Theory and treatment Unit 1 exam
Terms in this set (90)
What are the levels of client behavior and therapeutic responses?
-acting out nonviolent physical crisis
-tension reduction therapeutic rapport
What would a combative client need?
Nonviolent physical crisis intervention
How many staff should you have on outings?
What should the ratio be from staff to client if somebody is on elopement risk?
2 staff to 4 clients
What should the ratio be if somebody is on suicide risk?
Should also be 4 to 1 but never higher than that and its better if its lower than that
What are the ten components of recovery?
Self direction, individualized and person centered, empowerment, holistic, non-linear, strengths-based, peer support, respect, responsibility, and hope
What is recovery?
-achieving life and satisfaction
-journey of healing
-living beyond the diagnoses
-achieving purpose and meaning in life
-attending productive or fulfilling life regardless of yours or somebody else assumptions
1st order of change
symptom management, improving mental health status decreasing symptoms
2nd order of change
reducing other barriers like community and family
- pattern at which we look at things (we're trying to shift it from medical model to recovery model)
What habits support recovery?
-a caring relationship or two in a supportive sense and being grounded in the present because we cant change the past nor the future and all you can control right now is how you handle the present
What was the first law addressing mental illness?
In 1641 money was given to help mental illness but none of it was for therapy and it was only for things like food because they thought you couldn't recover
What was the importance of the olmstead ruling?
- affirmed the mental illness patients and had group homes for proper community support
Mental Hygiene movement
-the practice of maintaining and restoring mental health
-a branch of early 20th-century psychiatry that has become an interdisciplinary field
-based on human psycho social care or moral discipline
-associated with reform and development of the asylum system
-declined by the 20th century due to the overcrowding and misuse of asylums and the predominance of biomedical methods
Disability rights movements
-effort to improve the quality of life of people with disabilities
-worked to reform people with physical disabilities accessibility and safety
Employee assistance program
-confidential resources to assist employees with life issues that impact their ability to focus on or meet employment expectations
Legal aid societies
-nonprofit entities that provide civil legal assistance for individuals who cannot afford their own legal counsel
-recognizes that consumers who need to make behavior changes approach intervention at different levels
-it attempts to increase consumers; awareness of possible problems faced by the behavior and to engage them in identifying reasons for change
-an official who is appointed by a government and charged to investigate and address complaints reported by individuals
- no thought of changing in the future
-kinda like denial but based on little to no awareness of how a behavior can really have consequences
what you were like before an illness/injury
Disability vs. Chronic Illness
-A person with a disability can assume that their physical health is intact and devote energy to personal and social goals
-A person with a illness may attend more to the course of the illness and emotionally invest time and interest in life sustaining activities to the relative exclusion of other aspects of his/her life.
What are the stages of Kubler Ross of adapting to loss and pros and cons?
-denial, anger, bargaining, depression, and acceptance
-pros include it was easy to apply to injury like a spinal cord injury
-cons include equating a disability to death and made having a disability an undesirable state
What are the three stages of response to disability and responses to each stage? (Livneh)
-short term: shock, anxiety, defensive retreat, denial(healthy, typical response, just can't spend too much time there) denial of presence, implications, and the permanence
-intermediate: depression, mourning, questing yourself, affective reaction, aggressiveness (OT helps them to engage in everyday life, let know process is not linear, how to express anger)
-long term: integration and growth, acceptance, changing behavior, how do you do things now, might can be a mentor now
Describe disability communities.
- 1970's, created for people who do and do not have disabilities, goals where inclusion, participation, and decreasing stigma
Describe disability rights movement.
-decrease social prejudice, to improve quality of life for people with disabilities, created legislation to help improve the idea of people with disabilities
Describe Independent living movement.
-focus on giving people personal assistance , and decreasing architectural barriers so that a person can live independently
-promote less restrictive environment and
giving them assistance to live indep. where they want to
Describe independent living centers.
-are non residential, non profit, not where they live but give services to get housing, counseling, training
-goal is to assistance people with disability to achieve max potential in a less restrictive environment
What is advocacy and who does it?
-promoting the fact that people with disabilities can work, teaching the client how to advocate for themselves
What is evidence based practice, why use, why important, why not more, limitations?
-judicious use of whats considers to be current best practice when making decisions on client care
-to support what we did was effective
-in code of ethics
What level of evidence is the strongest?
Level 1- reviews multiple, well-designed, randomized controlled trials
Qualitative vs. Quantitative
-qualitative: level 5, tells us more about daily life and the persons experience, more subjective
-quantitative: level 1, easier to study
Describe assertive community treatment intervention.
-in 1970's, specialized type of case management that is available 24/7
-in response to deinstitutionalization movement
-goals: reduce admissions of people with mental illness at hospitals, develop community living skills, promote proper use of mental health services
-client can get services as long as they need it, whenever and where ever
Describe social skills training intervention.
-promote social skills
-5 key elements in how sessions happen: warm up, instructions, act, feedback, homework
-4 primary techniques: prompting, shaping, reinforcing, modeling
-3 basic models: basic, social problem solving, cognitive remediation
-based on using positive or negative reinforcements to help behavior
Describe supported employment intervention.
-traditional vocational rehab "train and place" vs individualized placement training "place and train"
- 7 key principles
Describe cognitive-behavioral therapy intervention.
-thoughts promote to our behavior
- can improve emotions by avoiding distortited thinking
-in groups or individual
-if you can change thought behavior then you can change behavior
Describe family intervention.
- how the family responds to having an individual with a mental illness in their family
-the person has a better outcome if the family supports them
-reduce number of relapse rates, enhance social skills, reduce family members stress so they can be more supportive
-evidence shows there is a decrease in relapse rate with family intervention
Describe motivational interviewing intervention.
1. express empathy
2. develop discrepancy
3. Roll with resistance
4. Support self efficiency
-help change behavior like smoking, based on belief that people have to want to change but we need to encourage to change
Describe behavior therapy intervention.
-based on cognitive and behavioral approaches
-looking at validation and invalidation, coming together of acceptance and change
-OT is better at doing this
-4 modules: mindfulness, interpersonal effectiveness, emotional modulation, distress tolerance
-emotional regulation how are we with our responses and can we temper that, focuses on reducing self harm
-a qualitative measure of the amount of emotion displayed
-this high level of expressed emotion can worsen the prognosis in clients or be a risk factor for the development of psychiatric disease
What are the stigmas associated with mental health and what causes it?
- that the person or the family is the cause of the mental illness when really the environment plays a factor as well
What are the three interventions to decrease mental health stigmas?
-to adress public, student, and professional attitudes
-Alport says you need to have an attitude change to get to know the people whom we have a fear about and decrease the stigma
-4 ways alport feels that can decrease stigma is see everyone as equal, have common goals, enter group cooperation, have support from the people in charge
-to address self-stigma and self-efficiency
-supporting occupational justice
Describe labeling theory.
- if you have an unwanted label you may pick up those behaviors of that label or people will only perceive you as that label
- the problem with this theory though is who gets to make those labels those?
-3 stages: person realizes their label, person develops skills to live with that label, person starts to hide the disability they were labeled for
Describe normalization theory.
-we should decrease the differences among people and we should change people to be more open minded
Describe minority group perspective.
-political action approach
-want to decrease stigmas
Describe Rite of Passage theory.
-phases: diagnosed(surrounded by family because of sick role), transition and preparing for new role, incorporation where it becomes a part of who they are but not who they are.
What are the most commonly stigmatized diagnoses?
schizophrenia and alcohol and drug abuse
How do stigmas have an impact on families?
-they usually try to hide it, they decrease their social contact, they usually neglect other family needs
-lack of integration with cultural experiences and norms
- where the government restricts the opportunities
of stigmatized groups
-person who sees a disability from a social perspective
-understands the need to examine broader contexts beyond personal factors
Types of emotional responses
-subjective burden: dealing with the diagnosis, pain, and guilt
-objective burden: learning to cope, more practical
- families goes through life stages
-relationships go through stages
individuals go through stages but also the family goes through different ones
-normative and non-normative events
What four factors help with the coping for the family?
-have a large social support system
-positive self ethics
-belonging to NAMI
-feeling respected and valued
Describe the model of human occupation.
Has 3 primary areas: volition (motivation), habituation (patterns and routines), and performance capacity (underlying abilities)
Describe Allen's Cognitive Disabilities Frame of Reference
-cognition impact person ability to carry out their occupations and that it determines the ability to live alone or not
-help the family understand where the client is at
-help determine what they can do, will do, and what they may do
a short period of rest from something difficult
Multi-family psycho-education group
A group of families and caregivers who participate in psycho-education. They are supportive of people with mental illnesses working together with mental health professionals as part of a treatment plan
-providing people with illnesses ways to co-manage their illness.
-when a person changes in their behavior due to other groups and they modify their culture to the one they live in now
-where you look at things through your own standards and experiences
-look at things through your own perspective
Describe counseling psychology model.
- capacity to be aware of your own assumptions and biases
-understanding our clients worlds view
-ability to develop appropriate intervention strategies
Describe culture emergent model.
-believes we learn culture by observing patterns and behaviors and it exist with us forever but we can change it
Describe Kawa model.
-not really client centered
-community is more important
-looks at flow of a persons life and trys to keep it flowing in the world
-social and cultural environments
-sensitivity to culture and religion
-these sensitivities help the optimal care of clients
-where a practitioner has the ability to decide on what he/she knows about his/her patients culture and if it fits into being treated
-approaching each new person without assumptions, while considering cultural hypothesis about that person that may or may not be tested
-provides cultural specific care to individuals and families of particular cultures
Describe supported housing.
-helping the person be matched to the specific housing that they need
-keeping your home is based on keeping their lease agreements
-housing is typical of a surrounding community
Describe Fairweather lodge.
-focus on creating work opportunities
-small family like units
-members are responsible
Weaknesses of the linear continuum paradigm.
-moving from level to level so that disrupts relationships
-skills in one setting aren't always transferable to the next
-settings often lack choice and freedom
-staff make the placement settings
How can OT work with support housing ?
-meet tendency obligations
What are Mosbys Hierarchy of needs? (1st motivational theory)
-biological (going up)
Describe approach/ avoidance models. (2nd motivational theory)
-we approach what we think we can do
-BAS: behavioral activation system, positive emotions
-we avoid what we think we can't do
-BIS: behavioral inhibition system, negative emotions, alerts us to threats
Describe self-efficiency. (3rd motivational theory)
-belief in your own capability
-primary driving force is the belief in the fact that we can do it
-comes from mastery(strongest), modeling(motivated by people similar to us), social persuasion, and somatic/emotional states(physical/emotional response to activity can encourage it or not encourage it)
-3 ways people meet goals: personal agency (your belief), proxy agency(someone believed in you when you didn't), or collective agency(people working together)
Describe self- determination. (4th motivational theory)
Intrinsic motivation- within us but dependent on 3 psychological needs: competence, autonomy, and relatedness
Extrinsic motivation- to obtain an outcome separate from the activity
Describe Flow theory of motivation. (5th motivational theory)
-intense and focused concentration on activity
-merging action and awareness
-self-regulation of motivation
-loss of self-consiousness
-ex. if you're a gamer and you get so focused on it and all of a sudden its three hours later
Describe Trans-theoretical model. (6th motivational theory)
-maintenance( having new behavior activity)
-may be a relapse
Describe dynamic systems theory.
-volitional system: interests, values, and personal causation
How does schizophrenia impact motivation?
-avolition: not wanting to do anything
How does attention deficit disorders impact motivation?
-seek rewards, diminished sensitivity to reinforces
-too much motivation
How do mood disorders impact motivation?
-approach/avoidance behaviors depending on mood
How do substance abuse disorders impact motivation?
-arent worried about the consequences
-BIS needs to be increased
-seek high need for reward needs to be modified
How do intellectual disorders impact motivation?
-motivation to master something decreases with age
-person has more failures as tasks become harder
What is the GAS scale?
-assesses individual progress regardless of outcome
-2 to +2 negative is lower that expected outcome, positive is higher than expected outcome
Describe motivational interviewing.
-for people who are not ready to make a change like somebody quitting smoking
-express empathy, develop discrepancy, roll with resistance, support self-efficiency
Describe re-motivation process.
-exploration to competency then to achievement
-usually start at exploration and go to achievement
What are the two coping strategies?
-emotion or problem focused
-approach or avoidance oriented