Adult and Geriatrics Dx Description and Assoc. dx Key elements of therapeutic Key elements to Sample activities Performance Manifestation approach therapeutic environment patterns Anxiet State of tension and Found in Allow them to express Calm, comfortable Yoga y uneasiness that the ego almost every themselves Decrease amount of Progressive relaxation is unable to resolve dx Concentrate on productive people Journaling with structure- Everyone can control Psychopaths activities Schedule of activities helps to see antecedents their anxiety but some and criminals Help them learn how to Give a tour of the therapy Just right challenge people cannot control do not express themselves experience Help them feel secure Guide pts. to choose anxiety Listen to their fears activities Redirect their attention to a Simple cooking tasks neutral topic Response: Different responses are needed for different pts. Ritualistic: never criticize Phobic: encourage pts. To talk about fears Intrusive: reassure you will be available Depres Feeling intense Wide range of Allow the pt. to talk about Decrease any stimulus Thought and behavior sion sadness, despair, and d/o themselves Increase opportunity for chart hopelessness Primary sx of Avoid being overly decision Replace harmful thoughts Occasionally affects affective protective/helpful Forced choice* with positive thoughts most people (mood) d/o Reinforce personal Calming – constant Incorporating relaxation Most people recover Schizophrenia appearance worry or tai chi or yoga Feel hopeless and Most Avoid too many choices Match tempo- speak Decrease stress helpless personality d/o Do not over plan slowly, softly and matter Painting by numbers- Possibly worthless and Normal Recognize negative feeling of fact with raised lines guilty response to Notify staff of suicidal Avoid being Gross motor activity- loss, and overprotective improve depression adjustment ideation Show decrease in Sleep hygiene depressive sx Like to do things for others Mania Disturbance in mood Be cautious on giving Work alone Exercise bike Excessively happy criticism Decrease stimulus Gross motor activities Operating at a higher Be firm, consistent Structured activities speed Reinforce limits Making a sandwich Behaviors are caused by dx Soccer- sport activity and/or meds Be aware of flattery- control they will try to gain control or manipulate you Halluc Sensory experience Wide range of Help understand what is Remove external Karaoke ination that doess NOT psychiatric d/o happening stimulating environment Songs that people should s correspond to external Schizophrenia Communicate in calm, clear, Keep alone but not know reality Manic and firm, natural, rhythmic, permanently Make a pizza- premade Appear as sight, hear, depressive soothing, manner Move to less dough and put toppings feel, smell, or tastes psychoses Keep person in reality overwhelming area on that they want things that aren’t there Organic mental Mtn. personal space Stimulating other Arise from a d/o sensations temporary or “how very interesting, tell permanent deficit in Substance me more about it.” Play Wii the brain function abuse d/o Age involvement with other trusted people Use bright colors

Delusi Wrong idea Psychotic d/o - avoid discussing Stimulating and involve Participate in a national ons A belief that is Schizophrenia delusions directly real life activities weekly trivia game in contrary to reality as - avoid looking order to keep up with real Bipolar life/reality based experienced by others (depressive or frustrated in a cultural group manic) - meet them at their Watching and summarizing the movie Belief NOT based in Eating d/o intellectual level reality Playing cards with Beliefs: ideas of Pts. with no - developing and friends reference other known organizing delusions Activities should meet Ie. The FBI is taking psychopatholo the pt.’s intellectual level thoughts from you gy Inaccurate thought May give clues to the pt.’s needs Paran description: type of - paranoid - look at the world from their - when in a group, let the - must be activities that - roles: oia thinking in which schizophrenia point of view pt. sit at a separate table the person can control, participant, persecutory and - psychotic - avoid approaching from but with whomever they meet at intellectual level helper, director grandiose ideas depression behind or suddenly wish without getting - routines: predominate. competitive - borderline - do not whisper- they will - keep the environment as standard, no manifestation: general and narcissistic think you are talking about stable as possible -1. cooper tooling: select surprises, suspiciousness and personality them - prepare the pt. for any the design, still level of know well in very extreme and direction from the leader advance about - be clear, concise, directive changes in their unbelievable ideas environment well in changes, need (paranoid ideation), - avoid arguing advance structure feel suspicious of those - 2. relaxation be truthful and do not make - maintain the same techniques: guided - habits: for a around them, group, make constantly alert and empty promises people in a group so they imagery: person with gradually build trust paranoia writes down sure set-up is concerned about - the pt. may try to make a consistent and whether others are special relationship with staff - don't force socialization what people say on the board people put harassing them, away materials persecuting them, in the same taking advantage, or spots treating them unfairly. - 3. pasta salad: planning and making: have materials listed and they make it.

Anger/ Man: through px or Psychotic d/o tasks sensitive to the pt. - stay a few feet away - journaling hostilit verbal violence, Schizophrenia get them to talk and do not face them - give a feelings y stiffening, destruction, directly Manic- use your words instead of worksheet sarcasm may be the - stay closer to the door beginning. Know what depressive the px signs are- psychosis acting out - keep door open - Wii for boxing prevention is best. Psychotic speak to pt. individually - do not be alone - collage Anger: strong feeling depression avoid punishing or criticizing - remove all weapons or - art of displeasure Organic mental tell them how to correct potential weapons - ripping magazines for Hostility: unfriendly d/o behavior - stay out of person’s pictures and threatening Some brain d/o reach attitude directed be direct and clear about - have a theme for them toward others what is expected - no brooms or mops to follow during art Verbally or px - destructive activity abusive: expressing then constructive activity unmet needs Seduct Man: touching Usually occur Approach in calm, non- -non-crowded - safe sex is enforced ive/sex shoulder, loosing ties, in pts. who are judgmental way, strict environment - sanding, px exertion ual masturbating in public, psychotic enforcement, explain the -non judgmental  - no contact sports acting pt. pt. Assoc. with rules of therapy. Be clear out about limits but mtn. -pt. should have personal - gross motor activities Any behavior that psychosexual space would normally be d/o therapeutic relationship, - seen as explicitly Last resort: get someone else -protected form sudden sexual or provoking a to work with them touch, smell, warmth of others sexual response May confuse therapeutic relationship