Mental Health Diagnoses

Question 1

Schizophrenia symptoms/deficits

Answer 1

-POSITIVE/NEGATIVE SYMPTOMS
- DEFICITS IN ATTENTION, WORKING MEMORY, AND EXECUTIVE FUNCTION

Question 2

INTERVENTIONS FOR HALLUCINATIONS

Answer 2

• Provide simple, structured, short-term activities such as staining glass, assembling wood kits, discussing
  current events and activities with strong sensory stimulation such as dancing and watching television.

Question 3

INTERVENTIONS FOR DELUSIONS

Answer 3

Provide intellectually challenging verbal activities such as board games, word games, chess, computer
games, current events discussion, and expressive activities like dancing.

Question 4

INTERVENTIONS FOR NEGATIVE SYMPTOMS

Answer 4

• Use highly structured activities with concrete expectations and goals. Specific skill training and
  psychoeducation is beneficial to individuals with negative symptoms.

Question 5

OT INTERVENTION FOR SCHIZOPHRENIA

Answer 5

• Structured tasks, expressive activities, functional living skills, sensory modulation, psychoeducation, social
  participation, social skills training, and vocational/educational training.

Question 6

INTERVENTIONS FOR DEPRESSION

Answer 6

• Maintain an approach that is inviting and confident without being demanding
• valued activities that can be completed successfully in one session
• EASILY ACHIEVED GOALS
• Disprove negative thoughts and question unrealistic belief
• provide external structure and meeting daily demands
• Activities should be concrete, tangible, short-term, simple, and success enhancing to enhance motivation and self-concept.
  - Concrete task provides structure and evidence of remaining ability to function which combats helplessness
  and distractibility
• A self-report to monitor the pleasure/value from working on or completing an activity is a behavioral intervention.

Question 7

Interventions for mania

Answer 7

• Arrange the environment to limit distractions
• Provide clear expectations of the end product and parameters
• When there are unrealistic ideas, provide realistic appraisal of behavior and end products while engaging in and
  after activities

-Allow client to pick activity, but offer only two or three choices

• Crafts, Gross Motor Activities (dance, exercise), Semistructured Activities (magazine picture collage)
• Redirect to a goal-directed action whenever distracted
• Activities should be concrete, tangible, short-term, simple, and success enhancing.
• Groups address skill development, problem solving, managing symptoms, coping with daily life stressors, simply
  recognizing pleasure and humor, and self awareness.

-Socratic questioning is client-centered “discovery” to clarify beliefs and thoughts that may support or hinder
occupational performance and goal attainment

-Open-ended, guiding questions that leads the client and OT to discover and solve problems

• Cognitive Behavior Therapy (CBT) centers on uncovering distorted beliefs and faulty thinking patterns and
  practicing alternative cognitive and behavior patterns.

Question 8

Intervention for anxiety disorders

Answer 8

• Teach how to prioritize tasks and break them down into manageable and attainable steps
  -Assertiveness training
• Cognitive-Behavioral Approaches
• Mindfulness
• Functional Behavioral Approaches
• Biofeedback
• Relaxation
• Visualization (picturing a pleasant scene) and autogenic training (which involves the person’s own verbalTime Management incorporate schedules and “to do” lists. Incorporating “worry time” into the daily routine
  helps decrease behavior.

-Sensory Modulation such as providing a “sensory diet” while incorporating a person’s interests and needs.

-Ex. Gross motor activities (yoga, dance, exercise), woodworking kits with model, and simple cooking tasks.
commands about homeostasis and concentrating on cues for relaxation
-

Question 9

interventions for personality disorders

Answer 9

• Create a safe, interesting, and playful context and a setting that makes clear, consistent, functional demands within
  a specific time frame
• work on IADLs, leisure and work activities
• social skills
• DBT
  - Replace self-denigrating thoughts with statements about self-worth and health using mindfulness strategies to
  understand emotions and ways of regulating emotions
• Groups/Cooperative activities
• Hoarding: Teach and practice strategies for removing objects and organizing those that remain.
  Paranoia: Wood, leather, and metal projects with written instructions (such as a bird feeder), clerical tasks
  (organizing), design tasks, photography, and puzzles.
  Splitting: Show that we all have strengths and limitations, increase awareness of seeing people in a blackand-white way, and accept the expression of both positive and negative aspects.

Question 10

General Treatment suggestions for Personality Disorder Clusters

Answer 10

• Environment and group treatments are good
• Maladaptive behavior should be pointed out and examined
• Feedback from peers is very useful
• New ways of relating should be practiced
• Individuals can benefit from mindfulness training and being helpful to others.

Question 11

General Interpersonal Treatment Approaches

Answer 11

• Establish a collaborative stance
• Provide understanding along with advice
• Confront defensive behavior in a supportive way by focusing on the demonstrated behavior and not judgment of it

-Provide consistency in the structure of the program and limit setting

-Encourage membership in social support groups

-Assist the client to think through the consequences of actions (anticipatory guidance and rehearsal). Give
hypothetical situations and consider possibilities and suggest more appropriate or novel ways to handle the hypothetical situations

• Show and express enthusiasm in their attempts to change and grow.

Question 12

Early stage dementia

Answer 12

• Memory, forgetfulness and recall is the primary concern
• Deficits in IADL’s such as financial management, complex home tasks, and driving
• Low tech assistive devices can be effective including calendars, check lists and note taking as memory
  aids.
• No cognitive decline, Very mild cognitive decline

Question 13

Middle stage dementia

Answer 13

• Mild cognitive decline, Moderate cognitive decline
• Poor concentration and decreased knowledge of recent events, and difficulty traveling alone to
  unfamiliar places
• Problems with ADL’s arise. Clients may avoid bathing or wear soiled/dirty clothing or difficulty with multistep ADL’s
• Provide simplified schedules in a familiar environment with repetition and consistency due to
  disorientation
• Reality orientation
• Validation therapy

Question 14

validation therapy

Answer 14

For example, a widow with dementia may express concern that she does not want to attend the
occupational therapy group on a specific day because she is afraid, she will miss her husband when
he comes to visit. Instead of correcting the client and explaining that her husband died several years
ago, a validation therapy approach would confirm the feelings of the moment and might include a
statement like “You really miss your husband, don’t you?” The therapist can assure the client that the
therapist will make sure that the nursing staff knows where the client is going to be for the next hour
should a visitor arrive

Question 15

reality orientation examples

Answer 15

-The use of reality boards listing information such as the time, date, next meal, etc.
-Name tags and labels for rooms.
- Reminiscence activities.
- Reminding clients of names and situations

Question 16

late stage dementia

Answer 16

• Moderately severe cognitive decline.6) Severe cognitive decline, 7) Very severe cognitive
  decline
• Dependence in basic self care task
• Forgets spouse name or the names of important people in their lives
• Environmental adaptations, mealtime positioning, adaptive feeding strategies, and nutritional intake monitoring will be the focus
• Home adaptations to increase safety: electronic monitoring devices, door alarms, pressure gates, and
  video intercoms are cost effective methods. Disconnect stoves, auto shut off appliances, and camouflage
  exits
• Caregivers fulfill the role as collaborators. Educate them on how to promote
  participation, and plan for the future needs of their loved one and supervise with greater confidence.

Question 17

eating disorders

Answer 17

• Early stage interventions: Avoid potentially distressing interventions, such as cooking, projective art, and body
  image improvement. Building a strong therapeutic alliance with the client is crucial
• Individual therapy helps teens build autonomy, self-reliance, and assertiveness based on self-awareness and the ability to self-reflect.
• Family-based therapy focus on a safe and reassuring environment so that they feel supported and not blamed at
  mealtime. Supportive, empathetic relationships are essential
• Treatment can include helping the individual to establish eating routines and working with the family to assist the
  client to understand the disorder and how the family can affect the course of the disorder

Question 18

Bullying & School Violence

Answer 18

• Help develop the skills needed to safely live in their environment, foster social skills, and teach respect for
  diversity
• Increase their actual and perceived levels of safety by encouraging sharing of experiences and dealing with effects.

Question 19

Suicide

Answer 19

• Patient and family education increasing suicide awareness
• Developing the rapport and the trust needed to build an effective therapeutic relationship
• Attempt to get the person to seek help from a doctor or the nearest emergency room

-Increase perceptions of adult support and increase the acceptability of asking for help

• Develop self-management skills and ways to organize the environment to decrease stress

-Teach strategies to manage suicidal thoughts by providing alternative activities to stop/divert negative thoughts or
suicidal ideation. Therapeutic activities should provide hope and a future-oriented focus.

Question 20

ADHD SYMPTOMS

Answer 20

ADHD presents with difficulty paying attention, listening, organizing, and focusing. They are typically forgetful, easily
distracted, fidgety, on the go, difficulty engaging quietly, impulsive, difficulty waiting, blurts things out, and often
interrupts

Question 21

CONDUCT DISORDER SYMPTOMS

Answer 21

Conduct disorders involve individuals engaging in high risk or harmful activities that are beyond the typical realm of acting out and involve violating the basic rights of others such as aggression to people and animals, destruction of property, and serious violations of rules.

Question 22

Oppositional Defiant Disorder

Answer 22

Oppositional Defiant Disorder involve individuals who cannot follow instructions or take directions. They become
anxious, aggressive, or distressed when their sense of control is threatened. These behaviors include aggression
and the tendency to be purposefully bothersome, annoying, and/or irritating to others. Often displayed by verbal
outbursts, fighting, or otherwise disruptive behaviors

Question 23

Reactive attachment disorder (RAD) SYMPTOMS

Answer 23

• The individual may be inhibited or withdrawn and unable to form
  attachments with any one person, or disinhibited, or forming attachments with any person
• Institutionalized, adopted, and neglected children face many obstacles to healthy attachment

-They present with a high need to be in control, frequently lie without reason, have poor eye contact except
when lying, they may be overly affectionate, inappropriately related with others including strangers or lack
interest in others and do not seek attention, lack a conscience and deny responsibility or project blame for
their actions, they hoard or gorge on food in the absence of want.

Question 24

Reactive attachment disorder (RAD) INTERVENTION

Answer 24

• Plans for each treatment activity to assure that the child feels safe and secure (both physically and
  emotionally)

-View the child’s behaviors as communication and consistently responds to them

-Assist parents and caregivers to establish predictable daily rituals and routines

-Assures that the parent is involved in treatment sessions

• Consider and identify all possible explanations for a child’s behaviors (behavior due to a sensory
  processing disorder, poor motor control, or possibly due to delayed emotional development)

-Include a therapy goal that each parent and child will successfully engage in mutually rewarding
interactions

Question 25

ADOLESCENT DISORDER INTERVENTIONS

Answer 25

• Structure and consistency
• Limit setting

    -Setting limits in a mental health setting ensures consistency and makes it clear to the adolescent what to expect.
     -Allow adolescents to take some responsibility by helping to develop the rules for the group. Most teens are more likely to follow the rules and adhere to the expectations of treatment if they were involved in process versus having rules imposed on them.
    -Provide positive reinforcement and praise instead of just negative consequences. Most adolescents in mental health treatment are not used to being positively praised for their behavior.

• Avoiding power struggles
• Implusivity
  - Do not put anything out on the table where you are having a group activity, ease transitions with a 5-
  minute warning before the group ends, provide a warm environment free from distractions, praise positive behavior as often as possible, maintain an even tone and affect while providing treatment.
  -Allow autonomy to not feel as though they are being “treated like a child,” but provide enough structure to
  maintain a therapeutic environment for the clients.
  -Provide choices so the adolescent can have the opportunity to have a sense of control and the ability to express autonomy in an acceptable, positive manner.
• Creating a therapeutic environment

Question 26

Developmental groups

Answer 26

Parallel- where tasks are done side-by-side and interaction is not required; OT provides
assistance with tasks and takes responsibility for meeting the social-emotional needs of each member

Project- emphasizing task accomplishment and minimal interaction; OT assists the group in selecting tasks that require interaction of two or more people for completion and meets the social-emotional
needs of members

Egocentric–cooperative- requiring more interaction and responsibility, group
members select, implement, and execute longterm tasks through joint interaction; OT gives support and
guidance for the task and meets the social-emotional needs of members

Cooperative- requiring much
interaction and taking care of others needs, members are encouraged to identify and gratify each other’s
social-emotional and task accomplishment; OT is an advisor and may not be present at all group
meetings

Mature groups,- where the members take on all necessary leadership roles to facilitate task accomplishment and caring for others needs; OT is a coequal group member.

Question 27

Directive Groups

Answer 27

The directive group and the focus group emphasize participation by meeting the needs of the most severely
and acutely mentally ill and most minimally functioning patients, with a wide range of diagnoses, ages, and
problems

Question 28

Psychotherapy Group

Answer 28

The goal is to resolve inter- or intra-personal issues

Question 29

Neurodevelopmental Groups

Answer 29

Neurodevelopmental groups utilize movement activities based on sensory integration theory and techniques.
The movements are usually imitative, gross motor movements and involve tactile, kinesthetic, and
proprioceptive input. The groups are designed for persons who are severely mentally ill such as those with
chronic schizophrenia.

Question 30

Psychoeducational Groups

Answer 30

This type of group teaches specific information or techniques to clients and their families, supporting clients
and their families well being.

Question 31

psychosocial clubhouse

Answer 31

Clubhouses are open to anyone with a history of mental illness who does not pose a safety threat. Member
have freedom of choice and full access to all clubhouse opportunities and records. Following hospitalization, the
clubhouse has a system of reaching out to reengage members, so they know that the clubhouse is still fully available.

Question 32

Prevocational rehabilitation

Answer 32

Helps members become used to basic work habits and the social rules of community work settings. Members
attend work groups where they perform jobs needed by the center or businesses within the community

Question 33

Transitional employment (TE): Stepping stones to permanent positions.

Answer 33

• Counselors and job coaches help clients adjust to jobs or adjust job factors to fit individual clients

-The goal is to provide a successful experience of work to help client’s adjust to work, enhance self-confidence, and offer job experiences for their résumés

• Part-time and time-limited position (typically 15–20 hours/week for 6–9 months). Temporary. The client can try
  out several jobs in succession.

Question 34

Supported employment (SE): Best practice acknowledged by professionals

Answer 34

• Full time or part time. “Owned” by the person holding the position after an interview where the employer (not
  the clubhouse) selects the employee

-Assistance with job development, coaching, and continuing follow-along for a period of time

-Individual Placement and Support (IPS)- Client is placed directly into competitive employment and services and accommodations are built around the client and the job. Provide specific suggestions and recommendations
to help employers support the worker.

• place and train empoyment

Question 35

Sheltered workshops

Answer 35

Training and employment are limited to specific disability groups.
Provides work experience and modified income to those unable to perform in a regular, competitive work
setting.
Tasks included sorting, counting, and bagging plastic tableware, assembling and counting and packaging
envelope

Question 36

Stages of Change

Answer 36

Precontemplation: Before an individual even considers change, person resists change.

Contemplation: The individual starts to consider changing, kind of unsure, but considers the pros and cons of
changing

Determination: Determination to at least start to change some behaviors

Action: Implementing behavioral change

Maintenance: The individual is learning to maintain the changes that they have implemented.

Question 37

Motivational Interviewing

Answer 37

-Often used in substance abuse treatment
- Helps activate the motivation a person already has and helps them move toward positive behavior change

-Resist the urge to fix things and give advice

The four general principles:
-Express empathy acknowledging that change is difficult.
-Develop discrepancy by identifying differences between current behavior and personal goals and values.
-Roll with resistance by avoiding confrontation.
-Support self-efficacy by showing that you believe the client is capable of making a change

-Motivational enhancement is an adaptation of motivational interviewing applied to eating disorders.
Enhances readiness to change in change-resistant clients

Question 38

Dialectical Behavior Therapy

Answer 38

• A cognitive-behavioral treatment protocol for complex and difficult to treat mental disorders that uses
  psychotherapy with psychosocial skills training to help individuals tolerate distressful feelings. Individuals with
  ineffective emotion regulation learn better strategies to improve emotion modulation skills
• The four modules include mindfulness, interpersonal effectiveness, emotion modulation, and distress tolerance
• Used with individuals with emotion dysregulation including those with Bipolar disorder and substance dependence,
  depressed elderly, suicidal adolescents, and binge eating

Standard CBT techniques can be used such as skills training, homework assignments, symptom rating scales,
diary cards, and behavioral analysis.

Question 39

Assertive Community Treatment

Answer 39

Full-support therapy with small caseloads, a multidisciplinary team rather than single case manager
responsibility, 24-hour service delivery, within a natural environment, real life environment, and direct skill
training. The multidisciplinary teamwork approach is a key factor in ACT. The team typically consists of 10 to
12 mental health professionals, such as an OT, nurse, psychiatrist, social worker, psychologist, employment
specialist, substance abuse specialist, peer specialist, or other related experts.

Question 40

Supported Housing

Answer 40

Independent living with community-based mental health services. Supported life approaches believe that
people with disabilities should have access to the same living, learning, and working environments as those
without disabilities. There is understanding that persons with disabilities may need certain types and intensity
of support, but they emphasize that support should be provided in real-world contexts and at a level
preferred by the person with the disability.