Nursing Care Plan for Impaired Social Interaction

IMPAIRED SOCIAL INTERACTION

Insufficient or excessive quantity or ineffective quality of social exchange

Related To (Etiology)

Impaired neurologic development or dsyfunction
Disturbance in the development of impulse control, frustration tolerance, or empathy for others
Disturbed relationship with parents/caregiver (lack of trust, abuse, neglect, conflicts, disorganized family system)
Lack of appropriate role models and/or identification with aggressive/abusive models
Loss of friendships due to disruptions in family life and living situations

As Evidenced By (Assessment Finding/Diagnostic Cues)

Dysfunctional interaction with peers (teases, taunts, bullies, and fights with others)
Difficulty making friends because of immature, disruptive, destructive, cruel, or manipulative behaviors
Isolated, having few or no friends, and/or poor sibling relationships
Blames others for poor peer relationships
Sad/depressed about not being liked by peers
Low self-esteem, or unrealistic, inflated esteem as the aggressor

Outcome Criteria

Use age-appropriate interpersonal skills to establish genuine and equal-status friendship with at least one person

Long-Term Goals

Child/adolescent will:

Interact with others using age appropriate and acceptable behavior within 4 months

Short-Term Goals

Child/adolescent will:

Participate in one-on-one and group activities without attempts to interrupt, intimidate, or manipulate others within 4 to 6 weeks
Use age-appropriate skills in play activities and interpersonal exchanges within 4 to 8 weeks
Describe a realistic sense of self using feedback from adults and peers within 4 to 8 weeks

Interventions and Rationales

Intervention

Use one-on-one relationship to engage the client in a working relationship. R: The client needs positive role models for healthy identification.
Monitor for negative behaviors and identify maladaptive interaction patterns. R: Negative behaviors are identified and targeted to be replaced with age-appropriate social skills.
Intervene early, give feedback and alternative ways to handle the situation. R: Children learn from feedback; early intervention prevents rejection by peers and provides immediate ways to cope.
Use therapeutic play to teach social skills such as sharing, cooperation, realistic competition, and manners. R: Learning new ways to interact with others through play allows the development of satisfying friendships and self-esteem.
Use role playing, stories, therapeutic games, and the like to practice skills. R: Solidifies new skills in safe environment.
Help client find and develop a special friend; set up one-on-one play situations; be available for problem-solving peer relationship conflicts;role model social skills. R: The abilities to reality test, problem solve, and resolve conflicts in peer relationships are important competencies needed for interpersonal skills.
Help the client develop equal-status peer relationships with reciprocity for honest, appropriate expression of feelings and needs. R: When people can identify personal feelings and needs, they are better prepared to use more direct communication rather than manipulation and/or intimidation.