

distracted

Perception 1st day 2nd day 3rd day

[Link] x x x

[Link] x x x

[Link] x x x

[Link] x x x

[Link] x x x

[Link] x x x

[Link] x x x

Day 1

Interpretation

On the first meeting the patient has no hallucination and illusion

Analysis

Choice theory of glasser posits that most mental illness is in fact the expression of unhappiness

and that we are able to learn how to choose alternate behavior that will result in greater reaction

One hallmark symptom of schizophrenic psychosis is hallucination (false sensory perception, or

perceptual experiences that do not exist in reality). Hallucination can involve the five senses and

bodily sensation. Hallucinations are distinguished from illusion, which are misperceptions of

actual environmental stimuli. My patient does not experiences any hallucination or illusions

Day2

33
Interpretation

On the second meeting the patient has no hallucination and illusion

Analysis

Choice theory of glasser posits that most mental illness is in fact the expression of unhappiness

and that we are able to learn how to choose alternate behavior that will result in greater reaction

One hallmark symptom of schizophrenic psychosis is hallucination (false sensory perception, or

perceptual experiences that do not exist in reality). Hallucination can involve the five senses and

bodily sensation. Hallucinations are distinguished from illusion, which are misperceptions of

actual environmental stimuli. My patient does not experiences any hallucination or illusions

Day 3

Interpretation

On the third meeting the patient has no hallucination and illusion

Analysis

Choice theory of glasser posits that most mental illness is in fact the expression of unhappiness

and that we are able to learn how to choose alternate behavior that will result in greater reaction

One hallmark symptom of schizophrenic psychosis is hallucination (false sensory perception, or

perceptual experiences that do not exist in reality). Hallucination can involve the five senses and

bodily sensation. Hallucinations are distinguished from illusion, which are misperceptions of

actual environmental stimuli. My patient does not experiences any hallucination or illusions

Attitudes 1st day 2nd day 3rd day

[Link] / / /

[Link] x x x

34
 [Link] x x x

[Link] x x x

[Link] x x x

[Link] x x x

[Link] x x x

[Link] x x x

[Link] x x x

[Link] x x x

[Link] / / /

[Link] x x x

[Link] x x x

[Link] x x x

[Link] x x x

[Link] x x x

[Link] x x x

Day 1

Interpretation

The patient was cooperative . He responds to what I say. He is also submissive he follows what I

say

Analysis

Choice theory of glasser posits that most mental illness is in fact the expression of unhappiness

and that we are able to learn how to choose alternate behavior that will result in greater reaction

Mood refers to the client’s pervasive and enduring emotional state. The patients mood may be

described as happy, sad, depressed, euphoric, anxious, angry. My patient although no expression

but he is happy

35
Day 2

Interpretation

He was also cooperative and submissive; he is willing to participate in the activities and follows

what I say

Analysis

Choice theory of glasser posits that most mental illness is in fact the expression of unhappiness

and that we are able to learn how to choose alternate behavior that will result in greater reaction

Mood refers to the client’s pervasive and enduring emotional state. The patients mood may be

described as happy, sad, depressed, euphoric, anxious, angry. My patient although no expression

but he is happy

Day3

Interpretation

On the last day, he was very happy always join the group and actively and voluntarily

participate in the activities

Analysis

Choice theory of glasser posits that most mental illness is in fact the expression of unhappiness

and that we are able to learn how to choose alternate behavior that will result in greater reaction

Mood refers to the client’s pervasive and enduring emotional state. The patient’s mood may be

described as happy, sad, depressed, euphoric, anxious, angry. My patient although no expression

but he is happy

36
 Defense
Mechanism 1st day 2nd day 3rd day

[Link] x / x

[Link] / x x

[Link] x x x

[Link] x x x

[Link] Formation x x x

[Link] compensation x x x

[Link] x x x

[Link] x x x

[Link] x x x

[Link] x x x

[Link] x x x

[Link] x x x

[Link] x x x

[Link] x x x

[Link] x x x

[Link] x x x

[Link] x x x

[Link] x x x

19. Intellectualization x x x

Day 1

Interpretation

For the first day the client use repression as his defense mechanism, he cannot remember why he

was in the mental hospital

37
Analysis

Sigmund freud believed the self or ego used defense mechanism, which are methods of

attempting to protect the self and cope with basic drives or emotionally painful thoughts, feelings

or events. My patient uses repression as defense mechanism

Day 2

Interpretation

My client for the second day use denial as his defense mechanism, he denied that he use illegal

drugs but in the chart is said that he uses marijuana

Analysis

Sigmund freud believed the self or ego used defense mechanism, which are methods of

attempting to protect the self and cope with basic drives or emotionally painful thoughts, feelings

or events. My patient uses repression as defense mechanism

Day 3

Interpretation

The patient has no denial and repression. He did not use any defense mechanism for the last day

Analysis

Sigmund freud believed the self or ego used defense mechanism, which are methods of

attempting to protect the self and cope with basic drives or emotionally painful thoughts, feelings

or events. My patient uses repression as defense mechanism

Affective State 1st day 2nd day 3rd day

[Link] x x x

[Link] Effect / / x

[Link] x x x

[Link] x x x

[Link] x x x

[Link] x x x

38
[Link] x x x

[Link] x x x

Day 1

Interpretation

On the first day I observed that he manifest flat affect, he appear that he is just staring but he is

happy

Analysis

Choice theory of glasser posits that most mental illness is in fact the expression of unhappiness

and that we are able to learn how to choose alternate behavior that will result in greater reaction

Affect is the outward expression of the client emotional state. Clients with schizophrenic report

and demonstrate wide variances in mood affect. They often are described as having flat affect

(no facial expression) or blunted effect (few observable facial expression). On the firstday my

client manifest a flat affect

Day 2

Interpretation

There were no feelings of fear of ambivalence, irritability, rage but there is flat affect

Analysis

Choice theory of glasser posits that most mental illness is in fact the expression of unhappiness

and that we are able to learn how to choose alternate behavior that will result in greater reaction

Affect is the outward expression of the client emotional state. Clients with schizophrenic report

and demonstrate wide variances in mood affect. They often are described as having flat affect

(no facial expression) or blunted effect (few observable facial expression). On the firstday my

client manifest a flat affect

Day 3

39
Interpretation

On the last day the client did not have flat affect because I saw him smiling

Analysis

Affect is the outward expression of the client emotional state. Clients with schizophrenic report

and demonstrate wide variances in mood affect. They often are described as having flat affect

(no facial expression) or blunted effect (few observable facial expression). On the firstday my

client manifest a flat affect

Thought Process 1st day 2nd day 3rd day

[Link] x x x

[Link] of ideas x x x

[Link] Salad x x x

[Link] x x x

[Link] x x x

[Link] x x x

[Link] x x x

[Link] x x x

[Link] x x x

[Link] x x x

[Link] x x x

[Link] Accusation x x x

[Link] x x x

[Link] x x x

[Link] x x x

[Link] x x x

[Link] x x x

[Link] x x x

Day 1

Interpretation

40
There was no blocking, flight of Ideas, word salad, delusion, preservation, echolalia etc.

observed in the patient

Analysis

Choice theory of glasser posits that most mental illness is in fact the expression of unhappiness

and that we are able to learn how to choose alternate behavior that will result in greater reaction

Schizoprenia often is referred to as thought disorder because that is the primary feature of the

disease. Thought process becomes disordered, and the continuity of thoughts and information

processing is disrupted. My patient has no blocking, flight of Ideas, word salad, delusion,

preservation, echolalia etc.

Day 2

Interpretation

There was no blocking, flight of Ideas, word salad, delusion, preservation, echolalia etc.

observed in the patient

Analysis

Choice theory of glasser posits that most mental illness is in fact the expression of unhappiness

and that we are able to learn how to choose alternate behavior that will result in greater reaction

Schizoprenia often is referred to as thought disorder because that is the primary feature of the

disease. Thought process becomes disordered, and the continuity of thoughts and information

processing is disrupted. My patient has no blocking, flight of Ideas, word salad, delusion,

preservation, echolalia etc.

Day 3

Interpretation

There was no blocking, flight of Ideas, word salad, delusion, preservation, echolalia etc.

observed in the patient

Analysis

41
Choice theory of glasser posits that most mental illness is in fact the expression of unhappiness

and that we are able to learn how to choose alternate behavior that will result in greater reaction

Schizoprenia often is referred to as thought disorder because that is the primary feature of the

disease. Thought process becomes disordered, and the continuity of thoughts and information

processing is disrupted. My patient has no blocking, flight of Ideas, word salad, delusion,

preservation, echolalia etc.

CHAPTER
42
 III

PREDISPOSING FACTOR

Predisposing factor/ causes are those conditions, which make the individual susceptible to the
effect of precipitating cause, and thus make lively to develop a psychosis. It is generally believed
that no human being can escape all predispositions to mental disorder. In most instances,
however, the predisposition to mental disorder is not strong enough to extinguished the
individual resistance of the person

1. Client stop schooling in his 3rdyear high school

His mother and father cannot have much enough money for their daily living, the family decided
that the client must stop schooling; in that case he finished only 3rdyear high school

2. Going with wrong peers

After the client stop, he moves his attention to his peers whereby his peers force him to drink
alcohol, smoke cigarette and use marijuana

3. Wife separation

Because of financial problem, the client and his wife had an misunderstand that is so big that the
client’s wife divorce his husband

43
 Psychodynamics

Adolescent. Client stop schooling

erickson Jung Adler Sullivan

The inability to settle in suppression of feeling 1st neurotic need the client has
school is disturbing especially anxiety was not met because patterned his
The indiscriminate need life to be a
To please the other and be miserable easy
Like them was not done going and full of
. Vices

Difficulty of building self concept

Young adult

Young adult The 2nd neurotic need was His aspect of personality
Divorce /w wife not met because he was divorce was diminished because
So there is no one will take over of improper relationship
His life
Feeling of confusion Freud genital stage
Indecisiveness, antisocial behavior diminished

Isolation, difficulty of interacting to other

Late adoslescense
Pressure being a father
Poverty,single parent Lack of interest and commitment there was no principal
To his son satisfaction in his life
Because he lost his wife

Stagnation result to severe anxiety

44
 Retreat into psychosis

Use of defense mechanism repression denial,etc. to protectself and cope with

Painful thought

Psychopathology

Psychopathology

Enlarged ventricle and smaller medial temporal lobe

Intrauterine and early postnatal life-abnormal neurodevelopment

*Enlarged lateral and third ventricles

*Small thalamus and hippocampus
*Left hemisphere smaller and softer than normal

Change in brain Volume averaging 3%

Dysregulation or
Hipofrontality (reduced
hyperresponsiveness of the neurons
metabolic activity in the
frontal cortex

Presynaptic Altered 5 HT Dysfunction of N-

dopaminergic auto receptor methyl D-
receptor abnormality aspartate
receptor

Decreased activity of Decreased activity of

Increased density
Inability to serotonin glutamate
of dopamine
appropriately sort
receptor sites in
and interpret
basal ganglia
incoming stimuli

Loss of ability to Experienced sensory

Dopaminergic
screen external overload
activity
sensory stimuli

Hypofrontality (reduced
activity of frontal cortex)
45
 Sort and interpret incoming
stimuli

Hallucination and Impaired ability to

delusion appropriately
respond to the
[Link]
environment

One Third Of Patients Who Stop Treatment For

Schizophrenia Early Do So Due To Poor Response
Hong Liu-Seifert and colleagues from Eli Lilly and Company in Indianapolis, USA, analysed the
reasons for stopping treatment of patients who took part in four previous Eli Lilly studies. The
studies included a total of 1627 patients and compared the effects of taking olanzapine,
risperidone, quetiapine or ziprasidone in patients diagnosed with schizophrenia or related
disorders.

Liu-Seifert et al.'s analysis shows that 53% (866/1627) of patients stopped treatment early. Of
the 866 patients who stopped treatment, 36% (315/866) did so because the treatment was felt not
to be effective or because their symptoms worsened. Only 12% of patients who stopped
treatment early did so because of adverse events such as dizziness, fatigue, vomiting or weight
gain.

Of the 315 patients who stopped because of poor response to treatment, 80% stopped because
they themselves believed it wasn't effective. Only 20% of the patients studied stopped taking
medication based on a doctor's decision that the treatment wasn't effective.

Summary:

A third of patients treated for schizophrenia who stop taking their medication early do so because
they do not feel any significant improvement or because their symptoms are worsening. A study
published today in the open access journal BMC Medicine reveals that patients with
schizophrenia are three times more likely to stop treatment because of poor response or
worsening symptoms, than because of adverse non-psychiatric side effects.

Reaction

46
I was so disappointed withit because the drug must be a good benefit for the people, they must
encourage the others that the drugs was one of the big needed for them to achieve mental health
and I wish that someday we can discover new class of drug that is fewer of side effect and longer
in duration with increase positive outcome

2007, December 15,., [Link]

Effective New Treatment For Schizophrenia

The authors studied paliperidone extended-release (ER) tablets, an investigational drug which
orally delivers the active metabolite of the drug risperidone, which is an already established
efficacious antipsychotic. The authors recruited 444 patients who were experiencing an acute
episode of schizophrenia and, after evaluating the severity of their symptoms, administered one
of four treatments for 6 weeks: 6 mg or 12 mg/day of paliperidone ER, 10 mg/day of olanzapine
(the active comparator), or placebo. During the six weeks of treatment, the investigators
monitored the patients for side effects and assessed their symptom improvement.

Dr. Stephen Marder, senior author on the paper, explains the findings: "This double-blind study
found that two doses of paliperidone extended release tablets were more effective than placebo
for treating the symptoms of acute schizophrenia. Patients receiving the most effective dose of
paliperidone (6 mg) also demonstrated improvements in their social functioning." Jeffrey A.
Lieberman, M.D., Chairman of the Department of Psychiatry at Columbia University and
Director of the New York State Psychiatric Institute, comments, "This study demonstrates the
efficacy of the 9-hydroxy metabolite of risperidone that has antipsychotic efficacy and an
acceptable safety profile which provides psychiatrists with yet another treatment option. It has
practical advantages with its long half life, duration of action and extended release formulation."
Dr. Lieberman cautions though that this finding is not "a novel or breakthrough treatment and
does not provide major differences or advantages over existing treatments." Additional studies
are currently underway to further evaluate the long-term (up to one year) efficacy and safety of
paliperidone ER in the treatment of schizophrenia.

Summary:

I a new study scheduled for publication in the December 15th issue of Biological Psychiatry,
Marder and colleagues examined the efficacy and safety of a new psychotropic agent for the
treatment of schizophrenia in a 6-week, randomized, placebo-controlled trial. Which has a good
result

47
 Reaction:

Schizophrenia is one of the most debilitating of the major psychiatric disorders, and is also one
of the most difficult to treat. Although numerous antipsychotic treatments are available, they can
cause significant side effects and many patients experience only a partial relief of their symptoms
and up to 30% no relief at all. It is beter for the people because it will make contribution for the
people with schizophrenia

Drug study

Drug Dose, Route, Classification Mechan Contraindication Side Effects Nursing

frequency ism of responsibilities
action

multivita 25o mg od vitamins Stimulat Contraindicated on CNS:faintness, *stress proper

min e patient who have Dizziness nutritional habit
collagen allergy to
formatio tartrazine, large GI:diarrhea, *protection
n and dose are heartburn, nausea from sunlight
tissue contraindicated and vomiting
repair, during pregnancy *check the urine
involve GU:acid ph
in urine,oxaluria,rena
oxidatio l calculi *Tell patient to
n- report sign of
reductio Other:discomfort hypersensitivity
n at injection site
*Inform patient
reaction
that trace
element are
normally
received from
diet intake

Drug study

Drug Dose, Route, Classification Mechan Contraindication Side Effects Nursing

frequency ism of responsibilities
action

Haloperi 10mg bid antipsychotic Blocks Contraindicated Autonomic:Dry *Take this drug

48
dol postsyna with mouth, exactly as
ptic hypersensitivity to salivation,nausea prescribe
dopamin typical anti and vomiting
e psychotic, coma or *Inform the
receptor severe CNS CNS:drowsiness,in patient for side
in the supression somnia, tremor effect
brain,
depress CV:hypotension, *report sore
the orthostatic throat, fever,
RAS, hypotension rash, weakness
includin
g those Endocrine:lactatio *avoid
parts of n, breast prolonged
the brain engorgement,galac exposure to the
involve torhea sun
with
*Monitor
wakeful
elderly patient
ness and
for dehydration
emesis

CHAPTER
49
 IV

Edward Joseph P. Acosta November 22, 2010

Patiet: RU

Orientation Phase

Objectives

1. To be able to establish rapport with the client

[Link] e able to build a trusting relationship with the patient

3. To be able to gather information about the patient

[Link] be able to let the patient verbalize feelings

Nurse – Patient Interaction Analysis of Nurse Response Interpretation and analysis

of Patient response

N: Good morning Giving Recognition- Grooming – unkempt, clean but

Acknowledging-indicating wrinkled clothes with body odor,
P: Good morning din awareness he has no facial expression, but
with eye contact

Giving Information- Making

N: ako nga pop ala si jay, tara available the facts that the client Cooperative – works together
maghilamos tayo,pakisuot needs ,He has no facial expression, but
nalang itong isang pares ng with eye contact

50
tsinnelas pati yung name tag
mo.

P: okey

(After hygiene)
He has no facial expression, but
N: RU ako nga pala ulit si jay with eye contact, Scratching his
ang magiging student nurse Giving Information- Making skin performed consciously
mo. Galing akong CEU o available the facts that the client
tinatawag ding Centro Escolar needs
University

P: ah okey

N:Bale nandito kami ngayon Giving Information- Making He has eye contact with no facial
hangang Wednesday, sa available the facts that the client expression
Wednesday kami ay needs
magpapaalam na dahil di niyo
na kami makikita pa muli.

P: Silence
He has eye contact with no facial
Encouraging expression- asking expression, Submissive –
N: Kamusta po kayo the client to appraise the quality obedient
of his or her experience
P: Ayos lang naman

N: RU mahilig kabang Exploring- Delving further into a He has eye contact with no facial
magexercise subject or idea expression, patient appear
sincere
P: Ou naman
Cooperative – works together
Giving Information- Making ,He has no facial expression, but
N:ah, mamaya onti available the facts that the with eye contact
mageexercise tayo client needs

P:Sige

N:tara Submissive – obedient

Giving Information- Making Scratching his skin performed
N:magpapakilala pala tayo available the facts that the consciously
mamaya para makilala mo client needs
yung mga kasama ko at ang
aking C.I. pati mga kasama
mu.

P:silence
Cooperative – works together
N: tara oras ng Advising –telling the client ,He has no facial expression, but
magexercise,gagayahin natin what to do with eye contact
yung nasa harapan ah.

P: Ou

(After excercise)

N:Naging Masaya kaba sa Encouraging expression- He has eye contact with no facial

51
execise natin asking the client to appraise expression
the quality of his or her
P:ou naman experience

N:tara therapy na naten, Sali Advising –telling the client

ka ah what to do Cooperative – works together
,He has no facial expression, but
P: osige with eye contact

(After play therapy)

He has eye contact with no facial
N:nagging masaya ka bas a Encouraging expression-
expression, patient appear
play therapy natin asking the client to appraise
sincere
the quality of his or her
P: Masaya naman experience
Cooperative – works together
N: ngayon naman ,He has no facial expression, but
Magkakaroon tayo ng Giving Information- Making with eye contact
occupational therapy at ditto available the facts that the
ay magdradrawing tayo client needs

P: Silence

(After occupational therapy)

He has eye contact with no facial
N:Nakita ko kanina yung Making observation- expression, patient appear
drinawing mu ano ang dahilan verbalizing what you see to sincere. Submissive – obedient
at yun ang niisipan mo the client

P:school, Pagaaral

He has eye contact with no facial

N:anu pala yung nasa kaliwa Focusing – concentrating on a expression, patient appear
ng drinawing mu single point sincere. Submissive – obedient

P: school Building

Scratching his skin performed

N:Nakita ko din na consciously
maydalawang tao dun sa Making observation-
drinawing mo, sino yung isa verbalizing what you see to
dun? the client

P: kapatid ko

He has eye contact with no facial

expression, patient appear
N: yug isa pa Focusing – concentrating on a sincere. Submissive – obedient
single point
P: ako

He has memory of recent past

,He has no facial expression, but
N: ah, Hangang saan ba ang Exploring- Delving further with eye contact,
into a subject or idea
Natapos mo sa pagaaral

P:3rd year college

52
 He has memory of recent past
Exploring- Delving further ,He has no facial expression, but
N:anong kurso mo into a subject or idea with eye contact

P:Marines
He has memory of recent past
Focusing – concentrating on a Scratching his skin performed
single point consciously
N:Anong dahilan at tumigil ka
sa pagaaral

P:walang pera

He has eye contact with no facial

N: RU anong gusto mung Broad Openings- allowing the
expression
pagusapan naten client to take the initiative in
introducing the topic
P:Ikaw, anu ba gusto mung
malaman
He has eye contact with no facial
expression
Exploring- Delving further
N:Ilan taon kana into a subject or idea
He has memory of recent past
P:29

Exploring- Delving further

into a subject or idea
N:May asawa kaba ngayon

P:ou naman He has eye contact with no facial

expression, patient appear
Exploring- Delving further sincere
into a subject or idea
N:Asan na siya ngayon at ano
trabaho niya

P:Nasa Tindig Araw,Bahay He has eye contact with no facial

expression, patient appear
Exploring- Delving further sincere
N:May anak ba kayo into a subject or idea
He has eye contact with no facial
P:ou expression, patient appear
sincere
Exploring- Delving further
into a subject or idea
N: Ilang taon na

P:Isang Taon gulang

Fantasy – use of imagination or
day dreaming, an imagined
Encouraging expression- series of events
asking the client to appraise
N:naging msaya ba kayo ng the quality of his or her
buong pamilya mo experience
P:masaya naman
Denial – the unconscious
disapproval of thoughts, feelings,
Focusing – concentrating on a wishes, needs which are
N:may naging problema ba single point coniously unacceptable
kayo ng pamilya

53
P:wala

Introducing unrelated topic- Submissive – obedient

changing the subject
N:May dumadalaw ba sayo
dito

P:magulang ko

Scratching his skin performed

Exploring- Delving further
consciously
into a subject or idea
N:kamuzta naman ang
magulang mo

P: ayos naman
He has eye contact with no facial
Exploring- Delving further expression
into a subject or idea
N:ilang beses kana dinadalaw
ng magulang mo ditto

P:dalawa He has eye contact with no facial

expression, patient appear
Placing event in time or in sincere
sequence – clarifying the
N:Ilang taon na kayo nandito relationships or events in time

P:wala pa
Client misinterpreted the
Placing event in time or in months he was here
sequence – clarifying the
N:ilang buwan relationships or events in time
P:lima Repression – involuntary
Focusing – concentrating on a banishment of unacceptable or
single point painful thoughts ,feelings and
impulses into the unconscious
N:Anong dahilan panu kayo
napunta ditto
Repression – involuntary
P:Hindi ko alam banishment of unacceptable or
Restating- repeating the main
painful thoughts ,feelings and
idea expressed
impulses into the unconscious
N: wala ka bang maalala

P:nandito nalang ako, dinala

ako ng magulang ko Exploring- Delving further
into a subject or idea
N:sa tingin niyo ano ang
dahilan at dinala kayo ditto
Denial – the unconscious
P:silence disapproval of thoughts, feelings,
wishes, needs which are
Exploring- Delving further coniously unacceptable
into a subject or idea
N:May ginawa kaba
He has eye contact with no facial
P:wala
expression, patient appear
Encouraging expression- sincere
asking the client to appraise
N:gaano mo kamahal mga the quality of his or her
magulang mo experience

54
P:mahal na mahal He has eye contact with no facial
expression, patient appear
Exploring- Delving further sincere
into a subject or idea
N:yung asawa mo at anak mo

P:mahal na mahal din

Cooperative – works together
Focusing – concentrating on a ,He has no facial expression, but
with eye contact
N:maari mu bang ilarawan ang single point
asawa’t anak mo
Scratching his skin performed
P:okey naman consciously
Introducing unrelated topic-
N:napunta kanaba dati sa changing the subject
hospital

P:di pa He has memory of recent past

Exploring- Delving further

into a subject or idea
N:Ano ano naba ang naging
sakit mu

P:tigdas He has memory of recent past

General leads- asking for
contiuation
N:anu pa
Submissive – obedient
P:Bulutong He has eye contact with no facial
Exploring- Delving further expression
into a subject or idea
N:nagagalaw mu ban g
maayos ang iyong katawan
He has eye contact with no facial
P:ou naman expression
Scratching his skin performed
Exploring- Delving further
consciously
into a subject or idea
N:nakakaramdam ka ba ng
onting pagkakaroon ng Cooperative – works together
depresyon ,He has no facial expression, but
with eye contact
P:wala naman Exploring- Delving further
into a subject or idea
N:nakakaramdam ka ba ng
onting pagkakaroon ng
Pagkabahala

P:wala naman He has eye contact with no facial

expression
Exploring- Delving further Scratching his skin performed
into a subject or idea consciously
N:nakakaramdam ka ba ng
onting pagkakaroon ng pagka
walang pagasa

P:wala naman Cooperative – works together

,He has no facial expression, but
Exploring- Delving further with eye contact
into a subject or idea

55
N:nakakaramdam ka ba ng
onting pagkakaroon ng
sobrang kagalakan

P:wala naman Submissive – obedient

Exploring- Delving further Scratching his skin performed
into a subject or idea consciously

N:nakakaramdam ka ba ng
onting pagkakaroon ng
paghihinala

P:wala naman
Submissive – obedient
Exploring- Delving further
Scratching his skin performed
into a subject or idea
consciously
N:nakakaramdam ka ba ng
onting pagkakaroon ng
pagkalito

P:wala naman
He has eye contact with no facial
Exploring- Delving further expression, patient appear
N:nakakadumi kaba ng into a subject or idea sincere
maayos

P:ou

Submissive – obedient
Exploring- Delving further patient appear sincere
N:nakakatulog kaba ng into a subject or idea
maayos

P:ou naman

Encouraging comparison – Scratching his skin performed

consciously
asking the similarities and
N:sa tingin mo ikaw ba ay differences be noted
tumataba o pumapayat

P:sakto lang
Submissive – obedient
patient appear sincere
Focusing – concentrating on a
N:maari mo bang ilarawan ang single point
isang kaibigan

P:maasahan, di ka
iiwanan,nandiyan lage
pagmaykaylangan ka.

Focusing – concentrating on a Submissive – obedient

N:maari mu bang ilarawan ang single point patient appear sincere
iyong pangkaraniwan na araw

P:ok lang naman

patient appear sincere, looked

Focusing – concentrating on a
pissed
N:maari mu bang ilarawan single point
yung ayaw mu sa isang tao

56
P:iyong madakdak He has memory of recent past

Exploring- Delving further

into a subject or idea
N:anu ang ginagawa mu dati
seniu pagmay bakante kang
oras

P:kasama ko mga kaibigan ko

He has memory of recent past
Scratching his skin performed
Exploring- Delving further
consciously
into a subject or idea
N:anong ginagawa niyo

P:wala lang

He has eye contact with no facial

Exploring- Delving further expression, patient appear
N:naninigarilyo kaba into a subject or idea sincere

P:ou
He has eye contact with no facial
Exploring- Delving further expression, patient appear
into a subject or idea sincere
N:Gaano kadame

P:medyo madami din

Exploring- Delving further He has eye contact with no facial

into a subject or idea expression, patient appear
N:umiinom kaba sincere
P:ou General leads- asking for
contiuation
N:gaano kadalas

P:mga dalawang beses isang

lingo He has eye contact with no facial
Exploring- Delving further expression, patient appear
into a subject or idea sincere
N:Yung mga kasama mu ba ay
umiinom at naninigarilyo

P:ou Submissive – obedient

Scratching his skin performed
Exploring- Delving further
consciously
into a subject or idea
N:may mga iniinom ka ba na
mga gamut

P:ou Cooperative – works together

,He has no facial expression, but
Exploring- Delving further with eye contact
into a subject or idea
N:ilan

P:dalawa
He has eye contact with no facial
Exploring- Delving further expression, patient appear
N:alam mo ba kung ano ito into a subject or idea sincere

P:Hindi
He has eye contact with no facial

57
 Exploring- Delving further expression
into a subject or idea Scratching his skin performed
N:Sino ang importante sayo consciously
ng lumalaki ka

P:pamilya ko

Placing event in time or in He has memory of recent past

sequence – clarifying the
N:Ikaw ba ay minamaltrato relationships or events in time
noong kabataan mo

P:hindi He has memory of recent past

Exploring- Delving further
into a subject or idea
N:yung mga magulang muba
ay gumagamit ng bawal
nagamot

P:Hindi

Denial – the unconscious

N:Ikaw Exploring- Delving further disapproval of thoughts, feelings,
into a subject or idea wishes, needs which are
P:Hindi din coniously unacceptable

Exploring- Delving further

N:anong hilig mo into a subject or idea
P:( silence)
He has eye contact with no facial
expression, patient appear
Exploring- Delving further sincere
N:Marunong kabang sumayaw
into a subject or idea
P:(silence)

Submissive – obedient
Scratching his skin performed
N:marunong ka bang kumanta Exploring- Delving further
consciously
into a subject or idea
P:ou
Cooperative – works together
,He has no facial expression, but
Focusing – concentrating on a with eye contact
N:anung klase single point

P:rap He has eye contact with no facial

expression, patient appear
sincere
Exploring- Delving further
N:Anong hilig mung sport into a subject or idea
P:(silence) He has eye contact with no facial
expression
Scratching his skin performed
Exploring- Delving further consciously
N:marunong kabang into a subject or idea
magbasketball

P:ou
Submissive – obedient

58
 Scratching his skin performed
Giving Information- Making consciously , patient did not like
N:sa miyerkules pala ay may available the facts that the to show his talent
socialization day tau, at bka client needs
gustu mongkumanta

P:Hindi
Cooperative – works together
,He has no facial expression, but
Giving Information- Making with eye contact
N:sige tapos na ang oras natin, available the facts that the
bukas nalang ulit,at maraming client needs
salamat sa oras. Advising –telling the client
what to do

Edward Joseph P. Acosta November 23, 2010

Patiet: RU

Working phase

Objectives

[Link] be able to identify client’s problem and needs

2. To be able to provide therapeutic techniques to reduce anxiety and to promote positive change
and independence

3. To be able to give appropriate interventions regarding client’s problems and needs

Nurse – Patient Interaction Analysis of Nurse Response Interpretation and analysis

of Patient response

N:hello RU, kamusta Giving Recognition- Grooming – unkempt, clean but

Acknowledging-indicating wrinkled clothes with body odor,
P:ayos lang awareness he has no facial expression, but
with eye contact

Advising –telling the client Cooperative – works together

N:maghilamus na tayo RU what to do ,He has no facial expression, but
with eye contact
(after exercise)
Encouraging expression- He has no facial expression, but
N:RU nasiyahan kaba sa asking the client to appraise with eye contact, Scratching his
exercise natin the quality of his or her skin performed consciously
experience
P:ou naman

Cooperative – works together

N:tara RU making tayo sa

59
biblio therapy Advising –telling the client ,He has eye contact with no
what to do facial expression
P: sige

(after biblio,remotivation and

occupational therapy)

N:RU kamuzta naman ang

ginawa nating Encouraging expression- He has eye contact with no facial
biblio,remotivation asking the client to appraise expression, Submissive –
atoccupational therapy the quality of his or her obedient
experience
P:Masaya naman

N:RU tanung kulang kung Testing- appraising the He has eye contact with no facial
anung araw na ngayon client’s degree of insight expression, patient appear
sincere
P:Martes

Cooperative – works together

Testing- appraising the ,He has no facial expression, but
N:na saan tayo client’s degree of insight with eye contact

P:pav 1

Testing- appraising the Submissive – obedient

N:anung date ngayon client’s degree of insight Scratching his skin performed
consciously
P:hindi ko na alam

N:anong natutunan mo kanina Cooperative – works together

sa kwento sa bibliotherapy Exploring- Delving further ,He has no facial expression, but
into a subject or idea with eye contact
P: tumulong

N:Sino ang paborito mong He has eye contact with no facial

Exploring- Delving further
bayani expression, patient appear
into a subject or idea
sincere. Submissive – obedient
P:Jose rizal

N:ano ang dahilan at siya ang Scratching his skin performed

naging paborito mo consciously
Focusing – concentrating on a
P:tumutulong siya sa kapwa single point
hindi niya iniiwan ang mga
kasama

N:RU maalala kop ala bukaz

Giving Information- Making
na ang socialization day natin He has eye contact with no facial
available the facts that the
ito nadin ang huli nating expression, patient appear
client needs
pagkikita at magpapaalam sincere. Submissive – obedient
nadin ako sayo

60
P:ah ou

N:nagustuhan mo ba ang
pagawang parol He has no facial expression, but
Encouraging expression- with eye contact,
P:ou, Masaya nga eh asking the client to appraise
the quality of his or her
experience

N:dati ba gumagawa ka na din He has memory of recent past

ng parol Placing event in time or in ,He has no facial expression, but
sequence – clarifying the with eye contact
P:ou medyo lang relationships or events in time

N:anung ginagawa niyo ditto He has memory of recent past

sa pasko Exploring- Delving further Scratching his skin performed
into a subject or idea consciously
P: wala pa hindi pa ako
nagpapasko ditto

Scratching his skin performed

N:pero naabutan mu ba ang consciously , misperception of
ondoy dito Placing event in time or in event
sequence – clarifying the
P:ou relationships or events in time

N:saan kayo natutulog nun

Cooperative – works together
P:doon lang ,He has no facial expression, but
Exploring- Delving further with eye contact
into a subject or idea
N:saan b

P:diba natutulog ako kanina, He has eye contact with no facial

doon ung pwesto naming
Exploring- Delving further expression, patient appear
into a subject or idea sincere

N: hindi ba kayo nahirapan

Submissive – obedient
Scratching his skin performed
P:hindi naman
Exploring- Delving further consciously
into a subject or idea

N:wala bang nagaaway sayo He has eye contact with no facial

sa loob expression

P:wala naman Exploring- Delving further

into a subject or idea

N:ayos lang ba yung mga

He has eye contact with no facial
kasama mo sa loob
expression
P:ayos naman
Exploring- Delving further

61
 into a subject or idea

N:Panu pagnagkagulo dun Submissive – obedient

anong ginagawa mo Scratching his skin performed
consciously
P:wala naman, tinitignan o Exploring- Delving further
lang sila into a subject or idea
He has eye contact with no facial
expression

N:kamusta yung mga kaibigan

mu dati sa labas He has eye contact with no facial
expression, patient appear
P:ayos din naman Encouraging expression- sincere
asking the client to appraise
the quality of his or her
experience
N:Maaari mu ba silang
ilarawan

P:mabait,maaasahan He has eye contact with no facial

Focusing – concentrating on a expression, patient appear
single point sincere

N:umiinom ba sila
He has eye contact with no facial
P:ou minsan expression, patient appear
Exploring- Delving further sincere
into a subject or idea
N:naninigarilyo ba sila

P:ou minsan
Exploring- Delving further
into a subject or idea He has eye contact with no facial
expression, patient appear
N:gumagamit ba sila ng bawal sincere
na gamot

P:hindi
Exploring- Delving further
into a subject or idea

N:kumain kana ba ng Scratching his skin performed

umagahan consciously
P:ou Exploring- Delving further
into a subject or idea

N:anu kinain mo
Cooperative – works together
P:tinapay ,He has no facial expression, but
Exploring- Delving further with eye contact
into a subject or idea
N:sapat naman ba ang
Submissive – obedient
kinakain niyo ditto He has eye contact with no facial
expression
P:sapat naman Exploring- Delving further
into a subject or idea

N:kumakain kaba ng tatlong

Scratching his skin performed

62
beses sa isang araw consciously

P:ou namn Exploring- Delving further

into a subject or idea

N:ano ang paratiniyong

kinakain Cooperative – works together
,He has no facial expression, but
P:giniling with eye contact
Exploring- Delving further
into a subject or idea
Submissive – obedient
N:marunong kaba maggitara He has eye contact with no facial
expression
P:medyo lang
Introducing unrelated topic-
changing the subject
N:gustu mo ba magpakita ng
talento,bukaz sa socialization
day Scratching his skin performed
consciously , Client did not want
P:Hindi to show his talent to others
Encouraging expression-
asking the client to appraise
the quality of his or her
N:ayaw mo ba,sasabayan ka experience
naming, saka yung iba ay
kakanta din
Giving Information- Making Client did not want to show his
P:hindinalang manonood available the facts that the talent to others,He has no facial
nalang ako client needs expression, but with eye contact

N:anu pala ang relihiyon mo

Submissive – obedient
P:katoliko He has eye contact with no facial
Exploring- Delving further expression
into a subject or idea
N:sino ang nagbibigay sayo ng Cooperative – works together
pagasa sa buhay ,He has no facial expression, but
with eye contact
P:kapaid ko
Exploring- Delving further
into a subject or idea

N:sinong kapatid He has eye contact with no facial

expression, patient appear
\P:yung kuya ko sincere
Focusing – concentrating on a
single point

N:anung dahilan at ang kuya

mo He has eye contact with no facial
Focusing – concentrating on a expression
P:tinutulungan niya kami Scratching his skin performed
single point
consciously

N:ditto kanaba talaga sa ward

63
nine He has memory of recent past

P:hindi naman Introducing unrelated topic-

changing the subject

He has memory of recent past

N:saan kaba dati Scratching his skin performed
consciously
P:ward 6 ako dati ilipat ako Introducing unrelated topic-
ward 9 changing the subject

Denial – the unconscious

N:nakita ko na lagi kang disapproval of thoughts, feelings,
nagkakamot, may nangangati wishes, needs which are
ba sayo coniously unacceptable
Making observation-
P:ano my galis ako verbalizing what the nurse
percieve

He has eye contact with no facial

N:tinatanung ko lang kung expression
nangangati ka
Seeking information- seeking
P:wala naman to make clear that which is not
meaningful or that which is
vague
N:may allergy kaba sa peanut He has eye contact with no facial
butter expression
Introducing unrelated topic-
P:wala naman changing the subject

Submissive – obedient
N:yun ang kakainin natin Scratching his skin performed
mamaya, gusto mu ba nun Encouraging expression- consciously
asking the client to appraise
P:ou naman
the quality of his or her
He has eye contact with no facial
N:cge tapos na tao, hintayin experience
expression
nalang natin mga kasama mu

P:ah sige Giving Information- Making

available the facts that the
client needs He has eye contact with no facial
expression, patient appear
N:RU ito na ang pagkain mo sincere
Pag may kelangan ka
nanditolang ako
Offering self- making oneself
P:salamat available

He looks graceful when thanking

N:salamat din me for foods

P:Jay gustu mo ba
Accepting- indicaing reception

He has eye contact with no facial

N:sige sainyo lang yan wag expression, patient appear
mo na akong intindihin sincere

64
 P:sige

Accepting- indicaing reception He has eye contact with no facial

expression, patient appear
N:tara na, naging Masaya sincere
kaba sa araw na ito

P:naging Masaya ako salamat Encouraging expression-

asking the client to appraise
the quality of his or her Cooperative – works together
experience ,He has no facial expression, but
N:kukunin ko na pala yung with eye contact
name tag mo at tsinelas

P:salamat ah
Giving Information- Making
N:salamat din available the facts that the He was smiling happy and
client needs cheerful

Accepting- indicaing reception

Edward Joseph P. Acosta November 23, 2010

Patiet: RU

Termination phase

Objectives

[Link] be able to let the patient verbalize his feelings regarding terminaton

2. To be able to assist patient in accepting and reacting regarding terminaton

3. To be able to let the patients summarize the interaction that have gone through between the
patient and nurse from day 1

65
Nurse – Patient Interaction Analysis of Nurse Response Interpretation and analysis
of Patient response

N:Gandang Umaga RU Giving Recognition- Grooming – unkempt, clean but

Acknowledging-indicating wrinkled clothes with body odor,
P:Gandang umaga din awareness he has no facial expression, but
with eye contact

Advising –telling the client

N:tara maghilamos kana what to do Cooperative – works together
,He has no facial expression, but
P:O sige with eye contact

Giving Information- Making Submissive – obedient

N:Ngayon ang socialization available the facts that the
day natin, huling araw na natin client needs
magkikita, pero magsasaya
muna tayo

P:ou naman

Voicing doubt- expressing He has eye contact , Cooperative

N:RU ayaw mo bang sumali uncertainty about the reality of – works together
sa palaro the client perception
P:gusto naman

He was smiling happy and

Exploring- Delving further
N:RU kamusta cheerful
into a subject or idea
P:natalo ako pero ayos lang

Cooperative – works together

N:RU kainan na Advising –telling the client
,Submissive – obedient
what to do
P:jay kain

He looks graceful when thanking

N: ah sige ayos lang kain kana Accepting- indicaing reception
me for foods

P: jay salamat

N:salamat din
He was smiling happy and
cheerful with eye contact
Encouraging expression-
N:Nasiyahan kaba sa asking the client to appraise
pagsasama nating isang lingo the quality of his or her
experience
P:ou naman

N:ako din, magiingat ka lage Accepting- indicaing reception He was smiling happy and
ah cheerful with eye contact

P:Ingat ka din, salmat ulit

66
 (shaking hand)

PRIORITIZED NURSING DIAGNOSIS

1. Disturbed thought process related to substance abuse

2. Impaired memory related to use of ego defense mechanism

3. Ineffective Individual Coping related to maturational crisis

Nursing problem Rank Justification

1 This was the highly to be

prioritize because it affects
the emotion of the person if
[Link] Individual
not treated early the client
Coping related to may worsen and may
maturational crisis develop severe symptom of
his mental illness
[Link] thought 2 The client needs to know
process related to
events in the right place and
substance abuse in the right time so that if
there is any needed info for

67
 health and safety for him it
[Link] memory will be accurate
3
related to use of ego This was the second to be
defense mechanism prioritize the client must
know what happened and
assist him to accept or what
reaction he will manifest

NURSING CARE PLAN

CUES NURSING SCIENTIFIC GOAL NURSING RATIONALE EVALUATIO
DIAGNOSI EXPLANATIO INTERVENTIO N
S N N

N:anung Disturbed Refer to SHORT Frequently orient Patient safety is SHORT

ginagaw thought psychopathology TERMAf patient to reality jeopardized during TERM GOAL
a niyo process ter 8 and surroundings. periods of
hours of Goal met
dito sa related to nursing
Allow patient to disorientation.
pasko inappropriate interventi have familiar Maintaining reality
affect as on the objectives around orientation After 8 hours of
P: wala evidence by patient him enhances patient’s nursing
pa hindi improper will be sense of self worth intervention the
pa ako placing of able to Teach prospective and personal patient was able
nagpapas event care givers how to dignity to
ko dito -identify orient patient to
external Patient will
factors
time, place and These caregivers
person and will be responsible accept
that
explanations of
contribute circumstances as for patient safety
N:pero to the required after discharge inaccurate
naabutan alteration from the hospital interpretaton
mu ba s Give positive within 3 days
ang feedback when Positive feedback
ondoy - thinking and increases Terminate the
dito recognize plan
behavior are selfesteem and
and
conduct/c appropriately, or enhances desire to
P:ou when patient repeat appropriate LONG TERM
ompensat
verbalize that behaviors GOAL
e for
OBJECT sensory certain ideas
IVE impairem Speaking slowly Goal met
expressed are not
Unable ent based in reality and inface to face
to place After 2weeks of
position is most
LONG nursing

68
the event TERMAf Use simple effective when intervention the
in time ter explanation and communicating client wa able to
of 2weeks of face to face with an elderly
nursing With assistance
orderly interventi
interaction when individual
manner on the communicating experiencing from care
client will with the patient hearing loss giver,patient
Client be able to will be able to
was Express reasonable Expression of interrupt non-
using - doubt if patient doubt by a trusted reality based
marijuan regain/ma relays suspicious individual may thingking by
intain beliefs in response foster similar discharge
a before usual
level of
to delutional uncertainties in the
conscious thinking part of the patient Terminate the
ness plan

-verbalize
awareness
of
sensory
needs and
presense
of
overload
or
deprivatio
n

CUES NURSING SCIENTIFIC GOAL NURSING RATIONAL EVALUATION

DIAGNOSI EXPLANATIO INTERVENTIO E
S N N

N:Anong Impaired Pressures of SHORT Evaluate skill To assess SHORT TERM

dahilan memory being separated TERM proficiency level degree of
panu related to use with his wife including selfcare impairement Goal met
kayo of ego After 8 activities
napunta defense hours of After 8 hours of
ditto mechan nursing Implement nursing intervention
evidence by Develops severe intervent appropriate To maximize the patient will be
P:Hindi Client did anxiety ion the memory retraining level of able to
ko alam not patient technique such as function
remember will be keeping calendars Will able to state 2
anything able to ways to help him
Unable to Encourage remembering
what
N: wala respond to Will ventilation of To lessen essential things
happened in
ka bang demands of adult able to feelings of feelings of when possible
an event ism
maalala functioning state 2 frustration powerlessness
ways to helplessness and and Terminate the plan
P:nandit help him so forth hopelessness
o nalang rememb LONG TERM
ako, Weak ego Monitor patients
ering
dinala Goal met
essential behavior and assist
ako ng things in the use of stress
magulan After 2weeks of
Maladaptive use when management
g ko Helpful in nursing intervention
of ego defense possible techniques deciding the client will be
N:sa mechanism whether able to
LONG Determine patients
tingin response to effects quality of life
TERM Practice methods
niyo ano of medications is improved
ang when that will help
After prescribed to

69
dahilan Cannot 2weeks improve attention, considering remembering
at dinala remember events of concentration side effects essential things
kayo nursing memory processes
ditto intervent and to modify Terminate the plan
ion the emotional
P:silence client response
will be
OBJEC able to
TIVE
Observe Practice
experien methods
ce of that will
forgeting help
rememb
ering
essential
things

CUES NURSING SCIENTIFIC GOAL NURSING RATIONAL EVALUATION

DIAGNOSI EXPLANATIO INTERVENTIO E
S N N

N:May Ineffective Pressures of SHORT Encourage same In order to Goal met

ginawa Individual being separated TERM staff members to promote
kaba coping with his wife work with patient development After 1 hour of nurse
related to After 1 as much as of trusting patient interaction
P:wala maturational hour of possible relationship patient was able to
crisis as nurse verbalize feelings
N:yung Evidence by Develops severe patient Establish trusting The
mga improper use anxiety interacti relationship therapeutic Terminate the plan
magulan of defense on nurse
g muba mechanism patient Encourage patient relationship is LONG TERM
ay will to verbalize build or trust
gumaga Unable to verbaliz feelings of fear Goal met
mit ng respond to e and anxiety
bawal demands of adult After 2weeks of
feelings
nagamot functioning Explore with Help patient nursing intervention
LONG patient the options comes to term the client will be
P:Hindi TERM available to assist of unresolved able to
stressful situations issues
Weak ego After Patient will
2weeks Enhance positive To provide demostrate use of
N:Ikaw of reinforcement for adaptiverespo more adaptive
nursing evidence of nse to stress coping skills by
P:Hindi Maladaptive use discharge and
intervent gratification
din of ego defense willingness to
ion the delayed
mechanism participate in
client appropriately
OBJEC therapeutic
will be
TIVE Do not debate community
able to
-decrease argue, rationalize Ignoring these

70
of social Patient or bargain with attempt may Terminate the plan
support will patient work to
-change demostr decrease
in usual ate use Provide large
communi of more motor activities in To facilitate
cation adaptive which patient may relationship
patterns coping participate development
skills by
discharg
e and
willingn
ess to
participa
te in
therapeu
tic
commun
ity

CHAPTER
V
71
CHAPTER V

A. Play Therapy

ENGLISH TAGALOG
A. Definition A. Kahulugan

Play therapy is a technique whereby the Ang play therapy ay isang teknik na

patient’s natural means of expression, kung saan ditto ay nailalabas ng

namely play, is used as a therapeutic pasyente ang kanyang saloobin, ito ay

method to assist him in coping with nakakatulong upang malagpasan ang

emotional stress or [Link] is also sariling stress o troma. Nakakatulong

advance the psychosocial development din ito sa pakikisalamuha natin at ang

and mental health of people through pagaling n gating kaisipan

play. B. Layunin

B. Purposes 1. ito ay makakatulong upang maayos

1. Play therapy helps patient work ang emosyonal at behavioral na

through emotional and behavioral situasyon pati na ang problema sa

72
 issues and helps address family pamilya

problems 2. makakatulong sa magandang

2. Play therapy develops a dynamic pagsasama ng pasyente at ng

interpersonal relationships between therapist

the patient and the therapist 3. ang therapist ay pumapasok sa

3. The therapist enters the world of mundo ngpatiente na kung saan

the patient developing a safe place nagkakaroon ng tiwala

and a relationship trust 4. mailalabas ng patiente ang kanyang

4. It can help the patient expresses saloobin at isip.

their feelings,thoughts experiences 5. ito ay isang paraan upang ang

and behaviors through play pasyente ay mailabas ang

5. Play therapy is a medium for damdamin,maikwento ang kanyang

patient to express their feelings, karanasan

explore relationships,tell about 6. Magkakaroon ang pasyente ng

experiences and discloses wishes tiyansa na umunlad ang kanyang

6. The aim of play therapy session is pagunawa at malagpasan ang mga

that the patient will have mahihirap na sitwasyon

opportunities for developing an C. Mga Alituntunin

understanding of how to deal with 1. .mamili ng pasyente na

difficult situations and emotions matutulungan ng therapy

within a safe environment with a 2. At Ihanay sila bilang grupo

supportive adult 3. ihanda ang mga materyales, ung

C. Standard rules hindi makakasakit sa pasyente

1. Select patients who might benefit 4. Samahan ang pasyente sa lugar na

from play therapy and group them pagdadausan ng laro at sabihin ang

accordingly mga alituntunin

2. obtain materials for the session, 5. sabihin ang mga bawal at kung

those that cant harm patient gaano katagal ito isasagawa

3. meet the patient and introduce him 6. mailarawan ang mechanics ng laro

to the play area and the mechanics at gamitan ito ng demonstration

of the game D. Paraan ng Pag-gawa

73
 4. Inform the limitations and how long 1. mahahati ang grupo sa 2, at bawat

the session will last grupo ay may 5 residente at kasama

5. describe the mechanics of the game nila ang kanilang student nurse.

and use demo if possible 2. Merong dalawang blangkong

D. Technique kartolina na nakadikit sa pader at sa

1. The group will be divided into 2 ilalim naman nito ay may mga

that will consist of 5 residences and larawan ng prutas.

the assign student nurse each sub 3. And mga manlalaro ay pupunta

group. malapit sa kartolina ngunit sila

2. There are 2 blank cartolina posted dapat ay nakatalikod ditto.

in the wall and below it are pictures 4. Ang facilitator ng laro ay mag

of fruits. tatanung tungkol sa ibat-ibang

3. The player will go near the prutas.

cartolina but he must turn to his 5. Pagkatapos hintayin ang hudyat

back facing his members. para hanapin ang tamang sagot.

4. The facilitator of the game will ask

the questions that consist of

different kinds of fruit.

5. And after the question and the “go

signal” has been deliver the player

must look for the picture of the

correct answer.

E. Interpretation: E. Enterpretasyon

My patient participated in the games Ang aking cliente ay sumasali sa

implemented. During the games he was ginawa naming laro, habang

seen giving his best so as not to drop to naglalaro ay nakita ko siyang

loose. While waiting for his turn he just ginagawa ang lahat ng makakaya

stood still in the line and observes upang hindi matalo. Habang

players walking and the others are hinihintay ang kanyang

laughing and cheering for their pagkakataon siya ay omoobserba sa

74
 groupmate ibang manlalaro na nagtatawanan at

F. Analysis: nagbibigay ng moral support

According to Erick Erickson [Link]

contemporary psychoanalytic theory Ayon kay Erick Erickson ng

play provides the child with an contemporary psychoanalytic

intermediate reality; it tells what the theory ang paglalaro ay nagbibigay

purpose of things are, the connection ng realidad; ito ang nagsasanbi ng

between an inner and an outer world purpose ng mga bagay, at

and how memories of the past apply for paguugnay sa loob at labas ng

the future mundo at gaano ang alaala ay

My patient claimed that he likes the nagagamit mo para sa kinabukasan

game implemented and said that it was Sinabi ng pasyente ko na gusting

so fun gusto niya ang laro at sobrang

Masaya ito

B. Music & Art Therapy

ENGLISH TAGALOG

A. Definition A. Kahulugan

Music and art are universally appreciated  ang therapy na ito ay ginagamit upang

and understood as effective media of mailabas ng bawat tao ang kanilang

expression and communication that exist in saloobin, ideya o nararamdaman king saan

all cultures. Music affects us all in many hindi nila ito kayang ilabas sa pamamagitan

ways, from being highly motivating and ng pagsasalita. Ang mga musika ay

stimulating, to calming and relaxing. When nakakatulong sa atin sa pamamagitan ng

used in therapy, music can reach even pag papakalma ng ating kalooban. Ito ay

those resistant to other treatment madalas na ginagamit sa kadahilanang ito

approaches due to its accessibility, ay nakapagbigay ng seguridad sa

familiarity, feelings of security associated damdamin ng mga pasyente, ang mga

with it, its capacity to express the range of materyales dito ay madaling mahanap, at

human emotion, as well as the joy of ito ay napatunayang nakapaglalabas ng

75
creating and being in music emosyon ng mga indibidwal na gumagamit

B. Purpose ng ganitong gawain.

1. to give individual the opportunity to B. Layunin

examine and analyze their talents to 1. upang bigyan ng pagkakataon ang isang

potentials to make and for them to tao na ilabas ang kani-kanilang talento

realize that they are worth living in o kakayahan sa pag guhit at upang itaas

this world ang kanilang tiwala sa sarili

2. to increase patient's concentration 2. upang bigyan sila ng pagkakataong

and memory retention makapagisip ng malalim at maipagbuti

3. to stimulate individual's creative ang kanilang memorya

imagination and perception 3. upang maipakita ang kani-kanilang

4. to gauge the patient's capabilities of galing sa pagdidisenyo

analyzing their work 4. upang maalalayan ang mga pasyente sa

5. to promote relaxation thru music kanilang abilidad sa pag eeksamin ng

appreciation kanilang iginuhit

C. Standard Rules 5. upang makapag bahagi ng magandang

1. never leave the patient unattended pakiramdam sa pamamagitan ng

2. choose the kind of music to be pakikinig sa musika

played carefully (not too sad nor C. Mga  batas na dapat sundin

too exciting) 1. huwag iwanang mag isa ang

3. ask patient about his/her feelings pasyente

after song played 2. piliing mabuti ang musikang

4. provide materials that are safe to ipaparinig. Ito ay dapat hindi

use like crayons and bond paper masyadong malungkot at hindi

5. make sure that everybody is masyadong masaya

participating 3. tanungin ang pasyente sa kanilang

6. give patient an ample time to finish saloobin sa bawat musikang

their work ipaparinig

7. encourage patient to describe her 4. siguraduhing ang mga gagamitin ay

work and what were her thoughts ligtas para sa mga pasyente

and feelings while listening to the 5. siguraduhing ang bawat isa ay

76
 music and doing her artwork kasali

D. Techniques 6. bigyan ng sapat na oras sa pag guhit

1. two papers and crayons will be 7. maaring tanungin ang pasyente sa

given to each patient kanyang iginuhit at kung ano ang

2. Instruct the patient that the first kanyang mga naiisip o

paper will be used for their drawing nararamdaman habang nakikinig ss

with the slow music and the second musika.

one will be for the fast music D. Paraan ng Paggawa

3. First is to play the slow music. Ask 1. ang bawat pasyente ay bibigyan ng

the clients to draw whatever they dalawang papel at mga pangkulay

feel or what their thoughts are 2. bilinan ang pasyente na ang isang

while listening to the music. papel ay gagamitin sa pag guhit

4. The same instruction will be given habang sa mabagal na musika at

for the fast music ang isa ay para sa mabilis na

musika

E. Interpretation 3. unang patugtuging ang mabagal na

During the music and art therapy my [Link] ang pasyente sa

patient was seen to be thinking deeply and kanilang mga saloobin

then after few minutes, he began to get a 4. pangalawa ay ang mabilis na

piece of crayon and started drawing during musika. Tanungin din ang pasyente

the nature melody. He drew a school ang kanilang saloobin

building with 2 persons and a flag he used E. Interpretasyon

only the color red habang sinasagawa ang music at art therapy

ang aking pasyente ay nakita kong nagiisip

ng malalim at pagkaraan ng ilang minto

F. Analysis kumuha siya ng isang pirasong krayola at

In piaget theory of cognitive development nag simulang mag drawing habang

in stage of intuitive and concrete operation pinapatugtog ang muhika, gumuhit siya ng

where the client thinks of one idea at a time isang paaralan na may flag at 2 katao at

and understaning of relationship lahat ay kulay pula.

Painting offers many people a F. Analysis

77
 comfortable opportunity for no social ang painting ay nagbibigay ng

exchange. in music and art therapy, the comportableng oportunidad para sa mga

art provided by each members gives the walang socialidad sa iba. Dito binibigyan

therapist a personal insight into the ng mga miyembro ang kanilang mga

artist personality, what he was thinking therapist kung ano ang saloobin nila at

and his feeling during the melody. nararamdaman nila. Ang aking pasyente

My patient when asked about the nung tinanong ko siya kung anong dahilan

reason why he chose to draw school at yun ang ginuhit niya sabi niya na isa

with flag and two person, he said that siya sa dalawang tao at ang isa ang

he was the one of the two and the other kanyang kuya, naalala niya ang kanyang

was his brother, he draw it because he pagaaral noon at gusto niyang bumalik sa

reminds of his schooling days and he eskwelahan niya dati

want to go back to school,

E. Bibliotherapy

ENGLISH TAGALOG

A. Definition A. Kahulugan

Bibliotherapy can be defined as the use Ang bibliotherapy ay ang proseso kung

of books to help people solve problems. saan gumagamit ng libro para

Another, more precise definition is that matulungan ang isang tao na malutas

bibliotherapy is a family of technique ang kanyang [Link] ay isang

for structuring interaction between a technique kung saan nagkakaroon ng

facilitator and a participant based on masayang pagbabahagian ng ideya sa

mutual sharing of literature. pagitan ng pasyente at facilitator ukol

B. Purpose sa literaturang binasa

1. To develop an individual's self- B. Layunin

concept. 1. Para mahasa ang sel-concept ng

2. To increase an individual's bawat isa.

understanding of human behavior or 2. Para madagdagan ang kaalaman ng

motivations. bawat isa tungkol sa ugali ng tao at

3. To provide a way for a person to find motibasyon.

78
 interests outside of self. 3. Para magsilbing daan sa bawat isa

4. To relieve emotional or mental upang magkaroon ng interes sa ibang

pressure. gawain maliban sa sarili.

5. To show an individual that he or she 4. Para malunasan ang emosyonal at

is not the first or only person to mental na alalahanin.

encounter such a problem. 5. Para maipakita sa bawat isa na hindi

6. To show an individual that there is lang sila ang humharap sa ganoong

more than one solution to a problem. problema.

7. To help a person discuss a problem 6. Para maipakita sa bawat isa na

more freely. mraming sulusyon sa kanilang

8. To help an individual plan a problema.

constructive course of action to solve a 7. Para matulungan ang bawat isa  na

problem. malayang pag-usapan ang kanilang

C. Standard Rules problema.

8. Para matulungan ang bawat isa na

1. The article that will be using for the
magplano ng kongkretong aksyon para
bibliotherapy should not create any
malutas ang problema.
conflict on the patient’s attitude or
C. Mga Batas na Dapat Sundin
behaviour. You should choose an

article that will motivate the patient 1. Ang babasahin o artikulo na dapat

or will present him/her to the piliin ay hindi dapat

reality. makapagpabalik ng masasamang

2.  The kind of the article should be ala-ala sa kliyente upang sa ganoon

depending on the patient’s level of ay maiwasan ang anumang

understanding. If in case that the bayolenteng reaksiyon ng mga ito.

article cannot be understood by the 2. Ang klase ng babasahin na

patient or the patient cannot be able ipapabasa ay nakadepende sa

to read, the nurse will be the one to kakayanan ng mga pasyente na

read it for the patient. maintindihan ang mga nakasulat. At

3. The article should not be too long kung sakali mang hindi ito

or too short to read. maintindihan ng pasyente o walang

79
 4. The copy of the article should be kakayanan ang pasyente n

legible to be easily read by the mkapagbasa, ang nars ang inaatasan

patient. para gumawa ng mga ito para sa

D. Techniques pasyente

1.    The article should be given to the 3. Ang pipiliing artikulo ay hindi

patient after the termination phase. sobrang haba, at hindi ring sobrang

2.    The article should be given to the iksi.

patient for them to read. The nurse 4. Ang artikulong dapat piliin ay ang

should help the patient in case he/she madaling mababasa ng pasyente.

has a problem in reading or in D. Paraan ng Pagsasagawa

understanding some words. 1. Ang artikulo ay ipinamimigay

3.    After the patient read the given sa pasyente matapos ang

article, they should express their Termination phase

feelings regarding the topic or sight 2. Ang artikulo ay ibinibigay sa

their reflections about the content of mga pasyente para basahin. Ang

the article. mga nars ang siyang dapat

E. Interpretasyon: tumulong sa mga ito kung

The bibliotherapy provided by the group sakaling nagkaroon ng

was about helping others with all your problema sa pagbasa, o may

heart. He looks to the person reading the mga salitang hindi maintindihan

story, he was so focused while listening to 3. Pagkatapos basahin ang

the story telling artikulo, ang pasyente ay dapat

E. Analysis: magbahagi ng kanilang mga

According to fowlers stage ofspiritual saloobin o karanasan na tugma

development in stage of individual sa nilalaman ng kwento.

reflective a stage of angst and struggle the [Link]

individual take personal responsibility for Ang biblio therapy na isinagawa ng grupo

their beliefs and feelings ay tunkol sa pagtulong sa kapwa ng buong

The printed word in bibliotherapy may be puso. Ang aking pasyente ay nakatingin sa

means of modifying or stimulating the mambabasa at siya ay naka focus habang

emotions. Reading may help to lift the nakikinig sa storya

80
 spirit of a depressed patient, improved the F. Analysis

attention span of the individual with Ito ay daan upang mailabas ang ating

limited power of concentration,relieve emosyon. Pagbabasa ay makakatulong

insomnia, stimulate the imagination, and upang itaas ang depres na nararamdaman

foster desirable attitude and ideal in ng pasyente at gumanda ang atensyon ng

patients. isa na may mahinang concentrasyon at ito

The patient said that he liked the story din ay nakakatulong samay insomia,at

because it was about helping others, when nagbbigay ng magandang attitude sa

he asked about what did he feel about the pasyente

story he said he was happy because its Sabi ng pasyente na gusto niya yung

about giving all what you got even your kwento dahil tunkol ito sa pagtulong sa iba,

life just for the sake of others siya ay Masaya dahil ito ay ang pagtulong

sa abot ng iyong makakaya kahit kapalit

pang iyong buhay para sa iba.

F. Occupational Therapy

ENGLISH TAGALOG

A. Definition A. Kahulugan

Occupational therapy uses meaningful Ang mga itinuturo sa occupational

and purposeful occupations to promote therapy ay iyong mga trabaho na may

health. These can be work related matututunan at makakatulong sa ibang

activities to leisure activities. It is the tao. . Kadalasan ito ay may kinalaman

use of activities to promote health and sa mga normal na gawain ng isang tao,

independence, particularly after the mga trabahong kadalasang ginagawa at

acute phase of illness. Such therapy is mga gawaing may interes ang mga

81
 often vital for reorienting patients tuturuan. Ito ay ang paggamit ng iba’t

unable to work for long periods. ibang Gawain upang makatulong sa

B. Purpose kalusugan at kakayahan na gawin ang

1. To enable patients to perform those daily isang bagay ng walang kinakailangang

occupations they find useful or meaningful tulong sa ibang tao. Ang ganitong

in their environment.  therapy ay mahalaga sa mga taong

2. To help people acquire the skills to care matagal na hindi nakapagtrabaho.

for themselves B. Layunin

3. To help people increase their functional 1. Para hayaan ang bawat isa na

independence in daily life while preventing makagawa ng pang araw-araw na

or minimizing disability gawain na kung saan ito’y

4. To enhance their self-esteem and sense mapapakinabangan nila.

of accomplishment. 2. Para matulungan ang bawat isa na

makuha o maabot ang kani-kanilang

5. To help people achieve
kakayahan.
independence in all areas of their lives
3. Upang matulungang mapaunlad ang
C. Standard Rules
kakayahang makagawa ng mag-isa
1. Ensure that the materials are
4. Upang madagdagan ang kanilang
complete.
tiwala sa sarili at gayon di ang
2. No sharp objects must be seen in
pakiramdam ng pagkakuntento.
the area.
5. Upanag tulungan ang bawat isa na
3. Breakable materials must be not
matupad o makamtan ang kakayahang
used.
makagawa ng mag-isa sa lahat ng
D. Techniques
aspeto ng buhay.
1. Get all the materials needed inside
C. Mga Batas na Dapat Sundin
the envelope.
1. Maghugas ng kamay bago hawakan
2. Then after that, get the two big
ang pagkain.
circles and then paste the one
2. Walang mga matutulis na bagay
opposite side.
ang dapat makita sa paggagawan ng
3. Get the other circle and then paste
pagkain.
the two opposite side to form three
3. Ang mga babasagin na bagay ay

82
 circles, combined by each side. dapat iwasang gamitin o kaya’y

4. After doing so, paste the tail below huwag na lamang gamitin

assisted by the student nurses. D. Paraan ng Pagsasagawa

5. The student nurses will help the 1. Kunin lahat ng mga gagamiting

residents design the lantern. kagamitan sa loob ng sobre.

2. Pagkatapos, kunin ang dalawang bilog

E. Analysis
at pagdikitin ang magkabilang dulo,
During the therapy he was attentive and
ngunit sa isang gilid muna.
seemed to listened very well although 3. Kunin ang ikatlong bilog at pagdikitin

he was slight confused about the ang mga dulo.

instruction of the facilitators, he do the 4. Pagkatapos gawin, kunin ang tali at

job determinedly according to piget of idikit sa ibaba ng pinagsamasamang

theory cognitive development the client bilog sa tulong ng mga student nars.

developed formal operation phase 5. Ang mga student nars ay tutulong

whereby he uses rational thinking while upang lagyan ng palamuti ang parol.

he was doing the work and have his E. Analysis

Habang isinasagawa ang therapy siya ay
reasonings
nakikinig ng mabuti kahit na parang
F. Interpretation
nahihirapan siya sa pagsunod sa mga instructor
Occupational therapy provides the
gayun pa man ginagawa niya ito sa abot ng
patients skills and knowledge that they
kanyang makakaya
can use as a means for daily living
[Link]
when they get out of the institution.
Ang therapy na ito ay nagbibigay sa pasyente
My patient was happy, he said that he ng husay at kaalaman na magagamit nila para

done it few times before and it felt sa kanilang buhay pagwala na sila sa

good institusyon

Ang aking pasyente ay Masaya at sinabi niya

na nagawa niya na ito dati at masarap sa

pakiramdam

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ENGLISH TAGALOG

A. Definition A. Kahulugan

A simple group therapy that uses nature Ito ay paggamot gamit ang isang
simpleng grupo na may layuning
in an effort to reach the unwounded
maabot o malaman ang mga tungkol sa
areas of the patient’s personality and
nakaraan ng pasyente at upang
get them moving back to reality tulungan bumalik sa katotohanan

B. Purpose
B. Layunin
1. To stimulate patient to be fellow
1. tumutulong sa pasyente upang bumalik
explorer of the real world
sa katotohanan.
2. To develop the ability to
2. mabuo ang kakayahang
communicate and share ideas and
makipagkomunikasyon at mgsabi ng mga
experience with others
naiisip at karanasan sa iba.
3. To develop the feeling of
3. Mabuo ang pakiramdam ng pagtanggap
acceptance and recognition
at pagkilala.
C. Standard Rules
C. Mga Batas na Dapat Sundin
Can be used in a ward situation,
Maarai gamitin sa loob ng ward kahit
regardless of the length of time patient
na gaano na katagal ang pasyente sa
has been in the institute, his age, or
institusyon , ano man ang edad o kaya
reason for his illness and gender.
kung ano man ang rason sa kanyang

sakit. Maaaring gawin sa loob ng 45-60

Ideal is 45 - 60 minutes
minutos.
D. Techniques
D. Pamamaraan
1. Climate Acceptance
1. Climate Acceptance
1.1 The leader stands at the center
1.1 ang pinuno ay tatayo sa gitna ng
of the group and introduces
grupo at ipapakilala ang kanyang
himself/herself and the rest of
sarili at ang iba pa kasamahan sa
the group
grupo.
1.2 The leader asks the patient to
1.2 ang pinuno ay aatasan ang mga
introduce themselves
pasyente na mag pakilala sa grupo

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 1.3 After the intro, the leader may 1.3 pagkatapos ng pag papakilala,

comment on the weather, the ang pinuno ay maaaring mag

residents’ appearance or a kumento sa klima ng panahon, ang

pleasant compliment itsura ng mga pasyente o ano man

1.4 This creates a pleasant and papuri sa kanila.

relaxed atmosphere 1.4 ito ay makakalikha ng maganda

2. Bridge to Reality at maayos na atmosphere.

2.1 Ask bounce questions (short 2. Bridge to Reality

and easy to answer) 2.1 mag tanong ng maikli at madali

2.2 Then ask anybody who sagutin na tanong.

knows a poem about the 2.2 tanungin ang grupo kung sino

topic of discussion ang may alam na tula tungkol sa

2.3 Questions should be paksa.

general-specific 2.3 ang mga tanong ay dapat

2.4 Try to read your poetry to general-specific

the group and later ask the 2.4 basahin ang tula sa grupo at pag

residents to read it katapos atasan ang mga pasyente na

2.5 Have visual aids present basahin din ito

3. Sharing the world we live in 2.5 mag handa ng visual aids

3.1 Stimulating questions 3. Sharing the world we live in

leading to the topic 3.1 gumawa ng tanong tungkol sa

3.2 Leader should try to explore paksa

the topic under discussion 3.2 ang pinuno ay maaari palawakin

4. Appreciation of the works of the ang paksa habang ito ay tinatalakay

world 4. Appreciation of the works of the

4.1 This step is blended with world

step 3 4.1 ito ay halo ng step 3

4.2 Relate the residents so he 4.2 pag isipin ang mga pasyente

will be able to think for 5. Climate of Appreciation

himself 5.1 ang pinuno ay tatanungin ang

5. Climate of Appreciation buod ng paksa na tinalakay

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 5.1 The leader should try to ask 5.2 ipakita ang kagalakan sa pag

the summary about the topic punta ng mga residente sa Gawain

which has been discussed

5.2 Express your appreciation to

the residents for coming to

the session

E. Interpretation: [Link]

The patient during the remotivation Habang sinasagawa ang remotivation

therapy was observe to be listening therapy ang pasyente ay nakikinig ng

attentively. He was quiet and all eyes to mabuti, siya ay tahimik at ang mata niya ay

the poem being read by his co-patients. nakatuon sa poem na binasa, bihira siya

He seldom speaks and talks only when magsalita at magsasalita lamang kapag

called. tinawag

F. Analysis: [Link]

According to Dorothy Hoskins Smith Ayon kay dorothy Hoskins Smith

remotivation therapy is a group therapy remotivation therapy ay isang group

of an objective nature used by an therapy na ang balak ay ipakita ang

attendant with his own patient, get realidad sa pasyente

them moving towards the reality Ang pasyente ko ay alam ang tubig at kung

My patient knows how water was used, panu ito gamitin, alam din niya kung gaano

and he know how water important in ito kaimportante sa mga may buhay

our life

86
87
APPENDICES

Psychiatric mental health nursing by Videbeck

The article is "Efficacy and Safety of Paliperidone Extended-Release Tablets: Results of a 6-Week,
Randomized, Placebo-Controlled Study" by Stephen R. Marder, Michelle Kramer, Lisa Ford, Els
Eerdekens, Pilar Lim, Mariëlle Eerdekens and Adam Lowy. Dr. Marder is affiliated with both the
Veteran's Affairs Veteran's Integrated Service Networks 22 Mental Illness Research, Education, and
Clinical Center, and the Department of Psychiatry and Biobehavioral Sciences at the David Geffen School
of Medicine, University of California in Los Angeles, California. Drs. Kramer, Ford, and Lim are at the
Titusville, New Jersey location, while Dr. Eerdekens and Mr. Eerdekens are at the Beerse, Belgium
location of Johnson & Johnson Pharmaceutical Research and Development. Dr. Lowy is affiliated with
Comprehensive NeuroScience, Inc. in Washington, D.C.

88
Article:
Discontinuation of treatment of schizophrenic patients is driven by poor symptom response: a pooled
post-hoc analysis of four atypical antipsychotic drugs
Hong Liu-Seifert, David H Adams and Bruce J Kinon
BMC Medicine 2005, 3:21 (23 December 2005)

[Link]

89