*NBCOT Exam Prep (Mental Health Practice and Groups – Flashcards
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aphasia
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absence or impairment of ability to communicate
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apraxia
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inability to perform purposive mvmts without sensory or motor impairment
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agnosia
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loss of visual, auditory, or other sensations
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loss of executive function
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impairment in ability to think abstractly, plan, initiate, sequence, monitor, and stop complex behaviors
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OT intervention for drug abuse
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psychosocial therapy, coping, stress mgmt, social skills training; cog-base interventions geared toward increasing ct motivation and control of life
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delusion
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belief or impression that is firmly maintained despite being contradicted by what is generally accepted as reality or rational argument
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hallucination
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perception in the absence of external stimulus that has qualities of real perception
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negative symptoms
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inexpressive faces, blank looks (flat affect), monotone and monosyllabic speech, few gestures, seeming lack of interest in the world and other people, inability to feel pleasure or act spontaneously
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catatonic schizophrenia
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Affected people may exhibit a dramatic reduction in activity, to the point that voluntary movement stops, as in catatonic stupor. Alternatively, activity can dramatically increase, a state known as catatonic excitement.
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OT intervention for schizophrenia
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illness mgmt and recovery, including grps; Assertive Community tx to provide support and skills training in natural environment; family psychoeducation; supported employment; dual dx tx for co-occurring mental illness and substance abuse
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Assertive Community Treatment
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NAMI established, an effective, evidence-based, outreach-oriented, service delivery model for people with severe and persistent mental illnesses
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mood disorders (types)
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depressive disorders, major depression, dysthymic disorder (less severe, 2 yrs), bipolar I (one or more manic or mixed episodes), bipolar II (one or more major depressive episodes and at least one hypomanic episode), cyclothymic disorder (chronic 2 yrs mood disturbance with fluctuating hypomanic and depressive symtoms)
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OT intervention for mood disorders
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cognitive behavioral therapy to uncover distorted beliefs and faulty thinking patterns; interpersonal psychotherapy to improve interpersonal and psychosocial functioning
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cognitive-behavioral therapy
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includes education on how the ct's cognition (thoughts) and behaviors impact ADL, description and rehearsal of coping skills to train cts in techniques so that they have choices, implementation and maintenance of learned coping skills by ct and family; distorted thinking is problematic, focus of therapy is to inc awareness and eventually change cog distortions to alter behavior and the impact on function
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agoraphobia
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an intense fear and anxiety of being in places where it is hard to escape, or where help might not be available
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OT intervention for anxiety disorders
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cog-behavioral training; relaxation therapy including breathing, meditation, visualization, and progressive muscle relaxation; expressive writing to help ct understand and accept the occurrence of stressors
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somatoform disorders
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physical symptoms are felt that have a psychiatric source; these disorders are real and should not be mistaken for malingering or symptom magnification
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OT intervention for eating disorders
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physical harm reduction, cognitive reconstruction, psychosocial functional enablement; lifestyle redesign and living skills training, communication training, stress mgmt, projective artwork and crafts; relapse prevention, body image improvement
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personality disorder
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11 total types; Cluster A: paranoid personality, schizoid personality, schizotypal; Cluster B: antisocial personality disorder, borderline personality disorder, histrionic personality disorder, narcissistic personality; Cluster C: avoidant personality disorder, dependent personality OCD
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OT intervention for personality disorder
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maintain collaborative relationships; consistency; validation; motivation for change; mood stabilization and expression of appropriate emotions; promotion of self-concept, self-esteem, insight, and judgment; dev interpersonal relationships
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inpatient acute care
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admitted as a result of active and uncontrolled symptoms; brief and designed to manage behavior, stabilize cts, and refocus on engagement in occupation
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long-term hospitalization
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in cases of severe, distressing and uncontrollable symptoms or serious threat to self or others, ct may be hospitalized for extended pds of time (2 weeks to 2 months); stabilize symptoms, medicate, habitualize patterns of ADL
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community based mental health clinic
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meet with mental health professional for ongoing med mgmt, lifestyle mgmt, self care, and grp therapy; general monitoring of health conditioning
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consumer-based, nonprofit, or health system based day treatment program
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lifestyle mgmt program designed to assist cts over an extended pd of time and provide meaningful occupational engagement as tolerated for cts with more chronic mental health condition
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skilled nursing residential care and home health care
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cts with chronic mental health may need ongoing care when conditions are ot suitable for living with family/friends; home health for aging in place or continued living in home
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community residential
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halfway houses, adult foster care; transitioning from SNF or hospital stay; temporary supervision under grp living for halfway house
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supported employment, transitional employment, vocational rehab
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clubhouse programs will encourage employment; supported employment seems to work best
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behavior modification
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operant conditioning; behavior shaped by positive or negative reinforcement; intermittent positive reinforcement is best; controversial for adults because little cognitive processing needed
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Allen Cognitive Levels
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based on Piaget's development; as cog levels increase so do functional abilities
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intentional relationship
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therapeutic use of self; triad between therapist, client, and occupation; principles 1. self-awareness and interpersonal self-discipline are fundamental to the intentional use of self 2. "head before heart" for practitioners 3. practice "mindful empathy" 4. ct defines successful relationship 5. balance a focus on activities with a focus on the interpersonal
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kawa model
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cultural safety; healing must come from within a safe cultural context
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Model of Human Occupation
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impact of volition, performance, and habituation on engagement in occupations
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PEOP Model
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interactions; key model that describes the experiences of individuals and populations and explains the impact of the key components of the model on health, wellness, and QoL
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Psychoanalytic and Psychodynamic Models
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mechanism for improving self-identity and improving interpersonal relationships; deep-seated origins of human emotion and motivation
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restating/paraphrasing
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repeat what ct says to confirm accuracy of what is understood
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reflecting
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confirm the implied feeling in what the ct has communicated
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clarifying
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clear up any confusion by summarizing what the ct has said in clear, concise statements
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scaffolding
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therapist does what is too difficult, ct does the rest
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fading
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gradual withdrawal of support as ct gains skills
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coaching
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providing explicit expectations and support to enable ct to complete an activity
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adaptation
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changing the requirements of the occupation to be more congruent with the cts abilities
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modification
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reduction of the demands of an occupation
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task-oriented groups
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focus on the process of producing something (product or service) as a group; conflict addressed when they happen
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activity groups
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focus on function and "replicate living in the community or family" with an emphasis on direct experience and the use of activity to develop skills
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group dynamics
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properties of the grp that emerge from the interactions among grp members
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group process
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how things are said and done and how the grp goes about accomplishing those goals
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directive leadership
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low cognition
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facilitative leadership
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fair to good insight and motivation
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advisory leadership
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mature grp, able to work effectively in resolving conflicts, high verbal abilities; works alongside grp in coaching capacity
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forming stage
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become acquainted with one another, familiarize with task
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storming stage
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challenge one another and leader
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norming stage
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develop trust and avoid conflict as focus on task at hand
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performing stage
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work together as cohesive unit; conflict resolved
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reforming or transforming stage
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reflect on hx, evaluate
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initial stage
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learn expectations, get to know each other, concerned with trust
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transition stage
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wonder about being accepted and about safety, struggle with conforming vs risk taking behavior
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working stage
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trust built, becomes more cohesive, share and communicate effectively
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final stage
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task completed, evaluate experience
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parallel
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complete tasks side by side with little interaction
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project
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emphasis on task, some interaction occurs
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egocentric-cooperative
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interaction expected
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cooperative
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taking care of each other's needs
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mature
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assume leadership roles and address one another's needs
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explicit norms
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are articulated and set the ground rules
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implicit norms
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unspoken but understood
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group roles that evolve around tasks
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initiator-contributor, information seeker, coordinator, recorder
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group roles that build and maintain
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encourager, harmonizer, compromiser
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group roles that benefit the individual
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aggresor, blocker, recognition seeker, dominator
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group populations
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populations (ex homeless, at risk youth), occupations (ex cooking, gardening), context (ex support grps, peer networking), performance skills and client factors (ex cognitive skills, muscle strengthening, social skills), performance patterns and task demands (ex parenting, routines, new habit exploration), OT process (ex eval, d/c)
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psychodynamic group
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explore symbolic meaning of activities anf grp process; projective media such as clay, collages, painting, poetry
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cognitive-behavioral group
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seeks to change the way he or she thinks about things using relaxation and stress mgmt; can use role-playing; primary focus on teaching and learning
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CBT principle: shaping
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approximations of approp behavior are reinforced or rewarded to facilitate the acquisition of a behavior
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CBT principle: chaining
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one step in sequence sparks the next step until all are learned
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CBT principle: reinforcement
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positive feedback to inc that behavior
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CBT principle: practice
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repetition of behaviors is often necessary to improve
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ACL groups
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level 1-5, incorporate assessment into intervention; all members must be within the same cognitive level
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ACL: Level 1
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participants would not benefit from group
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ACL grp: Level 2
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participants will be successful in situations in which they can move about and copy mvmt that is modeled
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ACL grp: Level 3
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participants focus on elements of repetition and manipulation
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ACL grp: Level 4
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participants work on goal-directed activities such as crafts
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ACL grp: Level 5
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participants engage in activities with graded structure, such as clay modeling or mosaic project; exercise control over medium and control impulses
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developmental group
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allow engagement in grp activities structured to present the just right challenge; progress to next step in developmental sequence; activities address needs of all
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sensorimotor group
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deliberate and thoughtful design of sensory experience
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MOHO groups
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members engage in activities toward a therapeutic outcome related to participation related to roles and occupation; Role Checklist can be used; Kielhofner described the Functional Group Model- seeks to enhance occupational behavior and thus adaptation
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humanistic model groups
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emphasize self-actualization, exploration of values, and focus on the present
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behavioral model groups
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seeks to change behaviors using techniques such as teaching, reinforcing, and extinguishing
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Lifestyle Performance Model
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activity patterns that constitue a lifestyle; good QoL involves sense of balance among autonomy with four domains; grp activities in these domains can inc autonomy
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LPM: reciprocal interpersonal relationships
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connection to others
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LPM: intrinsic gratification
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fun and pleasure
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LPM: societal contribution
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activities that benefit others
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LPM: self-care and self-maintenance
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care of oneself and surroundings
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clubhouse model
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community centers that provide work and support for people with mental illness; focus on strengths; not a clinical program; membership voluntary; built on consensus, members vote
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needs assessment
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set of procedures to ID and describe specific areas of need for a population; leads to goals for grp; steps include 1. research 2. collaborate with potential participants in writing a survey 3. administer survey 4. face to face interviews 5. phone interviews 6. interview key informants 7. conduct a focus grp 8. gather secondary data on potential participants 9. analyze the data 10. write a profile of a typical participant the program serves
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group protocol
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group title; author (grp facilitator); model or frame of reference; purpose of grp; grp membership, size and type; grp goals; outcome criteria; methods used, including media and leadership style; time and place of meeting; supplies needed and cost; reference citations
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Seven Steps of Group Leadership (Cole)
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1. intro 2. activity 3. sharing 4. processing (discuss feelings about grp experience) 5. generalizing (make note of common threads) 6. application (leader articulates the connection between what transpired and how new insights and skills have been obtained) 7. summary
