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Erickson's Modelling and Role Modelling Theory

a. Describehow one (1) of the following nursing theories apply to a mental health  KE 1

.Erickson's Modelling and Role Modelling Theory

.King's Theory of Goal Attainment

Erickson's Modelling and Role Modelling Theory

The Erickson’s modelling and role modelling theory was developed by Erickson, Tomlin and Swain in 1983 to enable nursing professionals to provide care and nurture to each individual patient through awareness of their unique personality and mental health; the theory also enables nurses to respect the mental health status of each patient and allows them to provide theory-based clinical care focusing on the requirements of the patients. The theory applies to the mental health context as it facilitates the nurse to build trust, promote positive orientation of the patient and their control; it also enables the nurses to promote the strengths of the patient to develop mutual, health-centered goals (Erickson, 2017).

King's Theory of Goal Attainment

The King’s theory of Goal Attainment developed by Imogene King in 1968 and it applies to mental health nursing as the goal of this theory is to promote communication between the nursing professional and the patient to make “transactions” which are the development of goals and working to achieve the developed goals. The theory described individuals as an open system that has unique requirements, wants and motivations that varies between individuals. Moreover, the theory applies to mental health as it considers each individual as a unique being and they should be considered as a personal, unique “system” that involves the perception dimension, body image, self-development and growth, personal space, coping and their learning. These dimensions facilitate the relationship between the patient and the nurse as an accurate self-perception allows the perception of others and aids in establishing improved interaction with the environment (Hajbaghery & Tahmouresi, 2018; Caceres, 2015).

b. Briefly discussvalues and philosophies of Mental Health Nursing

The core values of mental health nursing are crucial for the professionals for the provision of appropriate care. According to the Nursing and Midwifery Council the core values for nursing professionals is to treat individuals as unique beings and respecting their dignity and privacy, taking care to not discriminate against those seeking and receiving professional help. It is also necessary for nurses to promote the well-being of the recipients of care and the health of their families, people in the community and carers. It is crucial for the professional to provide good quality care and demonstrate high standard of practice through integrity and honesty which are upheld in the nursing profession (Happell et al., 2019). The personal philosophy of mental nursing states that nursing professionals must respect the morals and remain open-minded to the individual’s beliefs, culture and religion as it would facilitate the creation of a patient-nurse relation that is safe and secure. The creation of such a relation also promotes the development of a better care plan and an improved recovery of the recipient of care. The CMHN philosophy of nursing described that the nurses should respect the ways of life and self-realization of an individual and find harmony between the view of work and their life; moreover, the philosophy also promotes building communities that promotes the residents to support each other outside their professional roles (Tanaka et al., 2018).

Provideat least one (1) example for each of the social, psychological, cognitive and physical factors associated with mental health 

The social, psychological, cognitive and physical factors associated with mental health



Cognitive Factors

Deteriorating attention; for example, Alzheimer’s disease patients have been reported to have increased chances of deteriorating attention among other cognitive factors (Fredriksen-Goldsen et al., 2018).

Physical Factors

Genetics; For example, mutation in the DNA demethylase ten-eleven translocation 2 has been linked to increased risk of frontotemporal dementia, Alzheimer’s disease (Konig  Stogmann, 2021).

Social and Environmental Factors:

Lack of social support, substance abuse (Alegria et al., 2019).

Psychological Factors:

Emotional abuse, Neglect (Wathelet et al., 2020).

Consumers and the carers have similar perspectives on the mental health care services; they wish to change the provision of mental health care services as they have recognized factors such as language, accessibility, physical space design and consideration of practical help and individual needs. The carers perceived that they are “sidelined” in the treatment and as a result, feel distressed; therefore, they wish to be involved in recovery and respected. Both the recipients and carers wish for the diversion of the attention on broader health that addresses the psychological, physical, social needs of the individual and the treatment focusing on the individual rather than just the ailment. Moreover, a partnership in the recovery process with the professionals is also desired by the carers and recipients (Katsikitis et al., 2017).

Outlinetwo (2) impacts that each of the following have on a person with mental health conditions:

a person with mental

health conditions

two (2) impacts


· Negatively affects relationships

· Leads to exclusion of the individual from communities (Rossler, 2016).


· Leads to deterioration of the condition as it has not been managed earnestly.

· Interferes with treatment process as the individual faces a loss of hope and low self-esteem (Chan & Fung, 2019; Wofford, Defever & Chopik, 2019)


· Dictates how individuals describe their symptom

· Acts as barrier to seeking professional help by the affected individual (Al-Krenawi, 2019;

Belief system

· Affects the manner in which the individual seeks help

· Influences the manner in which the individual perceives their condition (Choudhry et al., 2016; Stolzenburg et al., 2019).

Define each of the mental health disorders below. State their clinical features (signs and symptoms) andtreatment strategies. Describe the clinical features (signs and symptoms) and treatment strategies (the number required is noted individually) for each of the 

the mental health


State their clinical features and Describe the clinical features

a. Mood disorders


Mood is defined as the sustained and pervasive feeling that is internally endured that affects the aspects of an individual’s behavior in the external environment. Mood disorders are prolonged disturbance of mood in the form of depression, anxiety or a combination of depression and euphoria. They are categorized as depressive and bipolar disorders (Sekhon & Gupta, 2020).

Clinical Features (Signs and symptoms) identify at least five (5):

· Feeling emotions in their extremities- unusually happy after a low mood

· Elevated energy, agitation

· Engaging in risky behavior

· Heightened self-esteem

· Decreased interest in activities that were once enjoyed by the individual (Sekhon & Gupta, 2020; Boat & Wu, 2015).

Treatment strategies include, identify at least two (2):

· Mood stabilizers such as valproic acid or lithium

· Selective serotonin reuptake inhibitors such as fluvoxamine, serotonin-norepinephrine reuptake inhibitors such as levomilnacipran (Sekhon & Gupta, 2020; Mbaba et al., 2018).

b. Personality disorders


Personality disorders are characterized by a specific behavior pattern that drastically deviates from the “normal” behavior. These are maladaptive, pervasive and chronic patterns of mood, cognition and behavior. The affected individuals experience abnormal affective responses and distorted reality perception that results in distress in the individual’s life (Fariba, Gupta & Kass, 2021).

Clinical Features (Signs and symptoms) identify at least two (2):

· Paranoid, rigid thoughts (Newlin & Weinstein, 2015)

· Emotional unavailability (Fariba, Gupta & Kass, 2021).

Treatment strategies include, identify at least two (2):

· Depends on the cluster disorder type

· Cluster A disorders may benefit through training in individual social skills

· Cluster B individuals may benefit from group and individual therapy and pharmacologic treatment such as antipsychotics, valproic acid (Fariba, Gupta & Kass, 2021).

c. Anxiety disorders


It is a group of mental disorders that has a characteristic disturbance as anxiety and those disorders where the individual experiences anxiety when they attempt to control their symptoms. The disorder produces feeling of worry, fear and constant overwhelming about everyday activities (Munir & Takov, 2021).

Clinical Features (Signs and symptoms) identify at least five (5):

· Tension about normal activities

· Anxious worrying

· Fear

· Restlessness

· Sense of panic or impending danger (Rose & Tadi, 2021; Munir & Takov, 2021).

Treatment strategies include, identify at least three (3):

· Psychotherapy

· Cognitive Behavioral Therapy

· Psychoactive drugs such as antidepressants (Strohle, Gensichen & Domschke, 2018).

d. Psychoses


It is a mental condition where an individual experiences severe loss of contact with their reality and it is identified through hallucinations, delusions, disorganized pattern of speech and having sensations that do not exist such as hearing voices and others (NIMH, 2022)

Clinical Features (Signs and symptoms) identify at least four (4):

· Hallucinations

· Delusions

· Disorganized behavior

· Paranoid ideas (NIMH, 2022; Arciniegas, 2015)

Treatment strategies include, identify at least three (3):

· Antipsychotic medicines

· Social support

· Combination of pharmacologic treatment with psychological therapies (NHS, 2022).

e. Organic disorders


Demonstrable abnormality in the biochemistry of organ or tissues or abnormality in the construct that are usually not hereditary unless the cause of the abnormality is genetically inherited (Baizabal-Carvallo et al., 2019).

Clinical Features (Signs and symptoms) identify at least three (3):

· Agitation

· Irritability

· Confusion (Baizabal-Carvallo et al., 2019).

Treatment strategies include, identify at least two (2):

· Rehabilitation therapy

· Pharmacologic modification of neurotransmitter function (Baizabal-Carvallo et al., 2019).

f. Panic disorder


A mental disorder characterized by recurring unpredictable panic attacks accompanied by constant worry about the attacks in future and changed behavior developed to avoid such attacks (NIMH, 2022).

Clinical Features (Signs and symptoms) identify at least four (4):

· Sense of danger

· Fear of losing control

· Depersonalization

· Derealization (Chutko et al., 2014)

Treatment strategies include, identify at least two (2):

· Anti-anxiety and anti-depressant medication

· Cognitive behavioral therapy (Ziffra, 2021).

g. Social phobia and specific phobias


Social phobia or social anxiety disorder is the chronic fear, avoidance and anxiety of social settings where the individual senses a potential for being scrutinized and/or negatively judged by people.

Specific phobia is the severe fear of certain situations or objects such as height, animals and others

Clinical Features (Signs and symptoms) identify at

least two (2) for each

· Sweating

· Trembling

· Rapid heart rate (For social phobia)

(physical and psychological):

· Irrational fear of an object

· Avoiding the situation or object with immense distress

· Experiencing loss of ability to think “blank mind” for both the phobias (Eaton, Bienvenu & Miloyan, 2018).

Treatment strategies include, identify at least three (3):

· Sertraline, paroxetine for specific phobia

· Cognitive behavioral therapy for social phobia (Wechsler et al., 2019).

h. Obsessive-compulsive disorder


Features a pattern of irrational fears or obsessions and thoughts that leads to compulsions in an individual where they engage in repetitive behavior

Clinical Features (Signs and symptoms) identify at least two (2):

· Obsessing over an activity or thought

· Hoarding, checking and re-checking (Sanikhani et al., 2020)

Treatment strategies include, identify at least two (2)

· Exposure Response Therapy

· Cognitive Behavioral Therapy (Williams, Whittal & Torre, 2022)

i. Post-traumatic stress disorder


It is a disorder that develops in individuals who have experienced shocking, traumatic and dangerous incidents.

Clinical Features (Signs and symptoms) identify at least two (2) for each (physical and psychological):

· Psychological: Flashbacks, recurrent nightmares about the experience

· Physical: Irritability, self-destructive behavior

King's Theory of Goal Attainment

Treatment strategies include, identify at least six (6):

· Counseling

· Medication

· Short-term psychotherapy

· Long-term psychotherapy

· Cognitive behavioral therapy

· Home remedies such as chamomile, green tea (Krediet et al., 2020).

j. Depression


It is a type of mood disorder that affects the ability to function and the individual’s mood causing persistent loss of interest and sadness.

Clinical Features (Signs and symptoms) identify at least five (5):

· Outbursts

· Loss of interest

· Feeling sad

· Emptiness

· Tiredness

· Insomnia, sleep disturbances (Alexopoulos, 2019).

Treatment strategies include, identify at least two (2):

· Anti-depressants

· Cognitive Behavioral Therapy (Alexopoulos, 2019).

k. Bipolar disorder


It is a serious mental health condition that causes severe mood swings in individuals such as emotional extremities that affect the physical and mental wellbeing of the individual.

Clinical Features (Signs and symptoms) identify at least four (4)

· Unpredictable modifications in mood

· Increased energy levels

· Major depressive episode

· Loss of appetite (NIMH, 2022).

Treatment strategies include, identify at least two (2):

· Psychotherapy

· Medication

l. Eating disorders


Serious condition that is related to persistent eating behavior which negatively affects the emotion, health and ability to function in various areas of life.

Clinical Features (Signs and symptoms) identify at least three (3) for each (physical and emotional / behavioural):

· Physical: Weight fluctuation, Changes in bowel habits, hair, skin

· Psychological: Body image issues, preoccupation with areas related to eating such as calories, dieting, self-portrayal in a negative manner (Williams & Levinson, 2020).

Treatment strategies include, identify at least two (2):

· Therapy, education on nutrition

· Medication (Hilbert et al., 2019).

m. Borderline personality disorder


Disorder that affects the ability of an individual to think and feel about themselves and others (Chapman et al., 2022).

Clinical Features (Signs and symptoms) identify at least four (4)

· Hypersensitivity to rejection

· Self-image issues

· Unstable relationships

· Fear of abandonment (Chapman et al., 2022).

Treatment strategies include, identify at least two (2)

· Mentalizing-based therapy

· Dialectical behavior therapy (Chapman et al., 2022).

n. Schizophrenia


Chronic mental disorder where people abnormally interpret reality.

Clinical Features (Signs and symptoms) identify at least two (2)

· Delusions

· Hallucination (Patel et al., 2014).

Treatment strategies include, identify at least three (3)

· Coordinated specialty care

· Second-generation antipsychotics (Patel et al., 2014).

o. Dementia


It is a group of symptoms that affect the social and thinking abilities severely that it interferes with the life of the affected individual.

Clinical Features (Signs and symptoms) identify at least two (2):

· Loss of memory

· Difficulty in understanding, speaking and expressing (CDC, 2022).

Treatment strategies include, identify at least two (2)

· Cholinesterase inhibitors

· Aducanumab (CDC, 2022).

p. Delirium


It is a clinical syndrome that develops in older individuals which is also known as acute confusion state (Lourdes et al., 2021).

Clinical Features (Signs and symptoms) identify at least three (3)

· Restlessness

· Agitation

· Hallucinations

Treatment strategies include, identify at least three (3):

· Antipsychotics (Melatonin)

· Tools for improving orientation (Lourdes et al., 2021).

q. Generalised anxiety disorder


Chronic condition where the individual cannot tolerate uncertainty (Munir & Takov, 2021).

Clinical Features (Signs and symptoms) identify at least three (3):

· Constant worrying

· Unable to relax

· Nervousness (Munir & Takov, 2021).

Treatment strategies include, identify at least two (2):

· Serotonin reuptake inhibitors

· Cognitive behavioral therapy (Munir & Takov, 2021).

Statement A: The EN should identify possible causal factors and address them using appropriate communication skills.

Statement B: If required, she should ask for assistance from colleagues.

  1. StatementA is correct & statement B is 
  2. StatementB is correct & statement A is 
  3. Bothare correct
  4. Bothare incorrect

Brieflyexplain the following three (3) common behaviours that are associated across a range of mental health conditions and their effects on a person and 

Disorganised speech or behaviour Hallucinations

Mood extremes (such as depression)



Briefly explain

Disorganised speech or behaviour

This behavior is the incoherent speech displayed by an individual suffering from a mental disorder that hinders their ability to communicate their thoughts cohesively.


It is the perception of nonexistent events or objects that can also include hearing, seeing or feeling things that are not present such as smell or taste.

Mood extremes (such as depression)

Mood extremes is the experience of feeling extreme feelings over a long period such as extreme sadness or happiness, even both depending on the situation.

Describehow an EN can manage challenging behaviours by recognising triggers and deflecting them using the following techniques:

Active listening and observation skills Ensuring effective communication and Seeking expert assistance where required


Active listening and observation skills

An EN can manage challenging behavior through utilizing the skill of actively listening to the person and observing their behavior as it involves providing the individual time to explore their feelings and thoughts thereby building a safe connection with the professional that improves the outcome for the individual (Loos, 2021).


effective communication

Effective communication helps the professional to understand the condition of the patient and track the changes in care so that they can ensure the safety of the patient and recognize any area for the improvement of care provision such as recognizing triggers that can be avoided to prevent distress in the patient and successfully deflect them (Kirca & Bademli, 2019).

Seeking expert

assistance where required

Nurses seek expert assistance when they understand that a situation is out of their clinical expertise, in this way, the professional avoids any error on their behalf and ensure that good standard of care can be delivered to the patient especially in a sensitive situation where the patient might be triggered; experts that are consulted for assistance possess experience in such situations that aids the professional in handling triggers and deflecting them through the expert’s help (Bindon, 2017).

  • Strengths-based
  • Peer support
  • Holistic
  • Non-linear
  • Person-centered (, 2022).

Researchthe National framework for recovery-orientated mental health services (Australian Government).

a. Inyour own words, explain briefly any three (3) of the principles of recovery oriented mental health practice

The uniqueness of the individual helps them in recognising that having opportunities is important than the cure that dictates a meaningful life will be led by the individual; it empowers the individual and allows the acceptance of recovery outcomes as unique and personal as they are at the center of care they are receiving. Second, the individual is provided opportunity to make choices about the manner they want to lead their lives, ensuring that the individual is supported and provided high standard care; Laastly the principle of partnership and communication respects that the individual is the expert in their life and their recovery will be focused on partnering with them to provide support in a manner that is understood by them and it also highlights the importance of sharing relevant, important information between the professional and the individual (Health.nsw, 2022).

b.  Discuss how evidence-based practice is applied in mental health recovery

Evidence-based practice is predominantly utilized in mental health recovery through application of data from randomized controlled trials and other research that provides the professionals with the prevention and treatment methods that have been supported by credible evidence. Nurses are required to apply evidence based practice in their provision of care so that the patient’s safety is upheld and a good quality service is provided to them

Researchthe Mental Health Act and describe the key features and objectives:

a. Keyfeatures and objective 

  • Providing assistance to individuals that display signs of mental illness
  • Treating individuals with mental health illness
  • Provide the opportunity to individuals  for assessment and treatment in the least restrictive manner upholding their human rights and dignity (Mental Health Act, 2014)

List two key features for each of the following domains under the Mental Health Act.

b. Involuntaryadmission 

  • Individuals can be admitted involuntarily or against their will
  • Determination of subjecting the individual to community treatment or continued involuntary detainment under the act in a mental health facility (Mental Health Act, 2014). 

c. Consumerrights

  • They have the right to safety
  • Right to information
  • Right to basic needs and education
  • Right to representation (MHA, 2014)

 d. Involuntaryreview processes 

It reviews the emergency involuntary procedures that occur on the inpatient psychiatric units for the individuals in the Commissioner’s custody (MHA, 2014).

e. Seclusionand restraint

Under the act, seclusion and restraint can only be utilized in situations where the reasonable practical ways of preventing harm in the patient have been attempted with no results. It is used as a last option to prevent serious harm to the patient and others involved.

 f. Admissionprocedures 

The admission procedure involves the assessment of the individual to obtain necessary information about the current mental state, the risk of harm they possess to themselves and others, mental health history, physical health assessment, history of substance use, social situation and the strengths and goals. The assessment is carried out by a team of specialists after which the individual is admitted  to the mental health facility as a voluntary patient (MHA, 2014).  

g. Communitytreatment orders

Under the act, the Tribunal is capable of imposing community treatment order that authorizes the compulsory treatment of a person within the community.  

Core Values in Mental Health Nursing

h. Roleof the mental health practitioner 

Under the act, the mental health practitioners and psychiatrists are encouraged to develop secure and safe relationship with the recipients of care and provide them the necessary information that supports their decisions about their care.

i. Consent

The act requires that the patient are provided treatment for their mental condition and only they can refuse or provide informed consent to their treatment. No other individual is authorized by the law to make the decision on behalf of the patient.

 j. Confidentiality

The act allows the designated people to share confidential information when they are dispensing their responsibilitie sunder the MHA, 2016. The confidential information can be shared by and with the family, carers and rights advisers.

Mental health patients often suffer from oral health issues due to the side effects of medication, poornutrition and reduced motivation for self-care. Considering this statement, describe any five (5) strategies that an EN can use to manage such situations and prevent oral 

  • The EN can encourage the patient to practice self-care
  • They can encourage healthy eating habits in the patient
  • They can educate the individual about the benefits of proper nutrition
  • They can encourage the patient to maintain good oral hygiene
  • They can also encourage the patients to communicate their symptoms to the medication so that an alternative can be found by the professionals.

Listthree (3) rights of the person with a mental health condition and describe with an example how an EN can support these rights

  • Statement of rights, compulsory mental health treatment and privacy and confidentiality. An EN can ensure that the individual is provided with a written statement of their rights immediately as they become compulsory patients, moreover, the nurse can force the individual to be assessed to prevent any serious deterioration in their condition and lastly, the nurse must maintain the privacy and confidentiality of the information shared by the individual except in prescribed situations (MHA, 2016).
a. Listfive (5) impacts of discrimination, negative stereotyping and stigma that can have an impact on a person with mental illness
  • Lowered self-esteem
  • Loss of hope
  • Reluctance to continue treatment
  • Worsening of symptoms due to avoiding treatment
  • Interference with recovery, loss of improvement in the condition

 b. Providetwo (2) strategies that an EN can apply to ensure their own interactions with this person are 

  • The nurse could practice compassionate care for the patient and demonstrate active listening
  • The nurse could also practice effective communication to ensure their relationship is secure and they can be suggested effective ways to recover through informing the patient on the options that are available (Hartley et al., 2020).  


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Personal Philosophy of Mental Health Nursing

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