Interaction Process Analysis

Introductory Page

Student Name: ________ Date: _

Client Initials: _M.M._ Diagnosis: Schizoaffective Disorder with Bipolar Disorder

Age: _19__ Sex: Male

Be sure to answer all questions listed below:

Description of nurse: What were you wearing? What were you thinking and feeling immediately prior to the
interview? What other factors influenced you at the time of the interactions? (1 point)

I was wearing loose fitting, red scrub pants. The hem of my pants just touched the tops of my
mostly grey, trimmed in turquoise tennis shoes. This allowed my black cotton crew socks to only be
seen while sitting down. My top was a black polo shirt with short sleeves that was also non-
restrictive and made out of 100% polyester. It had five black buttons. I unfastened the top two
buttons to prevent the collar on the front of the shirt from pressing against my throat. The polo has a
logo embroidered on the left upper chest. The logo was AP, in red thread, with a white line
underneath, and then School of Nursing in white thread underneath the white line. My Austin Peay
School of Nursing badge was firmly attached to the polo shirt with a metallic clasp. My name and
picture appeared on the badge, with my last name covered with red tape. To prevent from becoming
cold, I also wore a black, 60% cotton and 40% rayon cardigan that was unfastened. The cardigan had
six black buttons down the right side. I previously had my hair down and parted on the right side.
However, I pulled my hair back into a low bun, with a brown hair tie. It became frizzy after getting
caught in the rain, while retrieving my lunch in my car. I was wearing makeup that was subtle. This
included: foundation, a translucent powder, a peach/pink blush and highlighter on my cheeks, a soft
pink lipstick and lip gloss, and black mascara. I wore this uniform because it is required by the
Austin Peay School of Nursing department for the psych/mental health clinical. I was comfortable in
this clothing because I was able to move about freely.
I was thinking about how best to approach my client prior to the interview. I did not know how
receptive he would be towards my questions. My initial fear was that I might say the wrong thing to
him. I was worried about making him angry and then having him shut down. I did not have much
interaction with M.M. before our conversation; but, I was aware of his diagnosis and was extremely
interested in learning more about him and how his disorder affects his life. I remember thinking that
I was glad that I was able to converse with him right after lunch. Since my client and I had just eaten,
we were able to focus on the conversation and not on our hungry stomachs.
When I first sat down across from the client, I asked if he minded if I sat there. He replied
back, “Not at all”. Before I could sit down in the chair, he asked me what my name was. From that
very first interaction, my nerves and anxiety lessened tremendously. It was very easy from that first
initial question to ease into a productive conversation. He was very kind, respectful, and helpful
during our conversation. I had not expected him to be as talkative as he had been. That surprised me
quite a bit. It felt very natural to speak to him; and, I found that I was utilizing the therapeutic skills I
had been learning about all semester long. This form of communication has made me more confident
in speaking with clients/patients. The one thing that surprised me the most is how rewording a
question can elicit a more detailed response. I was very grateful that I could identify the right
questions to ask.

Description of client: Describe the client within the context of your meeting (appearance, affect, behaviors)?
How did you meet? (1 point)

The client was dressed in a tie-dyed shirt with a pair of jean shorts. He wore a maroon knit hat,
white crew socks, and tennis shoes. His outfit was appropriate for the weather that day, which was
in the high 70s to low 80s. The client had no stains or tears on his clothing. There was no odor
reported coming from either his body or clothing. He was well-groomed. He had a long beard that
fell a few inches past his chin. It appeared clean and well maintained. It was a light to medium
brown color. M.M.’s hair hung three inches below his shoulders. It was also light to medium brown
and curly. The last two to two and a half inches of his hair was dyed red. The client’s fingernails
were trimmed very short and appeared clean with no dirt embedded in them. His skin showed no
signs of bruising, lacerations, erythema, or irritations. M.M.’s skin color is consistent with his
genetic ethnicity. All teeth were intact and were white, with no stains or odors coming from his
mouth. He appears the stated age of nineteen. The client appeared to be quite comfortable and
relaxed sitting in the chair at the table. He reclined back and would often put one hand on the table.
The client was able to hold and maintain eye contact for quite a while. It was broken whenever
someone would walk past or when questioned about certain issues. There were times when I would
see him staring over my left shoulder. He was not zoning out because his eyes were moving back
and forth, as if he were watching something play out. The client’s affect was blunted. However,
while speaking he was able to express himself quite well. The way he spoke did not match up with
the facial expressions one would expect to find. The client’s behavior was calm and very
cooperative. He was very happy to talk about any topic. M.M. was a very intelligent young male.
He did not talk so much that he needed reigning in, but he spoke an adequate amount of time and was
able to answer specifically. He never overshared or under shared. The interaction took on a natural
progression and all the topics flowed into one another. He did not jump to different topics in our ten
minute conversation.

I met the client when I was introduced to the client by the nurse, who requested his permission for me
to speak with him.

Description of environmental setting: Where did the interaction occur? Who else was present? Describe the
physical environment. (1 point)

The interaction occurred in the main community room at the site. There were five tables
clumped together. Each table had four chairs. Two chairs were on one side and two on the other
side. I sat down across from the client.
One of my clinical group members sat next to me, while her client sat across from her. My
other clinical group members were at different tables speaking with their clients. Our clinical
instructor for the day and the program director were also present in the room. They sat off to the side
at one of the tables not being used by the student nurses and their clients.
This main community room, the clients stayed in the whole time, had been sectioned off into
four different areas. There were no walls that separated them but furniture placement helped to
modify each area. When walking through the door of this large room, five tables and twenty-two
chairs are located a few feet in. Immediately to the left of the entrance, going in a clockwise
direction, is the kitchen along the side of the wall. The kitchen was an older style with a mustard
colored stove/oven. From the kitchen, off to the side, is a sitting area with approximately eight
chairs. There was also a dry erase board attached to the wall. Continuing to move clockwise and to
the back of the room, there was the activity and crafts area. This contained three long tables, set up
like a “U”. There were approximately twelve chairs surrounding the tables. The room provided good
flow and allowed for the staff to be able to see all the clients without being hindered by walls.

Goals: Give objectives for this session, yours and the patient’s (did the patient have any?) Indicate which were
mutual. (2 point)

1. The client will identify the reasons/triggers that make him become angry and aggressive.

(Mutual)

2. The client will verbalize two coping skills, which he currently does not have, to help manage

his aggressive tendencies. (Mutual)

3. The client will try interacting with family and friends more instead of going off to be alone.

(Client)

4. The client will set aside a block of time every day, to engage in an activity that makes him

feel calm and happy. (Nurse)

5. The client will have a better understanding of his mental illness by learning about its

disease processes.(Nurse)

6. The client will be able to properly express emotions and thoughts in an appropriate way.

(Mutual)

Significant background data to interaction: Give a brief summary of the interview prior to the analyzed
segment (pertinent content, themes, feelings, behavior). What made you choose the following segment to look
at in depth? Indicate when in the relationship did his interaction occur (first meeting, second, etc.)
(2 points)

Before beginning the analyzed segment, the client and I introduced ourselves to each other.
This started the orientation phase. M.M. informed me that this was his first day at the facility. I told
him that this was my first and only day at this site as well. I informed him that he did not have to
answer any questions that would make him feel uncomfortable. I was also informed him that
everything he said to me would be kept in strict confidence. I told him that we would only be able to
speak for about thirty to forty-five minutes because my peers and I would be giving our presentation
shortly. He reported that he understood and still wanted to speak with me. The client appeared
relaxed and calm during this segment.

I chose the following segment because I wanted to understand what the client’s hallucinations
and delusions are like for him. I was interested in how he copes with seeing and hearing things on an
almost daily basis. I also wanted to know if they were also triggering some of the anger and
aggression issues he experiences and if he had a support system in place.

This interaction occurred during our first and only meeting. I did not know much about him but
he did provide me with some background information that helped as the interaction progressed.

Summary Comments: Summarize the conclusion of the interaction after the analyzed segment (what was
discussed? how was interaction terminated?). Were the goals met? What were your overall feelings and
reaction to the interview? What did you learn from doing the analysis? (2 points)

The client and I discussed random topics after the last analysis was finished. It seemed like he
didn’t want to talk anymore about himself or his mental disorder. After seeing the difference in his
body language while discussing his ex-girlfriend, I knew that he was beginning to shut down and
become withdrawn. In order to bring his mood back up, I asked him about his favorite music,
movies, foods, and books. After a few minutes discussing these topics, I gently asked him if he
would be open to finding a therapist to speak to. The client stated, “Yeah, I’d be open to that. No
one else seems to care enough to listen to me but, I also find it difficult to open up to others”.

Some goals were met. The client was able to identify some triggers that lead to him becoming
angry and aggressive. We also were able to come up with new coping mechanisms to deal with his
anger. He decided that when he starts to feel the anger building he will sit down and write some
poetry or take a walk. The client is also aware of how to make an environment that produces a
minimal amount of stimuli. The other four goals have not been met yet. However, the client did pick
an activity, baking, to do every day for an hour to help relieve stress. The client is going to make a
conscious effort to interact more with his family. He will also find better ways at expressing his
thoughts and emotions and educate himself more on his mental illness, schizoaffective disorder with
bipolar disorder.

I found myself feeling sorry for the client. Here is a male who is only 19 years old and yet is
dealing with such an enormous strain on his life. His family life is rather unstable due to his parents
picking up and moving every few months. Just when he starts to feel comfortable in a place, it is
time to move again. He never feels settled and it prevents him from forming lasting relationships
with others. I also felt empathy for him because of the depressive symptoms he has in regards to the
bipolar disorder. It is hard to see the client go through life thinking that he is worthless and who
blames himself for his schizoaffective disorder.

I learned from this analysis that I need to rephrase the questions I ask a client. I got lucky that
the client did not just respond with a ‘yes’ or ‘no’ when asked a closed-ended question. I also learned
I need to control my own reactions to certain situations. For example, when the client told me he saw
a clown standing in the corner of the room, I made the mistake of looking over my shoulder. It was
not because I was curious but because I have a very real fear of clowns. I also need to remember to
use silence as a part of therapeutic communication. Looking back, there were some portions of the
exchanges that would have benefitted from this and could have elicited a better response.
Nurse Client Nurse Centered Client Centered Communication
Statement Statement Analysis Analysis Technique
Analysis
Would you My Mom a. I asked this a. The client’s a. This question
tell me why signed me up question because I reaction to my could either be
you came for this wanted to see if the communication answered by saying
here today? program client was able to technique seemed yes/no or it could
(Maintained because I’ve acknowledge and to work well for lead to no further
eye contact been having a recognize the him. He had no discussion. This
with the client hard time reasons he was qualms or issues was un-therapeutic
and used a trying to placed in this answering my communication.
calm and control my program. question and Exploring
clear tone of anger and answered it therapeutic
voice) I’ve been b. The client without any technique “enables
taking it out responded as hesitation. I the nurse to
on my family expected and it was found it examine important
a lot lately, an effective tool. interesting that ideas, experiences,
like throwing The client was able when he talked or relationships
things and to acknowledge and about his anger more fully”
yelling at recognize one of the and lashing out at (Halter, 2014, p.
them. main reasons he his family, his 152).
(Client’s needed to get help. facial expression
brow Not only for his remained in a b. Where would
furrowed safety and well- neutral state you like to begin?
before being but for the (blunted affect). (T) This is the
lowering his safety of his family giving broad
head to look as well. b. Acting Out: openings
at both hands The client deals technique. This
resting in his c. I made sure to with his emotional technique “clarifies
lap. His keep my face disturbances by that the lead is to
voice trailed expressionless but actions, like be taken by the
off at the end on the inside I could physical patient” (Halter,
of his only imagine what aggression, rather 2014, p. 154).
answer.) he was going than being able to
through at such a reflect on his
young age. feelings.

d. The client’s anger c. Autonomy vs.

is an indication of Shame and Doubt:
utilizing poor coping The client wants
skills because he is so badly to be out
unaware and on his own but
uneducated on using every time he
more positive coping thinks he would
mechanisms. like to move out
of his family’s
e. Next, I would like house, he makes a
to understand what mistake that
triggers this strong shows he is
emotion in him and unable to meet a
what coping large amount of
mechanisms he has self-needs and this
tried in the past. makes him doubt
himself; which,
f. I felt bad for the then in turn,
client because he is makes him feel
essentially dealing shameful.
with two mental
illnesses at such a d. Blunted Affect:
young age and is This is a symptom
still trying to come that is common in
to terms with this the schizophrenia
illness. I also felt symptoms of
like his family life is schizoaffective
not the most stable. disorder.
So, it is hard for him
to seek help in a city e. Ineffective
that he and his coping R/T
family will not be inadequate
living in for too preparation for
long. As soon as he stressors AEB
makes some physical and
progress he is verbal outbursts
uprooted again. toward self and
others, lack of
*WORKING knowledge about
PHASE his mental
disorders, and
unable to express
his feelings and
emotions.

f. The client and

nurse will sit
down together for
30 minutes to
discuss what
triggers lead to his
anger and
aggression issues.

g. The client had a

 blunted affect.
This is related to
schizoaffective
disorder because
“schizoaffective
disorder affects
the emotions and
cognition such as
knowing,
thinking, judging,
and problem
solving”
(Nordqvist, 2016).

Nurse Client Nurse Centered Client Centered Communication

Statement Statement Analysis Analysis Technique Analysis
You said that I get angry a. I asked this a. The client’s a. The
when you get when I see question because reaction to my communication
angry you things that I wanted to see if communication technique used is
have a others don’t he understood the technique seemed restating. It is a
tendency to see, especially I reason(s) behind unbalanced for therapeutic
take it out on when I see my why he gets this question. technique.
other people, dead angry and Like previously, Restating, “repeats
what is it that grandmother becomes verbally he answered and the main idea
triggers these who abused me and physically without any expressed” (Halter,
emotions in when I was a aggressive. hesitancy but his 2014, p.155).
you? kid. Maybe I eye contact was
(Maintained keep seeing her b. I was not focused on b. The question can
eye contact because I’m expecting the something he was be rephrased as
with the client bad. (Client client to answer seeing over my “What happens just
and brought maintains eye so quickly and left shoulder. before you start to
my hands up contact for only with no hesitancy become angry and
to rest on the 2 seconds on his part. It b. Rationalization: aggressive?” (T)
table) before his eyes was effective The client thinks Placing the events in
are drawn over because he the hallucination time of sequence.
and past my clearly stated of his dead This technique “puts
left shoulder.) why this triggers grandmother is events and actions in
such an emotion present because he better perspective”
in him. thinks he is still (Halter, 2014,
doing things that p.154).
c. I found myself are bad. He
feeling bad for cannot understand
him. I had an any other reason
enormous why she would
amount of still be around.
empathy for him
because of seeing c. Trust vs.
his dead abusive Mistrust: By
grandmother as being placed in
one of his the care of his
hallucinations. grandmother, who
He experienced physically abused
her cruelty in his him for most of
childhood and his childhood, he
now is subjected is unable to truly
to it again, even trust those around
after her death. him, even his own
parents.
d. The client’s
hallucinations are d. The client’s
indicative of hallucinations are
having a a major
disturbed thought component of
process. having
Sometimes his schizoaffective
hallucinations disorder because
mimic the this disorder takes
experiences he on the symptoms
has had in his of schizophrenia.
past.
e. Disturbed
e. Next, I would thought process
like to see if he R/T childhood
experiences other trauma AEB
hallucinations or hallucinating his
delusions that deceased
might provoke grandmother,
his outbursts or if physical abuse he
the one about his sustained as a
deceased child, and being
grandmother is suspicious of
the only one. others.

f. I had a hard f. Teach the client

time listening to to think of
the physical activities he
abuse he enjoys, such as
sustained as a listening to music
child by his or baking, that
grandmother, will help distract
 who is now him from paying
deceased. To too much attention
know that he to his
experiences hallucination.
hallucinations
quite frequently g. The client has
is hard to hallucinations.
comprehend. This is related to
schizoaffective
*WORKING disorder because
PHASE “the most
common are
auditory and
visual
hallucinations in
schizophrenia
(Burton, 2012).

Nurse Client Nurse Centered Client Centered Communication

Statement Statement Analysis Analysis Technique
Analysis
You mentioned Well, I do see a a. I asked this a. The client a. The therapeutic
that you get giant spider in question because seemed a little communication used
angry when tap shoes a lot I wanted to see ifpuzzled at first was focusing. It is a
you see things and I also see the client only but then therapeutic
others do not that clown, got angry from answered my technique. Focusing
see, what are Pennywise, you just the questions. It was “concentrates
your other know…from hallucination because I attention on a single
hallucinations the movie “It”. about his unintentionally point” (Halter, 2014,
and do they Who wouldn’t deceased threw him off p. 154).
make you want to see that grandmother or with two
angry? all the time? (A all them. questions instead b. I should have
(Maintained faint nervous of just one. There combined the two
eye contact laugh erupted b. I did not have was a point where questions in a better
with the client from him.) any expectations he laughed a little way. The question
and slightly They don’t as to how he but his facial should have been:
tilted my head make me angry answered the expression never Do you feel anger
to the side. I but I do get questions. It was changed. with the other
placed my really nervous effective because hallucinations you
hands back on when I see he mentioned b. Humor: The experience? (T)
my lap.) them. two more client tried to Encouraging
(Client leaned hallucinations lighten the comparison. This
forward placing that could help subject matter by technique “brings
elbows on the answer my laughing some recurring themes in
table while question. and poking fun at experiences”
ringing his it. This is a way (Halter, 2014, p.
hands.) c. My reaction that he deals with 154).
was immediately stressors that
fearful. I hate makes him
clowns and nervous.
remembered
watching that c. Industry vs.
movie as a child Inferiority: The
and having client feels like
nightmares from these
it. I tried to wipe hallucinations
the expression make him like he
from my face as is not an adult.
soon as I Client stated,
realized it. “The things I see
make me feel like
d. The client is I’m still a child, I
experiencing want to feel like
anxiety from someone my
mentioning the age”. By feeling
clown like he has failed,
hallucination. He he feels inferior
does not like to others around
clowns and him.
spiders. They do
not anger him d. Self-blame:
but they do make The client seems
him quite to blame himself
nervous. for the symptoms
he has developed
e. Next, I would with this disorder.
like to find out if Self-blame falls
the client has a under the
support system depressive
or person. symptoms of
Someone who he schizoaffective
can share his disorder.
emotions and
feelings with. e. Disturbed
personal identity
f. Initially, I felt R/T altered
fear because I sensory
would not want perception AEB
to see clowns stating that he has
and spiders most hallucinations,
 of the time. I staring at one
had to quickly place in a room,
regroup myself and laughs to
because I had himself.
not realized,
until that f. The nurse will
moment, just educate the client
how much fear I on how to create
still had for an environment
clowns. I even that is low in
remember him stimuli, such as
looking over my turning off the
left shoulder lights and closing
again when he the door to reduce
mentioned. the noise level.
Without
realizing it, I g. The client
turned to look as blames himself
well. for his symptoms.
Self-blame
*WORKING “amplifies our
PHASE perceived
inadequacies,
whether real or
imagined, and
paralyzes us
before we can
even begin to
move forward”
(Formica, 2013).
Self-blame falls
under the
depressive
symptoms of
schizoaffective
disorder.

Nurse Client Nurse Centered Client Centered Communication

Statement Statement Analysis Analysis Technique
Analysis
You appear Um, well I try a. I asked this a. The client’s a. The therapeutic
nervous when to talk to my question because response would communication
speaking about family but the client seems indicate that he has used is making
your they don’t to want to talk no real emotion observations. This
hallucinations; understand about what he is towards it because is a therapeutic
do you have and my going through of his monotone technique. Making
anyone you can girlfriend and but is afraid voice and blunted observations “calls
talk to about it? I broke-up a people will affect. However, attention to the
(Maintained eye year ago. reject him his nonverbal person’s behavior”
contact, crossed (Client sat because of it. behavior, like (Halter, 2014, p.
one leg over the relaxed in his lowering and 154).
other, and chair b. It was slightly shaking his
leaned forward maintaining effective in the head, would b. An appropriate
on the table, eye contact, sense that he conclude that he is question would be:
with my fist but then sat up gave an answer. sad about not When you are
propped straight I was expecting having someone he feeling anxious or
underneath my crossed his to hear that he can share his angry who are the
chin) arms and might already feelings. people you can
stared at the have a therapist speak to? (T)
floor) he can speak to b. Isolation: The Encouraging
about his illness client lacks having description of
but that was not an adequate perception. This
the case. support system. technique
When the question “increases the
c. I felt sad for has been raised, he nurse’s
him. I knew he feels sad, lonely, understanding of
wanted to be and dejected. This the patient’s
able to explain leads him to perspective (Halter,
to someone what choosing isolation 2014, p. 154).
he was seeing instead being
and hearing. I around others.
also knew that
he felt like c. Initiative vs.
others will reject Guilt: The client
him because of in the past has
what he needed help
experiences. I accomplishing
think he would different tasks.
benefit greatly Authority figures
from having an would ask him why
unbiased person he could not
speak with him perform these tasks
on a consistent on his own. He
schedule. could not explain
to them why,
d. The client has because he did not
poor socializing understand either.
skills. He is so He felt an
afraid of being enormous amount
rejected by of guilt because he
people that he felt like he failed
ends up isolating these people.
himself from d. Feelings of guilt:
others including The client feels
his own family. guilt. Not only
from the things he
e. Next, I would has not been able
like to discuss to accomplish, but
his relationship also from feeling
with his ex- like he caused his
girlfriend and if own mental illness.
his illness had Feelings of guilt
anything to do are a depressive
with the symptom of
breakup. schizoaffective
disorder.
f. This one was
hard for me. e. Impaired social
I’m a person interaction R/T
who likes to get self-concept
everything off disturbance AEB
my chest but my spending time
client tends to alone, appears
hold his feelings anxious when
and emotions in others are around
until it builds to him, and unable to
the point of interact properly
being explosive. with others.
I noticed that he
really wants to f. The nurse will
talk about what assist the client in
he goes through identifying a
on a daily basis structured activity
but he is afraid that is conducive to
of putting so the patient’s pace
much of himself and skill.
out there for
others to hear. g. The client had a
defeated look on
*WORKING his face which
PHASE comes from the
guilt he
experiences. Guilt
is a symptom of
depression.
Schizoaffective
disorder is caused
by “an imbalance
 of the
neurotransmitters
serotonin and
dopamine in the
brain…which help
to control mood”
(Nordqvist, 2016).

Nurse Client Nurse Centered Client Centered Communication

Statement Statement Analysis Analysis Technique Analysis
You Well…um… not a. I asked this a. The client a. The
mentioned really because question because clearly did not communication
earlier you she has I wanted to see if want to speak too technique used is
had a schizophrenia he has ever had much about the focusing. This was
girlfriend, was too. We argued someone close to relationship with un-therapeutic
she supportive a lot and it him that he is his ex-girlfriend. because the way the
of your wasn’t good. I able to speak It was obvious he question was asked
diagnosis? like to think that with about his was trying to it could have elicited
(Maintained it was all just a mental illness. avoid it as much just a Yes or No
eye contact, bad dream. as possible by response. Focusing
both of my (There was a b. The question picking up his brings attention back
hands were long pause was effective cell phone and to a particular point
interlaced, before he because it scrolling through (Halter, 2014, p.
resting on my answered. Client showed why his it. 154).
lap.) kept shifting his ex-girlfriend was
weight while not a support b. Avoidance: b. Tell me about
sitting in the system to him. It The client was your relationship
chair and took also highlights uncomfortable with your girlfriend
his cell phone some of the and did not want and how she
out of his pocket dysfunction in to speak about supported you. (T)
and started the relationship. this subject This elicits an open-
looking through The client matter. He ended response.
it. No eye responded as mentioned that he This is exploring
contact was expected because tries not to think because it will
made). he has difficulty about it and when examine the
opening up other he does he finds relationship between
people. something else to the client and his ex-
do to keep his girlfriend (Halter,
c. I felt empathy mind off of it. 2014, p. 154).
toward the
patient because I c. Intimacy vs.
know how hard Isolation: The
it is for him to client is 19 years
want to open up old and has not
and speak to reached this stage
someone. Even yet, but if he stays
though I on this projected
expected the ex- path of avoiding
girlfriend not to people and
be a support stressors, he will
system to the isolate himself
client, I was even more.
hoping that she
was able to make d. Withdrawn:
a connection The client
with him and be withdrawals
that support himself from
person he situations that
needed. might be too
emotionally
d. The client painful to
likes to pretend experience. This
that a major is part of the
stressor in his depressive
life did not really symptoms of
happen. It seems schizoaffective
he likes to avoid disorder.
areas of his life
that cause him e. Chronic low
the most stress. self-esteem R/T
past failures AEB
e. Next, I would shame and guilt,
like to explore if thinking he
the client has had deserves bad
other things to happen
relationships like to him, and
this one because thinking he
it might show a caused his own
pattern of poor symptoms of his
decision making. mental disorder.

f. It was a little f. The nurse will

difficult to discourage the
understand why client from
the client tends reliving past
to go after things mistakes by
that are not good listing those
for him. mistakes and
Everyone identifying new
deserves to make realistic goals in
the best order to move
decisions they forward.
can for g. The client
themselves. He made no eye
tends to go after contact. This is
the things he one symptom
thinks he “that is a typically
deserves. It is displayed
like he is behavior” of
punishing depression in
himself just for those who
being who is and experience
I find that to be a bipolar polar
miserable way to along with their
go through life. schizoaffective
disorder diagnosis
*WORKING (Kanter, Busch,
PHASE Weeks, &
Landes, 2008).
 References
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