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OT Process > Psychosoc Approaches > Flashcards

Psychosoc Approaches Flashcards

1
Q

Model of Human Occ (MOHO) Principles

A

Occ is dynamic & context dependent. Personal occ choices shape individual. 3 inherent elements to humans: volition (thoughts/feelings of motivation), habituation (behavior patterns) & performance (phys/ment skills needed. Environment (phys/soc) impacts individual thru opps, demands, resources & constraints.

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2
Q

MOHO Eval

A

Focuses on exploring individual occ, hx, goals, volition, habits and occ performance - any procedure that provides pertinent info on environment/person may be used

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3
Q

MOHO Intervention

A

Focuses on occ engagement & includes acts that are purposeful, relevant and meaningful to ppl and their social context

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4
Q

PEO Model Prinicples

A

Occ perform (OP) is dynamic in nature & considered outcome of transactional relationship between ppl, occs & environment. OP changes across lifespan.

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5
Q

PEO Eval

A

Address OP issues of client. Emp environment of individual to include where pt lives/works/plays. Eval is pt-centered and flexible as there are no specific evals

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6
Q

PEO Intervention

A

Considers transational relationships pf occs w people & their environment to address OP issues/goals. Recognizes temporal nature of OP as the P-E-O are constantly changing. Offers many aves for change as practitioners can be flexible in their choice of intervention strategies

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7
Q

Life-Style Performance Model Principles

A

Seeks to ID and describe the nature & critical “doing” elements of an environment that support/foster achievements of a satisfying/productive life style. *Looks for match between person and environment. Performance and QOL can be enhanced by am environment that provides the 10 fund human needs. Performance is measured in the quality of fx’ing in 4 domains - self care maintenance; intrinsic gratification; service to others & reciprocal relations

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8
Q

Life-Style Performance Model Eval

A

Focus on obtaining activity hx & life style performance profile r/t the 4 skill domains. Environmental factors are explored.

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9
Q

Life-Style Performance Model Intervention

A

Addresses 5 main Q’s: 1.What does the pt need to be able to do? 2.What is the pt able to do? 3.What is the pt not able to do? 4.What interventions are needed and in what order. 5.What are the characteristics and pattern of acts/environment that will enhance the pts QOL? -Any tx that promos performance in 4 domains are acceptable

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10
Q

Ecology of Human Performance Model (EHP) Principles

A

Emp role on pts context and how environment impacts task performance. Applicable to ppl across life span. 4 main constructs: person, task, context & P-T-C transaction.. Ecology refers to interaction between P & E. Performance occurs when P acts to perform T in C. C are dynamic. Defines I as using supports in C to meet needs/wants

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11
Q

EHP Eval

A

Utilizes checklists designed w this model: for P, E, task analysis & personal priorities & Sensory profile

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12
Q

EHP Tx

A

Five specific strategies designed to help the P, C & T: Establish/restore, Alter, Adapt/Modify, Prevent & Create.

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13
Q

Occ Adaptation

A

Concerned w process pt goes thru to adapt to E. 3 elements: P, occ E & interaction between the 2. Occ provides means by which humans adapt to changing needs/conditions. Desired to participate in occ in intrinsic, motivational force. Occ adaptation is a normative process that is most pronounced during periods of transaction.

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14
Q

Occ Adaptation Eval

A

Focuses on occ environment, role expectation and individual potential for adaptation & best means for adaptation to occur

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15
Q

Occ Adaptation Intervention

A

Focus on increasing skills needed for occ adaptation. Addresses both individual and environment

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16
Q

Role Acquisition

A

Pt employs task and soc skills to meet demands of personally desired & necessary roles. Performance is addressed thru fx/dysfun continuums of 7 categories: task skills, interpersonal skills, fam interact, ADLs, school, work, leisure.

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17
Q

Role Acquisition Eval

A

Focus on gathering data indicative of fx/dysfun in 7 categories

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18
Q

Role Acquisition Intervention

A

Focused on acquisition of specific skills need in order to fx in environment. LTGs based on persons expected environment. Tasks/interpersonal skills can be taught sep or in context of learning soc roles. Adequate repertoire of behavior needed. Intrapsychic content shared/reality testing. OT must know specifically what behaviors pt wants to perform. Any tx that employ teaching-learning principles are acceptable.

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19
Q

Cog Disabilities Model Principles

A

Based on Piaget. Cog ability is determined by bio factors and potential for improvement is dictated by those factors. Fx’al behavior is based on cognition. Supports adaptation if cog level can’t be changed.

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20
Q

Cog Disabilities Model Levels

A

I. Auto actions. II. Postural actions (comfort) III. Manual actions (manipulation) IV. Goal directed actions V. Exploratory actions (trial/error) & VI. Planned actions (absence of disability)

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21
Q

Cog Disabilities Eval

A

Focus on ID individual current cog abilities and implications for performance, I and need for A. Observation during task emp. Specific eval tools: ACLS-5, Routine Task Inventory & Cog Performance Test

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22
Q

Cog Disabilities Tx

A

Acts are chosen based on pt highest cog level/maintaining that level. Adaptations are made as needed. Emp caregiver involvement

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23
Q

Sensory Models Principles

A

Aka SI, SP, Sens Motor Model, Sens Defensiveness/Modulation or Sens Based Tx. Req use of strength based person centered & relationship centered model of care. Important to help recog symptoms & strengths

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24
Q

Sensory Models Eval

A

Sensory Profile, ACLs

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25
Q

Sensory Model Tx

A

Snoezelen/multi-sensory rooms, weighted blankets & other self soothing items, psycho-edu & sensory diets

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26
Q

Psychodynamic/Psychoanalytic Principles

A

All behavior is largely determined by unconscious, psychological forces/internal process. Interactions between these create thoughts/emos. Abnorm behavior results when these are in conflict (intrapsychic conflict) and are resolved when brought to consciousness/explored. Behavior patterns begin in early childhood. Defense mechanisms used - for non-psychotic pts mild-mod psychopathology , well integrated egos & capacity for introspection/insight

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27
Q

Psychodynamic/Psychoanalytic Defense Mechanisms

A

Narcissistic: Denial, Projection & Splitting. Immature: Passive-aggressive, Regression, Somatization. Neurotic: Rationalization, Repression, Displacement & Reaction Formation. Mature: Humor, Sublimination & Supression

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28
Q

Psychodynamic/Psychoanalytic Eval

A

Magazine pic collage

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29
Q

Psychodynamic/Psychoanalytic Intervention

A

Projective/fx’al tasks used to promo self-awareness & exploring intrapsychic content. Bring unconscious stuff to consciousness. Proper used of this approach req spec training and edu

30
Q

CBT Principles

A

Specifically effective w depression but used for schizo, anx, bipolar, panic, OCD, personality, somataform & eating d/o. Works to alter neg thoughts. Looks at thoughts & actions. Cognitive triad: neg self-eval, pessimistic world view & sense of hopelessness of future. 3 basic concepts: all moods are created by thoughts/interpretations-When ppl are depressed, thoughts are pervasively neg-Neg thoughts will cause emo distress/distortions. Thinking influ behavior and can be self-reg.

31
Q

CBT Eval

A

Beck Depression Inventory (BDI-II) - self completed questionnaire; no spec training. Eval of cog is frequently completed by OT.

32
Q

CBT Intervention

A

Assist pt in ID of current probs/solutions. Collab of OT/pt is necessary. Help pt recog patterns of thoughts. Provide hw/structured assignments. Scheduling, cog rehearsal, self-reliance training, role paying, diversion techs, participation - life skills wkbk

33
Q

Dialectical Behavioral Therapy (DBT) Principles

A

Form of CBT that addresses SI & self injurious behaviors. Common w BPD.

34
Q

Recovery Model Principles

A

Prim focus to improve QOL & ability to attain desired life goals thru self advocacy. Focused on: self-direction, pt-centered, empowerment, holistic, nonlinear, strengths-based, peer support, respect, responsibility, hope, family & community.

35
Q

Recovery Model Eval

A

QOL Interview: measures pt level of fx using objective-based Q’s & life satisfaction using subjective-based Q’s. Oregon QOL Questionnaire: measures adjustment in relation to how individual needs are met in combo w demands society places upon pt (self report or semi-structured). Empowerment scale: self-esteem, activism, power, control & anger.

36
Q

Recovery Model Intervention

A

Development/implementation of WRAP (wellness recovery action plan). Storytelling means of decreasing stigma & advocacy

37
Q

Psychiatric Rehab Model Principles

A

Goal: to help individuals develop skills necessary to compensate for/adapt to/control the influ of symptoms on fx. Individualized & pt centered. Strength focused, comm based services, fam involvement, environmental mod, holistic & vocational focus/skills training.

38
Q

Psychiatric Rehab Model Eval

A

Assessments are based on real-life situations, eval for readiness for change

39
Q

Psychiatric Rehab Model Intervention

A

Assertive Community Tx, Tx takes place in natural context, Day programs, Clubhouses, Voc rehab & supported edu

40
Q

Psychosocial Eval Areas

A

Performance skills & impact on performance, client factors & physical conditions/limitations that impact performance. Impact of individuals social, cultural, spiritual & physical contexts. ID of roles/behaviors req by pt based on society or goals. Precautions/safety issues. Hx of behavior patterns. Pt goals, values, interests & attitudes. Consider/involve fam. Pt ID-ed probs. Desired outcomes & living situation.

41
Q

Psychosocial Assessment Methods

A

Interviews (structured/unstructured). Standardized tests. Clinical observations. Rating scales. Questionnaires. Self-report inventories

42
Q

Mini-Mental State Examination (aka Folstein)

A

Widely used, quick screen for cog fx. Structured tasks presented in interview format. P1=verbal responses to assess attn., orient., mem. P2=ability to write sentence, name objects, follow verb/written directions & copy design. Max score=30; 24 or less=cog impairment. Pop: pt w cog/psych impairment

43
Q

Short Portable Mental Status Questionnaire

A

Assess intellectual fx w 9 q’s like “What day is it?, Who’s the prez?” & subtraction task. 0-2=intact, 3-4=mild, 5-7=mod & 8-10=severe. Pop: pt w cog/psych impairment

44
Q

Adolescent/Adult Sensory Profile

A

Completion of 60 item questionnaire about pt reactions to daily sensory experiences via person’s self report. Cutoff scores indicated typical performance and probable, definite and sig differences. Pop: 11-65yrs

45
Q

ACLS-5

A

Req performance of 3 leather lacing stitches. Level 3: running stitch; Level 4: whipstitch; Level 5: cordovan stitch. Scores range from 3.0-5.8. Pop: pt w cog/psych impairment

46
Q

Beck Depression Inventory

A

Measurement of presence/depth of depression. If lang diff use interviewer otherwise self questionnaire. Rates feelings relative to 21 characteristics associated w depression. Items scored 0-3 w 3=most severe. High scores=high depression. Pop: adolescent/adult

47
Q

Elder Depression Scale

A

Completion of 30-item checklist looking at presence of dep symptoms. Items scored yes/no. 10-11=threshold most often used to indicate depression. Pop:older adults.

48
Q

Hamilton Depression Rating Scale

A

Measures severity of illness/changes over time in pt w depressive illness. Info gathered thru interview, consultation w fam, staff other individuals. OT rates info relative to 17 symptoms. Pop: dx of mood disorder

49
Q

Bay Area Fx Performance Eval (BAFPE)

A

Assesses cog, affective, performance & soc skills needed to perform ADLs. Brief interview, Task Oriented Assessment (TOA)=5 timed, standardized tasks, The Soc Interaction Scale (SIS)=observation of 5 situations & optional self report questionnaire. Scoring for TOA= 3 comps, 12 parameter & 5 tasks & Scoring for SIS= 7 situation & 5 parameter score & 1 total SIS score > not combo. Pop: Adults w psych, neurolog or dev dx.

50
Q

Comprehensive OT Eval Scale (COTE Scale)

A

Structured method for observing/rating behaviors & behavior changes in areas of general, interpersonal & task skills. Individuals behavior observed during therapeutic session as the individual completes a task. Behavior rated by OT based on specific criteria. Tasks selected by OT. Each item rated on scale of 0=norm to 4=severe. Pop: adults w acute psych dx.

51
Q

Activity Card Sort (ACS)

A

ID of persons level/involvement in 20 instrumental act, 35 low phys act, 17 high phys act & 17 soc acts. Pt presented w 89 cards and sorts: never done, gave up doing, do less than past, do the same, do more than past. Scores are combo-ed to global scores for current act, prev act & percent retained. Pop: Originally for adults w dementia - 3 versions now available to address adults/older adults in institutional, community or recovery settings.

52
Q

Activities Health Assessment

A

Pt completes Idiosyncratic Act Configuration Schedule w color coded chart of how time is spent in a wk, completes questionnaire & interview. Not scored. Acts classified & sub grouped. Sig placed on level of balance, satisfaction & comfort w each act. Pop: adult thru elders

53
Q

Adolescent Role Assessment

A

Assess dev of internalized roles w/in fam, school & soc settings thru semi-structured interview that follows guide. Scoring indicated behavior that is appropriate, marginal or non-appropriate. Pop: 13-17yrs

54
Q

Barth Time Construction (BTC)

A

Focuses on time usage, roles and underlying skills & habits. Pt constructs color coded chart, individually or group that describe how time is spent. COTE scale may also be completed by OT on observations. % of time are calc-ed according to main groupings. Discussion.

55
Q

Canadian Occ Performance Measure (COPM)

A

Semi-structured interview to ID pts perception of OP in self care: fx’al mob/comm mngt/personal, productivity: work/home mngt/play or school & leisure: rec/soc. Caregivers may answer if pt cant. Items scales 1-10=high. Pop: 7+/parents of small children

56
Q

Goal Attainment Scaling (GAS)

A

Facilitates active participation in goal-setting process by having pt/caregivers ID desired tx outcomes. Used post-tx GAS can assess attainment of goals. Personal interview during goal settings/post tx. No scoring protocol. Pop: Older kids, adolescents, adults & care-givers of pts who cant participate.

57
Q

Occ Circumstances Assessment Interview (OCAIRS)

A

Based on MOHO. Focuses on nature/extent of individual’s occ adaptation in 12 areas. Info gathered w semi-structured interview w guide that asks Q’s about 12 areas. Q’s may be adapted to meet needs. Scored 1-4=high. Pop: orig for adults-elder w psych dx but now broader. 3 forms: psych, phys dys & forensic MH.

58
Q

OP Hx Interview (OPHI-II)

A

Gathers info on pt life hx inc. past/present OP & impact of dx. Semi-structured interview covering 5 content areas addressing daily routines, occ roles, occ choices, crucial life choices & occ behavior settings. OT rates occ ID/competence 1-4= exceptionally occ comp. Narrative written. Pop: pts who are able to participate in comp interview from adolescents to elders - not recommended for 12 and under.

59
Q

Occ Self-Assessment

A

Self report checklist of perceptions of efficacy in areas of OP & importance. 2-part self report consisting of list of 21 everyday acts. Pts use 4pt scale to rate competence and importance. Pop: 18+

60
Q

Role Checklist

A

Assesses self-reported role participation and value of specific roles. Checklist completed by pt alone or w OT. Part 1- ID major roles past/present/future & Part 2- ID degree to which he/she values the role. Rated continuous, disrupted/changed, present, desired, valuable, somewhat valuable & very valuable roles. Pop: Adolescents-elders w phys/psychosoc dysfun

61
Q

Projective Assessments

A

Based on psychodynamic/psychoanalytic models; allow pts to project intrapsychic content. Inc: House-Tree-Person, Draw-A-Person, Kinetic Fam Drawing, Magazine Pic Collage.

62
Q

Magazine Pic Collage

A

Most typically used projective assessment. Observation of the task offer lots of insight - can be easily adapted. Discussion post completion. All but no psychosis.

63
Q

Elements of Group Protocol

A

Title, purpose, rationale, theoretical base/FOR, criteria for membership, goals, method/format & group roles.

64
Q

Kathy Kaplan Directive Groups

A

Highly Structured groups designed to assist pts w limited abilities in developing basic task/soc skills. Each session is divided into5 parts w 15min review of session by leaders. Part 1: consists of an orientation to the purpose/goals. II: review of names/intro. III: warm-up acts. IV: 1(+) acts designed to meet goal. V: give meaning to acts/debrief & close.

65
Q

Ross 5 Stage Groups

A

Pts w schizo, ID, Alzheimer’s and neurolog impairments. Stage 1: Orientation. 2: Mvmt w gross motor acts to stim/alert. 3. Perceptual-motor to calm/focus. 4. Cognitive-promo org thinking. 5. Closure.

66
Q

Therapeutic Strategies for Children Acting Out

A

Interpretation, redirection, limit setting & time out

67
Q

RADAR

A

Screening for domestic abuse. R: Routinely ask. A: Affirm & ask. D: Doc objective findings & pt statements. A. Assess & Address safety. R: Review options & Referrals.

68
Q

Phases of Adjustment

A

Shock, anx, denial, depression, internalized anger, externalized anger, acknowledgment, adjustment.

69
Q

Tx for Suicidal Ideation

A

ID motivation behind desire. Develop a Contract for Safety that specifies what pt should do if experiencing suicidal thoughts. Development of prob solving/stress mngt techs. ID pos goals/interests & pos attributes/supports. Use acts that produce successful outcomes & opps for expression. Mod phys act. Future-oriented tasks. Pt/fam edu.

70
Q

OT Role w Self Harm

A

Improve self mngt w technique edu. Alternate coping strategies. CBT & DBT techniques. Sensory approaches. Dev/improve prob solving & communication skills.

71
Q

Stages of Grief

A

Denial, Anger, Bargaining, Depression, Acceptance.

OT Process (16 decks)

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