Midterm Part II (420) Flashcards
a mental health problem must cause distress and dysfunction to be diagnosable. That is, it must be:
Maladaptive
schizophrenia is usually diagnosed in
early adulthood
many individuals with mental disorders also suffer from another disorder simultaneously, this is called
comorbidity
generalized anxiety disorder is a psychological disorder diagnosed i situations where:
a person has been exessively worrying about money, health, work, family, life ,or relationships for at least six months, knows that concerns are exaggerated, and experience distress.
which class of disorder represents a condition that involves disruptions or breakdown in memory, awareness, or identity
dissociative disorder
the main difference between major depressive disorder and bipolar disorder is
bipolar disorder involves swings in mood from overly high to sad and hopeless and back again
which of the following would be an example of re-educative , insight music therapy
music facilitated discussion to promote insight and awareness
the school of psychology whose goal was to identify the basic elements of experience was called
structuralism
BASIC ID
Most psychological problems are multifaceted and call for careful assessment
of seven, reciprocally transactional dimensions in which individuals operate
Behavior (our actions)
Affect (our emotions)
Sensation (our senses)
Imagery (our ability to use images or visualize)
Cognition (our language-based thinking
Interpersonal Relationships (our intimate connections)
Drugs/Diet or Biological Processes (our physical bodies & health)
Music and Art
Soundtrack Autobiography - create a playlist and cover art that currently
represents them
Scribble Art - listen to unfamiliar recorded music and move their pencil across
the paper without lifting from the paper. Then, finish creating the piece with
colored pencils or crayons. Give the creation a title, theme song, etc.
My Song - therapist distributes small pieces of paper to the group, group
members write the name of a song that currently represents them OR that
inspires/motivates them. Therapist then mixes up the papers and reads them
one at a time. Group members have to identify which person selected which
song. After group member is identified, they have to explain why they chose
that song specifically
Recreational Music Therapy
Music Therapy “Games”
- Quick rapport builders
- Useful for larger groups
Examples:
Musical Hot Potato
Art and Music
Name That Tune
Music and Dice Game
Music Jeopardy
Complete the Lyrics
TV Theme Song Game
Musical Chairs
Musical Wheel of Fortune
Music-Based Charades
Junk Band Percussion
Heads-Up
Songwriting
Composing music & lyrics
Group or 1:1
Product or process
Spectrum of structure
Goals & Objectives:
- Express emotions, narratives, ideas, concerns
- Experience relief, validation, joy
- Bolster therapeutic process & outcomes
- Build connections
- Support sociocultural identity
- Promoting leisure & enjoyment
- Enhanced sense of achievement
- Music to convey messages & emotions
Spectrum of structure in songwriting
High structure: people with chronic and severe mental conditions, not in touch with reality, can be completed in one session. Ex: fill in the blank songwriting
Medium structure: acute care and brief treatment, can be completed during multiple sessions for people with severe mental health conditions, can be completed in a single session in acute care and crisis stabilization. Ex: lyric replacement
Low structure: often requires multiple session because of autonomy, choices, and decisions. Ex: Free composition
Facilitating songwriting
Brainstorm on a dry-erase or chalkboard
- If the group becomes stuck, play the entire phrase or verse
- When determining the lyrics for music, sing the melody on a syllable so the
patients can hear the musical phrase
- You can rhyme or not rhyme
- Record the song for patients!
- Perform the song for the staff with the patients
- Try not to change their words
Lyric Analysis
Discussion of lyrics and music to address a variety of clinical
objectives
- Patients are encouraged to share their perspectives of the music,
what the song lyrics may mean, or how the lyrics may be interpreted
- Therapist’s prompts can be direct or indirect
Goals:
Self-expression
Emotional regulation
Coping skills
Self-awareness
Goal-setting
Facilitating lyric analysis
Use high-quality live music
- Assign a task to the group during music
listening to keep them engaged (e.g., identify
a favorite phrase)
- Promote engagement and acceptance (“there
are no wrong answers”)
- Give lyric sheets to patients
- BUT do not assume everyone can read
- Think of reflective questions to give for
homework
Goals and objectives in psychiatric MT
Goals:
Physical
Emotional
Psychological
Social
Cognitive
Behavioral
Language/Communication
Sensory
Musical
Objectives:
Support self-efficacy
Support agency, mastery, and autonomy
Decrease anxiety
Improve affect
Decrease perception of depressive symptoms
Decrease auditory hallucinations
Improve level of social functioning
Improve global state
Support quality of life
Promote symptom reduction
Provide education on illness management
Support coping skills
Promote problem-solving skills
Promote adherence to medication
Decrease stress
What can impact the intervention? (lyric analysis)
Therapeutic Function of Music Connection
- What element of music?
- Listener Interpretation
- d/t music facilitation
- Therapist Interpretation
- Questions used as prompts
Steps of processing group exercises (lyric analysis/dvorak)
Adapted a conceptual framework for processing group exercises developed by Kees
and Jacobs (1990)
- In MT → “group exercise” = lyric analysis
- Framework splits objectives into five levels
1. Processing the exercise (lyrics/music) itself
2. Reflecting on reactions to the exercise (lyrics/music)
3. Discussing how the exercise (lyrics/music) was affecting the group process
4. Reflecting upon their own feelings, thoughts, or insights
5. Reflecting on how the exercise relates to their lives
Problems with Diagnoses
Poor diagnostic reliability
- Revisions in the DSM - pros & cons
- Diagnoses are imprecise, based mainly on subjective (potentially biased)
patient-reported symptoms
- Subjective provider diagnoses
- High frequency of “not otherwise specified” diagnoses in DSM
- Comorbidity
- Many symptoms are common and overlap a number of different
diagnoses
- e.g., “difficulty concentrating” is a symptom of 16 different disorders
- Extraordinary variability within diagnoses
- Lack of input from those with mental health diagnoses
Transdiagnostic theory
An individualized treatment approach where clinicians do not emphasize a
specific diagnosis but rather focus on cognitive, behavioral, and affective
features and patterns
“The patient’s specific disorder is not of relevance to treatment”
Transdiagnostic theory simplifies treatment provision by delivering an
intervention applicable for a number of people regardless of their specific
mental health condition.
Can be helpful for emotional regulation strategies
Transdiagnostic theory for group MT
De-emphasize specific mental health diagnoses
- Places importance on patients & their needs (cultures, identities, values,
presenting problems)
- Group members may share commonalities, behaviors, psychosocial stressors, symptoms,
affective states, maladaptive thought processes, problems, and treatment goals
Defining late adulthood
65+
- 49.2 million (15.2%) Americans are 65+
- By 2060, that number is expected to grow to 98.2 million (25%)
- Demographers vs. Developmentalists
- “Young Old” - healthy & active
- “Old Old” - health problems, difficulty with ADLs
Defining aging
Optimal Aging - those who enjoy better health and social well-being
Normal Aging - those who seem to have the same health and social concerns
as those in the rest of the aging population
Impaired Aging - those who experience poor health and dependence to a
greater extent than would be considered “normal”
Successful Aging - making adjustments, as needed, to continue living as
independently and actively as possible
what supports successful aging?
Being able to adjust well to changing situations early in life = being able to
adjust well to changing situations later in life
- Perception
- Sick/Vulnerable vs. Positive Views
- Youth-Oriented vs. High Esteem for Older Adults
- Primary aging:
- aging that is irreversible and is due to genetic predisposition
- Secondary aging:
- refers to changes that are caused by illness or disease
Theories of aging
Peripheral slowing hypothesis
- Overall processing speed declines in the peripheral nervous system, affecting the brain’s ability
to communicate with muscles and organs.
- Generalized slowing hypothesis
- processing in all parts of the nervous system, including the brain, are less efficient with age. This
may be why older people have more accidents. Genetics, diet, lifestyle, activity, and exposure to
pollutants all play a role in the aging process
- Hayflick Limit
- Cells divide a limited number of times and then stop. This phenomenon is evidenced in cells
studied in test tubes which divide about 50 times before becoming senescent.
- Free Radical Theory of Aging
- Free radicals are a byproduct of normal cell function. When cells create energy, they also
produce unstable oxygen molecules. These free radical molecules have a free electron, which
makes the molecule highly unstable. Free radicals then bond to other molecules in the body,
causing essential molecules to not function as they should.
- Many of the changes that occur as our bodies age are caused by free radicals. Damage to DNA,
protein cross-linking and other changes have been attributed to free radicals. Over time, this
damage accumulates and causes us to experience aging.
Physical changes of aging
Changes in physical capabilities
Decrease in bone density and size
Loss of physical strength
Less coordinated
Prone to physical injury
Chronic health conditions
Malnutrition
Sensory impairments
Oral health
Bladder control & constipation
cognitive changes of aging
Deficits:
Spectrum of memory deficits from minimal to
significant
“Normal” cognitive aging
Abnormal loss of cognitive function
Slower processing speeds
Longer to recall words
Difficulty inhibiting and controlling attention
Leads to off-topic, tangential conversation
Benefits:
Increased general knowledge about the world
More sophisticated understanding of the
world
social changes in aging
Erikson - Integrity vs Despair
Mental Health Changes = social isolation
Retirement = more time for leisure activities
Ability to work part-time for ease of transition
Stronger ties to family and community (not to
career)
Ability to engage in leisure activities
Sedentary lifestyles can contribute to quicker
decline
Continuity Theory - as people age, they see
themselves the same as they once did
Disengagement Theory - as people age, they AND
society mutually withdraw
dementia
A loss of cognitive functioning (thinking,
remembering, reasoning)
- Interferes with daily life and activities
- Ranges in severity from mild to severe
Signs/Symptoms:
- Memory loss, poor judgment, confusion
- Difficulty speaking, understanding, expressing
thoughts
- Difficulty reading and writing
- Increased wandering, getting lost
- Difficulty handling money, paying bills
- Increased repeated questions
- Decreased ability to complete daily tasks
- Losing interest in normal activities or events
- Hallucinating or experiencing delusions or
paranoia
- Decrease empathy
Cause:
- Dementia is the result of changes
in certain brain regions that cause
certain neural connections to
stop working properly.
Types:
- Alzheimer’s Disease
- Vascular Dementia
- Lewy Body Dementia
- Frontotemporal Dementia
- Mixed dementia
Diagnosis:
- Medical assessment to rule out a potential treatable disease
- Physical exam, blood tests, cognitive & neurological tests, brain scans (CT,
MRI, PET)
- Review of medical/family history for risk factors
- Psychiatric evaluation (for behavioral or mood changes)
Alzheimer’s
Most common type of dementia
- Progressive disease
- Mild memory loss → loss of the ability
to carry out a conversation or
respond to the environment
Cause:
- No single cause, likely a
combination of factors
- Risk Factors:
- Age
- Family History/Genetics
- Education, diet, environment?
Signs/Symptoms
- Memory loss that disrupts daily
life (e.g., getting lost in a familiar
place, repeated questions)
- Trouble handling money
- Difficulty completing familiar
tasks
- Decreased or poor judgment
- Misplacing things and being
unable to retrace steps to find
them
- Changes in mood, personality, or
behavior
MT goals for dementia, alzhiemer’s, cognitive decline
Orientation to time, place
Maintenance of social behaviors
Maintenance of receptive and
expressive language
Reducing disruptive behaviors
Maintenance of memory
Increased positive affect
Improved caregiver relationships
Reducing anxiety
Reducing agitation/restlessness
Promote socialization & communication
MT interventions for alzheimer’s, dementia, and cognitive decline
Reminiscence
Movement & Music
Instrument Play
Singing
Songwriting
Memory Training
