Exploring the Concept of 'Self' in Mental Care Practice

This essay delves into the multifaceted concept of 'self' within the context of mental healthcare, emphasizing its crucial role in shaping therapeutic relationships between healthcare practitioners and clients. The paper explores the complexities of self-awareness, self-disclosure, and the therapeutic use of self, highlighting their impact on patient care and treatment outcomes. It examines how the concept of self is applied in various mental health settings, including occupational therapy and social work, and discusses the influence of personality traits, belief systems, and anxiety on the therapeutic process. The essay further investigates the role of self in the nursing field, drawing upon philosophical, psychological, and biological perspectives, and underscores the importance of self-knowledge, ethical attention, and empathy in establishing effective therapeutic relationships. Finally, it addresses the effects of healthcare providers' attitudes and self-awareness on the treatment of patients, particularly those with borderline personality disorders, and stresses the need for a holistic approach to mental healthcare.

Concept of ‘Self’ in Mental care Practice
University
Name
Date

2
Abstract
Approaches applied in mental health practice are often dynamic and involve close interest and focus
of the inert person. In creating a harmonious caring process in mental care practice, there is a need
for understanding self-concept. ‘Self’ has been applied in this context of inherent ability to formulate
and establish underlying relation which is key to building a therapeutic association between the
client and the health care practitioner in the mental health care field. Despite this avenue existence
of self complexities offer a critical avenue for analysis and focus which can influence how relations
are built in the care practice. In this process, the self is demonstrated to play a fundamental role in
shaping and building therapeutic relations among nurses and clients in mental care practice. This
review demonstrates an underlying significant relation between aspects of the self and therapeutic
care process in the mental health domain. This synergism is fundamental in the mental health arena.

3
Introduction
Mental health care diagnostic approaches are often faced with care provider attitudes. The
paramount needs of therapeutic relationships between the patients and nurses have been exploited
for decades especially in mental care avenues. Psychiatric nurses often are challenged to make
changes in the manner they relate to clients, by shifting from biomedical approaches to the holistic
and ethical processes. Virtues such as compassion, moral obligation, and empathy are essential
aspects of the application of self and are increasing avenue in nursing. Despite this, the nursing field
has continued to incorporate aspects of medical models into an emphasis on neuroscientific theories
related to psychiatric and mental health care while placing nursing models and paradigms at low
levels during the psychiatric assessment and care provision.
The complex nature of self can be traced back to a period of psychoanalysis assessment (Mandel,
2007). Currently, it has been applied in helping mental health professionals in the psychoanalysis
arena. Despite these complexities often arise; Fresshwater (2002) describes authentic self as part of
the nursing process while analysis by Arnd-Caddigan and Pozzuto (2008) asserts that social carers
apply the interpersonal process in their inherent relationships among clients. Other fields have
applied the use of self as a role. Despite this, an argument by Hagedorn (2000) views the usage of
self for therapeutic purposes is crucial in the occupational therapy field. In this regard, the form by
which self takes often is complex and depends on the nature of interventions applicable. Despite
this, its usage is central in shaping interpersonal relationships occurring between patients or clients
and practitioners irrespective of the periods applied to work.
Complexities of ‘self’-440
The concept of self is widely accepted and applied while its use remains ambiguous in many settings
(Dewan, 2006). The foundational origins of self can be traced in avenues of occupational therapy,
social work, and psychotherapy applied in mental health. In occupational therapy, the ideological
usage of self according to Stein and Cutler (2002) as a therapeutic tool was introduced by
psychiatrists. The application of therapeutic use of self in occupational therapy premise is applied in
reinforcing the clients based on their key strengths and further helping them to overcome stressing
experiences. In this regard, occupational therapists apply innate interpersonal; skills in recognition of
their straights and weaknesses. In other settings usage of conscious use of self has been applied to
refer to how one becomes effective in evaluating and implementing interventions. According to
Tylor (2009), self-definition entails therapist efforts in achieving high benefit based on their

4
interactions with clients. Thus in a more general manner, the therapeutic self refers to the usage of
one's personality, perceptions, insights, and judgments in the process of offering therapy sessions.
In social work application, Arnd-Caddigan and Pozzuto (2008) observed at self at a practitioner’s
level. This implication refers to the ability of the social worker to spontaneity their vulnerability, self-
awareness, and genuineness while undertaking interaction with others. While taking this approach,
they are mindful of one’s ability to showcase and demonstrate being mindful of the usage of one's
belief, demonstration of sharing one's self and willingness to showcase self disclose in a good
manner.
Self has been applied in the context of personality traits. It is an important aspect of our usage and
influence of the therapeutic approach. Applying personality implies that self-knowledge is key for
initiating self-healing. In this case, self-healing is a fundamental aspect of healing before a worker
can be able to heal others. In applying this concept, a health care practitioner or a worker attempts
to answer questions such as; ''What traits do I bring?'', ''How this field can influence my needs?’’.
Other avenues in which personality can be demonstrated entail showcasing aspects of humor and
touch.
Another fundamental complexity of self entails application on a belief system. The belief system can
influence the therapeutic process, thus there is a need for being aware of how it can be of help or
hamper therapeutic process which is essential in facilitating growth and development. In this regard,
there is a need for being aware of beliefs that have the potential to demean the inherent
relationship either knowingly or unknowingly to the client.
In its application of dynamic relations, mutuality and professional intimacy needs to be enhanced
between the practitioner and the patients or client. In this avenue, it is a normal norm that the client
and practitioner have innate emotions, vulnerabilities, and experiences which are essential in this
process. In displaying this recognition, the practitioner in this setting can express and share the
innate self and be a game-changer in influencing others. Further, in aspects of anxiety, the self has
been demonstrated to have a fundamental role. In the inherent therapeutic relations, it can invoke
anxiety majorly due to performance insecurity. This anxiety experience can be beneficial in gaining
valuable insights which are the basis for self-appraisals.
Lastly in demonstrating aspects of self in mental care assessment entails application in self-
disclosure. Objections are built which can switch focus in either way client or the practitioner. In this
avenue, concerns have been raised as to practitioners showing frightened attitudes based on clients'
statements.

5
Role of ‘self’ in treatment
In the nursing field, the concept of self has stimulated a fundamental interest in philosophy,
psychology, and biology (Freshwater, 2002). The application of self in the therapy process is
obtained from an influential personality Peplau who investigated attributes of psychotherapeutic
avenues. A key interest is acted upon on the relevance of nursing practice acting with positive
intention geared towards therapy processes.
A cutting edge definition of therapeutic use as an avenue of nurses in their personality consciousness
and full awareness can create a synergism on the nursing intervention. In this process, essential
aspects entail possession of self-insight, self-understanding to assess own behavior and that of
others.
In the psychotherapy avenues of treatment, Cain (2007), demonstrates that clients often expect to
be understood by their practitioners especially therapists who possess skills of trustworthiness,
caring and optimism on their ability to change. In this sense, the application of self is an essential
component for the therapists. Further demonstrates empathy has a positive outcome on the
patient. The qualities of therapists are the fundamental aspects key in understating self and
demonstrate empathy and other essential virtues in their relationship with the client.
The therapeutic usage if self has similar illustrations on beliefs and activities in which practitioners in
the care settings need to having to demonstrate and engaging positively with the clients. Common
themes applicable in this process entail conscious use, purposeful use and intentional use which are
essential in self themes. The ultimate therapeutic application of these values of self is essential for
therapeutic use in value base skills which are essential for the benefit of the client in the care
process.
Treatment relation between mental health professionals and families
Establishing the inherent therapeutic relation of patients’ requiring care and usage of self is inherent
in health care practice. This application concept calls for mental providers to acquire skills about self-
awareness, self-knowledge, ethical attention, empathy and limitless boundaries in their professional
duties (Kwiatek, McKenize, & Loads, 2005). Applying self in this process creates an avenue of
communicating characterized by virtues and traits of open-ended questions, validating, clarifying,
reflecting, focusing, summarizing and minding individual values concerning practitioner and client.
Self-awareness skills entail the ability to reflect on thoughts, feelings, and actions and realizing that
being a care provider, there is a need for conveying attitudes that has an avenue of obstruction on

6
the therapeutic process. In gaining an understanding of this concept, the mental health practitioner
can identify aspects that shape mental health state as defined by race, health, culture, gender,
events at an early age and social-economic surroundings (Hugo, 2001). Attaining this level of
knowledge is crucial in distinguishing personal exercises and clients' ideals (Grando, 2005).
Self-disclosure entails the sharing of fundamental personal information amongst others, which is key
in building the discussion between the nurse and clients in the therapeutic relations in the mental
care process (Unhjem, Vatne, and Hem, 2018). This offers an avenue for facilitating aspects of
reciprocity by the client and at the same offers normalcy on the experience of the client.
Nevertheless, this concept has been problematic in the manner in which self-disclosure by health
care practitioners has been accepted in which can have detrimental effects (Stickley & Freshwater,
2006).
Cultivation of awareness aspects can enhance relationships with patients while entrenching a deeper
understanding and profound nurse perception and cultural biases in knowledge levels and views. At
the center of the mental health care process is the nurse-client relationship. This offers an avenue
for creating a dynamic journey through the application of skills and knowledge in a considerate
manner. This established a therapeutic relationship in the nursing process facilities and enhances
comfort and well being of both parties.
Finally in this aspect of the relation is the usage of self to develop facets of personality which often
unfolds with time. This application by clinicians offers an opportunity to embrace interpersonal and
curative approaches which offer an avenue for refining the therapeutic alliances between the two
parties that the patients and the practitioner. This usage of self is guided through a demonstration of
showing growth, openness, appreciation and varying degree of interpersonal relation skills (Foster,
McAllister, & O’Brien, 2006).
Effects on care and treatment
Mental health analysis is often faced with the harmful effects of diagnosis concerning health care
provider’s attitudes (Rossen & Bland, 2005). The inherent role for therapeutic relationships among
patients and nurses in the mental health arena has been discussed for while; the perceived
observance has been rudimental on mental care nursing (Barker, 2001). Nurses in the psychiatric
fields have often encountered challenges in the manner in which they can relate to patients,
especially shifting from biomedical avenues to holistic and ethical care (Sumsion & Law, 2006).
Virtues such as moral commitment, empathy, compassion, aspects of self-therapeutic use and
reflection are playing a fundamental role in the nursing arena. With this regard, psychiatric nursing

7
practices have often continued to incorporate various avenues of medical models and theories in
assessment and care practice for mental health patients and their families.
In considering these complexities and effects on the treatment process, an observational study on
attitudes for patients’ with borderline personality disorders demonstrated significant effects of
treatment based on self (Fagin, 2004). This category of mental health patients is often faced with
stigma and unkind level of attitudes, considering this marginal percentage of health care nurses
often favor offering medical assistance to these patients, which often has effects on the care and
treatment offered (Filer, 2005). Studies have demonstrated that borderline personality trait care
often sways the overall quality and value of care among mental health nurses together with patients
(James & Cowman, 2007). An excerpt of statements among health care practitioners and providers
in their experiences showed that working with this set of patients often leads to uncomfortable
personal responses, as many of the patients’ have a feeling that health care nurses are not willing to
attend to them. A characteristic feature of their description outlays a grim, negative attitude couple
with a punitive care process (Shattell, Starr, & Thomas, 2007).
The majority of nurses in mental care settings have demonstrated and showcased difficulties and
challenges in offering care services to a portion of mental health patients. These challenges range
from aspects of verbal and physical abuse to them, apprehension, splitting of staff, distancing and
exploitation avenues. In these actions nurse’s can react with actions on resentment, displaying
biasness and rude responses and opinions (Bland, Tudor, & McNeil Whitehouse, 2007). Further
negative labeling of mental health patients has often regarded to be the preferred term of usage.
Further, mental patients can demonstrate difficulties in avenues of building rapport, enhancing trust,
and fortitude and determination aspects. In severe cases, the nurses often encounter burn out and
frustrations in the process of facilitating care.
With the increase in levels of strictness, challenging working environments and lack of supportive
role modeling make nurses encounter and suffer from anxiety and poor job ratings and satisfaction
levels. Further limited training for nurses on the changing dynamics of mental health often
predisposes to evolving behaviors of self-harm and increased suicidal (Bland & Rossen, 2005).
Conclusion
The underlying concept of self in therapeutic avenues is fundamental in mental health care avenues.
Understanding the underlying aspects and variables which apply to self is an essential component
and tool in health care practicing especially when dealing with both patients’ and families.
Understanding the key parameters of self entailing self-awareness, self-disclosure, personality, and

8
interpersonal traits are fundamental avenues of self-care applications. Applying these concepts in
mental care practices offers an avenue for understanding and building a positive therapeutic
relationship with clients, patients’ and families of those involved.

9
References
Arnd-Caddigan, M. and Pozzuto, R., 2008. Use of self in relational clinical social work. Clinical Social
Work Journal, 36(3), pp.235-243.
Arnd-Caddigan, M. and Pozzuto, R., 2008. Use of self in relational clinical social work. Clinical Social
Work Journal, 36(3), pp.235-243.
Bland, A.R. and Rossen, E.K., 2005. Clinical supervision of nurses working with patients with
borderline personality disorder. Issues in Mental Health Nursing, 26(5), pp.507-517.
Bland, A.R., Tudor, G. and McNeil Whitehouse, D., 2007. Nursing care of inpatients with borderline
personality disorder. Perspectives in Psychiatric Care, 43(4), pp.204-212.
Cain, D.J., 2007. What every therapist should know, be and do: Contributions from humanistic
psychotherapies. Journal of Contemporary Psychotherapy, 37(1), pp.3-10.
Fagin, L., 2004. Management of personality disorders in acute in-patient settings. Part 1: Borderline
personality disorders. Advances in Psychiatric Treatment, 10(2), pp.93-99.
Filer, N.J., 2005. Borderline personality disorder: attitudes of mental health nurses. Mental Health
Practice, 9(2).
Foster, K., McAllister, M. and O'Brien, L., 2005. Coming to autoethnography: A mental health nurse's
experience. International Journal of Qualitative Methods, 4(4), pp.1-15.
Freshwater, D. ed., 2002. Therapeutic nursing: Improving patient care through self-awareness and
reflection. Sage.
Freshwater, D., 2002. The therapeutic use of self in nursing. Therapeutic Nursing: Improving Patient
Care through Self Awareness and Reflection. Sage Publications, London, pp.1-15.
Grando, V.T., 2005. A self-care deficit nursing theory practice model for advanced practice
psychiatric/mental health nursing. Self-Care, Dependent Care, & Nursing, 13(1), pp.4-8.
Hagedorn, R., 2000. Tools for practice in occupational therapy: A structured approach to core skills
and processes. Churchill Livingstone.
Hugo, M., 2001. Mental health professionals’ attitudes towards people who have experienced a
mental health disorder. Journal of psychiatric and mental health nursing, 8(5), pp.419-425.

10
James, P.D. and Cowman, S., 2007. Psychiatric nurses' knowledge, experience and attitudes towards
clients with borderline personality disorder. Journal of Psychiatric and Mental Health Nursing, 14(7),
pp.670-678.
Kwaitek, E., McKenzie, K. and Loads, D., 2005. Self-awareness and reflection: exploring
the'therapeutic use of self'. Learning Disability Practice, 8(3), pp.27-31.
Shattell, M.M., Starr, S.S. and Thomas, S.P., 2007. ‘Take my hand, help me out’: Mental health
service recipients' experience of the therapeutic relationship. International journal of mental health
nursing, 16(4), pp.274-284.
Stein F. and Cutler, D., 2002. Psychosocial occupational therapy: a holistic approach.
Stickley, T. and Freshwater, D., 2006. The art of listening in the therapeutic relationship. Mental
health practice, 9(5).
Taylor, R.R., Lee, S.W., Kielhofner, G. and Ketkar, M., 2009. Therapeutic use of self: A nationwide
survey of practitioners’ attitudes and experiences. American Journal of Occupational Therapy, 63(2),
pp.198-207.
Unhjem, J.V., Vatne, S. and Hem, M.H., 2018. Transforming nurse–patient relationships—A
qualitative study of nurse self‐disclosure in mental health care. Journal of clinical nursing, 27(5-6),
pp.e798-e807.