mental health- symptom management Flashcards
symptoms
- not the disease
- behavioural evidence
- behaviour might be more useful than the diagnoses in relation to treatment
treating based on symptom
activities to treat the symptom should be appropriate for the interests of the client, the occupational role, and the client’s level of functioning
3 OTA response variables to the needs of the client
self
environment
activity
3 anxious behaviours
ritualistic
fearful
demanding
how to deal with anxious behaviours
ritualistic- accept their little rituals
fearful- ask them to talk about their fears
demanding-give specific times available and locations
depression,,,, treatment
-don’t try to cheer them up as this reduces the importance of the person’s feelings
-report behaviour such as giving away personal items
Environment: safe and subdued; provide opportunities to work 1:1; increase the amount of stimulation as tolerated and the number of people in a group for example. Activities: 1st – simple, short-term, familiar, high success rate;
Simple task – making a phone call, brushing hair – solitary activities without the need to share tools etc. ——Gross motor activities help to release tension, increase 02 intake and increase blood flow to the brain.
-In an OT program beware that a suicidal person may remove objects to use in in a suicide attempt. OTA’s need to be alert to ways tools and supplies can be used in a suicide attempt.
risk of suicide
family history past attempt unemployment poor health substance abuse recent life changes
mania, what the crap is it?!
Recognizing mania – hyperactivity, agitated, rapid speech, flight of ideas, difficulty concentrating, lacking in judgement, they may dress outrageously ( may wear several belts, hats at the same time); excessive makeup; lots of energy, they like to flatter others and give gifts ( be mindful of this). Other antics – try to split up staff and create a tempest in a teapot, sometimes like to ask for a priviledge and build it up so that the request is beyond expectations. What purpose do these tactics serve? Manipulation and control…why? Leads caregivers to assist client and therefore they don’t have to take responsibility for themselves.
mania… OTA response
TUS = These clients can demand constant attention, praise, and approval from staff. However their attention seeking behaviour and their bizarre self-centredness, causes others to avoid them. Be cautious about giving praise or approval. Avoid criticizing as they are very vulnerable and feel easily rejected. Be calm, matter of fact, firm and consistent. Setting and enforcing limits is important and usually needed. Environment = eliminate or reduce distractions, only introduce new items when the client is ready for them in their project etc. Have the person work alone, facing a blank wall. Activities = Due to high energy levels have the opportunities for the client to get up and move around. Short-term activities provide immediate gratification are helpful for someone with poor frustration tolerance and inability to wait for results. Activities can be portable, structured and have 3 or fewer steps. Activities that are unfocused, creative or require directions should be avoided. Activities that require fine manipulation or attention to detail will be challenging. Materials should be controllable, not floppy or unpredictable – leather, wood vs clay. How would you develop longer attention span over time?
mania… more on response
self- don’t praise or criticize… rather be straight forward, matter of fact, calm, consistent, firm
environment- reduce distractions, work alone
activities- short term activities, provide opportunities for client to move around, few steps…
avoid these activities: unfocused, creative, with directions, with fine manipulation and attention to detail
hallucination
Definition: A sensory experience that has no basis in external reality. A hallucinating person sees, hears, feels,
smells or tastes things that are not there.
hallucinations.. how to respond
self- reassure the client, tell them you believe what they are experiencing, be comforting and calm, redirect client to a different topic
environment- reduce stimulation, but avoid isolation
activity- highly structured, engage with a few others, simple and structured activity, such as basic life skills
delusions
Delusions – is a false belief, not based on reality which is peculiar to the individual.
delusions.. what’s an ot to do?
self-don’t discuss delusions, redirect person’s attention
environment- stimulating, real life activities
activity- occupational role, reflect the person’s interests
paranoia
suspiciousness, unbelievable ideas, used as a defense against rejection
- make them feel like an intelluctual equal
- make them feel important and think about themselves
paranoia… what’s an ot to do?!
self- do not surprise them, be clear, consistent, and firm, and stay in charge of the activity or situation
environment- keep the environment stable and consistent, if there is a change occurring, warn client before hand. may want to isolate, need to be coached to join a group
activity- ones that they can control, such as working with material. structured activities.
hostility and aggression
unfriendly, threatening, aggression
can’t express themselves, or scared of rejection
aggression… what’s an ot to do?!
self: speak privately, do not punish or criticize
set clear expectations
be cautious, obvs
environment: stand 5 feet away, leave the door open, be close to the door
activities: art and dance to express feelings, activity requiring force and moving objects, sports, peeling potatoes, wood sanding.
sexual behaviour
objective-nonjudgemental, but reinforce rules, discourage any offers haha
self-avoid physical contact, do not encourage talk of sexual relationship, notify and document any sexual occurences, encourage other clients to report any sexual harassment or abuse
environment- give client personal space
activity- gross motor, social skills training
confused and impaired memory
could affect alertness, orientation, concentration, attention, memory, comprehension, memory, judgement, problem solving
may be frightened, anxious, agitated
confabulation (making up stories to cover up cognitive diff.. especially for memory loss)
depressed, disturbed sleep
labile emotions
dressing dyspraxia
confused/impaired memory… what’s an OT to do?!
-non threatening and supportive approach
observe effective/ non-effective strategies
self- remind client who you are, be warm and accepting, intervene when things are going wrong, consider the 5 c’s (clear, calm, consistent, concise, concrete)
environment: good lighting, signs, neat, use a routine/schedule
activities: life skill activities, walking programs, familiar crafts and hobbies, reality orientation
attention deficits and disorganization
problems paying attention to a task, lack of planning, unsuccessful with activities
presenting features: decreased concentration and attention, distracted by hallucinations or memories
goal- promote concentration
self- make sure you have their attention, activities that will improve skill but not be threatening, use touch if it helps to re-direct
environment- if client is distracted by things and people, work alone, if client is distracted by mind, provide vigorous stimulation
activity- simple, sequence, limited steps, avoid flexible goals or outcomes, simple craft games, IADLS such as laundry, coping and stress management skills to increase awareness of behaviours
