NCM_117 Psychiatric Nursing > How to improve Self Concept

Self-Awareness > Conclusion on Self Concept

Self-awareness skills Self-Concept: Who are you?

“The first most important person you must
believe in is yourself.”
Aims
> To know about Self Concepts – Who I
am.
> Importance of Self Awareness in our life
> Importance of Assessing ourselves in
our career life
> Knowing how to promote ourselves in
various situations.
Objectives
> To Know the components of Self
Concepts
> To Understand Strength and Weakness
of our personal life.
> To elaborate our skills in different
situations.
Self-concept refers to your subjective
description of who you think you are.
Self-image is your view of yourself in
particular situations.
Self-Concept Definition
- It is how you know and understand
yourself. It is the conceptual and mental
understanding that you hold for your
existence.
The Three Components of “Self-Concept”
Embodies the answer to the question
“Who am I?”
- Self-Image
- Ideal Self
- Self-Esteem
Carl Rogers (1959)
> Believes that the self-concept has three
different components:

Self-Concepts Self-Image
> What is Self-concept: Who are you? The view you have of yourself.
> Definition of Self Concept?
> Components of Self Concept: Self-esteem or self-worth
- Self Esteem How much value you place on yourself.
- Body Image
- Personal Identity Ideal Self
- Role Performance What you wish you were really like
> Influences on Self-Concept
> Positive Self Concept
An Important Part of your Self-Concept
Self-Image
- An internal feeling that influences how
you see yourself.
- How you believe other people see you.
- Learned beliefs about how you see your
physical appearance, personality and
abilities.
- Related to beliefs, attitudes, and
opinions.
Self-Esteem
- How you feel about yourself (emotional).
Each person has its own personal views.
- Characteristics and beliefs of one’s body
and mind that shapes self-esteem.
- Synonyms or near-synonyms ‘self-
worth;, ‘self-regard’, ‘self-respect’, and
‘self-integrity’.
- Confidence in one's own worth or
abilities; self-respect.
- It refers to the way we see and think
about ourselves.
Self-Concept: Components
Self Esteem Body Image
Role Performance Personal Identity
10 steps which lead to Self Esteem
1. Know YOUR self.
2. Understand what makes you feel
great.
3. Recognize things that get you
down.
4. Set goals to achieve what you
want.
5. Develop trusting friendships that
make you feel good.
6. Don’t be afraid to ask for help.
7. Stand up for your beliefs and
Values.
8. Help someone else.
9. Take Responsibility for your own
actions.
10. Take good care of yourself.
Good self-esteem gives you the:
Courage to try new things.
Power to believe in yourself.
Confidence to make healthy choices for
your mind and body now and throughout
your life.
Body Image
- It’s based on your thoughts and feelings
about the way your body looks.
- People are judging your appearance can
affect your body image.
- Poor body image comes from negative
thoughts and feelings about your
appearance, and a healthy body image is
made up of thoughts and feelings that are
positive.
Body image is a major factor in self-esteem;
which is the way you think and feel about
yourself as a person.
 Influences to Self-Concept
Self-Concept: Components
Self Esteem Body Image
Role Performance Personal Identity

Role Performance
- This concept relates to how successfully
you play prescribed role.

- Their performance are measured in

terms of their relative success or failure in
that role.

How to improve your self-concept?

Self-Concept: Components
- Identify and recognize your strengths to
Self Esteem Body Image
improve confidence.
Role Performance Personal Identity
- Learn to praise yourself.
- Develop a positive attitude.
Personal Identity
- Spend time with supportive friends.
- is the concept you develop about
yourself that evolves over the course of
your life. Self-Concepts: Conclusion
• Building a healthy body image
and good self-esteem can be
Self-Concept: Who you think you are hard work because it takes
> Confidence in one’s own abilities. time to become confident.
> Self-respect
• As you perform your role
> We see and think about ourselves. effectively, you will experience self-
acceptance and learn to recognize
- Your thoughts and feelings about the the qualities, skills, and talents that
make you special from others with
way your body looks.
dignity values
- Your appearance
• Identity from others.
> How successful you play the prescribed
Conclusions
role.
- Self-Concept is not fixed permanently.
Part of it is dynamic and changing. You
can learn to improve your self-concept. - Care about what other people think and
To improve you must change, is a process feel.
that occurs over life time.
- To step back and to review ourselves.
- On the other hand, if you were capable - Self-Reflection
of clarifying all the negative critics and
judgment your received, you can create a
How self-awareness makes you more
positive image of you and therefore a
effective?
good self-esteem.

How? By accepting who you are. Letting - Skill Development

go of your past through forgiveness of
yourself and others. And building self-
esteem and confidence.
Self-Awareness:
A Powerful Tool for Leaders
“The need to know and the fear of
knowing.”
-Abraham Maslow (1968)
Self-Awareness
- It’s knowing yourself.
It’s the key to
o Self-knowledge (understanding of
oneself or one’s own motives or
character).
o Self-Understanding (awareness of
and ability to understand one’s
own actions).
- Knowing your strength and weaknesses
- Decision making skills
- Stress
- Motivation
- Leadership
SWOT Analysis
- A systematic method of analyzing the
Strengths, Weaknesses, Opportunities,
and Threats.
- It helps you focus on your strengths,
minimize threats, and take the greatest
possible advantage of opportunities
available to you.
- Tools you can use when analyzing and
getting to know yourself.
The SWOT Framework

What is Self-Awareness?
- Who you really are?
- Why you do things in the way that you
do?
- Think about your own thinking!

SWOT Matrix
- Strength > External
- Weaknesses > Internal
- Opportunities > Helpful
- Threats > Harmful
Strength
- It’s the area of your life where you are
strong, where you are better than the
competition and where your forte lies.
Some questions that can help you identify
your personal strengths:
o What are your talents and which
things are you naturally good at?
o Which knowledge and skills have
you developed over the years and
are really good at?
o What are your positive personality
traits?
o What are you much better at than
other people?
Weakness
- All the areas where you are lagging
behind, where you have shortcomings
and gaps in skills.
Some questions that can help you identify
your personal weaknesses:
o Where could you improve?
o Where are you not talented
enough?
o Where in life have you struggled
the most?
o Which things are you avoiding and
are afraid of?
Opportunities
- It’s all about the environment’s
paradigms and flows that help you
achieve your objectives and accelerate
your execution process.
Questions to identify opportunities:
o Which are the biggest changes that
are occurring in your current
environment?
o Do you know people who can help
you achieve your objectives?
o What kind of moments do you
hope for? Are they actually
happening?
Threats
- External factors that have a negative
influence and can prevent you from
achieving your goals.
Some questions to identify threats:
o Which are the biggest changes that
are occurring in your current
environment?
o Which obstacles are you facing at
the moment and why?
o What are the biggest risks you are
facing?
Building Up Strategy
- SWOT is a fun way of getting to know
yourself and analyzing your situation all in
itself.

- But what counts much more is building a
life strategy and a decision-making
system based on the conducted SWOT
analysis.
1. Matching
- Simply means connecting internal
strengths with opportunities.
- You look at strong points and the ways
you can take advantage of them based on
the opportunities that are given in the
environment in which you function.
- Matching your weaknesses to threats
can show your biggest vulnerabilities.
- You’re always only strong in a specific
context and you have to be aware of that
context and which situations cause you to
step out of it.
2. Converting
- Simply means transforming weaknesses
into strengths and transforming threats
into opportunities.
- It’s easy to write that down, but it’s
much harder to do in real life.
Benefits of SWOT
- Personality Development
- Good Relationship
- Decision Making
- Career Development
Traps of SWOT
- There is always a big gap between what
you think is true (the subjective reality)
and what actually is true (the objective
reality).
- Seeing weaknesses as a balanced
antagonist to strengths.
How do you assess yourself?
How will you assess yourself in the future?
Skills to Develop
o Time Management
o Communication Skills
o Interpersonal communications
o Grooming and Etiquettes
o Delegation of Work and Authority
o Leadership Skills
o Self Confidence
o Technological Skills
o Managing Stress and Tensions
o Self – Evaluations
What is Johari window?
- The Johari Window is a communication
model that can be used to improve
understanding between individuals.
- It involves information – feelings,
experience, views, attitudes, skills,
intentions, motivation, etc.
Johari Window
- It is a useful tool for self-understanding,
awareness and personal growth.
- It also can used to discover your
strengths blind spots and areas to explore.
- Works best in a high trust environment.
Two key ideas behind the tool:
- Individuals can build trust between
themselves by disclosing information
about themselves.
- They can learn about themselves and
come to terms with personal issues with
the help of feedback from others.
How does it work?
- Using the Johari model, each person is
represented by their own four- quadrant,
or four-pane, window.
- Each of these contains and represents
personal information - feelings,
motivation - about the person, and shows
whether the information is known or not
known by themselves or other people.
4 Quadrants
1st Quadrant: Open
2nd Quadrant: Blind
3rd Quadrant: Hidden
4th Quadrant: Unknown
Quadrant 1: Open Area / Arena
- What is known by the person about
him/herself and is also known by others.
Open Area
- Represents the “public” or “awareness”
area and contains information that both
you and others know.
- Information that you don’t mind
admitting.
- Gets bigger over time as relationships
mature.
- A productive relationship is related to
the amount of mutually held information.
- Building a relationship involved.
Quadrant 2: Blind Area, or "Blind
Spot “
- What is unknown by the person about
him/herself, but which others know.
- This can be simple information, or can
involve deep issues (for example, feelings
of inadequacy, incompetence,
unworthiness, rejection) which are
difficult for individuals to face directly,
and yet can be seen by others.
Blind Area
- Information about yourself that others
know but you are not yet aware.
- Others may see you differently than you
see yourself
- Effective relations strive to reduce this
area.
- Open communication encourages
people to give you feedback.
Quadrant 3: Hidden or Avoided Area
What the person knows about
him/herself that others do not.
Hidden Area
- Information that you know that others
do not.
- Private feelings, needs, and past
experiences that you prefer to keep to
yourself.
- If this area is too large, you can be
perceived as lacking authenticity.

Unknown Area
- Information that is unknown to you and
to others.
- Areas of unrecognized talent, motives,
or early childhood memories that
influence your behavior. Self-disclosure is the process by which
people expand the Open Area
- Always present, never disappears.
vertically.
- Open communication can expose some
of this area. Feedback is the process by which people
expand this area horizontally.
Key Points:
- In most cases, the aim in groups should By encouraging healthy self-
be to develop the Open Area for every disclosure and sensitive feedback, you
person. can build a stronger and more
- Working in this area with effective team in personal,
others usually allows for professional and family life.
enhanced individual and team
effectiveness and productivity. Four Benefits of Self- Disclosure
- The Open Area is the ‘space’ where o Increased accuracy in
good communications and cooperation
communication
occur, free from confusion, conflict and
o Reduction of stress
misunderstanding.
o Increased self-awareness
o Stronger relationships

Increased Self-awareness
Self-awareness

- The ability to recognize and understand

your moods, emotions, drives and their
effect on others.
- The foundation on which self- With practice you will:
development is built. o Feel more comfortable.
- Increases as you receive feedback from o Find self-disclosure rewarding.
others. o Find others begin to open up and
share more thoughts, ideas, and
feelings with you.
The Johari Window: A Model for Self-
Understanding
Model considers that there is information.
o you and others know.
o only you know about yourself.
o only others know about you.
o nobody knows.

The Johari Window

- Your willingness or unwillingness to
engage is self-disclosure, and listen to
feedback, has a lot to do with your
understanding of yourself and others’
understanding of you.
Self-Disclosure/ Feedback Styles
Two communication processes within our
control that impact relationships:
o Self-disclosure of thoughts, ideas,
and feelings
o Seeking feedback from others
Characteristics of using both effectively:
o Honesty
o Openness
o Mutual respect
Practice Self-Disclosure
- Do you need to practice more self-
disclosure?
- Could you benefit by telling others more
about your thoughts, feelings, wants and
beliefs?
Summary
- Open communication is the key to job
satisfaction and personal growth
Self-disclosure promotes communication
within an organization.
- Most people want and need accurate
feedback from coworkers and supervisors
- The Johari Window helps conceptualize
four kinds of information areas involved
in communication
o Open: you and others know
o Blind: only others know
o Hidden: only you know
o Unknowns: no one knows
- Open area grows as relationships
develop.
Everyone can learn to use self- disclosure.
o Describe feelings and emotions
accurately.
o Avoid making judgments.
 o Repair damaged relationships.
Learn art of apologizing and forgiveness
o Discuss as situations happen.
o Select the right time and place.
o Avoid inappropriate disclosure.
Mental Status Examination WHO: Licensed clinicians with special
training in mental health (e.g.,
psychologist, psychiatrist, neurologist,
What is Administering the Mental
advanced practice nurse, psychiatric
Status Examination (MSE)?
nurse, occupational therapist, social
- Is the portion of the neurologic worker) administer the MSE.
assessment during which the clinician
broadly evaluates the patient’s current
mental state based on his or her > Although clinicians who do not
appearance, mood, sensorium, cognition, specialize in mental health do not
and thought patterns. administer the MSE, individual
components of the exam are included in
- The MSE does not alone provide
the comprehensive physical examination
sufficient information to formulate a
and abbreviated MSE checklists have
diagnosis. Rather, the data gathered
been developed for use in non-psychiatric
during the MSE is combined with
settings.
information gleaned from the physical
examination, medical and social history,
and laboratory test results to derive a > With the patient’s permission and
neurologic or psychiatric diagnosis. cooperation, it is usually appropriate for
family members to be present during the
MSE.
> The MSE is conducted as an interview
that begins when the patient and
examiner first interact. > The desired outcome of administering
the MSE is to obtain comprehensive
information about the patient’s current
> There is no set way to complete the
mental state to identify the presence and
MSE; the examiner can vary the pace and
extent of neurologic and/or psychiatric
direction of the interview according to the
abnormalities.
patient’s needs and level of comfort, but
all components of the MSE should be
addressed by using a checklist or > Subsequent tests can be administered
structural framework. to detect improvement or worsening of
the patient’s condition and/or to evaluate
the patient’s response to treatment.
> The examiner then documents his or
her findings in a brief written report.
Why is Administering the Mental
Status Examination (MSE)
WHERE: The MSE can be administered
Important?
in any home or healthcare setting.
> The MSE is a key component of the
psychiatric assessment. It is performed as
part of the initial psychiatric evaluation in
outpatient and inpatient settings, and can
also be performed in an abbreviated form
in emergent medical and psychiatric
situations.
> The initial MSE is necessary to obtain
information that helps the treatment team
identify a patient’s potential for violent or
suicidal behavior and establish a safe
environment for the patient.
> The MSE is important in determining
the neurologic effects of physical illness
(e.g., stroke or other neurologic injury).
Alteration in a patient’s mental status can
be among the first clinical indications of a
neurologic problem, while improvements
in mental status can signal recovery from
a neurological injury.
FACTS:
Investigators determined that the
standard MSE format is usually suitable
for patients with mild to moderate mental
retardation but must be adapted
significantly to provide an accurate
evaluation of patients with severe or
profound mental retardation (Levitas et
al., 2001).
The MSE involves obtaining an overview
of the patient’s mental health. A
structured framework or checklist should
be used to make sure that each aspect of
the examination is addressed and
systematically AMSIT is an acronym for
the following:
o Appearance, behavior, and speech
o Physical appearance (e.g., in
relation to age, dress, grooming,
signs of illness)
o Approachability (e.g., body
language, eye contact, attitude
toward interviewer)
o Psychomotor activity (e.g., posture,
gait, handshake, rate and
coordination of movements,
abnormal movements)
o Speech quality and organization
(i.e., rate and flow, intensity of
volume, clarity, liveliness, quantity,
coherent, relevant, flight of ideas)
o Mood (e.g., predominating mood or
affect, range and stability of affect,
appropriateness of affect)
o Sensorium or special senses (e.g.,
orientation, memory, concentration,
constructional ability)
o Intellect and cognition (i.e., general
knowledge base, vocabulary, and
understanding of basic concepts [e.g.,
knowledge of who the president is or
what states in the U.S. border their
own state])
o Thought patterns (e.g., coherence,
logic, perceptions, judgment, insight)
Mental Status Examination (MSE)
> Utilizing a framework or checklist does
not necessarily mean the MSE will be
administered in a linear or formal fashion.
This is because observation rather than
direct questioning is used to obtain a
significant portion of the data and
because aspects of each component of the
MSE are revealed throughout the course
of the interview.

> Further, the examiner might

intentionally administer the MSE in a less
structured or formal fashion if the patient
is agitated, anxious, or distrustful,
requiring that the examiner spend more
time establishing rapport before
proceeding with formal interview
questions.

> The patient’s condition makes

assessment of certain cognitive functions
difficult or impossible (e.g., if the patient is
sedated or developmentally impaired).

> The examiner wishes to develop a

rapport with the patient before
proceeding with a formal examination.

> An abbreviated MSE is being performed

and the examiner must focus on the
information that is most relevant (e.g.,
suicidality, acute psychosis).
Psychosocial Assessment
Psychological adaptation to Physical
illness
> Psychosocial adaptation process, other
than the physical adaptation is more
complex and less understood of the two
modes of adaptation.
> No two human beings responds
emotionally the same way to the same
event.
> This in in contrast to physiological
adaptation, which is observable and more
predictable.
> From the patient record, psychological
information can be retrieved for nurses to
form a psycho-social assessment of a
patient.
Psychosocial adaptation
> Involving both psychological and social
aspects.
> Relating social conditions to mental
health.
> The action or process of adapting or
being adapted.
Psychosocial adaptation after a major
illness depends on the following factors:
1. Social History
This includes information about a
patient’s lifestyle and availability of
persons who can support him emotionally
during a difficult event.
2. Level of stress during the year before
admission
This factor assesses the patient’s current
life situation, which includes the major
stressors he/she has experienced during
the past year.
3. Normal coping pattern
People respond to difficult times in
certain ways. When asked, most patients
can describe what they normally do to
cope when they have a serious problem
or are experiencing high levels of stress.
4. Neurovegetative Changes
These are signs of differences in a
person’s normal psychophysiological
functions. They include changes in sleep
patterns, appetite, bowel functioning,
energy levels and sexual functioning.
5. Patient’s understanding of illness
Does the patient fully understand what is
now happening and will it continue to
happen to him/her as a result of his /her
illness? How threatening is this illness to
this patient?
6. Mental Status
Is there any evidence of emotional,
intellectual or perceptual dysfunction at
this time?

7. Personality style
This is the way a person normally
interacts socially with others. Sometimes
someone’s personality style causes
problems in his ability to adapt to
hospitalization and care givers and to his
illness.

8. Major issues of illness

Illness can cause many types of
psychosocial stress for the patient and his
family. These include disruptions in his
ability to trust, maintain self- esteem,
retain a sense of control, tolerate a major
loss, avoid feelings of guilt and maintain
intimacy in his close relationships.

> By using the 8 psychosocial assessment

factors, nurses should be able to predict
with a good level of accuracy whether a
patient will be able to adapt to a sudden
change in health status.

> If one or more of the indicators points

out a potential problem, the nurse can
observe the response closely.