Managing Extreme Emotions in Mentally Ill Patients Training

Objectives:
• Define key concepts: mental illness, extreme emotions, and emotional dysregulation
• Identify common mental health disorders associated with emotional extremes
• Recognize the impact of extreme emotions on patient behaviour
• Understand the biopsychosocial model of mental illness

Topics:
• Overview of mental health disorders: mood, anxiety, personality, psychotic disorders
• Defining extreme emotions: anger, fear, euphoria, despair
• The biopsychosocial model: biological, psychological, and social factors
• Stigma and its impact on treatment
• Introduction to therapeutic communication

Objectives:
• Describe the brain structures involved in emotional regulation
• Explain the role of neurotransmitters in mood and arousal
• Understand the stress response and its effects on behaviour
• Identify how mental illness alters emotional processing

Topics:
• Limbic system: amygdala, hippocampus, prefrontal cortex
• Neurotransmitters: serotonin, dopamine, norepinephrine
• HPA axis and cortisol in stress
• Emotional dysregulation in psychiatric conditions
• Neuroplasticity and recovery

Objectives:
• Use observation and communication to assess emotional state
• Identify early warning signs of escalating emotions
• Apply validated assessment tools (e.g., PANSS, BPRS)
• Document observations accurately

Topics:
• Signs of emotional escalation: verbal, non-verbal, behavioural
• Structured clinical interviews and rating scales
• Risk assessment: suicide, aggression, self-harm
• Documentation standards (SOAP notes)
• Cultural considerations in assessment

Objectives:
• Demonstrate verbal de-escalation strategies
• Use non-verbal communication to reduce tension
• Apply the 'CALM' framework (Connect, Assess, Listen, Mobilize)
• Recognize when de-escalation is effective or when to escalate

Topics:
• Principles of de-escalation: empathy, respect, validation
• Verbal techniques: open-ended questions, reflective listening
• Non-verbal cues: posture, eye contact, tone
• The CALM approach step-by-step
• Debriefing after de-escalation

Objectives:
• Differentiate between anger, hostility, and aggression
• Implement anger management strategies
• Understand the use of PRN medication and restraints (legal aspects)
• Develop a safety plan for aggressive incidents

Topics:
• Triggers for aggression in psychiatric settings
• Behavioural interventions: time-out, redirection
• Pharmacological interventions: rapid tranquilization
• Legal framework: Mental Health Care Act, use of force
• Post-incident review and support

Objectives:
• Recognize symptoms of anxiety and panic attacks
• Apply grounding and breathing techniques
• Use cognitive-behavioural strategies to reduce anxiety
• Educate patients on anxiety management

Topics:
• Anxiety disorders: GAD, panic disorder, PTSD
• Panic attack symptoms and first aid
• Grounding techniques: 5-4-3-2-1 senses
• Breathing exercises: diaphragmatic, box breathing
• Cognitive restructuring basics

Objectives:
• Identify signs of mania and hypomania
• Implement strategies to reduce overstimulation
• Use limit-setting and structure
• Monitor for risks: impulsivity, poor judgment

Topics:
• Bipolar disorder: manic episode features
• Environmental modifications: low stimulation, routine
• Communication: calm, clear, consistent
• Medication adherence support
• Safety planning for manic behaviour

Objectives:
• Recognize severe depression and suicidal ideation
• Use therapeutic communication to support hopeless patients
• Implement behavioural activation
• Collaborate with multidisciplinary team for safety

Topics:
• Major depressive disorder: symptoms and severity
• Suicide risk assessment and prevention
• Therapeutic techniques: validation, hope instillation
• Behavioural activation: scheduling pleasant activities
• Referral pathways

Objectives:
• Understand how psychosis affects emotional expression
• Use reality-oriented communication
• Manage hallucinations and delusions that trigger emotions
• Ensure environmental safety

Topics:
• Schizophrenia and schizoaffective disorder
• Positive and negative symptoms
• Communication with psychotic patients: concrete, simple
• Strategies for hallucinations: distraction, reality testing
• Crisis intervention for psychotic agitation

Objectives:
• Define trauma-informed care principles
• Recognize trauma responses in emotional dysregulation
• Apply safety and trust-building techniques
• Avoid re-traumatization

Topics:
• Types of trauma: acute, chronic, complex
• Trauma-informed principles: safety, trustworthiness, choice, collaboration, empowerment
• Emotional regulation as a trauma response
• Creating a safe environment
• Self-care for caregivers

Objectives:
• Explain DBT principles and structure
• Teach distress tolerance skills
• Apply interpersonal effectiveness techniques
• Use mindfulness for emotional awareness

Topics:
• DBT overview: biosocial theory, dialectics
• Distress tolerance: STOP, TIPP, ACCEPTS
• Interpersonal effectiveness: DEAR MAN, GIVE, FAST
• Mindfulness exercises for patients
• DBT in group vs individual settings

Objectives:
• Identify cognitive distortions related to emotions
• Use thought records to challenge irrational beliefs
• Apply behavioural experiments
• Integrate CBT with other interventions

Topics:
• Cognitive model of emotions
• Common distortions: catastrophizing, black-and-white thinking
• Thought record and cognitive restructuring
• Behavioural activation and exposure
• CBT for specific disorders

Objectives:
• Identify classes of psychotropic medications
• Understand indications, side effects, and interactions
• Monitor medication adherence and response
• Educate patients and families about medications

Topics:
• Antidepressants, mood stabilizers, antipsychotics, anxiolytics
• Side effect management: weight gain, sedation, extrapyramidal symptoms
• Medication adherence strategies
• Polypharmacy considerations
• Role of the nurse in pharmacotherapy

Objectives:
• Apply the Mental Health Care Act in practice
• Understand patient rights and informed consent
• Handle ethical dilemmas in emotion management
• Maintain confidentiality and documentation standards

Topics:
• Mental Health Care Act 17 of 2002
• Patient rights: autonomy, dignity, privacy
• Informed consent and capacity assessment
• Ethical principles: beneficence, non-maleficence, justice
• Mandatory reporting and duty of care

Objectives:
• Recognize psychiatric emergencies
• Implement crisis intervention models (e.g., SAFER)
• Coordinate with emergency services
• Conduct post-crisis debriefing

Topics:
• Types of crises: suicide attempt, severe agitation, catatonia
• Crisis intervention model: SAFER (Stabilize, Acknowledge, Facilitate, Encourage, Recovery)
• Emergency protocols: code grey, code white
• Collaboration with police and ambulance
• Debriefing and critical incident stress management

Objectives:
• Recognize signs of burnout and compassion fatigue
• Implement self-care strategies
• Build resilience through peer support and supervision
• Use reflective practice

Topics:
• Burnout, vicarious trauma, compassion fatigue
• Self-care plans: physical, emotional, social, spiritual
• Supervision and debriefing
• Mindfulness and stress reduction
• Organizational support: employee wellness programmes

Objectives:
• Educate families about emotional dysregulation
• Use family therapy techniques
• Manage conflict and provide support
• Develop collaborative care plans

Topics:
• Family dynamics and mental illness
• Psychoeducation for families
• Communication skills: active listening, validation
• Conflict resolution and setting boundaries
• Involving families in treatment planning

Objectives:
• Understand roles of different team members
• Participate effectively in team meetings
• Coordinate care across disciplines
• Use shared decision-making

Topics:
• Team roles: psychiatrist, psychologist, social worker, OT, nurse
• Interprofessional communication
• Case conferences and care planning
• Shared decision-making models
• Conflict resolution in teams

Objectives:
• Apply knowledge to complex real-world cases
• Integrate multiple interventions
• Analyze outcomes and adjust plans
• Present case formulations

Topics:
• Case study 1: Bipolar patient with aggression
• Case study 2: Depressed patient with suicidal ideation
• Case study 3: Psychotic patient with disorganized behaviour
• Case study 4: Trauma survivor with emotional dysregulation
• Group discussion and problem-solving

Objectives:
• Consolidate learning from the course
• Develop a personal action plan for practice
• Evaluate course outcomes and provide feedback
• Prepare for certification assessment

Topics:
• Review of key concepts and skills
• Action planning: setting goals for practice
• Self-assessment and reflection
• Course evaluation and feedback
• Certification requirements and next steps