Chapter 5 Flashcards

1
Q

Why is motivation so important in OT

A
  • it provides the foundation for understanding an individual’s participation in occupation
  • > motivation is the drive behind what we choose to do
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2
Q

What are the three steps in starting to help patients in OT

A

1) directing
- >tell people what to do and how to go about it

2) Guiding
- >it involves listening and offering expertise where needed

3) Listening
- >interested in what the other person has to say
- >seek to understand and respectfully refrain

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3
Q

What does prepatory change talk consist of?

Think of the acronym DARN

A

D-desire
->”I want or I wish or would like to or I hope to”

A-ability
->”what we believe we can do”

R-reason
->”background for making the change, the why”

N-need

  • > has an urgency component to it
  • > “If i don’t make a change, my diabetes will worsen significantly”
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4
Q

What does motivating change talk consist of?

Think of the acronym Cats

A
  • commitment
  • > commitment language signals the likelihood of change
  • > commitment language is what people use to make promises to each other
  • > include phrases like, “I will”, “I swear”, “I guarantee”
  • activation
  • > this is the language that indicates movement towards an action
  • > this is not like a binding contract but does suggest the person is moving in that direction of change
  • > include phrases like, “I am willing to”m “I am ready”, “I am prepared”
  • Taking steps
  • > this is language that indicates a person is already taking steps towards change
  • > “I called my friend to make a time to go walking”
  • > “I went to my first group therapy session”
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5
Q

What are theories that explain motivation

A
  • Maslow’s Hierarchy of Needs
  • Approach/Avoidance Model
  • Self Efficacy
  • Self determination theory
  • Flow Thery
  • Transtheoretical Model
  • Model of Human Occupation
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6
Q

What does the transtheoretical model do

A
  • it helps to set up a plan that is appropriate for our client
  • > helps identify why something may not be working
  • can provide a point of reference for our clients
  • > so they can identify where they are at in the process of change

-it is a cycle, relapse is expected and a natural part of the process

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7
Q

What are the steps of the transtheoretical model

A

Pre-contemplation

Contemplation

Planning

Action

Maintenance

RELAPSE

  • then from relapse, it goes all the way back to precontemplation
  • in pre-contemplation and action, you can move forwards and backwards
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8
Q

How does the volitional subsystem in MOHO relate to motivation

A
  • volitional subsystem is linked more frequently to motivation
  • volition provides:
  • > motivation for occupation
  • > choice of occupation
  • > the way people engage in their chosen occupations
  • the volition subsystem consists of:
  • > values
  • > interests
  • > personal causation
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9
Q

What are common self perception concepts that appear in the OT literature

A

-they are self esteem, self efficacy, personal causation or a sense of agency, self awareness and self identity

  • low self esteem and low self efficacy affect personal causation
  • > people will feel like they have less control over their lives
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10
Q

What are beliefs

A
  • the lenses through which we view the world
  • beliefs are the bedrock of behavior and the essence of our affect
  • they are shaped and shifted through our interactions with others and the environment we live in
  • beliefs resides in what we think, what we feel and what we do
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11
Q

What are the three types of beliefs

A

Surface beliefs
->automatic thoughts

Intermediate beliefs
->values, attitudes and rule of living

Core beliefs or schemas
->beliefs about ourselves our world and the future

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12
Q

What is the difference between constraining beliefs and facilitative beliefs

A
  • constraining beliefs decrease solutions and options to problems
  • facilitative beliefs increase solution options
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13
Q

What is trauma

A
  • refers to an experience or experiences that overwhelm an individuals ability to cope or integrate ideas and emotions involved in that experience
  • > it is an experience that threatens or harms a person
  • > has a serious negative effect on a person’s physical, emotional, social and spiritual wellbeing
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14
Q

What parts of the brain can trauma effect

A
  • pre-frontal cortex
  • > affect the planning and making decision aspect of our brain
  • amygdala
  • > after trauma, the amygdala can become overstimulated and as a result it looks for a threat everywhere

underactive hippocampus

  • > killing of the cells in the hippocampus due to stress
  • > this results in less memory consolidation
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15
Q

What is PTSD characterized by

A
  • characterized by 4 main symptom clusters
  • intrusion
  • > the re-experiencing of a traumatic memory
  • > there does not need to be a trigger for it
  • persistent avoidance
  • > avoidance is extreme
  • > triggers lead to avoidance
  • persistent negative thoughts and feelings
  • marked alterations in arousal and activity
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16
Q

What are the four principles and practice of trauma informed care

A

1) Trauma awareness
- >how common trauma experiences can be
- >acknowledge various coping strategies

2) Emphasis on Safety and Trustworthiness
3) Opportunity for Choice, Collaboration and Connection
4) Strengths Based and Skill Building

17
Q

What is motivational interviewing

A

-a collaborative conversations style used as a way of strengthening a persons own motivation for change

  • it has its roots in addiction counselling
  • > it has been well researched over the last 36+ years and continues to be a popular way of interacting with people

-it can be used fro short interactions, be an intervention on its own or paired with other treatment perspectives

18
Q

Does motivational interviewing sit on the conversation continuum?

A
  • yes

- >it starts off with directing then moves to guiding and ends with following

19
Q

What is righting reflex

A
  • it is the desire to fix what is wrong with people
  • > and to quickly set them on a better course
  • > it relies heavily on DIRECTLY
20
Q

Does motivational interviewing try to resits righting reflex

A
  • yes

- >it is a key concept to resist righting reflex

21
Q

What are the 4 aspects of motivational interviewing spirit

A
  • partnership
  • acceptance
  • compassion
  • evocation
  • > the act of bringing or recalling a feeling, memory, or image to the conscious mind
  • > note that ideas about change are already in a person
22
Q

What are the four components of acceptance within motivational interviewing

A

1) Absolute worth
- >unconditional positive regard
- >when people are accepted as they are, they are mobilized to change

2) Accurate empathy
- >an active interest and effort to understand a person’s internal perspective
- >to see the world through their eyes
- >it is about meeting the person where they are at
- >the opposite of empathy is imposing your own perspective

3) Autonomy
- >we do not have to agree with what clients choose to do
- >we have to respect that they are able to make that decision

4) Affirmation
- >to seek and acknowledge the person’s strengths and efforts
- >this is more than appreciating

23
Q

What are the core skills of motivational interviewing

-use the acronym oars

A

O-open ended questions

A-affirmations

R- reflection

S-summary

24
Q

What are the 4 processes of motivational interviewing

A

1) Engaging
- >resisting the righting reflex, explore motivation, being empathetic and empowering the patient

2) Focusing
- >collaboratively identifying the goal of the MI session or ongoing counselling

3) Evoking
- >thought of the as the heart of MI
- >change talk happens in this process
- >simplest method to evoking is to ask open ended questions

4) Planning
- >move from discussing importance to an actual change plan
- >moving from evoking to planning is a clinical judgement