CRC Prep Flashcards
Prepare for the CRC exam
Workforce Investment Act
1998- Streamline workforce development services, designed for employees and employers, targets individuals with disabilities
ADA Title V
1990-MISC- can’t discriminate for being involved in an ADA complaint, insurance carrier’s can allow for pre-existing conditions
ADA Title IV
1990-Telecommunication- requires 24 hour relay services and must not cost more than voice services.
ADA Title III
1990-Public Accommodations- prohibits discrimination in goods, services and facilities, new construction must be accessible, failure to remove barriers if possible is discrimination.
ADA Title II
1990-Public Entities- State and Local Gov’t. Prohibits discrimination in govt services, no exclusion from public activities, focuses on public transportation- must have 1 accessible car on commuter trains
ADA Title I
1990-Employment- prohibits employment discrimination for private and govt, applies to employers with 15 or more workers, requires reasonable accommodations unless there is “undue hardship” to employer.
Americans With Disabilities Act
1990- most significant civil rights legislation for indiv. with disabilities. 5 Titles: I Employment, II Public Entities, III Public Accommodations, IV Telecommunications, V Miscellaneous
Rehabilitation Act - Title V
1973- 8 sections
501-non discrimination in hiring, recruiting, promoting
502-architectural and transportation barriers compliance
503-prohibits employment discrimination by Federal contractors
504- defines reasonable accommodations, prohibits discrimination in any federally supported activity
508- 1986 amendment- ensures access to computers and other electronics and access to Rehab Centers for VR
Rehabilitation Act
1973- Most significant act in the movement of disability rights. Enabled order of selection. consumer involvement a must. Includes case closure as a goal, supports rehab research and program evaluation. for individuals diagnosed with a disability that is a substantial handicap to employment and would benefit from increased employability.
Barden-Lafollett Act AKA Voc Rehab Act
1943-Expanded eligibility for services to people with intellectual and psychiatric disabilities.
Javits-Wagner-O’day Act
1971- Extended Purchase authority to sheltered workshops.
Wagner- O’day Act
1938-Helped sheltered workshops compete for federal contracts.
Randolph Sheppard Act
1936-priority service contracts for persons who were blind to operate vending stands on Federal property
Social Security Act
1935-Provided benefits for people with specific disabling conditions
Soldiers Rehabilitation Act
1918- helped to develop a priority of service to those who were injured in the line of duty
Smith Fess Act AKA Voc Rehab Act
1920- Expanded services to persons with other types of disabilities
Workforce Innovation and Opportunity Act (WIOA)
2014-replaced WIA will be enacted at least until 2020. requires collaboration of several workforce development programs. Emphasizes youth in transition, provides competitive integrated employment opportunities, improves services to employers and people w disabilities through Pre-ETS (pre-employment transition services)
Federal Register
Daily or weekly publication by national archives and records administration that contains federal agency regulations and rule changes
Federal Requirements
Term used to generally refer to federal laws and regulations.
Smith Hughes Act
1917-Provided education and vocational-technical training to displaced workers.
Code of Federal Regulations CFR
Codification of the general and permanent rules published in the federal register. Updated and printed 1x per year.
7 steps to this type of therapy
- Joining and accommodating
- Enactment
- Structural Mapping
- Highlighting and modifying interactions
- Boundary Making
- Unbalancing
- Challenging unproductive assumptions
Structural Family Therapy- Salvador Minuchin
Experiential Therapy Types
Gestalt, Person Centered, Reality Therapy
Thinks of family counseling as neutralizing triangles ie triangulation.
Family Systems Therapy- Bowen
Coined the term “thinking in circles”(fam therapy) or “thinking in lines” (Individual therapy)
Family Therapist: Nichols
Adlerian therapy- 4 stages
whole organism, interaction between person and environment. very positive, great for people who think they are failing in life.
4 stages:
1. establish cooperative relationship
2. assess client problems (insight into family and birthorder)
3. insight into client statements
4. reorientation to assist client in more effective beliefs and behavior
Adlerian- 4 major concepts
- Teleology-peoples goals for future influence present at least as much as they influence the future
- early recollections-perceiving family atmosphere rather than actual events is critical toward developing a lifestyle.
- lifestyle-comprehensive mosaic of individual beliefs and goals in relation to others in their life, which constitutes self worth.
- family constellation-family is seen as childs first social group. birth order determines social relationship formation until 6 or 7 then other social groups impact person.
Frued- Psychoanalysis- 5 psycho-social stages of development
Fixation or regression at any of these stages can result in dysfunction.
- Oral
- Anal
- Phallic-Oedipus complex- boys sexual attraction to mom; Electra complex-girls sexual attraction to dad
- Latency period- decrease in sexual interest
- Genital stage
Frued- Psychoanalysis- How many defense mechanisms?
Which one is the “only healthy defense mechanism”?
- Displacement-Directing hostility towards safe object
- Sublimation- (ONLY HEALTHY DEFENSE MECH)redirecting sexual or aggressive energy into creative channels.
- Regression- moving from advanced stage to lower stage
- Rationalization- believing or stating acceptable explanation for behavior as opposed to real explanation
- projection-attributing own desires and impulses to others.
- Denial- lacking acknowledgement of a threatening reality
- reaction formation-actively expressing opposite of a threatening impulse.
- Repression- Blocking threatening thoughts from entering consciousness.
- Ritual and Undoing- performing elaborate rituals to undo acts
- Compensation-Developing positive traits to make up for limitations
- identification-enhancing self work and compensating for a sense of failure by identifying with an organization or cause.
- Introjection- Taking on anothers values or standards
Sigmund Freud- Psychoanalysis concepts
instinctual drives, unconscious motivation, past experiences. Psyche = personality structure Id- primative impulses Ego-rational Superego- morality
Transference
Freud- clients unconscious redirection of experiences regarding someone else onto therapist
Countertransference
Freud- Experience of therapist placed onto client in response to transference.
counselor provides unconditional positive regard, empathy, genuineness/congruence. This approach is non-directive, non threatening, involves active listening, reflection and clarification. Clients perception more important than actual event.
Carl Rogers “Rogerian Therapy”person centered therapy-
Albert Ellis
Rational Emotive Behavior Therapy- ABC Model-
A- activating event
B- Belief about A
C- consequence
Thoughts affects feelings which affect actions. Therapist acts as teacher and directs session, dispute is common due to challenging faulty beliefs.
Possible add on D- Disputation of irrational beliefs and E- effective new rational beliefs
Examples of Cognitive Behavioral Therapy (CBT)
REBT- Albert Ellis
Cognitive Therapy- Aron Beck
Transactional Analysis- Eric Bernes
CBT
NO single theorist at the front of this widely practiced approach. Goal directed, structured and time limited.
Cognitive reframing- changes the meaning placed on events.
Cognitive restructuring- challenging dysfunctional automatic thoughts.
Transactional Analysis
Eric Berne- assumes a person is able to chose and redirect or reshape their own destiny. develops contracts before sessions and used frequently in group settings. Egos states- parent, adult and child 4 levels- Structural analysis Transactional analysis Game Analysis (life)script analysis- advanced analysis
William Glasser
Reality therapy-people are able to deal with their needs through a realistic and rational process. Used frequently in prisons or substance abuse programs.
uses choice therapy, praises responsible behavior, dissapproves of poor behavior, natural consequences vs punishment, no excuses.
Fritz and Laura Perls
Gestalt (WHOLE) therapy-primary goal of full integration of person. Verbal and Non verbal should be congruent ie actions match words. Moral injunctions: Live here and now Stop Imagining Stop unnecessary thinking Express Give in to unpleasantness accept no "should" or "ought" take full responsibility
Aron Lazarus
Multi-Modal Therapy- must be tailored to individual needs of client who is assumed to have multiple problems. Addresses BASIC ID Behavior Affect Sensations Imagery Cognition Interpersonal Relationships Drugs, biology
REBT
Rational Emotive Behavioral Therapy- Albert Ellis
ABC Model-
A- activating event
B- Belief about A
C- consequence
Thoughts affects feelings which affect actions. Therapist acts as teacher and directs session, dispute is common due to challenging faulty beliefs.
Possible add on D- Disputation of irrational beliefs and E- effective new rational beliefs
Multi-Modal Therapy- Aron Lazarus
Multi-Modal Therapy- must be tailored to individual needs of client who is assumed to have multiple problems. Addresses BASIC ID Behavior Affect Sensations Imagery Cognition Interpersonal Relationships Drugs, biology
This type of short term counseling develops resilience, empowerment, and recovery after an event that is overwhelming to ones psychological adaptation and coping skills.
Crisis Intervention
Polytrauma
more than one severe injury causing a traumatic response and arising after one traumatic event.
- injury to two or more body systems simultaneously
- TBI often occurs in polytraumatic experiences
- result in greater care intensity and caregiver burden
Multitrauma
More than one traumatic event causing a singular injury traumatic response
The 3 E’s of Trauma according to SAMHSA
Event, Experience, Effects
The 4 R’s of Trauma according to SAMHSA
Realizes, Recognizes, Responds, Resist Re-traumatization
SAMHSA’s Trauma Informed Approach
Six Principle Model
- Safety
- Trustworthiness/transparency
- Peer Support
- Collaboration and Mutuality
- Empowerment, Voice, Choice
- Cultural, Historical and Gender issues
Top 10 cause of death for people ages 15-24
Suicide
4 categories of risk for suicide
desire, capability, intent, buffers/connectedness
common link to suicidality
Mental Health Conditions
Tarasoff Ruling
1974- Duty to warn potential victims of harm as well as to protect clients from self-harm
Plan for keeping clients safe who are at risk
Safety Plan
Plans requiring notification, evacuation, emergency transportation, sheltering, access to medications and back up power, access to mobility devices while in transit or at shelters and access to information
Emergency Preparedness Plan
FEMA (Federal Emergency Management Agency) 4 steps for emergency preparedness
- Get informed
- Make emergency plan
- Assemble disaster supply kit
- Maintain both plan and kit
Developed the Emergency Preparedness Toolkit for Persons with Disabilities
Wisconsin Council on Physical Disabilities- 2017
7 categories for toolkit
11 therapeutic factors for what type of therapy?
- Instillation of Hope
- Universality
- Imparting information
- Altruism
- Corrective recapitulation of primary family group
- Development of socializing techniques
- Imitative behavior
- Interpersonal Learning
- Group cohesiveness
- Catharsis
- Existential factors
Group therapy
Emotional Fusion
unhealthy exaggerated need for others- Bowen Family Systems Therapy
Genogram
Family diagram that identifies triangles- Bowen Family Systems Therapy
Assists with routine adjustment and developmental experiences in a group setting
Group Counseling
Used to assist people with more profound adjustment, emotional or developmental maladaption.
Group Therapy
5 Stages of Group Development
Pre-group initial transition working final
attitude is comprised of these 3 components
cognitive, affective, and behavioral ie how people think, feel and act.
attitudinal barriers to disability
- Perceived cause
- Perceived responsibility
- Perceived threat
Congenital disability
present at birth- increased time and experience with the disability, may be more resilient due to no life experience without disability. Lifespan development occurs with the disability present.
Adventitious disability
occurring at any time over a persons life- often occurs without warning and occurs later in life after personality, self esteem and body image has developed. Disrupts plans, causes grief and loss response.
Developmental disability
developing over time- appear typical at birth. delays in typical development occur.
Elizabeth Kubler Ross- 5 stages of grief (can occur during disability adjustment, not just death)
Denial, Anger, Bargaining, Depression, Acceptance
- Initial Impact
- Defense Mobilization
- Initial realization
- Retaliation
- Reintegration
5 stages of adjustment to disability- many different models- but these are the general stages.
Achondroplasia
a form of short-limbed dwarfism. literal translation “without cartilage formation.”
Amyotropic Lateral Sclerosis
ALS/Lou Gehrigs Disease- progressive nervous system disease that affects nerve cells in the brain and spinal cord, causing loss of muscle control and eventual death.
Aphasia
It can affect your ability to speak, write and understand language, both verbal and written. Aphasia typically occurs suddenly after a stroke or a head injury.
Ataxia
the loss of full control of bodily movements.
Cerebral palsy- most common motor disability in childhood
considered a neurological disorder caused by a non-progressive brain injury or malformation that occurs while the child’s brain is under development. Cerebral Palsy primarily affects body movement and muscle coordination
Decubitus Ulcer
Technical term for bedsore or pressure ulcer
Encephalitis
infection or inflammation in the brain- usually caused by virus or bacteria
Hodgkin’s Disease
a type of lymphoma, which is a blood cancer that starts in the lymphatic system. The lymphatic system helps the immune system get rid of waste and fight infections
Huntington’s Disease
a fatal genetic disorder that causes the progressive breakdown of nerve cells in the brain. It deteriorates a person’s physical and mental abilities usually during their prime working years and has no cure.
Meniere’s disease
a disorder of the inner ear that can lead to dizzy spells (vertigo) and hearing loss. In most cases, Meniere’s disease affects only one ear. Meniere’s disease can occur at any age, but it usually starts between young and middle-aged adulthood.
Multiple Sclerosis
MS a potentially disabling disease of the brain and spinal cord (central nervous system).
In MS, the immune system attacks the protective sheath (myelin) that covers nerve fibers and causes communication problems between your brain and the rest of your body. Eventually, the disease can cause permanent damage or deterioration of the nerves.
Muscular Dystrophy
a group of genetic diseases that cause progressive weakness and loss of muscle mass. In muscular dystrophy, abnormal genes (mutations) interfere with the production of proteins needed to form healthy muscle. There are many different kinds of muscular dystrophy.
Myasthenia gravis
An autoimmune neuromuscular disorder that is characterized by fatigue and exhaustion of muscles. Abbreviated MG. MG is caused by a mistaken immune response
Poliomyelitis AKA Polio
an infectious viral disease that affects the central nervous system and can cause temporary or permanent paralysis.
Spina Bifida
a birth defect that occurs when the spine and spinal cord don’t form properly. It falls under the broader category of neural tube defects.
Brain, Brain Stem and Spinal Cord
Central Nervous System (CNS)-receive and transmit information throughout the body enabling functioning
Cerebral Cortex- Frontal Lobe
consciousness, initiating activity, emotional response, language, memory for habits
Parietal Lobe
visual attention, touch perception, goal directed voluntary movements
Occipital Lobe
affects functions of visual processing
Temporal Lobe
Hearing and memory acquisition
Brain Stem
breathing, heart rate, swallowing, sweating, blood pressure, digestion
Cerebellum
coordination of voluntary movement
How many vertebrae in spinal column
33
Cervical Spine
C1-C7
Thoracic Spine
T1-T12
Lumbar Spine
L1-L5
Sacrum
S1-S5
Coccyx
4 fused vertebrae
Most common spine injuries to which part of spine?
Neck
Most common work injuries
Lower back injuries
Bones, muscles, connective tissue like ligaments and tendons. This system supports the body and protects internal organs and enables movement
Musculoskeletal system
can physiological changes due to aging affect medication absorption rates?
YES
an impairment in a major life activity resulting from a medical condition.
Functional Limitation
State/federal agencies provide eligibility-based vocational rehabilitation services to individuals with disabilities. Eligibility criteria include these 4 things:
- An individual must have a disability;
- It creates an impediment to obtaining, maintaining, or improving employment;
- The individual requires vocational rehabilitation services to obtain, maintain, or improve employment.
- Receiving Social Security (SSI/SSDI) results in presumptive eligibility.
mobility, communication, self-care, self-direction, interpersonal skills/acceptance, work tolerance, and work skills/work history
7 functional limitation domains provided by the Rehab Act of 1973
Mobility- functional limitation
Involves a person’s ability to move from one place to another at work and in the community. A person may require - or already utilize - others or assistive devices as a means to navigate their environment;
Communication- functional limitation
Includes talking, listening, understanding, and reading/writing related to vocational task engagement;
Self-care- functional limitation
Is defined as the ability to perform activities of daily living such as eating, toileting, grooming, dressing, cooking, shopping, washing, housekeeping, money management, and fulfilling health and safety needs as they relate to employment;
Self-direction- functional limitation
Refers to the ability to independently and effectively plan, initiate, and organize work tasks and to make decisions related to employment;
Interpersonal skills/acceptance- functional limitation
Describes the ability to establish and maintain interpersonal relationships. This also includes acceptance by others (a disability may cause behavior which is difficult for others to understand and accept).
Work Tolerance- functional limitation
is the physical, cognitive, and psychological capacity to meet the demands of the workforce. This may include the performance of the physical demands in a job (e.g. stamina, gross/fine motor skills, somatosensory, range of motion, and muscle strength, tone, reflex, psychomotor issues, etc.).
Work Skills/Work History- functional limitation
addresses the ability to demonstrate necessary entry-level work skills or experiences to attain employment (we determine whether there a reasonable expectation that a person is able to engage in work activities without training). A negative work history is demonstrative of numerous negative work experiences due to disability (short duration jobs, terminations, poor reviews, etc.).
Universal Design
UD can be used to reduce environmental barriers for people with disabilities. UD is defined by the Center for Universal Design at North Carolina State University as “the design of products and environments to be usable by all people, to the greatest extent possible, without the need for adaptation or specialized design.“
“An individualized, work-oriented process that employs simulated or actual work situations structured to progressively increase work-related strength, stamina, and productivity.”
Work conditioning or work hardening
Breakdown of disabling conditions (4 parts)
disability, impairment, activity limitation, and participation limitation
“a client has a spinal cord injury (disability), the impairment is paralysis, an activity limitation may be independent use of public transportation and a participation restriction may be a [subsequent] lack of…ability to participate in church”
How many adults experience mental illness
1 in 5
How many adults live with a serious mental illness
1 in 25 (4.05%)
To diagnose a major depressive episode there must be five or more of the following symptoms during the same two-week period, which must also represent a change from previous functioning. Symptoms may be self-reported or observed. At least one of the symptoms must be a depressed mood or loss of interest or pleasure. These symptoms must occur nearly every day. They result in significant distress or impairment in a major area of functioning (such as social, occupational, educational, etc.) and are not attributable to the effects of a drug or some other medical condition.
- Depressed mood most of the day (this may present as irritability in children or adolescents)
- Significantly reduced interest or pleasure in all, or almost all, activities most of the day
- Significant weight changes when not dieting (at least a 5% change) OR significant change in appetite (for children this may include failure to achieve expected weight gains)
- Inability to sleep (insomnia) or sleeping too much (hypersomnia)
- Psychomotor agitation or retardation (this symptom requires observation by others and cannot be self-reported)
- Fatigue or loss of energy
- Feelings of worthlessness or inappropriate guilt (not just guilt over being sick) which may also be due to delusions
- Diminished ability to think, concentrate, or make decisions
- Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt, or a specific plan for committing suicide
Persistent depressive disorder (also known as dysthymia) It is a chronic, but less severe form of depression. To be diagnosed with persistent depressive disorder, a person must be in a depressed mood for most of the day, more days than not, for at least two years (1 year for children). During this period of time, the person must not have been without symptoms for more than two months at a time. Symptoms are self-reported or observed. The person must show at least two of the following symptoms while depressed:
- Poor appetite or overeating;
- Insomnia or hypersomnia;
- Low energy or fatigue;
- Low self-esteem;
- Poor concentration or difficulty making decisions; and/or
- Feelings of hopelessness.
A diagnosis of persistent depressive disorder may contain up to five specifiers:
- With: anxious distress; mixed features; melancholic features; atypical features; mood-congruent psychotic features; mood incongruent psychotic features; or peripartum onset
- In full or partial remission
- Early or late onset
- With: pure dysthymic syndrome; persistent major depressive episode; intermittent major depressive episodes, with current episode; intermittent major depressive episodes, with current episode; intermittent major depressive episodes, without current episode
- Mild, moderate, or severe
Bipolar I disorder is characterized by the presence of manic, hypomanic, and major depressive episodes, whereas bipolar II does not include the presence of mania. What are symptoms of Mania?
Three of the following symptoms must be present (four if mood is only irritable) and are a notable change from usual behavior, present most of the day nearly every day and cause substantial functional limitations:
• Inflated self-esteem or grandiosity;
• Decreased need for sleep;
• More talkative or pressure to keep talking;
• Flight of ideas or subjective experience of racing thoughts;
• Distractibility—self-report or observation;
• Increase in goal-directed activity or psychomotor agitation; and/or
• Excessive involvement in activities that have a high potential for painful consequences.
How are characteristics of Mania and Hypomania different?
They are the same as with Mania, but less severe. Mania typically necessitates hospitalization to avoid harm to self or others while Hypomania is not not as distressing. It does not cause marked functional impairment. If the symptoms cause marked impairment then it is Mania not Hypomania.
Are both bipolar I and bipolar II disorders characterized by hypomanic and major depressive episodes?
YES
A diagnosis of Schizophrenia requires 2 or more of the following 5 symptoms during a one-month period:
○ Delusions: Fixed beliefs that are not amenable to change in light of conflicting evidence. They may include a variety of themes (persecutory, referential, somatic, religious, grandiose).
○ Hallucinations: Perception-like experiences that occur without an external stimulus. They are vivid and clear, with the full force and impact of normal perceptions, and not under voluntary control.
○ Disorganized speech: Inferred from a person’s speech, it is the presence of a formal thought disorder; derailment, loose association; and incoherence, word salad.
○ Grossly disorganized or catatonic behavior: Can manifest in many ways such as child-like silliness, unpredictable agitation, difficulty with goal-directed behavior.
○ Negative symptoms: A diminished expression of normal functioning (e.g. diminished emotional expression, anhedonia, or avolition).
Schizoaffective disorder is one of the more common, chronic, and disabling mental illnesses. As the name implies, it is characterized by a combination of symptoms of schizophrenia and an affective (mood) disorder. There has been a controversy about whether schizoaffective disorder is a type of schizophrenia or a type of mood disorder. Today, most clinicians and researchers agree that it is primarily a form of schizophrenia. What are the 4 criteria?
A diagnosis of schizoaffective disorder has four criteria (and must also meet depressive episode criteria for depressed mood):
- An uninterrupted period of illness which includes a major mood episode (major depressive or manic) and which is consistent with schizophrenia (criterion A) symptoms: delusions, hallucinations, disorganized speech, gross disorganization/catatonia, and negative symptoms–at least two of these must have been present for a significant amount of time and at least one of symptoms must be delusions, hallucinations, or disorganized speech;
- Throughout the duration of (lifetime of) the illness, delusions or hallucinations are present for two or more weeks in the absence of a major mood episode (major depressive or manic);
- Symptoms meeting the criteria for a major mood episode are present throughout the majority of the total duration of the illness (active and residual);
- The disturbance is not the result of a substance or other medical condition.
Anxiety disorder (lasting longer than 6 months)- selective mutism
• Selective mutism occurs when failure to speak presents in circumstances where speaking is expected (e.g. in school). The individual may speak in other situations. There are markedly negative consequences for the failure to speak in major life domains (e.g. school, work, social communication).
Anxiety disorder (lasting longer than 6 months)- Specific phobias
characterized by a situation or object nearly always inducing an immediate fear, anxiety, and/or avoidant response. The response is out of proportion to the actual risk imposed by the object or situation.
Anxiety disorder (lasting longer than 6 months)- Social Anxiety Disorder
a disturbance due to an individual’s fear, anxiety, and/or avoidance of social interaction and the possibility of being scrutinized. These situations may include meeting unfamiliar people, eating or drinking in public, or when performing in front of others. Ideation centers on negative evaluation by others, embarrassment, humiliation, rejection, or offending others.
Anxiety disorder (lasting longer than 6 months)-Panic disorder
• Panic disorder is the experience of persistent unanticipated episodes of intense panic with the fear of having more attacks or maladaptive behavior due to the panic attacks (e.g. avoidance behavior). Panic attacks are abrupt surges of intense fear or discomfort peaking in minutes and are accompanied by physical and cognitive symptoms (there must be four or more of 13 symptoms). At least one of the attacks must be followed by one month of either worry or concern regarding having additional attacks and a maladaptive change in behavior associated with or toward avoiding potential future attacks. Limited-symptom panic attacks present with four or fewer symptoms. Panic attacks are not considered a disorder in and of themselves. They may occur within any anxiety disorder and may serve as a marker for prognosis, diagnosis, severity, course, and comorbidity of anxiety and other mental disorders.
Anhedonia
An inability to experience pleasure from activities usually found enjoyable.
Lack of pleasure can have causes that aren’t due to underlying disease. Examples include overwork, recent tragedy, financial problems, bad weather, and boring activities.
Avolition
A term used to describe the severe lack of initiative to accomplish purposeful tasks
Persecutory Delusions
a set of delusional conditions in which the affected persons believe they are being persecuted, or that they are being tricked and that harm is going to occur.
Referential Delusions
a person experiencing a this type of delusion will believe something coincidental and innocuous refers back to him or her (or have strong personal significance) even in the face of strong evidence to the contrary.
Viktor Frankle
Existential therapist whose focus is on the search for meaning and purpose as a core component to life satisfaction.
Tardive Dyskenesia
Uncontrollable rhythmic movements which may indicate irreversible brain damage- result of long term use of anti psychotic medications
Dysarthria
Weakens muscles used for speech and causes slurred speech.
