Nursing Care Plan for Impaired Social Interaction

Impared Social InteractionIMPAIRED 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
  1. Use one-on-one relationship to engage the client in a working relationship. R: The client needs positive role models for healthy identification.
  2. Monitor for negative behaviors and identify maladaptive interaction patterns. R: Negative behaviors are identified and targeted to be replaced with age-appropriate social skills.
  3. 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.
  4. 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.
  5. Use role playing, stories, therapeutic games, and the like to practice skills. R: Solidifies new skills in safe environment.
  6. 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.
  7. 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.
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