chapter 11 Flashcards
A sensory experience that has no basis on external reality?
Hallucinations
Hearing voices, seeing animals, people, or lights, and feeling burning or crawling sensations on the skin?
Common Hallucinations
Most common may hear voices telling them to do something or criticize them or may hear music or strange sounds or someone calling their name. The sounds may be higher or softer then they actually are.
Auditory Hallucinations
Common may involve seeing walks move, having one’s face look strange in the mirror, or thinking people look transparent or flat.
Visual Hallucinations
This is usually unpleasant to the patient
Gustatory/olfactory Hallucinations
May be of itching or burning or a feeling that insects are crawling on our biting one’s skin
Tactile Hallucinations
- May be unable to perceive reality accurately enough to interact safely or effectively with environment
- may become frightened or agitated by hallucinatory content and may experience feelings of shame & isolation
- may be unable or unwilling to interact with others due to preoccupation with amount of overstimulation from Hallucinations
- usually motivated to be more in contact with reality
Predictable functional deficits/strengths
Schizophrenia, depression, mania, some personality disorders, dementia, and some physical illnesses
Where Hallucinations can be found
- Reassure a client and help them understand what is happening to them
- talk calmly, firmly, naturally, rhythmically, soothing manner
- avoid sarcastic comments
- try and redirect the clients attention to some neutral topic or activity and try to draw the person back to reality
- use grounding techniques
Therapeutic use of self for Hallucinations
Make the environment calm, quiet and nondistracting. DO NOT ISOLATE PERSON
Environment setting for Hallucinations
- Keep activities simple, highly structured, and interactive.
- DO NOT include fine motor coordination or detail due to intrusion of Hallucinations.
- DO NOT ALLOW TO WORK ALONE.
Appropriate activity guidelines for Hallucinations
A belief that is contrary to reality as experienced by others in one’s cultural group
Delusions
The belief the TV shows or newspapers have special messages
Ideas of reference
The belief that “they” are taking thoughts out of one’s head
Thought withdrawal
The thought that “they” are inserting thoughts into one’s head
Thought insertion
The feeling of being followed
Delusions of persecution
Feeling of having special powers
Megalomania or Delusions of grandeur
The delusion that someone is in love with you
Erotomania
Belief that something is horribly wrong with one’s body
Somatic
- Sometimes hard to recognize
- DO NOT reinforce or feed into delusional system
- DO NOT patronize client
Therapeutic use of self for Delusions
Should be relatively stimulating and provide opportunities for persons to get involved in real life activities of meanings
Environment for Delusions
- Should be suited to the person’s good intelligence,
- higher verbal & cognitive skills
- use activities that support the person’s occupational roles&interests
- DO NOT use activitiesthat are in any way related to the person’s Delusions
Guidelines for activities for Delusions
A type of thinking in which persecutory and grandiose ideas predominate
Paranoia
Hyper alertness, highly suspicious. Always scanning
Paranoid ideation
Extreme and unbelievable ideas (someone is out to get them)
Paranoid Delusions
- understand their world viewed and situation
- approach slowly
- use clear communication and congruent actions
- when in groups~om to keep person close to increase sense of safety
- stay in control as a leader
Therapeutic use of self for Paranoia
- Keep it stable and predictable, prepare client for transition or change
- support isolation until person can increase interaction
- watch if threatened do not block and always provide a path to exit
Environment for Paranoia
- used client controlled, structured, complex activities using easily controlled materials
- give supplies/directions all at once
- allow individual, independent work
Guidelines for activities for Paranoia
