Attitude- an orientation organized through experiences which respond consistently to an

object, person, or situation

- it is the way one feels toward the individual or experience

Acceptance- implies that the nurse treats the client as an important individual who has
inherent worth and not as a diagnostic entity or set of psychiatric symptoms.

-Implies that the nurse tries to understand the meaning, the client is conveying through his
behavior.

-Encourages the client to express his feelings to her, realizing that in this way he is able to
relieve emotional tension.

Attitude Therapy- a treatment that emphasizes the evaluation of current attitudes in terms of
the origins of the attitudes, the purpose these attitudes serve, and their possible distortions.

-prescribed ways on how to handle mentally ill patients according to the behavior symptoms
they manifest

-AIM: To modify a patient’s patterns of behavior which is viewed as a group of symptoms,

Characteristics of attitude therapy

1. Consistency must be used in order for the client to reach the maximum therapeutic value.

2. All persons who come in contact with the patient should have a uniform attitude.

3. Should be prescribed by the physician and should be individualized depending on the

Types of attitude therapy/ Approaches

-Attitude therapy is an attempt to prescribe the attitude that all staff and personnel will assume
toward a patient. These include active friendliness, passive friendliness, kind firmness, matter-
of-fact, no demand, indulgence, and watchfulness.

Active Friendliness- In active friendliness, the personnel/staff assume the initiative in making
friendly overtures with the patient. It is used on people that have depression or are withdrawn.
The nurse takes initiative to bring patient to activity and to be verbally supportive to the
patient.

Basic principle: to give attention to the patient before the patient request it.

-takes initiative to bring patient to activity and to be verbally supportive to the patient.

- assume the initiative in showing a consistent, genuine interest in the patients and their needs
24 hours a day.

- give sincere praise for accomplishment that shows progress.

…
Passive Friendliness- In passive friendliness, the personnel/staff wait for the client to take the
initiative in many aspects of the relationship. It is used on people that have distrust with others
or to patients who are paranoid. Maintain a distance of at least 4 feet from the client and avoid
touching him/her.

- indicated for suspicious or paranoid patients/ frightened by active friendliness or closeness

- maintain a distance of atleast 4 feet from the client and avoid touching him/her.

 Nurse must maintain distance because paranoid patients hates too much closeness but
make the patient feels that you are just around and willing anytime he needs you.

- real interest is shown by being available and alert but not pushing.

- wait for the patient to make the first move and respond accordingly.

Kind Firmness- Kind firmness requires the personnel/staff to convey to the client a feeling of
reassurance that they know exactly what has to be done. It is used on people who are
depressed, suicidal and uncooperative. The staff use mothering role, offer self and sit with the
patient.

Purpose: To put a depressed patient to work in monotonous, udergratifying repetitive work and
to criticize not the patient but the way he is doing the job. (eg it depends of the likes of the
client- reading, writing; hobbies); don’t force activities that is not interesting for the patient.

- it is used on people who are depressed, suicidal and uncooperative.

- The nurse use mothering role, offer self and sit with the patient.

 Character of which is to be firm with depressed patients and instead of sympathizing

Matter of Fact- Matter-of-fact approach has an element of casualness. The staff is not to
respond with overt emotion to the client’s pleas, apparent distress or manipulation. It is used
on irresponsible and manipulative people. Therapist has to state and stick to what they say and
not deviate from what they say.

- indicated for manipulative and demanding patients.

 Character disorders such as alcoholics, drug addicts and passive individuals. These
people are impatient with life. Their therapeutic need is to learn that manipulation is
unrewarding.

- has an element of casualness

 The staff is not t respond with overt emotion to the client’s pleas, apparent distress of
manipulation
 Therapist has to state and stick to what they say and not deviate from what they say.

- stick to the rules and regulations

- be firm and consistent with your approaches or with what you say to these patients
- explain the routine of the ward and follow rules and regulations

- patient is usually very angry, he will stride up and down the hallways and may become quite
abusive

 Let him work out on a punching bag

No “Demand”- This attitude is used on people who are difficult to control such as those who
are assaultive, aggressive and furious clients. Nurse needs to show caring behaviors to show the
person they won't hurt them. When they get out of control the therapist does nothing but just
come back to them later.

- observe for the safety of the patient while at the peak of emotion

- never approach the patient alone or he might perceive that you are challenging him to fight

- ask the help of the members of the team and surround the patient so that his hostilities may
not be focused to the object of his anger. Likewise, a large group surrounding him shall help
diffuse his hostilities.

 Tell the patient that you (the group) will not harm him instead you are all there to help
him.

Indulgence- Indulgence indicates an unusual amount of flexibility in dealing with the client’s
adherence to therapeutic routines. It is used among patients with dementia/Alzheimer disease.

- it does mean that a certain amount of divergence from his schedule (diet, activities, non
essential medications) is to be accepted.

Watchfulness- Watchfulness refers to the state of being constantly attentive and responsive to
signs of opportunity, activity, or danger. It is employed to clients who need constant
observation, e.g. suicidal clients.

- constant observation

Attitude therapy (Indulgence) for dementic patient

Nurse: A wonderful morning sir, I’m Judy and I will be your nurse. How should I call you sir?

Patient: The sun is bright like your smile Judy, you may call me Jay.

Nurse: Absolutely Jay. Just call me anytime and I would be more than willing to help.

Patient: Ok Judy. I will note on that.

Nurse: (Attempts to exit the room)

Patient: N…nurse? What was your name again?

Nurse: (Smiles) Oh, my name is Judy. Call me anytime, okay?

Patient: Okay Judy.

Patient: (walks around the nurse looking for something)

Nurse: hello Jay, do you need something? Are you looking for something?

Patient: (clueless) What? N…no… What was I’m looking for, do you know?

Nurse: I don’t know. Do you want something to eat or drink?

Patient: Y’ah.

Nurse: Okay, you can have the apple juice.

Patient: (not getting the apple juice and wandering…) Ha...have you seen my glasses? I want to
read.

Nurse: (Smiles to Jay) They’re around your neck.

Patient: Oh, silly me. I lose my head.

Nurse: No that’s okay. I understand what you are going through. Do you want something to
drink?

Patient: I don’t know, do we have any apple juice?

Nurse: We do, would you like me to pour you a glass? (Smiles)

Patient: Okay.

Nurse: (prepared the juice) have a seat here.

Patient: That’s so nice of you, thank you. (Sits beside the nurse)

Nurse: That’s my job Jay. Don’t hesitate to ask me help whenever you need it. I will always be
here to remind you with whatever you need.