What is occupational therapy? occupations: daily activities that make you you -thinIf you want to learn more check out the procedure through which information is relayed from one neuron to another across the synaptic gap is known as what? psy101
If you want to learn more check out basic chemistry concepts of matter and energy
We also discuss several other topics like mme unl
We also discuss several other topics like plasmodenta
Don't forget about the age old question of What assets are found in a balance sheet?
Don't forget about the age old question of Does intelligence lead to college success?
gs that make up your life Mental Illness: -mentally healthy= balanced OT Buzzwords/Characteristics of Healthy Mentally Healthy People: -adapatable -functional -meaningful -flexible Mental health is state of being relative rather than absolute -mental disorder- causes stress or disability, can’t out daily activities Occupation can improve mental health engaging entire being= holism *McLean Hospital Transinstitutionalized- didn’t really work, weren’t transitioned well - Community Mental Health Act- create community based treatment facilities to move mentally ill out of institutions psych rehab- most effective treatment NAMI- National Alliance on Mental Illness- helps decrease mental health stigmas Mental Health Parity- proposed policy to have insurance companies reimburse mental healthcare to the same extent they do physical health care Psychdynamics- determine personality and motivation MOHO- interaction among three systems -volition- motivation -habituaiton -performance skills/capacity- the ability to perform occupations/activities- skills to live -sensorimotor, cognition, emotional, etc. Narrative Reasoning- how people understand and tell the stories of their lives Both OTA and OTR involved in all stages of intervention process Theory- provide a set of principles to organize and explain, no one correct theory What is the purpose of theories? - framework on which to build your treatment - often use multiple theories at one time Theory of Object Relations: -ability to respond to people and objects -learn these reactions early in infancy -humans have inborn desire to satisfy needs -id- wants what it wants, when it wants it -personality dominated by id -superego- conscience or moralizer -ego- moderates between superego and id -deals with functions that are memory, perception, and reality testing -helps control impulses and organize action -id and superego are in constant conflict causes anxiety -other parts of personality developed by experiences and relationships Defense Mechanisms: -unconscious -help ward off anxiety -patients will often exhibit these -recognize them so you don’t take them personally **Developmental Theory: what this program is based on-solid foundation you build on -problems arise when developmental tasks aren’t mastered sufficiently -Developmental Lag- difference between person and where they should be -corrected by exposing person to different situations where they have to have a skill mastered Behavioral Theory: -all behavior is learned -actions that have positive outcomes are repeated -normal behaviors are learned if… adapative(positive) behaviors are rewarded and maladaptive behaviors are punished/ignored -abnormal behaviors- reversal of normal behavior -can be changed if therapist changes consequences -shaping- method of approaching behavior through series of steps -chaining- teaching a complete activity one step at a time -extinction- discouraging undesirable behavior -planned ignoring- planning to ignore a set of behaviors Cognitive Behavioral Theory: -thinking and behavior are linked -automatic thoughts and associated feelings generate behavior -we create our own experience and can change it by becoming aware of how we think and feel -you change it and are in control -CBT (cognitive behavioral therapy)- identifying thoughts and stopping behaviors associated with them-Social Models- very powerful teachers about how we think and feel Client Centered Therapy: -started by Carl Rogers -each human has the potential to direct his/her own growth and development -each person chooses course of action -when someone is mentally ill… they are not aware of their feelings and available choices -often feel like victims, help them realize they have a choice -a person becomes aware of their choices by exploring them with a warm, empathetic, therapist who genuinely accepts himself/herself and client -as a therapist, must be open and genuine Neuroscience Theory: -based in organic processes of the brain -states that mental illness is a result of chemical imbalances Psychiatric Rehab: -functioning adequately is possible for everyone -necessary skills are individualistic -we need to identify their chosen environment and how to live in it -psych rehab believes we can be friend of pt. must get close to support them Lorna Jean King- adults w/ schizophrenia display posture and behavior of kids with sensory processing disorders -she also noticed those with schizophrenia had trouble with certain activities because their balance is offWe must acknowledge our prejudices, it affects how we treat patients -recognize what upsets you so you can put that aside in therapy Claudia Allen- role acquisition and social skills training -control concept- people with mental illness suffer from a disturbance that guides motor actions -mental disorganization can impair performance tasks -people with mental disorders have cognitive disabilities that makes it difficult to live alone -task performance reflects abilities -Allen created the leather lacing project- a standardized test to test cognitive skills -identify and monitor any changes -adapt environment to help performance To treat cognitive deficits… -make things familiar so the pt. is more comfortable -6 levels of cognition (1- severe, 6-no impairment) -persons at levels 1-4 have difficulty living alone -cognitive levels assessed by motor skills tests -level 1: -level 2: repetition to self stimulate -level 3: cause and effect difficulties - level 4: trouble understanding when things are hidden from view - level 5: beginning to see abstract thinking - level 6: fairly high functioningMOHO: broad view of occupation and health -analyzes occupation and behaviors that go with -culture and environment in shaping occupation -emphasizes the effects of choice, interests, motivation, and habits -humans have an innate drive to explore and master their environment -human occupation: exploring, creating, and controlling the environment -looks at human as open system -open system- affected by environment around us -occupational adaptation- positive occupational identity and achieving occupational competence or thrive in the context of one’s environment -occupational behavior- interaction among person, occupational tasks, and environment *important to know each model because OTAs are professionals Development of Adapative Skills: -developmental model broken into adaptive skills -aims to help master not yet acquired occupational skills step by step -4 Basic Concepts -therapist provide an environment that facilitates growth -subskills are mastered in order -subskills from different areas may be addressed at the same time *-must tap into pt. intrinsic motivation Role Acquistion: -client participation -personalized goals -ability based goals*-increased challenges -natural progression -client knowledge- make sure client knows what’s going on -client awareness- make sure pt. is aware of the effects of good and bad actions -practice makes perfect -parts of a whole- if task is too hard, do one step at a time -imitation Social Skills Training: limited effectiveness -4 Groups- people with mental illness have trouble with -self expression- know self and how to express feelings appropriately -enhancing others (?) -assertive skills -communication skills -these skills should be taught in an environment the pt. is comfortable with and therapists should provide that environment -a common complaint from mental pt. is that they don’t have friends Sensory Integration- receive, process, output -Jean Ayers -Lorna Jean King- worked on proprioception, kinesthesia, and vestibular awareness with psych pt. -proprioceptive and vestibular system treatment good for pt. with schizophrenia (Except paranoid) *have to be careful, because if sensory integration is not good for someone, can make them physically ill *Sensory integration= look at the outcome *need to get pt. to where they can move without thinking about it-activities must be fun/pleasurable Areas of SI: -balance- vestibular -posture- postural control/alignment -ROM -correction of abnormal hip/shoulder -SI improves reception and processing -vestibular and gross motor best to do with these patients -activities cannot draw attention to body movment -parachute activities are great for SI as they work in posture, ROM, etc. Mental Health Concepts and Techniques: -Body functions- -experience of self- one’s ideas about self -life colored by this experience -psych pt. experience w/ others directly relates with how they feel about themselves -impairment of sensory functions -hallucinations- experiences of things that are not there -delusions- fixed false beliefs -neuromuscular and movement related functions are affected, sometimes by side effects of medicine Dynamic Interaction Among Person’s Tasks and Environments -occupational performance results from ongoing interaction among tasks or activity and environment -overlapping experience between task, therapist, and environment -minor changes produce big results -a few subtle shifts to environment affect activity and resultsModels Compatible with OT Framework -Developmental -Behavioral -CBT -Client Centered -Neuro -Psych Rehab 3 Levels of Motivation: -Exploration -Mastery -Sense of Acheivement Through the Lifespan: -foundation of occupation formed in childhood and influences development -Childhood- play and explore mentally, emotionally, and cognitively -Adolescent- play, peers more important, sense of immortality -want to be seen as competent -fantasize about occupations- tentative period -assess what can and can’t do- realistic period -Adulthood- work and produce -Later Adulthood- retire -a major issue here is that they are not ready and need to find a new roleMental Health Factors Through the Lifespan: -Childhood-ADD, ADHD, PDD (usually turns into a spectrum disorder), spectrum disorders, OCD starts to develop, ODD -ADD- trouble with attention span -ADHD- moving all the time, can’t sit still -PDD- cluster of disorder, developmental delays in more than one area Big Focus for OT: what delays are there? What can the child do or not do and how to work with that *Sensory processing= OT specialty -Middle Childhood- refinement of signs from early childhood -most behavioral based -start to see fear of school and behaviors to get out of going -start of bullying and cruelty towards animals -thoughts get refined and turned into behaviors -more signs of autism come out -Adolescence- beginnings of schizophrenia, mood disorder, substance abuse, eating disorders -often mood disorders are written off as teen behaviors, when might actually be an indicator -substance abuse starting younger than it once did -schizophrenia never out of the blue -eating disorders most seen in white women -altered body schemes -4 types, starting to classify overeating as one type -Adulthood- fruition of schizophrenia and mood disorders (becomes diagnosable), more substance abuse-Later Adulthood- dementia(many different forms), depression, polysubstance abuse (meds, unconscious, not manipulative abuse) DSM IV R: -developed common language -5 Axes *Axis I-clinical condition- what gets a person seen, major mental disorder -Axis II- personality disorders, mental retardation, learning disabilities -Axis III- medical issues -Axis IV-psychosocial conditions -Axis V- Global Assessment of Functioning (GAF) Mental Issues of Infancy, Childhood -cognitive disorders -learning disorders -motor skill disorders -communication disorders -Pika- eating things that have no nutritional value (ex. eating chalk) -tics (Terrets) -elimination disorders -deficits in self-care, social functioning, and vocational functioning -perceptual motor deficits, usually come physical component -sensory processing disorder Mental Issues of Later Life, Older Adulthood -Dementia- can be seen in stroke or head injury pt. *-not reversible-less rapid onset -memory deficits -judgement issues -deficits in social skills -upset at own deteriorating condition -alzheimers not a blanket term for dementia -paranoia and other medical conditions can accompany dementia -some caused by long time substance abuse -Vascular Dementia- shortened blood supply to brain -Loui Body Dementia- almost exclusively seen in Parkinson’s pt. -AIDS related dementia- often seen earlier in life -Delirium- -reversable -rapid onset -often caused by substance abuse or fever -can lead to dementia -delirium treatments (tremons)- sick from withdrawals and need medical help ASAP -need substance immediately, can die Substance Abuse- -Alcoholism most prevalent in West Virginia *-Amotivational Syndrome- long term pot use -comorbidity- addiction and mental illness -teaching people to use their downtime productively- huge step -difference between dependent and abuse- dependent- have physical w/drawals, abuse have psychological w/drawalsMajor Mental Illnesses: Schizophrenia- cluster of symptoms, biologically based -genetic component- very likely to get it if a parent has it -demonstrate some psychosis- out of touch with reality, hallucinations, delusions -Prodromal Phase (Ages 17-25)- start to see psychotic thinking and the behavior that goes with it -Active Phase (onset-Age 60)- first psychotic break, return to slightly less than normal, 2nd psychotic break, return to even less normal, third psychotic break, return to farthest from normal -Residual- still have some symptoms, but burnt out -episodes usually triggered by stressful/traumatic event -positive symptoms: -hallucinations -delusions -loosening of associations: talking in extreme bunny trails -negative symptoms: -poor ADL -don’t respond well to meds -social isolation -flat affect -subtypes: -catatonic- extreme psychomotor disturbances -waxen flexibility -too much sensory info and don’t know what to do with it so just shut down -disorganized- incoherent thinking and bizarre communication -strange mannerisms and gestures -poor to no communication -one of the lowest functioning -hebophronic- funny, very similar to disorganized -Paranoid- exception to all the rules -themes of being persecuted -very intelligent -monstrously large delusional systems -recover well, highest rate of suicide -undifferentiated- other types non specifiedODD- Oppositional Defiant Disorder -kids are mean, starts very young (sometimes as young as 4) -disruptive behavior, defy authority -initially looks like ADHD -diagnosed with conduct disorder, usually end up criminals and/or sociopaths -poor impulse control *-cruelty to animals -often mistake anxiety as anger -OT intervention: -build trusting relationships -be concrete, give the kid a vocabulary to describe what they’re feeling -help the child identify what situations are going to cause problems -must have good impulse control and high frustration tolerance -use positive reinforcement -help them tolerate change -help them acquire social interaction skills Mood Disorders: Mania- elevated mood Major Depression -Reactive Depression -Andihonia- lack of wanting to do fun things SAD Bipolar I&II Dysthymic- low mood all the time, not as severe as major depression, but always in a down mood Hypomaniac- milder form of mania