INTERACTION PROCESS ANALYSIS (IPA)

Students Name: Emily Schrecengost Clients Name: W.M.

Interview Date: __10/19/2016___

I. PURPOSE OF THE SESSION: List three goals for your patient for the day of the IPA.

1. Patient will be able to identify and practice coping skills to reduce stress

2. Patient will understand illness and identify reasons for needing hospitalization

3. Patient will have a plan upon discharge

II. EXPECTATIONS OF THE SESSION: List three goals for yourself during this interaction.

1. Build rapport with patient and use therapeutic communication

2. Remain open and nonjudgmental

3. Discuss with patient future discharge plans to overcome drug addiction

II. OBSERVATION: Include observations related to the patient and the unit environment.

When I arrived on the unit, my patient was sitting on the bench talking on the phone. She appeared calm and relaxed. I did not observe
any signs of sadness or anger. She was dressed appropriately, well-groomed, and smiling fittingly while on the phone. The
environment was calm but noisy. A television had a baseball game on with the volume turned up loudly. This did not seem to bother
my patient. There were a lot of patients in the common room. After getting off the phone, W.M. spoke briefly with two other patients.
They were questioning if any of them have gotten to see the doctor yet. When I approached her, she was very welcoming, but anxious
to speak with the doctor.

Many patients with psychiatric disorders have difficulty communicating. A process recording (IPA) assists the
new psychiatric nursing student to record the verbatim interaction after the conversation takes place with an
assigned patient then identify and analyze symbolic meanings, themes and techniques and blocks in therapeutic
communication ( Boyd, 146-152)
III. CONTENT:

INTERVIEWER INTERVIEWEE IDENTIFY COMMUNCATION ANALYSIS OF THE

(THE STUDENT) (THE PATIENT) TECHNIQUES INTERACTION
(was this technique effective? Why
or why not?
Was there anything else that could
have been explored?
What were major themes?)

Hi, W****? My name is
Emily, and I am a YSU nursing
student. I was wondering if
youd be willing to sit and talk
with me for a little bit?
Umm, yeah, thats fine. As
long as I dont miss the doctor.
Ive been waiting to talk to
him. Do you know what is
taking so long?
Introduction; Communication effective;
Information Goal of introducing self and
allowing conversation achieved

[standing facing patient, direct [standing facing me, relaxed

eye contact, relaxed posture, posture, eyes looking around
hand out to initiate handshake] the room and at me]

Unfortunately, I do not have
the answer to that. Would you
like me to go speak with one of
the nurses?
No, its okay. I think hes just
backed up. As long as he
doesnt leave before talking to
me. There are so many patients
here!
Offering self Effective; increased PTs
feeling of self-worth by
offering service to her

[PT sits at nearest empty table]

So, when did you come here?
What brought you in?
[sat down in chair near PT,
SOLER positioning]
Well, I was in the Emergency Exploring; Effective; PT was able to
Room for two days before they Open-ended question describe how long she has been
could get me a bed up here. I in the hospital and what
got on this floor on Monday. brought her here
Im here because my family
thinks Im trying to kill myself.
They caught me taking pills.
Im not trying to, though. I just
want to get high.

[PT sitting relaxed; facing me]

Can you elaborate further on
that? Im not understanding
what happened.
[SOLER; leaning in closer to
hear PT better]
I take pills to be numb. Muscle Exploring; Effective; PT was open to
relaxers. Theyre called Seeking Clarification discuss topic in further detail;
Baclofen. Im prescribed them, Major theme involved reason
but I take more than Im she abuses pills
supposed to. Well, my daughter
found me drooling and peeing
all over myself. I couldnt even
stand. She thought I was trying
to commit suicide but I wasnt.
I dont want to die; I just want
to feel numb. I dont want to
feel any pain. I dont want to
think anything. I just want to
be numb.

[PT sitting relaxed;

maintaining eye contact]
Okay, I understand a little
better now. So you arent
suicidal?
[SOLER]
Thats great to hear! I know
you mentioned you have a
daughter, do you have any
other children?
[SOLER]
Sounds like a full house! Can
you tell me about your
relationship with them? Do you
have other family members?
[SOLER]
You mentioned you daughter
caught you taking pills. Is this
the first time theyve learned
about you taking them?
[SOLER]
No, I dont want to die! I tried Restating Effective; PT willing to bring
committing suicide once, but I up history of suicide; also
know that was a mistake. I cut shows positivity
my wrists 21 years ago and that
was my only time. I remember
it was when I was pregnant
with my youngest. If I would
have taken my life, I would
have taken my childs as well.
Theres a reason I didnt die. I
wasnt supposed to. And Im
still not supposed to. I know I
dont want to die anytime soon.
[leaning on table; still relaxed;
looking around room
intermittently]
I have three children. The one Restating;
who found me is my oldest, Open-ended question
she is 25. Then I have two
more, 23 and 21 years old.
Then I also have 6
grandchildren.
[relaxed; smiling]
Before this incident, my Open-ended question; Effective; patient continues to
relationship with everyone was Exploring be open to answering questions
great! I love my children and and continuing conversation
grandchildren so much, and
Im afraid I ruined it with this
stupid sh*t. But I also have two
sisters. I only talk to one. I
have my mother too. We have
an okay relationship.
[relaxed; beginning to get
teary-eyed]
Yeah, this is the first time. Ive Exploring; Effective; patient began to
taken pills a bunch of times, Restating show feelings regarding her
but they always just thought I situation
was sick, like I had a medical
problem or something. Because
why would someone be stupid
enough to do something to
themselves that makes them so
sick and not even have control
over anything in your body?
[more teary-eyed; upset;
fidgeting with hands]
SILENCE approximately 30
seconds
[nodding head to show I am
listening; remain SOLER]
How do you feel you can
improve this situation and
better yourself?
[leaned in a little closer;
softened voice to have more
compassionate voice rather
than interview voice]
That is awesome that you can
say that. It is a big step to be
able to admit you have a
problem and know what you
feel is necessary to change
your ways. Have you made any
rehab plans for when you get
discharged from here?
[SOLER]
Th
IV. IMPRESSIONS/ASSESSMENT: 1) What did you observe throughout the session -- behavior and affect; 2) was the
behavior/affect appropriate, explain; 3) how does this behavior/affect fit with what you know about the clients past
behavior/affect; and 4) identify the major themes/issues that emerged.
Im afraid my family is going Using Silence Effective; patient used the
to want nothing to do with me silence to continue the
anymore. I cant believe my conversation and
daughter found me like that.
My grandson will probably
never want to see me again. He
saw me go to the bathroom on
myself. I just am so
embarrassed. I dont want them
to see me like this.
[rubbing eyes]
I know I have to go through Reflecting Effective; PT verbalized
rehab and sober up. I cant do understanding of necessary
this anymore. I feel like I treatment; knows she cannot
didnt learn my lesson before continue to abuse pills
when Id take drugs because I
never got caught. Now, I think
I learned my lesson. I
jeopardized my relationship
with my sister, my children,
and grandchildren, my
girlfriend. None of them want
anything to do with me right
now. Everything was so good
before this. I need to be able to
get back to how things were.
Yes! Im in the process of Encouragement; Effective; goal was met for
figuring everything out for it. I Open-ended question; patient to verbalize a plan after
think I am going to stay with Formulating a plan of action discharge; major theme was
my daughter and go to an patients understanding that she
outpatient rehab center in needs to get better
Meadville. I need to get better.
I want to be a good mother and
grandmother. I dont want to
do this anymore.
[PT back to a relaxed position;
does not appear as upset]
V. USE OF PROFESSIONAL SELF: Choose two significant interventions you made: 1) identify/describe; 2) what was your
impression of your effectiveness; and 3) what would you change.

VI. PLANS: (Brief statement of your plans for the next session, long range goals, short range goals that are relevant for this client.)

VII. ISSUES, QUESTIONS OR PROBLEMS: Include issues of diversity, value dilemmas, counter-transference etc.

VIII. EVALUATE THE OVERALL EFFECTIVENESS OF THIS INTERACTION: Relate this back to the goals you
established for you and the patient.

References: