Use open-ended questions, active listening, and reflection. Avoid "why" questions and giving advice. Practice phrases like "Tell me more about that" and "How did that make you feel?" Therapeutic silence is powerful too.
Suicide risk assessment comes first - ask directly about suicidal thoughts. Know your facility's protocols for safety precautions, one-to-one observation, and when to remove potentially harmful items. Document everything thoroughly.
Focus on antidepressants (SSRIs, SNRIs), antipsychotics (typical vs atypical), mood stabilizers (lithium, anticonvulsants), and anxiolytics (benzodiazepines). Know major side effects, especially extrapyramidal symptoms and serotonin syndrome.
Know de-escalation techniques: stay calm, maintain safe distance, speak slowly and clearly, avoid arguing or reasoning with delusions. Understand when restraints are appropriate and always follow the least restrictive principle.
Use the mental status exam: appearance, behavior, speech, mood, affect, thought process, thought content, cognition, insight, and judgment. Document objectively - what you observe, not interpretations.
💚 Remember: Your presence and genuine care can be as therapeutic as any medication!
