Psychosocial Flashcards
Stages of Coping
- Denial
- Guilt
- Depression
- Anger
- Acceptance
Obstacles to Coping
- medical costs
- cosmetic significance
- frequency of acute episodes
- chronicity of the problem
- life span
- recurrence risk
- family dynamics
- availability of support system
- biological clock?
- religion
- quality of life
- educational background
- cultural practices
Attending
observing a clients verbal and nonverbal behaviors as a way of understanding what the clients are experiencing, and displaying effective nonverbal behaviors to clients during genetic counseling sessions
Coping mechanisms
- strategies for solving problems or for modifying the meaning of an experience
- some may be problematic if engaged in intensely and for very long periods of time
- all defense mechanisms are attempts to cope, but not all coping strategies are defense mechanisms
Accepting Responsibility
coping mechanism in which patient criticizes or blames oneself
Confrontative
coping mechanism in which the patient tries to change the opinions of the person who is in charge (genetic counselor, physician, etc.)
Distancing
coping mechanism in which the patient acts as if nothing happened (tells children after appointment that they didn’t learn anything, when really they found out about a high risk for cancer)
Escape-avoidance
coping mechanism in which patient hopes for a miracle
Planning
coping mechanism in which patient identifies next steps and follows through
Positive Appraisal
coping mechanism in which the patient tries to see any possible positive results or outcomes (rather have a child with Down syndrome than no child at all)
Seeking Social Support
WHAT A DIFFICULT FLASHCARD
coping mechanism in which the patient talks with others in hope of learning more. For example, attending support groups for people with similar genetic conditions
Self-controlling
coping mechanism in which patient keeps to him or herself (short answers, “I’m fine”)
Countertransference
redirection of a psychotherapist’s feelings toward a client—or, more generally, as a therapist’s emotional entanglement with a client
Associative Countertranseference
- your client’s experiences taps into your inner self and you begin to focus on your own thoughts, feelings, and sensations
- triggered by your own past or current problems or situations that are similar to your client’s
Benign Countertranseference
- to prevent being disliked to avoid strong affect, you create an atmosphere that is the same among all clients and situations,
- due to an intense need to be liked by clients to fear of a strong client affect, especially anger.
- optimistic, cheerful interchanges, and by limited consideration of negative information or issues
- attempting to be more of a friend than a GC
Hostile Countertranseference
- when you dislike something about your client (e.g. mannerism, physical characteristic, attitude, value), and in an attempt to be unlike the client as possible, you try to distance yourself in overt and covert ways
- more common in GCs experiencing burnout
Overprotective Countertranseference
you regard some or most clients as childlike and in need of great care and protection, so you cushion the information you give, or you qualify your interpretations, or you don’t allow your clients to experience and express their painful feelings
Projective Identification
misperception that you understand exactly what a client is going through because you have had the same or similar experience
Rejecting Countertranseference
you may regard some or most clients as dependent and needy, but you react punitively, becoming aloof or cold, and behaving in ways that create distance between you, either because you fear the demands clients might place on you
Defense Mechanism
- unconscious responses to real or perceived threat
- attempt to maintain some measure of personal control and reduce painful emotions
Denial
defense mechanism in which the reality of a situation or perception is not consciously experienced or recognized
Displacement
defense mechanism in which the patient shifts their emotional response from original aim to a vulnerable target (mad at PCP or spouse, etc but yells at genetic counselor)
Identification
defense mechanism in which the patient assumes the behavior or opinion of someone else they look up to (my sister says if I have an amnio I will miscarry)
Intellectualization
defense mechanism in which the patient the represses emotional response and addresses the situation through rational, cognitive processes
Projection
defense mechanism in which the patient perceives their own feelings in others (a patient is feeling shame, but thinks his/her partner is ashamed)
Projective identification
defense mechanism in which the patient causes an unacceptable emotion in someone else (represses anger but acts in a way that makes the GC angry)
Rationalization
defense mechanism in which the patient justifies objectionable information with plausible statements (but I take my prenatal vitamin every day!)
Reaction formation
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Regression
defense mechanism in which the patient reverts to developmentally less mature behavior
Repression
defense mechanism in which feelings, perceptions, or memories are lost to consciousness or put out of mind
Sublimation
defense mechanism in which the patient channels unacceptable wishes into more socially acceptable activities (pain and anger toward diagnosis fuels advocacy work in an organization)
Undoing
defense mechanism in which the patient cancels out a distressing experience through a reverse reaction (an obsessive need for prenatal testing after having a child with Down syndrome)
Transference
An unconscious way that a client relates to the genetic counselor based on her or his history of relating to others
Five elements for true informed consent to be met
competence, amount and accuracy of information, patients understanding, voluntariness, authorization
Four principles of medical ethics
beneficence, non-maleficence, autonomy, justice
ABCs of psychiatric assessment
Affect and Appearance
- Appearance: Hair, eyes, stature, dress, grooming, appropriateness, attractiveness
- Affect/mood: Anxious, depressed, sad, worried, belligerent, etc.
Behavior
- By report/by observation of movement, body position, speech, bizarre, self-abusive, hyperactive/agitated, psychomotor retardation, impulsive, unstable, dramatic gestures, altered sleep, eating, intoxicated, or sexual patterns
Cognition and Coping
- Cognitive thinking: Disorganized, distorted, irrational, defensive, memory, concentration, attention, distractibility, delusions, hallucinations
- Coping style: Intellectualize, concrete, problem solving, diffuse
Suicide risk
- Present ideation, plans, actions
