Psychosocial approaches (ch 14) Flashcards
ACL level 1
Automatic Actions: automatic motor responses and changes in the autonomic nervous system. Conscious response to the external environment is minimal.
ACL level 2
Postural Actions: movement that is associated with comfort. There is some awareness of large objects in the environment, and the individual may assist the caregiver with simple tasks.
ACL level 3
Manual Actions: beginning to use hands to manipulate objects. The individual may be able to perform a limited number of tasks with long-term repetitive training.
ACL level 4
Goal Directed Actions: the ability to carry simple tasks through to completion. The individual relies heavily on visual cues. He may be able to perform established routines but cannot cope with unexpected events.
ACL level 5
Exploratory Actions: overt trial and error problem solving. New learning occurs. This may be usual level of functioning for 20% of the population.
ACL level 6
Planned Actions: absence of disability. The person can think of hypothetical situations and do mental trial-and-error problem solving.
The 3 components of CBT are didactic aspects, cognitive techniques, and behavioral techniques… define them…
- didactic aspects involve the therapist explaining the basic concepts and principles of CBT to the client.
- cognitive techniques involve eliciting automatic thoughts, testing automatic thoughts, identifying maladaptive underlying assumptions, and testing the validity of maladaptive assumptions.
- behavioral techniques are used with cognitive techniques to test and challenge maladaptive and inaccurate cognitions.
In CBT, what is the “cognitive triad”?…
A pattern of negative thinking… comprised of negative self-evaluation, pessimistic world view, and sense of hopelessness regarding the future.
Dialectical Behavior Therapy (DBT) is a form of CBT that focuses on…
addressing suicidal thoughts and actions and self-injurious behaviors. Commonly used with borderline personality disorder; also used to treat patients with depression, substance abuse, and/or eating disorders.
DBT uses assertiveness, coping, and interpersonal skills training.
The goal of psychiatric rehabilitation is…
to help individuals develop the skills necessary to compensate for, adapt to, and/or control the influence symptoms have on function, including any disability caused by social or enviro barriers.
The recovery model’s primary focus is…
to improve quality of life and the ability to attain desired life goals through self-advocacy.
Short Portable Mental Status Questionnaire (scoring)
1-10. 0 is intact intellectual functioning; 8-10 is severe intellectual impairment.
Hamilton Depression Rating Scale (population, focus, method, scoring)
Population: individuals with mood disorder.
Focus: measures severity of illness and changes over time in people with depressive illness.
Method: interview and consultation with family/staff.
Scoring: each item rated 0-2, with 0= absent and 2= present; 17 items rated. No significance to score, just notes changes.
Bay Area Functional Performance Evaluation (BAFPE)
Population: adults with psychiatric, neurological, or developmental diagnoses.
Focus: assess the cognitive, affective, performance, and social interaction skills required to perform ADLs
Method: interview, Task Oriented Assessment, Social Interaction Scale.
Scoring: scores of TOA and SIS are not combined. Scores give idea of overall function and person’s cognitive affective, social, and perceptual motor skills.
Comprehensive Occupational Therapy Evaluation Scale (COTE scale)
Population: adults with acute psych diagnoses.
Focus: structured method for observing and rating behaviors and changes in areas of general, interpersonal, and task skills.
Method: behavior observed during therapy session while person does a task.
Scoring: each item rated 0 (normal) to 4 (severe)
Activities Health Assessment
Population: adults through elders
Focus: time usage, patterns and configurations of activities, roles, and underlying skills and habits.
Method: person completes a schedule (color-coded chart) depicting the way his time is spent during a typical week
Scoring: not scored. Determination of person’s activities health made by person and OT based on schedule, questionnaire, and interview.
Adolescent Role Assessment
Population: ages 13-17
Focus: assess the development of internalized roles within family, school, and social settings.
Method: semi-structure interview.
Scoring: indicates behavior that is appropriate, marginal, or inappropriate.
Barth Time Construction (BTC)
Population: adolescent through elder
Focus: time usage, roles, and underlying skills/habits
Method: person makes a color-coded chart depicting the way his time is spent during typical week.
Scoring: not scored. significance of info based on appropriate use of time and discussion with person.
Occupational Circumstances Assessment Interview Rating Scale (OCAIRS), version 4
Population: most anyone with psychiatric diagnoses, and now phys dis, mental health, and forensic mental health
Focus: the nature and extent of a person’s occupational adaptation. 12 areas of occupational adaptation explored.
Method: semi-structured interview.
Scoring: each item rated 1-4 (4 highest). Case analysis method used to interpret data according to MOHO to make a profile of person’s strengths/weaknesses.
Occupational Self-Assessment
Population: 18+
Focus: self-report checklist of person’s perceptions of efficacy in areas of occ performance and their importance.
Method: two=part self reports. Clients give list of 21 everyday activities.
Scoring: clint uses 4-point scale to rate how well they do each activity, then 4-point scale to report how important activity is.
The Role Checklist
Population: adolescent+ with physical or psychosocial dysfunction
Focus: assesses self-reported role participation and value of specific roles to the person.
Method: checklist completed by person alone or with OT. Asks person to identify major roles in life, and degree to which he values each role.
Scoring: not scored; used to address goal identification and tx planning, QoL, and discharge planning.
what are projective assessments?
based on psychodynamic/psychoanalytic models, they allow clients to project intrapsychic content for discussion and resolution in therapy by bringing unconscious intrapsychic conflicts to consciousness through the completion and processing of an activity.
Managing problem behaviors:
Hallucinations
- create an environment free of distractions that trigger hallucinatory thoughts and interfere with reality-based activity.
- use highly structured simple, concrete, and tangible activities that hold the individual’s attention.
- when the person appear to be focusing on a hallucinatory experience, attempt to redirect him to reality-based thinking and actions.
Managing problem behaviors:
Delusions
- do not attempt to refute the delusion.
- redirect the individual’s thoughts to reality-based thinking and actions.
- avoid discussions and other experiences that focus on the validate or reinforce delusional material.
