Psychological Approaches Flashcards
Principles of MOHO
Three elements inherent to humans:
Volition- interest and personal causation
Habituation- habits/roles
Performance Capacity- skills for producing actions
PEO Model
Occupational performance is considered the outcome of the transactional relationship between ppl, their occupations, and the environment
a person’s place in their lifespan influences their roles, activities, expected skills and motivations
Ecology of Human Performance Model EHP
Principles
Emphasizes the role of an individual’s context and how the environment impacts a person and their task perfomance
The 4 main constructs include the person, tasks, context, and personal-context-task transaction
Evaluation
Utilizes checklists that include the person, the environment, task analysis, and personal priorities
Allen Six Levels of Cognitive Abilities
Cognitive Disabilities
Lvl 1 Automatic Actions: conscious response to external environment is minimal
Lvl2 Postural Actions: movement associated with comfort, may assist caregiver with simple tasks
Lvl 3 Manual Actions: begins with use of hands to manipulate objects, able to perform a limited number of tasks with LT training
Lvl 4 Goal Directed Actions: ability to carry simple tasks to completion, relies heavily on verbal cues, may perform established routines but cannot cope with unexpected events
Lvl 5 Exploratory Actions: overt trial and error problem solving, new learning occurs
Lvl 6 Planned Actions: absence of disability, can think of hypothetical situations and mental trial and error problem solving
Allen’s Cognitive Disability Levels Group Incorporation
Lvl 1 Automatic Actions: would not benefit from group dymamics
Lvl2 Postural Actions: will be successful in situations where they can move about and copy movement that is modeled
Lvl 3 Manual Actions: focus on elements of repetition and manipulation
Lvl 4 Goal Directed Actions: goal-directed activities such as craft projects
Lvl 5 Exploratory Actions: activities with graded structure such as clay modeling or mosaics
Allen Cognitive Level Screen-5 ACLS-5
observing three increasingly complex leather lacing stitches and determine the person’s cognitive lvl
Allen Diagnostic Manual
provides craft projects that can be used for eval as well as treatment that can also determine the person level of skills
Routine Task Inventory
gathers data about the person’s ADL performance from an informed caregiver
Cognitive Performance Test
assess functional performance of individuals with Alzheimer’s disease
Cognitive Behavioral Therapy CBT
Effective in the treatment of depression and other clinical populations; works to alter neg thoughts about themselves, the world,and the future by correcting misinterpretations of life events
Uses cognitive therapy (looks at thought and beliefs) and behavioral therapy (looks at person’s actions and attempts to change maladaptive behavior patterns).
Approaches Using CBT
Assist clients in ID of current problems and potential solutions
Uses active/collaborative practitioner-client interaction as part of process
Help client learn to id distorted/unhelpful thinking patterns and relate to more pos ways
Help clnt gain insight and acquire skills that max func
Provides homework and structured assignments as part of intervention
Behavioral Techniques in CBT
Scheduling activities- increasing mastery/pleasure; grade to enable client success
Cognitive Rehearsal
Self-Reliance Training- can be facilitated thru performing ADLS
Role Playing
Diversion Techniques
Engaging in physical, work, leisure/play, and/or social participation
Dialectical Behavior Therapy DBT
Focus
Addresses suicidal thoughts and actions and self-injurious behavior
Commonly used with borderline personality disorder; also depression, substance abuse, and eating disorders
Intervention
Teaches assertiveness, coping, and interpersonal skills
DBT groups address how acquisition of skills affects occupational performance and provide opportunity to practice new skills
Major Concepts That Guide Recovery
Recovery Model
Self-direction Individualized and person-centered Empowerment Holistic Nonlinear Hope Family Community
Recovery Model Intervention
The development and implementation of a Wellness Recovery Action Plan (WRAP) is essential part of the recovery process
Storytelling is means of decreasing stigma and supporting others
Advocacy
Areas Addressed in Psychosocial Assessment
Performance skills
Client factors and physical conditions
Impact of individual’s social , cultural, spiritual, and physical contexts
Id roles and behaviors that are req of the person
Precautions and safety issues
History of behavior patterns
Goals, values, interests, attitudes
Groups VS One-To-One
One-to-One Refusal to attend groups Inability to tolerate group interaction Disruptive behaviors Suicide precautions or a danger to self or others Issues needing one/one attention
Groups
More cost effective
Learn to live in social environment
Take advantage of groups dynamics and therapeutic milieu
Directive Groups
Highly structured groups designed to assist persons with limited abilities in developing basic task and social skills
Modular Groups
Focus of each session is rotated; different sessions covering one overall subject (indepen living skills covering money management, nutrition, etc)
Psychoeducational Groups
an intervention approach that uses a classroom format and principles of learning to provide info to members and to teach skills
Sensory Awareness Groups
includes activities to promote sensory func and environmental awareness
Managing Hallucinations
Create an distraction-free environment
Highly structured simple, concrete activities
Redirect when pt is focused on hallucinations
Avoid discussions that focus on or validate delusional material
Managing Akathisia
Allow the person to move around as needed w/o causing disruption
Whenever possible, select gross motor activities over fine motor or sedentary ones
Managing Offensive Behavior
Set limits and immediately address the behavior during the session
State reasons behavior is unacceptable in a nonconfrontational manner
Consequences if continued should be clearly communicated
Lack of Initiation/Participation
Together w/pt id reasons for lack of participation
Provide motivational hints
Manic/Monopolizing Behavior
Highly structured activities that hold the person’s attention and req a shift of focus from pt to pt
Thank pt for participation and redirect attention to another group member
Limit setting
Escalating Behavior
Avoid what can be perceived as challenging behavior
Maintain a comfortable distance
Actively listen
Use a calm, but not patronizing voice
Do not make value judgments
Clearly present what you would like the person to do
Avoid positions where you or the pt feels trapped
If it continues to escalate, remove other pts from area and get/send for other staff
Managing Acting Out Behavior In Children
Interpretation (enable child to express feelings)
Redirection
Limit Setting
Time Out
Managing The Effects Of Dementia
Make eye contact and show that you are interested
Value/validate what is being said
Maintain pos facial expression and tone of voice
Do not give orders
Use short, simple words and sentences
Do not argue/criticize
Create a familiar routine with enjoyable activities
Note effects of time of day on behavior and activity performance
RADAR Screening and Respond to Domestic Abuse
R- routinely ask; inquiring about potential abuse when interviewing
A- affirm and ask; acknowledge and support the person who discloses abuse
D- document objective findings and record client statements in quotes
A- assess and address person’s safety
R- review options and referrals
Phases of Adjustment to Disability
- Shock- emotional numbness, depersonalization, reduced speech/mobility
- Anxiety- restlessness, confusion, racing thoughts
- Denial- minimization, unrealistic expectations
- Depression- helplessness, isolation, decreased self-esteem
- Internalized Anger- blaming self for event or failure to recover
- Externalized Anger- attempt to retaliate for imposed losses, directed against those associated w/onset or rehab
- Acknowledgement- acceptance
- Adjustment- pos sense of self and potentialities
Suicide OT Interventions
Id of motivation behind suicidal intent and id alternatives
Create a contract for safety
Development of problem solving and stress management skills
Id goals and interest
Create activities for expression/validation of feelings and that produce successful outcomes and are future oriented
Mod physical activ to elevate mood
Develop skills that increase func perfomance
Pt ed
OT Intervention for Self-Harm
Improve self-management by teaching stress, anger, and emotional regulation skills
Instructing clnt on using alter coping strategies (ice, rubber bands)
Interventions using CBT or DBT if appropriated
Instructing in use of sensory approaches (massage, tactile stimulation, self-soothing)
Improving problem solving and communication skills
Adjustment to Death and Dying
Denial Anger Bargaining Depression Acceptance
OT Intervention Through Stages of Death/Dying
Assist individual in maintaining as much control and independence as possible
Respond honestly and at appropriate depth to questions
Assist w/develop of coping skills
Encourage pos life review
Assist w/pursuing interests and maintaining meaningful life roles
Incorporate friends/family in treatment
While being realistic, do not deprive individual of hope
Strategy for caregivers of a client with Alzheimer’s disease to assist with fall prevention
Engagement in activity-based interventions, along with daily structure, has been documented to assist in fall prevention.
