NURS 661 Exam 3 Flashcards
1
Q
PHQ-9: What score is moderate depression?
A
10-14
2
Q
PHQ-9: What score is moderately severe depression?
A
15-19
3
Q
PHQ-9: What score is mild depression?
A
5-9
4
Q
PHQ-9: What score is severe depression?
A
20-27
5
Q
Interpersonal therapy: when to use …
A
Good choice for adults with concerns of:
Loss, grief, interpersonal conflict, role transitions (midlife/empty nester/etc)
Mild to moderate depression
6
Q
What therapy modifications are used for older adults?
A
- Give them more time
- Speak clearly
- Large print
7
Q
What age does reasoning start to happen?
A
Intuitive thought substage:
- around 4-7 years of age
- asks more questions
8
Q
Techniques for teaching self-regulation to children:
- for yourself
- for the child
A
For the therapist:
- manage your own stress
- realistic expectations
- model self-regulation
- be supportive and encouraging
- reduce unnecessary demands
For the child:
- Motivational interviewing
—-To decrease resistance and hostility from child
- Strength-Based approach
—- What works for them
9
Q
Strength based approach for children
A
- Start with what’s present, NOT what’s absent
- Questioning strategies to find out what works for them and their abilities
10
Q
Which family systems to address bipolar
A
CBT with family system focus
11
Q
How long after trauma should you discuss the trauma with children?
A
TF-CBT 2-4 weeks after trauma
12
Q
Three main characteristics of ADHD in children
A
Inattentiveness
Hyperactivity
Impulsivity
13
Q
What is impulsivity
A
do without thinking of consequences
14
Q
Brain structures of ADHD
A
Prefrontal cortex
– Distractibility
– Forgetfulness
15
Q
What should happen if a child is taking stimulant and still has poor attention?
A
Add in cognitive training
- focused on enhancing working memory
16
Q
Example of a strengths-based approach
A
Praise a youth for maintaining control
If child is getting bad grades → praise the effort of turning in assignments and going to school
17
Q
GAD 7: Minimal
A
0-4
18
Q
GAD 7: Severe
A
15-21
19
Q
GAD 7: Moderate
A
10-14
20
Q
GAD 7: Mild
A
6-9
21
Q
Encouragement
A
Gives hope, determination
22
Q
Exhortation
A
Self-help, urge more drive, do the hard work needed for max achievement
23
Q
Inspiration
A
Feeling of enthusiasm that you get from something that gives new ideas
24
Q
Normalizing
A
Make the patient realize something they feel weird about it normal
25
Differentiation
Ability to maintain your own thoughts in the presence and pressure of close intimate relationships
26
Fusion
Believe that thinking about an action is the same as completing that action
Thinking about harming a partner is just as bad as doing it in real life
27
Transmission Process
Process of family emotions over the generations
-- Your cousin Jenny was divorced 5 times
28
Triangle Family: What is it and example
Part of the Bowen's family systems:
Dyads - unstable
Two people vacillate between close and distant
Seek out a third-person
Example:
- Child as an emotional extension of parents
Which is family projection process
29
Undifferentiated ego mass
Emotional oneness of family group
30
Bowen’s family systems theory
is a theory of human behavior that use the family as an emotional unit and uses systems thinking to describe the units complex interactions it's the nature of a family that its members are INTENSELY CONNECTED EMOTIONALLY
31
Sibling position
people who grow up in the same sibling position predictively have important common characteristics
Example, older children tend to gravitate to leadership positions and youngest children often prefer to be followers.
32
Codependent family
parents who are codependent may try to control their child's life. a. The control could show up in different ways:
They could be overly involved. For example, if a parent sees that something painful is happening in their child's life, they'll try to gain control by getting involved often too involved, like a helicopter parent.
33
Disengaged family
members are mutually withdrawn from each other, psychologically and emotionally
An example is families that share little to nothing.
Usually this happens in overly rigid families they're often described as detached.
There’s little to no communication, no flexibility to accommodate support and guidance
34
Enmeshed family
There are no boundaries between the family members.
Instead of the strong bonds that signal a well-functioning family unit- The family members in an enmeshed family are fused together by unhealthy emotions.
Usually in enmeshed families are rooted in trauma or illness.
Parents are usually excessively involved in children's minor conflicts and they don't allow children the opportunity to solve their own problems.
35
Toxic family
temporarily behave in toxic or unhealthy ways because of problems outside the family dynamic like challenges at work, school, health concerns, or emotional distress.
Usually, a toxic family is generally they have patterns of abuse, discrimination, manipulation, verbal abuse, or violence.
36
Minuchin’s factors that lead to family dysfunction
Family composition may change due to the birth of a child or the inclusion of a relative, like if a grandparent comes to live with a family or even the addition of a foster child.
But if the family does not change or modify its interactions and transactions to include the new family member stress resulting from the situation may cause family dysfunction.
37
How to promote self-statements during a family therapy session
Using “I feel” statements; and focus on self-awareness, and create a stress free zone and self-care: meditation, physical activity, and self-talk
38
Be able to give examples of the Structural Family Therapy Approach
and what is the goal
Family has a couple of children that are pushing the parents limits and emotional boundaries →
GOAL: create an effective family structure
39
Parentification
when parents rely on their children to give to them.
Example: teenage boy, whose dad is irresponsible and neglectful so the youth has to make adult decisions
40
Family mapping
To understand and uncover patterns of behavior and family interactions
41
Boundary making
Helps with enmesh family members, such as a parent who's overly involved with a child.
Boundary making may be introduced or reinforced to strengthen or change the distance between relationships.
42
Reframing
Couple is arguing
Therapist asks them to see it as a whole team problem vs an individual
43
Shaping competence
Acknowledging and praising positive behaviors
Therapist: Great you were able to work together to develop a plan
44
Tracking
Gain understanding of interactive patterns in which an presenting situation is embedded
Helping family members change the way they relate to eachother
45
Unbalancing
is to change the relationship of the members of a subsystem.
Example:
if a matched father and daughter are sitting next to each other in a therapy session and they frequently look at each at each other and laugh and ignore their mother-
The therapist may ask the mother and father to change seats, so that way, the mother is next to the daughter. And the father and daughter have more distance that would be a therapy technique of unbalancing in order to correct the blocking that was happening.
Example:
2 kids in session refuse to pay attention to the parent’s request
Therapist asks the kids to leave the room to work with parents
46
First order change
Making the decision to stop an action
47
Second order change
Doing something fundamentally different that what you’ve done before
48
Feedback loops:
- two components
- How is it a loop
Two components:
1. Action
2. Reaction
What makes it a loop → results of the reaction feedback into the process
49
Stages of change: Precontemplation
No thoughts of change
50
Stages of change: Contemplation
Aware of the problem.
No commitment
51
Stages of change: Preparation
Intent on taking action
has a plan
52
Stages of change: Action
active modification of the behavior
53
Stages of change: Maintenance
Sustained change
54
Stages of change: Relapse
Falls back into old behaviors
55
Grounding
Self-soothing skill
-- to use when having a bad day/ dealing with stress
Keeps you in the present
Good for:
- trauma or a lot of anxiety
Example
Identify a blue object around you
Count how many blue objects you see
56
Guided Imagery
Use words and music to evoke positive imagery scenarios with a view to bring a beneficial effect
Example
Imagine you’re on a beach
You can hear the waves
See the color of the sky
57
Mindfullness
Builds on principles of cognitive therapy
Pay attention to thoughts and feelings
58
Homeostasis
Tendency to resist change in order to maintain a stable environment
59
Supportive Self-talk
- what is it
- who is it good for
Useful for PTSD
Encouraging self to take a breath and focus
Example:
During a flashback say “this old stuff, I’m safe.”
-- Deep breath and long, slow exhale
-- “That’s the past. I’m not there.”
60
Insecure Attachement
Diminished ability to express needs and feelings
Adopt a safe distance
Solve problems alone without understanding the effect they have on their partners
61
Anxious Attachment
Demand reassurance
Blame and manipulate to engage partner
Needy
62
Recovery
Process of change to improve health and wellness
63
Erickson's:
birth - 18 mo
Infancy
Trust vs Mistrust
64
Erickson's:
18 mo - 3 yo
Early childhood
Autonomy vs Self-doubt
Shame and doubt
65
Erickson's:
3 - 6
Late childhood
Initiative vs Guilt
66
Erickson's:
6 - 12
School age
industry vs inferiority
67
Erickson's:
12 - 20
Adolescence
Identity vs Role Confusion
68
Erickson's:
20 - 30
Young Adult
Intimacy vs Isolation
69
Erickson's:
30 - 65
Adulthood
Generativity vs Stagnation
70
Erickson's:
65 - to death
Old Age
Ego integrity vs Despair
71
Life Review
Evaluation
Critical Study of life
72
Reminiscence
Share life experiences
Memories and stories
can help people with dementia remember places and people
73
