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psychosocial
exam 2
| Term | Definition |
|---|---|
| Consumer-Services | peer-run, self-help organizations or groups that are administratively and financially controlled by persons participating in mental health (consumers). They are not simply mental health services delivered by consumers, are independent, peer run programs. |
| Consumer-survivor movement | a diverse association of individuals who are either currently consumers of MH services or consider themselves survivors of psychiatry or MH services, or who simply identify as "ex patients" of MH services. Wants more choices and improved services |
| drop-in centers | a place for give and take exchange of information within a community. Informal,convenient and easy for people to obtain information |
| peer-support groups | informal private programs consisting of self help groups and peer support systems where people in recovery provide services to one another to assist with any difficulties in their life |
| education programs | informal including training programs during which consumers learn recovery and advocacy skills. Time limited. Use consumer led group format. |
| fidelity measures | assessment tools examining the extent to which a program's implementation is true to the program model |
| psychosocial clubhouses | international community of people who share the lived experience of MH and recovery. A physical place where people are afforded respect and varied opportunities to pursue valued and chosen occupations that hold meaning and purpose |
| work-ordered day | a building block of the club house philosophy; each day is structured to mirror the expectations of a work place preparing members for future employment |
| transitional employment | one of the oldest employment models, usually described in relationship to the psychosocial clubhouse. Goal is to give individuals work experience so they can transition into other jobs that will enhance their self sufficiency |
| supported employement | a competitive employment arrangement for people with disabilities that includes integration within their community |
| psychiatric rehabilitaion | a combination of services incorporating social, educational, occupation, behavioral and cognitive interventions aimed at long term recovery and maximization of self sufficiency |
| case management | individualized method or process for ensuring that a consumer is provided with needed services in a coordinated, effective and efficient way |
| classification | a systemic arrangement into classes or groups based on perceived common characteristics; a means of giving order to a group of disconnected facts |
| Person-Environment-Occupation | conceptual model used by OT to guide clinical reasoning and plan interventions. Emphasizes the occupational performance is influenced by the capacity of the individual, the characteristics of the occupation & the resources & task demands of environment |
| environmental press | occurs when forces in the environment, together with individual need, evoke a response |
| adaption | adjustment of a person to fluctuating circumstances within or external to the individual |
| flow | a timeless experience in an inherently satisfying activity wherein a persons skill just meets the challenge of the situation |
| transitional housing/homeless shelters | temporary safe housing lasting 1-30days |
| domestic violence | intentionally inflicted injury perpetrated by and on family members ; includes child abuse, sexual abuse and spouse abuse |
| entitlement programs | the kind of government program that provides individuals with personal financial benefits to which an indefinite number of potential beneficiaries have a legal right whenever they meet eligibility conditions that are specified by the standing law |
| Certified alcohol and drug counselors | professionals who assist clients affected by the use of alcohol or other drugs by focusing on gaining and maintaining skills for a substance free lifestyle |
| direct service provider | professionals who provide for the basic care and training of individuals with disabilities. Involves daily living skills development, speech and language, mobility, learning and vocational development as directed by state and federal regulation |
| consultant | a health care worker who acts in an advisory capacity |
| Housing First program | approach to ending homelessness that centers on providing homeless people with housing quickly and then providing services as needed |
| What 3 things does consumer-operated services offer? | mutual support, advocacy, community |
| Who created Psycho-educational model? | Lillie and Armstrong |
| The client is considered a ____ in the psycho-educational model. | student |
| Who was the psycho-educational model created for? | people who suffer from co-dependency, alcohol/drug abuse, chronic pyscho illness and HIV |
| A client must have ____ and _____ in the psycho-educational model | responsibility and motivation |
| Deficit for the psycho-educational model? | due to someone not learning the skill correctly whether it is because of MI or their environment |
| Goals of Psycho-educational model | training and development of skills, functional performance of everyday activities and education |
| teaching methods for psycho-educational model | role playing, modeling, videos, lecturing, pre and post test, direct teaching starting with basic skills, real life situations |
| Assessments for psycho-educational model | Task Checklist, KELS, semi-structured interview and self evaluations |
| KELS | Kohlman Evaluation of Living Skills- takes short time, measures basic skills in literacy, money management, self care and other areas |
| Founder of Sensory integration? Date? | Gene Ayers, 1960 |
| Sensory Integration theory based upon.... | neuroscience studies of how the brain operates, feels that people can change permanently because the CNS changes, they can change the environment |
| Sensory integration created for | disabled children and schizophrenic adults (Lorna Jean King) |
| Sensory integration addresses what issues? | all the senses (sight, hearing, smelling, taste and touch), proprioception, kinesthesia. and vestibular awareness |
| proprioception | a sense that helps us identify where parts of our bodies are even if we cannot see them |
| kinesthesia | gives us information about movement and position of the body as it changes with muscular effort |
| vestibular awareness | a sense that detects motion and the pull of gravity during movement |
| movement patterns related to schizophrenia | S-curve, shuffling gait, difficulty raising arms, inflexibility of neck and shoulders, shoulders and hip flexed in resting posture and changes in hand |
| goals in sensory integration | focus and get pt involved, get them to do things automatically without thinking, make it FUN, change the person, combine SENSORY input for increased MOTOR output |
| downfalls with sensory integration | Not very evidenced based, a therapist has to have advanced training to perform sensory integration testing |
| Who founded MOHO? Date? | Gary Keilhoffner, 1976 |
| What is MOHO based upon? | everyone has the potential to change and master their environment |
| What does MOHO look at? | environment, motivation, choice and interest |
| Is MOHO an open or closed system? | Open dynamic system |
| What is the goal of MOHO? | occupational behavior and this has 3 levels-occupational participation, performance and skill |
| output | what you put out |
| input | what is coming in from the environment |
| feedback | internal loop, how you bring in intake and produce output |
| throughput | internal process, organizes and models how you take in and react to output |
| What are the three subsystems of the MOHO? | Volition, habituation, performance capacity |
| volition | personal causation, values, motivation and interests |
| habituation | habits, patterns or ways of doing things, internalized roles, role script is sometimes culture or generation bound |
| performance capacity | underlying abilities, symbolic, shapes occupational behavior |
| 4 groups of underlying influences | musculoskeletal, neurological, cardiopulmonary and symbolic |
| A subsystem is broken down into 4 skill classifications. What are they? | motor, process, communication interaction (verbal/nonverbal), and social interaction (how you relate to others) |
| Cognitive disabilities Model | explains how impaired cognition affects performance |
| Who created the Cognitive disabilities Model? | Claudia Allen |
| Who was the Cognitive disabilities Model created for? | stroke, dementia, paranoia, schizophrenic and drug abuse pt |
| Does cognitive level change accordingly the Cognitive disabilities Model? | no it does not change |
| 1st level of ACL | automatic actions-bed ridden,slow to react, completely dependent |
| 2nd level of ACL | postural actions- aware of movement, does not know person or place. MAX assist |
| 3rd level of ACL | manual actions- aware of other people, good at repetitive acts, independent self care. MODERATE assist |
| 4th level of ACL | goal directed actions- follows one step direction, needs demonstration, does not recognize errors. MIN assist |
| 5th level of ACL | Exploratory actions- able to learn new actions, interested in how things work, makes sloppy mistakes, safety correction needed. Stand by assist |
| 6th level of ACL | planned actions- able to plan ahead, anticipate errors, NO assist |
| How did Consumer Operated Services come about? | through the pt right movement and general self help movement.It was formed because traditional health care pt were limited by their MI. This was to help people with MI long term |
| What was the purpose of COS? | eliminate or lessen the effects of secondary negative effects such as homelessness, healthcare and isolation |
| 3 types of COS | drop in centers,peer support groups and educational programs |
| drop in centers | few expectations of the members, just a place to hang out. meals are provided, members can relax, connect with peer support. family like environment and available after hours when support is needed. |
| peer supported group | self-help groups (AA, NA, peer support systems, people helping share the lived experience with MI. Can be in the form of group meetings but often one-on-one service |
| Educational programs | training programs where consumers learn recovery and self advocacy skills. Time limited |
| Core principles of any COS | consumer developed, control and provide the services. Peers are involved in the design and delivery of services. Participation is completely voluntary, strength based approach. Everyone is equal |
| Is assessment done with COS? | no assessment on members in COS because its strictly voluntary. May assess the program |
| COS population | 18 or older, live in the community, current or past MI recipient, voluntary, open weekends and holiday, |
| Limitations of COS | funding, interpersonal dynamics (what the members want to do and how active they want to be) |
| services of COS | self help activities, social and recreational activities, advocacy, community outreach, training, member satisfaction |
| psychosocial club house | operates with a blend of staff and members who assume leadership for all of clubhouse operations in an equal and strength based context in which members pursue personal goals related to their recovery |
| Where does funding for clubhouses come from? | state legislation, donations and federal funding |
| goals for COS | choices, support, socialization in control of ones life |
| Where does funding for COS come from? | federal, state and donations |
| What year did psychosocial clubhouses come about? | 1944 in New York |
| first standards coined "work ordered day" came about in what year? | 1989 |
| work ordered day | work 5 days a week, no pay but gain MH benefits, helps with running of clubhouse |
| mission of clubhouse | offers "respect, hope, mutuality, and unlimited opportunity to access the same worlds of friendship, housing, education and employment as the rest of society. The ability to work in the community as full participants who contribute to society |
| goals of clubhouse | keep members out of hospital and in the community in order to achieve social, financial, educational and vocational goals important to the individual |
| are assessments performed at psychosocial clubhouses | no specific formal assessments, just assessments of how the clubhouse is run |
| what are the pros of the community based management | develop close relationships, assist with skills training in a meaningful way, providing environmental adaptions, providing emotional support and coaching, help client identify strengths |
| what are the cons of community based management | lack of transportation, concern for being stigmatized, distractions |
| Brokerage Model | traditional model, manager does not provide direct clinical services, act as a liaison to other services, large case load -60 or more, high level of client responsibility, clients have to take responsibility |
| Strengths Model | focus on building strengths, seeks environmental support |
| What are 2 primary functions of the strength model? | person must have resources to develop own potential, persons behavior is dependent on resources available |
| Assertive Community treatment | has best outcomes, one stop shop, developed in 1960, most evidenced based, 6-10 people working with individual, more costly, 24/7 365, supported by NAMI, gaol is to decrease intervention |
| SPMI | SEVERE PERSISTENT MENTAL ILLNESS |
| PACT | programs for ACT, effective service for those with SPMI, evidenced bases |
| What is included in the assessments that are done with PACT? Completed in how many dayss? | history, physical education, A&D usage, education and employment, social, ADL's, family structure. Completed in 30 days |
| What assessments are done with PACT? | formal assessment, ADL/IADL, occupational profile, or just observation |
| What services/interventions are provided with PACT? | rehab (skills training)- role and habit development, support and direct assistance (team does whatever is needed to enable community living) |
| Barriers to employment when individual has MI? | medical model (separating MI from society), low education, limited vocational service, employment disincentives, legislative ineffectivness |
| decomposition of movement | movement that once was automatic but now has to be though through (sensory integration) |
| psychomotor retardation | general slowing of movement |
| What year did SS extend to cover those with MI? | 1956 but may have to be disabled for 2 years |
| section 504-rehab act of 1973 | protects qualified individuals with disabilities from discrimination |
| This focused on environmental accessibility such as ramps | 1990 ADA |
| What is FMLA? DATE? | family medical leave act- unpaid leave of absence to take care of family. 1993 |
| "ticket to work" | 1999- not very successful, suppose to help people be employed without losing benefits |
| What is the value of work? | income, contribute to society, self-effiency, freedom, equal opportunities, independence |
| Employee Assistant Programs | confidential, began to help with substance abuse, provide early detection, free to employee, short term but can refer to long term if needed |
| categories of assessments used in work place? | cognition, mood, insight, affect, judgement |
| role of OT in the workplace for MI? | work with employer to create healthy work environment, evaluations (interviewing and observations), outcome measurements (institute plans to make change) |
| OT interventions for changing workplace | change environment, change task, and change in employee/employer |
| What are the benefits of having housing? | increase IADL's and cognitive function, happens in context, fewer hospitalizations, individual will stay at home rather than get in trouble |
| Why is it often hard for homeless individual to obtain housing? | no credit, need money or income, no proof of income, and need reliable resources |
| Shelters | temporary, 1-30 days and safe, varying rules |
| transitional housing | promotes housing stability, up to 2 years, individual has to work towards a goal, may have other requirements |
| episodically homeless | one night to a few nights of no place to stay |
| chronic homeless | one year or more |
| funding sources for homeless | government such as HUD, private foundations or fundraising |
| Role of OT in shelters | trains in independent living skills, case managers, proactive and individualized interventions, interventions for families and children, consultation |
| Assessments for homeless | identify consumer strengths and weakness and problem areas, assess challenges, look at client as well as environment |
| What tools should you use with homeless? | MOHOST, ACL, ILLS, COPM, OSA- looking at client |
| Empowerment Theory | if we give people more control over their own lives then they will perform better. Give housing first work on skills later. Suited for one on one therapy |
| Situated learning theory | consumer learns best in their own environment, client makes choices on what they want to address, show client by modeling, context specific to identify barriers, clients identify what they want to change |
| MEDLS (Milwaukee Evaluation of Daily Living Skills) | created for chronically mentally ill, assess basic living skills, 20 subtest scored individually, client performs task with set amount of time, takes 80 min to 3 hours, no cumulative score, client uses own supplies |
| GAF (Global Assessment of Functioning) | performed by MD or psychiatrist. OT DOES NOT GIVE. below 70 there is a problem |
| COTE (comprehensive occupational therapy evaluation scale) | used in short term acute psychiatric facilities, scale defines 25 behaviors that occur in and are relevant to the practice of OT. Used in initial evaluation to record progress |
| Occupational Questionnaire | MOHO this looks at how the pt spends their time if they have meaningful activities |
| Occupational History nterview | MOHO looks at individuals occupational roles, school roles, peer group roles, family roles. Gives us detailed information about client |
| Assessment of Occupational Functioning | MOHO- used in interview setting to look at individuals major life roles, values, personal causation, interests, roles, habits and skills |
| KTA (kitchen task assessment) | used to determine what level of cognitive support is necessary in order for person to complete a task |
| What are the 6 items on KTA test? | initiation, organization, performance of all steps, sequencing, judgement and safety, and completion |
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