Mental Health Flashcards
Model of Human Occupation (MOHO)
Volition, habituation and performance capacity
Considers individuals to be open systems that can change as a result of interaction of the environment
Focus on environmental impact on individuals (physical, social and cultural components)
Assessment with this model will focus on roles and meanings (so think Roles Checklist)
Person Environment Occupational Performance (PEO and PEOP models)
Overlapping interaction of the person, occupation and environment/context of the occupation.
Performance is considered the outcome of the transactional relationship between people, their occupations and the environment
Life-Style Performance Model
Proposes a method for looking at the match between the environment and the individual’s needs
- Competence in activities with high priority in societal standing leads to greater self-efficacy than those that are lower social significance
- There are meanings attached to activities that impact motivation
- Increased intrinsic gratification and competence in activities matching neurobiology and psychological structure of the person
- Competence best achieved with readily seen outcomes
Good quality of life involves a sense of balance and autonomy among four domains (intervention focus):
- Self-care and maintenance
- Intrinsic gratification
- Societal contributions
- Reciprocal relationships
Ecology of Human Performance
Person, tasks, context, and personal-context-task transaction
Allen Cognitive Levels
(See OT Exam Prepper PDF)
Level I: awareness - noxious stimuli, responding and locating, rolling in bed, lifting UEs
Level 2: gross body movements - overcome gravity, righting reactions, aimless and directed walking, grabbing
Level 3: use of objects - grasping, distinguishing, observing effects on objects, using all objects (some tasks with long term repetitive training)
Level 4: familiar activities - sequencing, differentiating features, completing goals, personalizing, rote learning (able to perform established routines, but unable to adapt)
Level 5: learning new activity - neuromuscular adjustments, self-directed learning, considering social contexts, collaborating with others
Level 6: no disability - planning new activities
Occupational Adaptation Model
Concerned with the process that the individual goes through to adapt to their environment
- Person
- Occupational Environment
- Interaction between the two
Occupational adaptation will be more pronounced during periods of larger disruption
Role Acquisition Model
Performance is addressed through function/dysfunction in 7 categories
- Task skills
- Interpersonal skills
- Family interaction
- Activities of daily living
- School
- Work
- Play/leisure
Treatments utilize principles of learning to promote skill development in these categories
Cognitive Disabilities Model
By Claudia Allen (levels)
Functional behavior is based on cognitive level
There are 6 levels of cognition ability, and once it is clear the person’s cognitive level will not change, compensations for environment and activity are utilized
Interventions are going to be based on the individual’s highest cognitive level
Sensory Models
Includes the work of Jean Ayres (sensory integration), Loran Jean King (schizophrenia), Pat and Julia Wilbarger (protocols and sensory diets), Winnie Dunn (sensory processing model), etc.
Interventions for mental health might include:
- Multisensory environments, snoezelen rooms, etc.
- Self-soothing modalities (weighted blankets, comfort items)
- Sensory diets (alerting and calming stimuli)
Psychodynamic/psychoanalytic models
This is a rather dated approach, infrequently used today
Focus on unconscious psychological forces and internal processes…all about bringing these to the surface to resolve the intrapsychic conflicts
Also focused on the idea of defense mechanisms, some of which are considered more mature than others
Cognitive Behavioral Therapy (CBT)
Foundational idea: distorted thinking leads to behavioral and emotional problems related to mental illness
Automatic thoughts cause psychological disorder and through cognitive restructuring these thoughts are brought to awareness to be confronted and facilitate change
Three components:
- Didactic aspects - therapist explaining basic concepts and principles of CBT
- Cognitive techniques - eliciting and testing automatic thoughts, identifying and testing validity of maladaptive assumptions
- Behavioral techniques - used with the cognitive techniques to test and challenge maladaptive cognitions (e.g. goal setting, homework, restructuring cognitive thoughts)
OT role in all of this can focus on meaningful tasks and therapeutic activities for self-reliance training, increasing mastery/pleasure, and filling leisure
Recovery Model
Interdisciplinary
Conceptualizes recovery from illness as a journey of healing and transformation
Major concepts cover…client-centered empowered decision making, non linearity of recovery journey (there can be setbacks and disruptions), strengths based, personal responsibility, peer and relational support from self, community, service providers, family, etc.
Assessments will include Quality of Life Interview, The Empowerment Scale, COPM, Role Checklist, AMPS, etc.
Intervention: the development and implementation of a Wellness Recovery Action Plan is an essential part of the recovery process
Canadian Model of Human Occupation
All about therapeutic use of self and the effect of therapist-client relationship on improving function
Principles:
- Critical self-awareness and interpersonal self-discipline are fundamental to the intentional use of self
- Practitioners must “keep head before heart”
- Practitioners must practice “mindful empathy”
- The client defines a successful relationship
- Practitioners must balance a focus on activities with a focus on the interpersonal
Leadership Styles for mental health groups
Directive - low cognitive abilities, leader must provide direction and structure
Facilitative - fair to good insight and motivation, leader allows participants to take more responsibility while still maintaining control over goals and decision making
Advisory - mature group able to work together effectively in resolving conflicts, leader works alongside participants in a coaching capacity
Reisberg Levels for Neurocognitive Disorders
Level 2: very mild cognitive decline
Typical age-related memory loss, not noticed by others
Independent in ADL, IADL, work, etc.
Activities require more concentration, benefits from small compensations
Level 3: mild cognitive impairment
>1 domain impact to the extent that it is noticeable
Able to remain independent in familiar, noncomplex occupations
Difficulties with complex tasks, challenging environments…tend to withdraw to avoid attention on these deficits
Level 4: moderate neurocognitive impairment
Modest impairments evident on cognitive assessments
Independent with simple, repetitive ADLs…can live alone with assistance
Cannot independently perform familiar challenging activities, unable to use to sequence written cutes (soup directions on a can)
Level 5: major/moderate severe neurocognitive decline
>2 domains with significant decline, substantial impairments evident on cognitive assessments
Performs structured, repetitive, familiar tasks with cues and assistance…can live in their home with substantial assistance
Cannot perform IADLs, cannot drive, unable to use judgment to make decisions
Level 6: very severe neurocognitive decline
Very severe impairment in all cognitive domains
Dependent in all ADLs
Requires 24/7 care
Loses speech and motor capabilities
