Ch 14 Psychosocial approaches & Theories

Question 1

Cognitive disabilities model: automatic actions, level 1

Answer 1

Requires total cog assist. automatic motor responses and changes in autonomic nervous system. conscious response to external environment is minimal.

Question 2

Cognitive disabilities model: Postural Actions, Level II

Answer 2

Requires max cog assist. movement associated with comfort. Some awareness of large objects in environment, may assist caregiver with simple tasks. ADLs are accomplished by imitating the caregiver. Able to eat finger foods.

Question 3

Cognitive disabilities model: Manual Actions, Level III

Answer 3

Requires mod cog assist. beginning to use hands to manipulate objects, may be able to perform a limited number of tasks with long-term repetitive training. One-step, familiar and action-oriented (not goal oriented).

Question 4

Cognitive disabilities model: Goal Directed Actions, Level IV

Answer 4

Requires min cog assist. characterized by ability to carry simple tasks through to completion. Can perform 2-3 steps. Cannot problem solve. Task set up is required. Relies on visual cues. perform established routines but can’t cope with unexpected. Can be left alone at level 4.6. Groups: could participate in goal-directed activities such as crafts.

Question 5

Cognitive disabilities model: Exploratory Actions, Level V

Answer 5

Needs standby or supervision for cognitive assist. trial and error problem solving. are able to follow 4-5 step processes at a time. New learning occurs. Problems with judgment, reasoning, planning, semantic memory, episodic memory. May be the usual level of functioning for 20% of population.

Question 6

Cognitive disabilities model: Planned Actions, Level VI

Answer 6

absence of disability. Person can think of hypotheticals and do mental trial and error problem solving.

Question 7

Evaluation groups

Answer 7

used to gather info about task and group interaction skills to establish goals and intervention plan. Often still therapeutic through process/content.

Question 8

Task-oriented groups

Answer 8

Psychodynamic approach. assist members in becoming aware of needs, values, ideas, and feelings through performance of shared task. A task-oriented group presents opportunities for participants to practice situations they may encounter in daily life. A group environment in which conflicts are likely to occur can help participants practice resolving conflict in appropriate ways

Question 9

Developmental groups

Answer 9

purpose is to acquire and develop group interaction skills. includes 5 levels of interaction groups: parallel, project, egocentric, cooperative, and mature

Question 10

Parallel groups (developmental groups)

Answer 10

use individual tasks with minimal interaction required

Question 11

Project groups (developmental groups)

Answer 11

common, short term activities requiring some interaction & cooperation

Question 12

Egocentric groups (developmental groups)

Answer 12

require interaction on long term tasks, but completion of task is not the focus. Members beginning to express their needs and address those of others

Question 13

Cooperative groups (developmental groups)

Answer 13

learn to work together cooperatively, not specifically to complete task but to enjoy each others company and meet emotional needs

Question 14

Mature groups (developmental groups)

Answer 14

responsive to all members needs and can carry out variety of tasks. Good balance between carrying out task and meeting needs of members.

Question 15

Thematic groups

Answer 15

designed for learning specific skills

Question 16

Topical groups

Answer 16

focus on discussion of activities and issues outside of group that are current or anticipated

Question 17

instrumental groups

Answer 17

concerned with meeting health needs and maintaining function

Question 18

MOHO key points

Answer 18

3 inherent human elements: volition, habituation, performance capacity. Intervention focuses on occupational engagement that includes activities that are purposeful, relevant, and meaningful. MOHO groups can be focused around specific roles such as parenting (using The Role Checklist)

Question 19

Modular groups

Answer 19

individual can join anytime and still cover all topics as each session is rotated through a continuous cycle

Question 20

Life-Style Performance Model

Answer 20

Performance is measured in function in four domains: self-care, intrinsic gratification (fun), service, reciprocal relationships. Focuses on the “doing” or activity patterns that support a satisfying lifestyle.

Question 21

psychoeducational groups

Answer 21

uses classroom format and the principles of learning to provide information and teach skills.

Question 22

basic task skills group

Answer 22

develop basic cognitive skills for completion of simple tasks. skill acquisition focus vs psychodynamic approach of task-oriented groups.

Question 23

PEO key points

Answer 23

Occupational performance is considered the outcome the transactional relationship between people, their occupation, and the environment. Considers the transactional relationship between people, their occupation, and the environment.

Question 24

Cognitive Behavioral Therapy (CBT), Assessments & Groups

Answer 24

Alter negative thoughts and behaviors about themselves and the world. Evaluation: Beck Depression Inventory is the primary tool. Dialectical Behavior Therapy (DBT) is a form of CBT. Intervention includes DBT teaching assertiveness, coping, and interpersonal skills. Eliminate maladaptive thinking. Groups focus on shaping behavior, chaining steps, reinforcement, and practice. Example: Cognitive–behavioral therapy approaches in OCD include helping the client overcome the tendency toward compulsive behavior by identifying the triggers to a compulsive episode, planning a strategy for overriding the compulsion, and continuing to do the activity or task.

Question 25

EHP

Answer 25

Emphasizes the role of natural context and how the environment impacts task performance. Understanding how the environment can be adapted, modified, and restored to enable effective performance. Evaluation includes checklists designed for the model and The Sensory Profile. Modifying or adapting task tools is an intervention strategy of the Ecology of Human Performance Model.

Question 26

OA

Answer 26

Outcome: Increase adaptability, relative mastery, self-evaluation. As person becomes more adaptable, occupational performance improves. Intervention focuses on increasing the skills needed for occupational adaptation.

Question 27

Role Acquisition Model

Answer 27

Individual employs task and social skills to meet the demands of personally desired and necessary roles. Intervention focuses on the acquisition of specific skills needed to function in an environment.

Question 28

Cognitive disabilities model evaluation tools (4)

Answer 28

Allen cognitive level screen: leather lacing to determine cognitive level. Allen diagnostic manual: crafts to evaluate or treat. Routine Task Inventory: gathers data about ADL performance from caregiver. Cognitive Performance Test: Assesses functional performance of people with psychiatric or cognitive dysfunction

Question 29

Recovery Model

Answer 29

Primary focus is to improve quality of life through self-advocacy. Empower people by fostering intrinsic motivation. Conceptualize recovery from illness as a journey of healing transformation. Intervention includes a Wellness Recovery Action Plan (WRAP), storytelling, advocacy.

Question 30

Activities Health Assessment

Answer 30

Assesses underlying skills and habits, time usage, and life satisfaction by having the person construct a schedule which depicts how their typical week is spent.

Question 31

Phases of adjustment

Answer 31

shock, anxiety, denial, depression, internalized anger, externalized anger, acknowledgment, adjustment

Question 32

Managing Problem Behaviors: Hallucinations (generated by the mind)

Answer 32

create environment free of distractions that trigger such thoughts
use high structured simple, concrete activities that hold the client’s attention
redirect person when they are hallucinating to reality-based thinking and actions

Question 33

Managing Problem Behaviors: Delusions (rooted in reality)

Answer 33

Redirect the person’s thoughts to reality-based thinking and actions.
Avoid discussions and other experiences that focus on and validate or reinforce delusional material.

Question 34

Managing Problem Behaviors: akathisia (always feeling restless)

Answer 34

Allow the person to move around as needed if it can be done without causing disruption to the goals of the group
Keep in mind that participation on many levels and in many forms can be beneficial to the individual
Whenever possible select gross motor activities over find motor or sedentary ones

Question 35

Managing Problem Behaviors: akathisia (always feeling restless)

Answer 35

Allow the person to move around as needed if it can be done without causing disruption to the goals of the group
Keep in mind that participation on many levels and in many forms can be beneficial to the individual
Whenever possible select gross motor activities over find motor or sedentary ones

Question 36

Managing Problem Behaviors: Offensive behavior (physical or verbal)

Answer 36

Set limits and immediately address the behavior during the session
Reasons the behaviors are not acceptable should be clearly presented in a manner that is non-confrontational or judgmental
The consequences of continued offensive behavior should be clearly communicated
All other patient should be protected from any threats - the needs of the other members should be kept in mind

Question 37

Managing Problem Behaviors:Lack of initiation/participation

Answer 37

Together with the individual identify the reasons for lack of participation (e.g. lack of skill, irrelevance of activity, attention deficits, embarrassment, depression)
pay attention to motivational hints: clients are more likely to participate if they are interested in the activity or have ownership of the activity. Success and fun and motivating. Positive feedback and rewards are motivating. Try to find out with the persons motivators are. Food can be motivating. Curiosity can be motivating. Using secondary motivators such as praise is usually preferable to using primary reinforcers such as food.

Question 38

Managing Problem Behaviors: manic or monopolizing behavior

Answer 38

Select or design highly structured activities that hold the individuals attention and require a shift of focus from patient to patient. Thank the individual for their participation and redirect attention to another group member. Create boundaries and limits. (see offensive behaviors).

Question 39

Managing Problem Behaviors: escalating behavior

Answer 39

Avoid what can be perceived as challenging behavior such as eye contact and standing directly in front of the patient.
Maintain a comfortable distance
actively listen
use a calm, but not patronizing tone (speak more softly than the individual to bring their voice down.)
Speak simply clearly and directly

Do you not make or communicate value judgments about the individuals thoughts feelings or behaviors
clearly present what you would like the person to do
avoid positions where either you are the patient feels trapped
individuals most often calm in response to the above interventions- if they do not work, move the patient from the area and get help.

Question 40

Psychoanalytic & Psychodynamic Theory & Groups

Answer 40

The cornerstone of mental health practice. Use as a mechanism to improve self-identity and to improve interpersonal relationships. Gain control of unconscious and develop insight. Psychodynamic groups allow participants to explore symbolic meanings of activities, such as magazine collages, clay, or painting.

Question 41

Clubhouse Model

Answer 41

Community centers that provide support and work and recreational opportunities for people with mental illness. Focus on strengths rather than weaknesses. No therapists or psychiatrists are on staff.

Question 42

Semantic memory

Answer 42

Semantic memory includes things that are common knowledge, such as the names of colors, the sounds of letters, the capitals of countries and other basic facts acquired over a lifetime.

Question 43

Episodic memory

Answer 43

memory of autobiographical events (times, places, associated emotions, and other contextual who, what, when, where, why knowledge) that can be explicitly stated. It is the collection of past personal experiences that occurred at a particular time and place.

Question 44

Universality

Answer 44

the curative factor gained from other members’ sharing of similar feelings, thoughts, and problems.

Question 45

Catharsis

Answer 45

the release of strong feelings about previous or present experience