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Psychosocial FORs and Models of Practice

Terms in this set (74)

-A psychosocial frame of reference
-Developed by Gail Fidler

-Principles:
-The Life-Style Performance Model seeks to identify and describe the nature and critical "doing" elements of an environment that support and foster achievement of a satisfying productive life-style
-It proposes a method for looking at the match between that environment the individual's needs
-Four hypotheses are proposed: 1)"Mastery and competence in those activities that are valued and given priority in one's society or social group have greater meaning in defining one's social efficacy than competence in activities that carry less social significance" 2) "A total activity and each of its elements have symbolic as well as reality-based meanings that notably affect individual experiences and motivation" 3) "Mastery and competence are more readily achieved, and the sense of personal pleasure and intrinsic gratification is more intense, in those activities that are most closely matched to one's neurobiology and psychological structure" 4) "Competence and achievements are most readily seen and verified in the end-product or outcome of an activity; thus the ability to do, to overcome, and to achieve becomes obvious to self and others" (Fidler, 1996, pp. 115-116)
-Performance and quality of life can be enhanced by an environment that provides for ten fundamental human needs
-Performance is measured in the quality of functioning in four domains: 1) self-care and maintenance; 2) intrinsic gratification 3) service to others 4) reciprocal relationships

Evaluation: focuses on obtaining and activity history and a life-style performance profile related to the 4 skill domains; environmental factors are explored

Intervention: addresses five main questions that identify the focus on interventions: "What does ht person need to be able to do?" "What is the person able to do?" "What is the person unable to do?" "What interventions are needs, and in what order?" "What are the characteristics and patterns of activitiy and the environment that will enhance the person's QOL?" Any interventions/activities that promote performance in the 4 domains are acceptable
emphasizes role of an individual's context (cultural, physical, and social environments) and how the environment impacts a person and their task performance. Applicable to people across the lifespan. 4 main constructs: person, tasks, context, and personal-context-task transaction
11 assumptions: ecology refers to the interaction b/w a person and their environment; person's performance is understood by looking at the relationship b/ the person, context, and task; performance occurs when a person acts to engage in taks w/in a context; each person is a unique individual w/ sensorimotor, cognitive, and psychosocial skills and abilities; the range of a person's performance is based on the transaction b/w the person and the context; skills that a person possesses can be increased/decreased due to illness and/or stress; contexts are dynamic rather than static; the roles that a person has in life are made up of tasks; there is a difference b/w a person's performance in their natural contexts and simulated experiences; people are empowered by increasing their self-determination; this model defines independence as using the supports in a person's context to meet their needs and wants.

Evaluation: utilizes checklists that were designed along w/ this model. These include checklists for the person, environment, task analysis, and personal priorities.

Intervention: 5 specific strategies: 1. establish and restore: enhancing a person's abilities by teaching skills lost due to illness/disability/never learned 2. alter: assessing a person's contexts to determine which is the best match for the person's abilities 3. adapt/modify: changing the context/task in some way so that it leads the person to successful performance 4. prevent: minimizing risks that might develop so that probs in performance do not develop 5. create: assisting person by promoting enriching and complex performances in the person's context
-A major psychosocial assessment
-An assessment of task performance
-Focus: assesses the cognitive, affective, performance, and social interaction skills required to perform activities of daily living
-Method: 1) brief interview prior to assessment to collect basic demographic and clinical information and to familiarize the individual with the evaluation 2) the Task Oriented Assessment (TOA) (measures cognition, performance, affect, qualitative signs, and referral indicators through the completion of 5 standardized, timed tasks [sorting shells, bank deposit slip, house floor plan, block design, draw-a-person]; evaluator observes and rates task performance but does not provide guidance for task completion) 3) The Social Interaction Scale (SIS) (assesses general ability to relate appropriately to other people within the environment through observations of the individual in 5 situations [one to one, mealtime, unstructured group, structured group activity, structured verbal group]) 4) optional self-report social interaction questionnaire 5) perceptual motor screening
-Scoring and interpretations of TOA: 1) scoring consists of 3 component, 12 parameter, and 5 task scores 2) ten functional components of the 5 tasks are rated (paraphrase, productive decision-making, motivation, organization of time and materials, mastery and self-esteem, frustration tolerance, attention span, ability to abstract, verbal or behavioral evidence of thought or mood disorder, ability to follow instructions leading to correct task completion) 3) norms are presented for comparison with specific adult psychiatric populations
-Scoring and interpretation of SIS: 1) scoring consists of 7 situations and 5 parameter scores as well as one total SIS score 2) seven categories are rated (response to authority figures, verbal communication, psychomotor behavior, independence/dependence, socially appropriate behavior, ability to work with peers, participation in group/program activities)
-Population: adult individuals with psychiatric, neurological, or developmental diagnoses