Class notes week 3
Stepson who had turrets and other junk:
Turrets is a tick disorder that can be a word or a gesture: like pawing the ground with a foot, and whinnying like a horse. Had religious delusions, spoke in tongues, etc.
How to start with the client: give autonomy: “would this be a good time to talk?”
They say yes, you say:
“like shit”
“things always get worse before they get better” [stereotypical ]
“I’ve never known the cops to bring in someone just for raising their voice” [sounds accusatory, but it’s actually grounding the pt in accessing what really happened]
Confrontation: “I find you really offensive when you keep using the word bitch” [about the RN, also confrontational.]
How to deal if pt is asking personal questions: redirect to person, “we’re here to talk about you, so would you tell me a bit about your relationships?” Sometimes ok in the beginning to give a little information to build repore, but not after that.
Posture: open and attentive. Paranoid pts: don’t use direct eye contact with these pts. Be careful about intent conversations with some pts.
Neutral, caring tone of voice. Detached concern: don’t be absorbed by the suffering in the other. Soothing, calm rather than upbeat or jovial.
Schizoaffective: elements of mood disorders, and some elements of schizophrenia, less acute than schizophrenia alone.
Differences of Social and Therapeutic Convo:
Social Therapeutic
2 way 1 way
2 way focus 1 way focus
2 way goals 1 way goal.
Casual professional
Non-confidential confidential
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