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PHTY2230 > L36: Dynamic and Team Issues > Flashcards

L36: Dynamic and Team Issues Flashcards

1
Q

What is personality?

A
  • Characteristic patterns of behaviours and modes of thinking that determines a person’s adjustsments to their environemnt
  • Present rom adolescence, stable over time
  • Recognisable to friends and acquiaintances
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2
Q

What are 3 components of personality?

A
  1. Intelligence
  2. Attitudes, beliefs and moral values
  3. Emotional reactivity and motives
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3
Q

What is normal personality?

A

Allows a person to cope with their environemnt in a flexible manner

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4
Q

What is an abonormal/maladaptive personality? What are 3 results of this personality?

A

Inflexible responses and bahviours (resulting in)

  1. Perosnal discomfort
  2. Limited opportunities to kearn from experiences
  3. Difficulties in interpersonal relationships and occupational functioning
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5
Q

What are 3 characteristics of personality development?

A
  1. Biological contributions (eg. obsessional, anxious, anti-social)
    • Biological/herditery predisposition
  2. Responses to external events and experiences is shaped by:
    1. Cognitive capacity
    2. Developmental stage
    3. Affective state
  3. Traumatic events may be sensitising for some, steeling for others - resilience
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6
Q

What are the 3 layers of stress?

A
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7
Q

What are 3 defenses mechanisms when understanding reactions?

A

To something that is emotional threatening

  1. Patterns of thoughts, feelings or behvaiours that are relatively involuntary
  2. Arise in response to perceptions of psychic danger
  3. Designed to hide or alleviate the conflicts or stressors that give rise to anxiety
  • Psychological responses which protects us
    • Unconscious and automatic
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8
Q

What are 3 defese mechanisms?

A
  1. Narcissistic
  2. Immature
  3. Neurotic
  4. Mature

can observe them but cannot measure them

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9
Q

What are 3 narcissistic defenses?

A

Of external reality

  • very common and are normal in children (eg. child does something wrong –> parent ask if they did it –> child says no)
  • no normal in adults (can occur when in pain, isolated and stressed)
    • Eg. motor neuron disease —> in reality = will die but patient has false hope (they have a cure, they won’t die)
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10
Q

What is splitting?

A
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11
Q

What are 4 immature defenses?

A
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12
Q

What are 5 neurotic defenses?

A
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13
Q

What is projection which is immature defenses?

A

Attributing one’s own issue to another (eg. blame)

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14
Q

What is acting out which is immature defense?

A

Action to avoid being conscious of he accommopanyinh emotion

  • Eg. become intoxicated, leave marriage, have an affair after trauma
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15
Q

What is passive-aggression as an immature defense?

A

Aggression expressed indirectly through passivity, masochism

  • Punished the other person but very subtle
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16
Q

What is regression as an immature defense?

A

Return to earlier phase of functioning

  • Flu –> “I want my mum”
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17
Q

What is displacement as a neurotic defense?

A

Putting things else where

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18
Q

What is dissociation as a neurotic defense?

A

Extreme case of daydreaming

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19
Q

What is reaction formation as a neurotic defense?

A

An unacceptable impilse is transfomred into its opposite

  • Eg. purposely causes problem for someone and then tries to do something nice)
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20
Q

What is repression as a neurotic defense?

A

Idea is expelled- “convenient forgetting”

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21
Q

What are 5 mature defenses?

A
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22
Q

What is altruism as a mature defense?

A

Doing something with obvious and beneficial gain

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23
Q

What is humour as a mature defense?

A

Deal with something they are unhappy with

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24
Q

What is sublimation as a mature defense?

A

Channelling energy into something appropriate (eg. unhappy and then decides to take up sport, goes to gym)

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25
Q

What is suppression as a mature defense?

A

Putting something on “hold” and coming back to it at a later date when you feel more robust

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26
Q

What is anticipation as a mature defense?

A

Thinking things through and planning

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27
Q

What is the difference between repression and suppression?

A

Repression VS suppression

R: puts it “away” and never thinks about/deal with it again

S: put in on “hold” and come back to deal with it later

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28
Q

What is transference?

A
  • The patient relates to the therapist as though they are a significant figure from their past
  • Unconscious process
  • Inappropriate to the current situation and is a repetition of the past
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29
Q

What are 5 things that the therapist can do to make the patient “like” them more?

A
  1. Listen to information
  2. Accept a treatment plan
  3. Work on the treatment plan
  4. Attend regular appointments
  5. Try to please the therapist
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30
Q

What is countertransference?

A
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31
Q

What are 6 things we (as physio) might do if we don’t like a patient?

A
  1. Run late for appointments
  2. Cancel with short notice
  3. Fail to treat the patient with respect and dignity
  4. Fail to provide appropriate information
  5. Not push overselves to delve further when things do not go as well as planned in treatment
  6. Take short-cuts and compromise care
  7. Devalue the patient’s suffering

Don’t try as hard –> suboptimal care

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32
Q

What are 4 things that our response to patients is influenced by?

A
33
Q

What are 8 characteristics of the dependent patient?

A
34
Q

What are 11 ways to respond to the dependent patient?

A
  1. Self-monitor for countertransference with ALL patient
  2. Be aware of the power of idealisation
  3. Discuss the aims of treatment clearly
  4. Establish clear goals
  5. Define the patient’s role
  6. Establish the ground rules of therapy
  7. Recognisethat treatment success may be threatening for the dependent patient
  8. Discusss the finite nature of treatment at the outset
  9. Master the capacity to acknowledge feelings and distress whilst defining expectations
  10. Always consider the longer-term consequences of your actions
  11. Always reflect: “Whose need are being met by this?”
35
Q

What are 3 professional boundaries?

A
36
Q

What are 3 clinican aims in the therapeutic frame?

A
37
Q

What are 8 characteristics of therapeutic frame?

A
38
Q

Who is responsible for defining and maintaining the proper personal distance in the physio-patient relationship? What does the physio need to be vigilant about?

A
  • Health profession/physio
  • Changes over time
  • The potential for harm
39
Q

What are 5 types of perpetrators in terms of sexual boundary violation in the physio-patient relationship?

A
40
Q

What are 2 things to beware of in sexual boundary violation?

A
41
Q

Why is low or no fee for health session a common boundary crossing?

A
42
Q
A

NO! Unless receiving this on a frequent basis or expensive gifts

No social events together (eg. going for a drink)

43
Q

What are 3 meanings of accepting gifts/engaging in social contact?

A
44
Q

What are 4 characteristics of self-disclosure?

A
45
Q

What are 4 life stresses whihc all health professionals are at risk of violating boundaries for?

A
  1. Divorce
  2. Death of a family member
  3. Malpractice litigation
  4. Other adversity
46
Q

What is a MDT?

A
47
Q

What are 6 advantages of MDT?

A
48
Q

What are 6 characteristics of well-functioning teams?

A
49
Q

What are 4 characteristics of poorly functioning teams?

A
50
Q

What are 6 team factors that are problems affecting teams?

A
51
Q

What are 7 patient factors that are problems affecting teams?

A
52
Q

What are 5 characteristics of splitting?

A
53
Q

What are 3 characteristics of evolution?

A
54
Q

What are 3 things that splitting leads to?

A
55
Q

What are 5 ways to prevent splitting?

A
56
Q

What are 8 characteristics of scapegoating?

A
57
Q

What are 2 avoidance of scapegoating?

A
58
Q

What are 3 characteristics of being aware of the special patient?

A
59
Q

What are 4 major risks of the special patient?

A
60
Q

What are 7 ways to improve team function?

A
61
Q

What is stress and burnout?

A

Accumulation of exhaution and vocational disenchatment in workers involved in continual intense contact with people whose problems they must solve

62
Q

What are he 4 consequences of stress with consultants with poor mental health and stress?

A
63
Q

What are 2 consequence of stress?

A
  1. Increased rates of absenteeism (componding stress for others)
  2. Disengagement/withdrawl from patients
64
Q

What are 4 situations that disengagement/withdrawal from patients lead to?

A
65
Q

What are 3 impacts of stress on health professionals?

A
  1. Depression
  2. Substance use
  3. Cascading problems related to poor self-care
66
Q

WHat are 4 cascading problems related to poor self-care as a result of stress on health professionals?

A
  1. Lack of exercise
  2. Social withdrawal
  3. Relationship difficulties
  4. Lack of preventitive health care
67
Q

What are 5 ways to recognised burnout?

A
68
Q

Why do you need to beware in burnout?

A

Can be used as an “excuse” instead of ackknowledging personal, psychological and emotional issues

69
Q

What are 5 environmental factors of recognising complex contributions?

A
70
Q

What are 5 patient factors of recognising complex contributions?

A
  1. Personality diffuclties, or depression
  2. Poor porgnosis, chronic illness
  3. Unrelieved suffering
  4. Young or with young children
  5. Similar to oneself or rekindles past grief and loss
71
Q

What are 5 personal factors of recognising complex contributions?

A
  1. Appraisal of situation
  2. Expectations of professional performance
  3. Education and training
  4. Age
  5. Supportive relationship
  6. Background stressors
72
Q

What are 2 enhances capacity to support patients and respond to psychosocial issues?

A
  1. Patients who are distressed, regressed, angry or non-compliant pose a challenge for health professional
  2. Access to professionals with skills in psychosocial assessment and treatment assists patients and potential reduces the burden for the primary care provider
73
Q

What are 9 characteristics of patient-focused care?

A
  1. Strengthen referral bases
  2. Resist an “all or nothing” approach to treatment
  3. Identify and response to “micro-issues”:
    1. The contribution of “medically minor” symptoms to patient distress is significant
    2. Small increments in symptom control can lead to larger gains, increased patient satisfaction and reduced distress
  4. Structured break
  5. Supervision
    • Learning to tolerate uncertainty/adverse outcomes
  6. Attention to cognitive processing
  7. Social activities
  8. Recreational activities away from work
  9. “Debriefing”is not the answer
74
Q

What are 2 characteristics of identifying and responding to “micro-issues” for patient-focused care?

A
  1. The contribution of “medically minor” symptoms to patient distress is significant
  2. Small increments in symptom control can lead to larger gains, increased patient satisfaction and reduced distress
75
Q

What are 2 characteristics of self-reflection?

A
  1. The need for a sense of competence, control and pleasure from one’s work
  2. A personal philosophy of illness, death and one’s personal role
76
Q

What are 5 questions in regards for self-reflection?

A
  1. Who am I and what do I bring to this role?
  2. What do I expect of myself?
  3. How does work resonate with personal issues?
  4. How do I feel about my patients?
  5. Acknowledge the emotional dimensions of work
77
Q

What are 7 specific strategies in difficult cases?

A
  1. Identify points of perosnal vulnerability
  2. Self-monitor for responses
  3. Indetify an name the feeling
  4. Step back to gain perspective
  5. Consider the conseuquences for the patient
  6. Consider alternative strategies
  7. Talk with a trusted collegue
78
Q

What are 3 emerging evidence about the importance of PEP (Post-Event Processing)?

A
  1. Negative autobiohraphical memories of the event
  2. Distorted with introjections about other “failures”
  3. Leading to anticipatory anxiety about future events

Use of alcohol in this contect may not so much reduce anxiety as interere with negative processing and laying down of unpleasant memories

79
Q

What are 5 characteristics of self-care?

A
  1. The patient is the one with the disease
  2. Support- peers, family, friends
  3. Exercise
  4. Replenishing the store of good things
  5. Treating ourselves as well as we do out patients- professional help when needed

PHTY2230 (24 decks)

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