Mental Health Quiz #2

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Occupational Therapy Models

Involves occupation or activity as a treatment medium, Considers Functional performance in daily life activities and no one theory is sufficient

OT Practice Models (Anne Mosey)

1. Developmental of adaptive skills, 2. Role acquisiton and social skills, 3. Psycheducation approach, 4. Sensory Integration, 5. Cognitive disabilities, 6. Model of Human Occupation (MOHO).

Sensory Integration skills-6 areas of adaptive skills (Anne Mosey)-

-ability to recieve, select and use info from balance (proprioception), touch (tactile) and position (equilibrium) to perform functional activities.

Cognitive Skills-6 areas of adaptive skills (Anne Mosey)

-ability to percieve, represent and organize sensory info for thinking and problem solving.

Dyadic skills-6 areas of adaptive skills (Anne Mosey)

- ability to participate in a variety of relationships involving another person. (social skills)

Group Interaction Skills- 6 areas of adaptive skills (Anne Mosey)

ability to successfully participate in a variety of groups (project, egosentric, etc.) and participate as a contributing member.

Self-Identity Skills- 6 areas of adaptive skills (Anne Mosey)

ability to recongnize one's own assets and limiations and to perceive themselves as worthwhile, self-directed, consistent and reliable.

Sexual Identity Skills- 6 areas of adaptive skills (Anne Mosey)

ability to accept one's own sexual nature as natural and pleasurable and be able to participate in a relatively long-term sexual relationship that considers the needs of both partners.

Mosey's 4 basic concepts

Enviroment, order, chronological and intrinsic motivation

Role acquisition (Mosey)

The teaching of 'all' daily life roles (worker, family member, student, leisure, developmental, behavioral and cognitive-behavioral models.

Social Skills Training (Mosey)

The teaching of interpersonal skills needed to relate to other people effectively.

Ten-Role Acquisition principles

1.the person should participate in identifying problems and goals for treatment and inevaluation his or her own progress.

Ten-Role Acquisition principles

2.Choose goals and activitites that reflect the patient's interests, personal and cultural values, and present and future life roles.

Ten-Role Acquisition principles

3.Choose goals and activities that provide a realistic challenge but consistent with client's present level of ability.

Ten-Role Acquisition principles

4.Increase challenges and demands as the person's capacity increases.

Ten-Role Acquisition principles

5. Present skills in their natural developmental sequence.

Ten-Role Acquisition principles

6. Clients should always know what they are supposed to be learning and why.

Ten-Role Acquisition principles

7. Clients should be made aware of the effects of their actions.

Ten-Role Acquisition principles

8. Skills must be practiced repeatedly and then *applied to new situations.

Ten-Role Acquisition principles

9. the task is too complex or time consuming to learn all at one time teach one part at a time but always show or do the whole activity.

Ten-Role Acquisition principles

10. People learn how to do things by imitating others.

Social Skill Training

structured approach to teaching interpersonal skills, increase awareness and control of behavior (self-expressive, other-enhancing, assertive, and communication groups)

Self-expressive skills (sub-group)

Stating feelings, opinions and values

Other-enhancing skills (sub-group)

give support and encouragement, smile and express interest.

Assertive skills (sub-group)

Set limits and question anothers behavior

Communication Skills (sub-group)

control tone, choosing appropriate lang.

Psychoeducational approach (Model) (Lily Armstrong)

Based on educational principles and techniques (training and development of skills) "clients are students and enviroment is a classroom."

Treatment- Psychoeducational approach (Model) (Lily Armstrong)

Homework, class, quiz, test, video, film, role play, praise

Evaluation-Psychoeducational approach (Model)(Lily Armstrong)

Interview, task checklist and Kohlman Eval of living skills.

Jean Ayres

Developed Sensory Integration for treatement of learning disorders in children.

Lorna Jean King

Applied Sensory Integration for the treatement of adults with chronic schizophrenia

Sensory Integration

Neuroscience, all parts of the brain must be working in a coordinated manner to function properly, it gives us the ability to organize sensory info and act on it within a given enviroment.

Proprioception system (SI)

recognize where parts of our body is in space.

Kinesthesia system(SI)

movement and position of body in relation to muscular effort.

Vestibular system (SI)

awarness to body in relation to gravity, basic balancing yourself.

2 Main principles of Sensory Integration

Treatment intervention should focus on the outcome of the activity and the activity must be pleasurable.

Sensory Integration should be directed in these 5 areas

balance, posture, ROM, spontaneity and patterns.

Cognitive Disabilities (Claudia Allen)

focuses on the effects of impaired cognition, treatment uses the clients strenghts

Automatic Actions-6 Main Levels of Cognitive Disability Theory (Claudia Allen)

Level 1-Fight or flight; automatic responses

Postural Actions-6 Main Levels of Cognitive Disability Theory (Claudia Allen)

Level 2- Movement, awarness of large objects in enviroment, assist in simple tasks---feed themselves, limited hand movement.

Manual Actions-6 Main Levels of Cognitive Disability Theory (Claudia Allen)

Level 3- Use of hands to manipulate objects, long-term repetitive training, hook rug, cross-stitch, leather lace, stacking, folding laundry.

Goal Directed Actions-6 Main Levels of Cognitive Disability Theory (Claudia Allen)

Level 4-Task completion, relies heavily on visual cues, cannot cope with unexpected events, copy task.

Exploratory Actions-6 Main Levels of Cognitive Disability Theory (Claudia Allen)

Trial and error, (20% of the population functions at this level) Exploratory, new learning, these patients are usually going home.

Planned Actions-6 Main Levels of Cognitive Disability Theory (Claudia Allen)

Absence of disability, think hypothetical, problem solving, they can help you clean the closet, may not need to be treated.

Model of Human Occupation

Gary Keilhofner but based on concepts of Mary Reily--Analyzes and describes the development of occupational behavior. Which includes choice, interest, motivation, habits and health maintaining.

Basic Concept of MOHO

Human beings have an innate (inborn)drive to explore and master their enviroment, doing, exploring and acting help to organize and maintain us in the world.

Open Model

refers that the system can be affect and be affected by the things around them, change in any part changes the whole thing.

Dynamic Model

The whole can be greater then the sum of its parts, occupational behavior is continually created.

Open System Cycle

Output-humans act on enviroment. Intake-taking directions. Feedback-sensory and other info from enviroment. Throughput-all the info they have gathered into output.

Occupational behavior is the outcome of an interaction among

Individual, task and enviroment.

Volition-Sub-system of MOHO

Motivation, values and interests.

Habituation-Sub-system of MOHO

Habits and internalized values.

Performance-Sub-system of MOHO

Skills, rules for using skills.

Skills for MOHO

Motor,Process, Communication(interaction), Social interaction. And of course Framework.

MOHO-Enviromental oppurtunity

Characteristics of enviroment that permit or invite action.

MOHO-Enviromental Press

Stress/boundaries, approach, activity, enviroment, JUST RIGHT CHALLENGE. "GRADING"

Occupation

Is essential for human growth and development, change through out life, ot relates to habits and skill.

Exploration Motivation-3 Levels of Motivation for Occupation or Action

1.Is the desire to act, explore for the pure pleasure of it.

Competency Motivation-3 Levels of Motivation for Occupation or Action

2.Practice over and over again (desire to influence the enviroment in a specific way and to get better at it.

Achievement Motivation-3 Levels of Motivation for Occupation or Action

3. Is the desire to attain, compete with or surpass a standard of excellence.

Early Childhood 0-5 years (Kielhofner; Balance of work and play)

Play is a childs man occupation, they must explore the enviroment, rules guide actions and reality. Treatment-SI approach, behavioral approach, modify enviorment.

Diagnosis-Early Childhood 0-5 years

Unusual for mental health problems to diagnosised (ADD, ADHA, MR, failure to thrive, Reactive attachement disorder (nobody picked them up), & Seperation anxiety disorder (dont leave me).

Middle Childhood 6-12 years (Kielhofner; Balance of work and play)

Grade school, child begins to learn, delay gratification (patients, waiting, social skills, taking turns) coordination and cognitive skills. Treatment-
I. E.P., trust, improve self-esteem, enhance control, body awareness, sesorimotor, perceptual skills, cognitive abilities.

Diagnosis-Middle Childhood 6-12 years

Pre-antisocial, oppositional defiant disorder, Conduct disorder, ADHA, LD, drug and drinking, Asperger's (Mild Atisum)

Adolescence-Puberty to 21 years old(Kielhofner; Balance of work and play)

Identity seperate from parents, work (school and chores), puberty, career. Treatment; enhance ADL's and IADL's, leisure skills, self esteem, self id, SI, computer programs.

Diagnosis-Adolescence-Puberty to 21 years old

Major psychiatric disorder (schizoprenia, mood disorder) substance related disorder (eating disorder) ID issues (gender and rebel against authority) Hospitalization at this level.

Early Adulthood 21-40 years (Kielhofner; Balance of work and play)

Adults man concern is work, strive to succeed in career, friendships, intimate partner, parenthood, future. Treatment-Develop life skills, address ADL'S and IADL'S, social skills, leisure skills, vocational skills, education, pervention, goals.

Diagnosis-Early Adulthood 21-40 years

(**Largest adult grouping of mental health falling into early adulthood)Mood disorder (maybe labeled chronic), Personality disorder, anxiety disorder, alcohol and substance abuse, ineffective reactions to life stressors, domestic abuse, infertility, insecurity within job, lack of social support, HIV, STD, single parenting, divorce, and death of loved ones.

MidLife 40-65 years old(Kielhofner; Balance of work and play)

Reevaluate life's direction, concern with guiding the next generation (generativity), unable to direct themselves, feel cut off (stagnation), wrinkles, menapause, looks toward retirement. Treatment-previous interventions, conflict resolution, Dementia treatment (supervise closely, compensation, adapt enviroment, reality orientation)

Diagnosis-MidLife 40-65 years old

Continued chronic problems from before, burned out, life stressors, maladaptive disorder, early onset of dementia and organic brain syndromes

Late Adulthood 65-Death( Kielhofner; Balance of work and play)

Understand and appreciate accomplishment, (Erikson) ego integrity vs. despair, loss of career, creating new roles, aging body, change in status and social id, loss of friends and family. Treatment- Maximize functional independence (adl's and iadl's), reality orientation, remotivation, reminiscence

Diagnosis-Late Adulthood 65-Death

Depression, alzheimers, economic issues (america has the most wealthy senior citizens) medical issues.

Remotivation

Newspaper, current events, new grand babies, weddings, graduations, elections.

Reminiscence

Remembering about old times, "what was the first car you drove?" What is your favorite cookie recipe?' Talking about the way things looked back in the day...

InPatient Setting-Mental Health Treatment Settings

1.Acute care (hospital, public, private, VA, government proprietary) Akron General.
2. Long-term care (hospital, SKN, intensive psychiatric rehab services unit (IRPT) behavioral units, transitional services)

OutPatient Setting-Mental Health Treatment Settings

1.Community Mental Health Centers (CMHC)
2. Community Rehab Programs
3. Partical Hospitalization
4.Day Hospitals
5. Day Programs
6.Prevention Programs
7. Prevocational/Vocational Rehab

Community Residences-Mental Health Treatment Settings

1. Group Homes
2.Proprietary homes (room and board)
3. Half-way houses
4. Single-room occupancy hotels (SROs)
5.Supervised apartments
6. Shelters (Heavon of Rest)

Other Resources-Mental Health Treatment Settings

1. Program for assertive community (NAMI) North coast
2. Milieu (patient run facility, (inpatient,they have medical professionals)
3.Psychosocial Club (patient run, no docs)
4.Family therapy, stress manangement, crisis intervention, wellness/psychoeducation.

Home Health Care-Mental Health Treatment Settings

Services provided at residence.

50% of homeless are

Sustance abuse users or mentally ill.

Who is the consumer

Patient, client, consumer, student, resident, inmate, prisoner.

Who is the consumer--Children

SI approach, developmental theory and applied behavorial analysis

Who is the consumer---Adolescent

Age 12-21, Teen years, Prevocational, vocational activities, and cognitive treatments for learning. (hand eye coordination, properception)

Who is the consumer---Elders

Dementia, Depression, psychiatric, seen in homes, senior center and nursing home.

Consumer-Family Members

they need skilled communication because they carry the largest burden.

Parents--(Consumer-Family Members)

feel guilt, many illnesses are biological.

Sibling--(Consumer-Family Members)

worry they will get ill, resent sick member.

Spouse or partner (Consumer-Family Members)

wonder if they should leave spouse, guilt, cause of breakdown.

Children--(Consumer-Family Members)

May not realize parent is ill, fear violent, custodial role of parent, adversarial role-acts out, troublemaker.

Family caregivers--(Consumer-Family Members)

Emotional support, Respite care, support groups. Caring-Partnering-Informing-Directing Be ware of cultural and economic

Homelessness--(Consumer-Family Members)

Unpredictable interventions

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