Domain 2 - Psychosocial Concepts and Support Systems

Question 1

What does WHO consider an essential part of health?

Answer 1

“There is no health without mental health”

Question 2

Promoting mental health is part of case manager’s duty to:

Answer 2

• Advocate for the individual
• In an integrated case management environment, it is especially important to advocate for the client to be treated holistically for behavioral health issues in whatever setting the client presents.
• Facilitate care and services that can ultimately result in improved
  behavioral health for the client

Question 3

What is the difference between behavioral health and mental health?

Answer 3

Behavioral health includes specific actions and an individuals response to emotional triggers.

Mental health is thoughts, feelings, and biological factors.

Question 4

Who provides 70% of treatment for behavioral health conditions?

Answer 4

Primary care physicians

Question 5

AMI

Answer 5

Any mental illness

Question 6

SMI

Answer 6

Serious mental illness

Question 7

What is the difference between Any Mental Illness (AMI) and Serious Mental Illness (SMI)?

Answer 7

AMI encompasses all recognized mental illnesses. SMI is a smaller and more severe subset of
AMI.

Question 8

Behavioral health case management

Answer 8

Method of providing cost-effective, quality care by managing the holistic health concerns of individuals, families, and groups in need of extensive services

Question 9

Self-neglect

Answer 9

Self-neglect results from an adult’s inability to perform essential self-care tasks due to physical and/or mental impairments or diminished
capacity.

Tasks may include:
* providing essential food, clothing, shelter, health care
* obtaining goods and services necessary to maintain physical health, mental health, emotional well-being, and general safety
* managing financial affairs
* adhering to prescribed medications

Question 10

Self-harm

Answer 10

Self-harm or self-injury means hurting yourself on purpose. One common method is cutting with a sharp object. But any time someone deliberately hurts themself is classified as self-harm. Some people feel an impulse to cause burns, pull out hair or pick at wounds to prevent healing.

Question 11

Severe mental illness (SMI)

Answer 11

Severe and persistent mental illness describes
those individuals with mental illness that have complex symptoms.

Question 12

Substance-related and addictive disorders

Answer 12

Formerly referred to as substance dependence or abuse, involve the use of mind-altering substances yielding three basic types of disorders:
*substance intoxication
*substance withdrawal
*what is now called “substance use disorders”

Question 13

What are some types of behavioral disorders?

Answer 13

*depression
* bipolar affective disorder
*schizophrenia
* psychoses
* dementia
* intellectual disabilities
* developmental disorders including autism spectrum disorders (ASD

Question 14

What is integrated case management?

Answer 14

Recognizes and focuses on the whole person and the interaction of:
* Physical health/illness
* Behavioral health/illness
* Social determinants
* Inadequacy of social networks
* Health systems
* Limited, poorly controlled access to needed services

Can be provided in a variety of settings
(acute care, clinics, health plans, community, telephonically) by nurses, social workers, and licensed behavioral health professionals

Question 15

Dual Diagnosis

Answer 15

Coexisting severe behavioral health and substance use disorders

Question 16

The 5th edition of the Diagnostic and Statistical Manual of Mental Disorders(DSM-5) is the
current standard, which uses 3 major components to make a diagnosis:

Answer 16

• diagnostic classification
• diagnostic criteria sets
• descriptive texts

Question 17

Behavioral Health Assessments should include information about:

Answer 17

• Depression
• Anxiety disorder
• Alcohol use and dependence
• Drug use and dependence
• Behavioral health problems
• Multiple neuropsychological assessment tools

Question 18

A behavioral health assessment can identify:

Answer 18

• behavioral health problems (anxiety disorders, depression, bipolar disorders, eating disorders, among others
• Developmental problems (learning disabilities, autism)
• Substance use disorders (alcohol and drug abuse and dependence)
• Diseases of the nervous system (Alzheimer’s, Huntington’s, Parkinson’s, Epilepsy)

Question 19

The major purposes of a neuropsychologic assessment are to identify:

Answer 19

• The integrity of cognitive functions
• Determine the presence, nature, and severity of cognitive dysfunction

Question 20

Risk factors of suicide that a case manager is to be aware of include:

Answer 20

• Clients that indicate verbally or non-verbally that they do not want to live
• Do not fear death
• Have active thoughts of harming themselves
• Express a thought of how to commit suicide though they do not have a plan
• Express that they have a plan for harming themselves

Question 21

What is the new three-digit dialing code that will route callers to the National Suicide Prevention Lifeline

Answer 21

988

Question 22

Crisis intervention

Answer 22

the immediate and short-term care aimed at assisting to restore equilibrium – can walk us through our “new normal”. Crisis intervention is immediate and short-term psychological care.

Question 23

Motivational Interviewing (MI)

Answer 23

A directive, client-centric, collaborative process counseling style that assists clients to explore and resolve ambivalent feelings and insecurities, and elicits the internal motivation they need to change their behavior by helping them explore and resolve ambivalence, within an atmosphere of acceptance and compassion
* This intervention is designed to strengthen personal motivation for, and commitment to a specific goal, helping individuals become motivated to change the behaviors that are preventing them from making healthier choices

“Hands-off” approach allows for client to be more invested in the decision as they are making it based on their reasoning and in their time

Question 24

What are Motivational Interviewing (MI) four fundamental processes and what do they mean?

Answer 24

1. Engaging
   * To establish rapport with the client and express understanding
   * To show empathy
   * Promote buy-in for the client to change
2. Focusing
   * Clarify the readiness for change
   * Help them to develop direction
   * Show them possibilities
3. Evoking
   * Help them to explore their motivation
   * What are their goals and preferences
   * Assist in having them identify the barriers
4. Planning
   * Foster their commitment to change
   * Let them formulate a concrete plan, develop a course of action

Question 25

Autonomy

Answer 25

A person's ability to act on his or her own values and interests

Question 26

Ambivalence

Answer 26

The state of having mixed feelings or contradictory ideas about something or someone.

Question 27

What are the four principles of Motivational Interviewing (MI)?

Answer 27

* Express Empathy * Support Self-Efficacy * Develop Discrepancy – work with the client to identify the difference between the current and future states, and have them specify the goals they want to achieve * Roll with Resistance – allow client to verbalize their resistance to change and share their experience about concerns or challenges A fifth principle, avoid argument, is noted in some of the literature for MI. Arguments are counterproductive in the use of MI.

Question 28

What is an engagement tool utilized for Motivational Interviewing (MI) and what does it stand for?

Answer 28

OARS O - Open-ended questions A - Affirmations R - Reflective listening S - Summarizing

Question 29

What is Change Talk?

Answer 29

Statements that suggest a window of opportunity for change. Usually subtle, not a declaration, but shows contemplation to change. Using the O.A.R.S. technique can help to elicit change talk. Also, can look at: * pros and cons of the change * positives and negatives * past successes * look to the future

Question 30

In the Prochaska model (also called the Transtheoretical Model) for change, assessing clients’ readiness to change involves various stages. What are the 6 stages?

Answer 30

1. Precontemplation – not ready to change, may not see a problem 2. Contemplation – willing to consider they may have a problem 3. Preparation (Commitment to Action) – still may be ambivalent but the scale in tipping in favor of change 4. Action (Implementing the Plan) – putting the plan into action 5. Maintenance – normally takes about 3 to 6 months to complete; new patterns of behavior have been established 6. Termination – no longer feels the problem presents a threat

Question 31

What is Activation and why is it important?

Answer 31

The individual has the knowledge, skill and confidence to take on the role of managing their health and health care. It is important because higher activated individuals are more likely to engage in positive health behavior sand to have better health outcomes. Activation underlies most health behaviors. When behaviors are more difficult or complex, or require the client to be proactive, it is generally only the individuals with high activation who do them.

Question 32

What are the 4 stages in Activation?

Answer 32

1. Believe active role is important in self-care management 2. Possess confidence and knowledge to take action 3. Take action 4. Stay the course under stress, staying the course even when it becomes more complex and not so easy to continue

Question 33

What are the 4 levels of Activation and what are they comprised of?

Answer 33

Less Activated Patient (Level 1 and 2) * Don’t overwhelm client with too much information or changes * Build confidence through small step successes * Focus on what is important to the client, jointly set realistic behavioral goals Patients who are Moderately Activated (Level 3) * Assume the clients at this level are ready to use more information than clients at the lowest level * Jointly set realistic goals * Celebrate successes Higher Activated Patient (level 4) * Go beyond the basics, provide more in-depth information * Plan for challenging situations * Plan proactively to anticipate barriers and how to overcome them

Question 34

Health Literacy

Answer 34

“The degree to which individuals have the capacity to obtain, communicate, process, and understand basic health information and services needed to make appropriate health decisions.”

Question 35

What is the 5 steps in Conflict Resolution? (What are 5 things that can assist in prevention a conflict?)

Answer 35

Accommodating – meets the needs of the other party at your own expense * Avoiding – avoids conflict as a default action * Collaborating – meets the needs of all parties involved * Compromising – finding a solution that gives everyone a partial win, and everyone gives up something * Competing – taking a firm stand, useful in emergency situations when fast decisions are needed, or when someone is trying to take advantage of a situation

Question 36

What is the difference between empathy and sympathy?

Answer 36

*Empathy – experiencing someone else’s feelings *Sympathy – understanding someone else’s suffering Empathy fuels connection, and sympathy drives disconnection

Question 37

What are the 5 stages of grief?

Answer 37

Denial Anger Bargaining Depression Acceptance

Question 38

Bereavement

Answer 38

Effectively dealing with the loss of a loved one with the help of family, friends, and their personal belief systems—this may include feeling and expressing sadness and anger, but that’s normal and they get through it

Question 39

Cultural competency

Answer 39

A competency based on the premise of respect for individuals and cultural differences, and an implementation of a trust-promoting method of inquiry.

Question 40

Cultural proficiency

Answer 40

Knowing how to learn about individual and organizational

Question 41

Cultural humility

Answer 41

Lifelong commitment to self-evaluation and self-critique

Question 42

Cultural sensitivity

Answer 42

Skills that enable us to learn about and understand people who are different from ourselves, thereby becoming better able to serve them within their own communities.