Chapter 11 : Responding to Symptoms and Behaviors Flashcards
event that provokes the behavior
Antecedent Cause
the assistants own personality, the way he or she talks and acts towards the person in his or her care (synonymous with therapeutic use of self)
Self
the context in which your interaction with the client takes place
Environment
the thing that you and the client are doing together
Activity
A state of tension and uneasiness caused by conflicts that the ego is unable to resolve
Anxiety
These are strategies of what diagnosis:
1) encourage clients to talk about what is bothering them & express how they feel
2) focus 1st on what clients are concerned about
3) listen to their fears and redirect their attention to neutral topic
Anxiety
A feeling of intense sadness, despair, and hopelessness
Depression
These are strategies of what diagnosis:
1) allow client to talk about what is bothering them
2) OTA should listen and reflect back to what he/she hears clients saying but should never agree that situation seems hopeless
3) Reinforce good hygiene
4) Accept clients feelings
5) Be clear when giving directions and don’t give them too many choices
6) Avoid praising - acknowledge instead
7) Don’t try to cheer up client
8) Watch for suicidal remarks
Depression
A disturbance of mood characterized by excessive happiness (euphoria), generosity (expansiveness), irritability, distractibility, and increased activity level
Mania
These are strategies of what diagnosis:
1) Be aware of flattery
2) Be cautious in giving praise
3) Calm, matter of fact, firm, consistent
4) Be firm on supplies and materials - don’t let them overrun clinic
5) Give structure
Mania
A sensory experience that does not correspond to external reality
Hallucinations
These are strategies of what diagnosis:
1) Try to reassure and help them understand what is happening “I believe you see rats in the corner, but they are not really there. It’s your disease that makes you see them”
2) Calm, rhythmic, soothing talk
3) Don’t argue
4) Repeat word of phrase that is comforting to them “I am safe here”
Hallucinations
A belief that is contrary to reality as experienced by others in one’s cultural group
Delusions
taking ideas from brain
thought withdrawal
putting thoughts in brain
thought insertion
being followed or hurt
delusions of persecution
special power or powerful
megalomania or delusions of grandeur
delusions of someone being in love with you
erotomania
something is horrible wrong with your body
somatic delusions
These are strategies of what diagnosis:
1) Avoid discussing the person’s delusions
2) Re-direct persons attention
3) Don’t try to convince them it is not true
Delusions
A type of thinking in which persecutory and grandiose ideas predominate
Paranoia
These are strategies of what diagnosis:
1) Don’t approach suddenly
2) No whispering
3) Approach as intellectual equals
4) They have extraordinary memories
5) Don’t argue
6) Clear, consistent directions
7) Don’t promise things, be truthful
Paranoia
A strong feeling of displeasure
Anger
An unfriendly and threatening attitude directed toward other people
Hostility
An attack on a person or object; can be verbal, physical or both
Agressions
These are strategies of what diagnosis:
1) Be alert to signs of tension coming
2) Talk about what is bothering them
3) Be direct and clear about what you expect
4) Don’t be alone
5) Try to speak to person privately
Anger, Hostility, Aggression
Any behavior that would normally be seen as explicitly (openly) sexual or as provoking a sexual response
Seductive Behavior and Sexual Acting Out
These are strategies of what diagnosis:
1) Talk to them in calm, nonjudgemental manner
2) Setting rules should be strictly enforced
3) Avoid physical contact
4) Explain nature of therapeutic relationship
5) Have another staff work with client
Seductive Behavior and Sexual Acting Out
An impairment or defect in one or more of the mental functions needed for thinking
COGNITIVE DEFICITS: Confusion and Impaired Memory
These are strategies of what diagnosis:
1) Be clear, concise, concrete and consistent
2) Speak slow, use common terms
3) Match your tempo with what patient can handle
4) 5 C’s - calm, clear, concise, concrete and consistent
COGNITIVE DEFICITS: Confusion and Impaired Memory
Problems in directing attention to a task or in sustaining attention for a reasonable length of time
Attention Deficits
Lack of planning and order that interferes with successful completion of activities
Disorganization
These are strategies of what diagnosis:
1) say name loudly to get attention
2) firm but gentle touch on arm or shoulder
3) environment should avoid distractions
4) simple crafts
Attention Deficits & Disorganization
What diagnosis states that the first activities used should be ones at which the person is guaranteed success?
Depression
What diagnosis should use activities with strong sensory stimulation (music, dance, films, cooking)?
Hallucinations
What diagnosis should use intellectually challenging verbal activities… board games, current events, puzzles, word games… computer?
Delusions
What diagnosis should use have clients work independently without much need for instruction?
Paranoia
What diagnosis should use active sports - gross motor to release tension, sanding large projects?
Anger, Hostility, Aggression
What diagnosis should use forceful gross motor activities without physical contact and do things in their own personal space - protected from sudden touch, smell and warmth of others?
Seductive and Sexual Acting Out
These are strategies of modifying the enviro for WHO?
Safe, subdued
Limit stimulators (gradual increase w/comfort)
Reduce lighting & noise level
One-on-one
Encourage decision making skills gradually
Provide opportunities to make choices
Depression
These are strategies of modifying the enviro for WHO?
Eliminate or reduce distractions.
Solo activity, facing a blank wall.
Mania
These are strategies of modifying the enviro for WHO?
AVOID stressful & overstimulating; isolation
PROVIDE quiet, calm, & non-distracting
Hallucinations
These are strategies of modifying the enviro for WHO?
Relatively stimulating
Provide opportunities for involvement in real-life activities.
Delusions
These are strategies of modifying the enviro for WHO?
Stable & reliable (less change is better)
Prepare client for any changes
Tolerate & support those who isolate until client is comfortable
DON’T FORCE social contact
Gradually encourage group participation (even if just sitting on the outside and watching)
Paranoia
These are strategies of modifying the enviro for WHO?
Isolate client from others who irritate them
Stand 4-5 ft. away, to the side, not facing the person directly
Don’t be alone w/client who may be violent
Leave room door open & position youself closer to door than client
Don’t touch client
Remove all sharp objects & potential weapons (brooms, mops)
Anger, Hostility, Aggression
These are strategies of modifying the enviro for WHO?
Solo work, facing blank wall
Limit tools/supplies
May need vigorous stimulation to grab attention
Play classical and/or favorite music (monitor if distracting)
Attention Deficits and Disorganization
