Personality Disorders: Examples of Therapy Outcomes (Nursing)

00:01 So, what kind of outcomes are we looking to see? We would like to see that our patients who have an impulse to self-mutilate refrain from hurting themselves.

00:15 We want to be able to have our patients tell us one new method to solve a problem, a new way to go about solving some crisis that may arise to them.

00:31 We also want to increase awareness and this may sound that it is counterintuitive.

00:37 But I want people to be able to increase their awareness of when they are having a thought, an intrusive thought that is getting in the way.

00:49 I don't want them to give into that intrusive thought.

00:52 But I want them to be able to say, "Oh, yeah, there's that thought, again." I don't, I don't need to feed that bad dog, I think I'm going to think a different way.

01:04 So recognizing that the thought is there actually gives them a little bit of time not to act on that thought, to question that thought.

01:14 Also, to think about who are role models for them, and perhaps to start looking at the outcome that they want, not the outcome that their maladaptive behavior has taught them over a lifetime, is what's going to happen.

01:32 Rather, we want to have them say, "This is where I would like my life to end up.

01:39 I think I would like at the end of this day, to have sang one song with the radio and to recognize how that makes me feel.

01:49 So it's important that we don't run around trying to diagnose everybody.

01:56 And this short exercise shows you it was by -- in 2000.

02:03 How if we wanted to back when the DSM four was alive and well, how we could actually take our most beloved characters, and put a diagnosis on them.

02:17 For example, Winnie-the-Pooh, right Winnie-the-Pooh? What do you think Winnie-the-Pooh might have gotten a diagnosis of? Poor Winnie the Pooh, he would have been diagnosed with a cognitive and developmental disability.

02:33 He himself told you, he is a bear of very little brain.

02:38 What about Piglet? Piglet who runs around everywhere, right? Piglet, I think would be a general anxiety disorder.

02:50 If we are thinking about Poor Eeyore, old Eeyore even if we listen to his voice.

03:04 Eeyore will tell you, "It doesn't really matter." We would be checking Eeyore for his suicidality.

03:14 Poor Eeyore.

03:15 Think about all the rest of the Christopher Robin characters.

03:21 Poor Christopher Robin, we would say he was either schizoid or schizophrenic because he believed that all of these animals could talk to him.

03:32 So as we stop, as we think about personality disorders, as we think about psychiatric disorders and our position as nurses, as we are taking care of people, we are not there to diagnose them, we are not there to find out what their medical or psychiatric diagnosis is.

03:51 We are there to make Winnie-the-Pooh know that he is loved.

03:56 To let Piglet know that he's safe.

03:59 To let Eeyore know that he has the protective factor of all of his friends to be around him.

04:05 To let Rabbit know that there's no big problem coming up, and that it's okay to relax.

04:11 For Owl to know he doesn't have to be the smartest person in the forest and all of the rest of them.

04:20 So that they all feel safe and that they are able to get to the outcomes that they are looking for.

04:28 In summary, personality disorders are usually diagnosed in late adolescence or early adulthood.

04:36 And they can be co-occurring with other psychiatric or medical disorders.

04:44 It's important to remember that there are three clusters of personality disorders: A, B and C.

04:54 The A cluster usually has characteristics of odd and eccentric behaviors and thoughts.

05:01 For example, paranoid personality disorder.

05:07 The B is dramatic and emotional.

05:10 An example of a B cluster of personality disorder would be borderline personality disorder.

05:17 And C, the characteristics are anxiety and fearfulness.

05:23 And an example of a cluster C personality disorder is obsessive compulsive personality disorder.

05:32 We must always remain vigilant that as nurses, our focus is on our client not on a diagnosis and being able to see them in this present moment and see what they need with constant assessment and evaluation that we're helping them to move towards their recovery.