Lecture 1

Question 1

What factors would need to be present for diagnosis of a childhood mental health disorder?

Answer 1

• Takes account of the child’s stage of development
• Requires symptoms and signs to have a level of severity that interferes with the child and/or parents everyday life
• Anomalies in behavior, emotion or thoughts
• Persistent for at least 2 weeks
• Take account of the sociocultural context.

Question 2

Describe and discuss the issues associated with diagnosis

Answer 2

• May be a self-fulfilling prophecy - if they are diagnosed with a condition then it may make them feel that they have to fit that condition
• Stigma - early diagnosis may attach stigma that will last throughout their life
• Requires a professional
• Can be difficult to identify
• Labels the child

Question 3

Describe and discuss the issues associated with assessment

Answer 3

• Is often subjective and variable
• Sometimes don’t take into account person or environmental factors
• Need to collect information from a range of sources

Question 4

Describe and discuss the issues associated with treatment

Answer 4

• The issue surrounding medications and its provision
• Requires consent
• Can be costly

Question 5

Describe and discuss the issues associated with ethics

Answer 5

• Confidentiality

Question 6

What is resilience?

Answer 6

• The ability for someone to bounce back from hardship and adversity

Question 7

How does resilience relate to the development of mental illness?

Answer 7

• Allows an individual to develop social competence, problem-solving skills, autonomy and a sense of purpose
  >these are things that foster a positive mindset and a healthy lifestyle
• Without resilience, a person may give up or not fight to overcome adversity - leaving them in a negative mindset that may foster negative thoughts and behaviours (e.g. low self-esteem)
• Too much resilience may be an indicator of someone trying to mask their inner conflict rather than a healthy and strong mind - is something to look out for

Question 8

List 5 characteristics of resilient children

Answer 8

1. Problem solving skills
2. Positive sense of self
3. Sense of humour
4. Intelligence
5. Empathy

Question 9

What is it meant by resilience is a double edged sword?

Answer 9

• The appearance of resilience may not always be a good thing - it can sometimes be a mask to hide what is really going on

Question 10

What does the term parentification mean?

Answer 10

Child taking on the parent role

Question 11

Explain the following concept and give an example: risk factor

Answer 11

• Something that increases the likelihood of a negative event developing or occurring
  E.g. Bullying or poor academic achievement

Question 12

Explain the following concept and give an example: protective factor

Answer 12

• Something that supports positive and adaptive outcomes

E.g. support from family, positive self esteem

Question 13

Explain how and why risk and protective factors change over time

Answer 13

• Situations are continuously changing; thus, so are protective and risk factors

Question 14

Describe the OT role in CYMH

Answer 14

Focusses on engagement and participation and looks at things like:

• Meaning making/narrative
• Relationships
• Sensory regulation
• Occupational and roles
• Self care in mental health
• Play as occupation
• Activity analysis
• Competency/self efficacy

Question 15

Where does diagnosis and formulation fit in to the OT process?

Answer 15

• Diagnosis: before we see the child (by a professional) or after assessment (to help inform the professional)
• Formulation: after assessment (to gain a broader picture of the child’s circumstance)

Question 16

What kind of information should be gathered? (also needed for formulation process)

Answer 16

• Medical history
• Occupations (schools, ADLs)
• Social information (play, relationships)
• Sensory preferences
• Developmental history

Question 17

Why is it important to gather information about the child’s developmental history?

Answer 17

• Need to look at where the child is compared to where they should be

Question 18

Why would you undertake an assessment in CYMHS?

Answer 18

• To gain more information about the child’s abilities, development, beliefs, thought patterns, etc.
  >helps to gain a broader picture of the child and the context that they are in

Question 19

What sort of information can be gained from referral and why might this be important?

Answer 19

Information:

• Diagnosis
• Differential diagnosis
• Presenting problem

This is important to get a pre-assessment image of the child - to have some sort of knowledge and image of how they might present to help with the intervention process

Question 20

What is formulation?

Answer 20

• Process of putting together all of the information gathered from assessments and interviews to describe how and why the child presents the way that they do
• Why this child, with these symptoms, in this family and this time

Question 21

Compare and contrast the diagnostic process with the formulation process

Answer 21

Diagnostic:

• clinician looks at signs and symptoms that affects the client’s mood, thinking and behaviour
• must adhere to particular criteria

Formulation:
- puts together all info to guide further planning and decision making

Question 22

What are the 7 P’s of formulation?

Answer 22

1. Presenting problem
2. Pattern and onset
3. Predisposing factors (long standing factors that influence the child, but haven’t resulted in any issues)
4. Precipitation factors (the things that have happened just before the presentation)
5. Perpetuating factors
6. Protective factors
7. Prognosis and plan