Mental Health Nursing Care for Patientes with Schizophrenia at Risk of Violent Behavior Using the TAK Approach Session 2 at Menur Hospital in Surabaya
Abstract
Schizophrenia is a severe psychiatric disorder that may impair emotional regulation and adaptive behavioral control, creating a clinical risk of aggressive or violent behavior in some patients. In inpatient psychiatric settings, early recognition of anger and the provision of safe coping strategies are important components of nursing care. This study aimed to describe the implementation of Group Activity Therapy (TAK) Session 2, comprising deep-breathing relaxation and pillow-hitting techniques, and to document the responses of two patients with schizophrenia and a nursing diagnosis of risk for violent behavior at Menur Hospital, Surabaya. A descriptive comparative two-patient case-study design was conducted in the Kenari Ward from September 9 to 17, 2025. Data were obtained through nursing assessment, observation, interviews, documentation, and evaluation of the patients’ ability to perform the prescribed coping strategies. Both patients initially demonstrated pre-aggressive signs, including irritability, loud or rapid speech, poor eye contact, emotional lability, and clenched fists when discussing personally sensitive triggers. During the nine-day care period, both patients progressed from requiring guidance to independently performing deep-breathing relaxation. Participation in pillow-hitting was initially refused but was subsequently accepted, with both patients becoming more cooperative and able to express feelings without heightened emotional responses. However, these changes occurred alongside other nursing interventions, medication adherence support, therapeutic communication, spiritual coping, peer interaction, and routine inpatient care. Therefore, the observed improvements cannot be attributed independently to TAK Session 2. The case study indicates that TAK Session 2 can be incorporated into individualized psychiatric nursing care while patient readiness, triggers, and concurrent interventions are continuously considered. Larger comparative studies using standardized outcome measures and longer follow-up are needed to examine the specific contribution of this intervention.
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References
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Copyright (c) 2026 Asyila Aulia Putri, Miadi, Ade Andrian, Endah Suprihatin, Joylyn Llamado Mejilla
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