Mental Health Midterm

hope

recovery emerges from hope. Hope is the catalyst of the recovery process

person-driven

self-determination and self-direction are the foundations for recovery as individuals define their own life goals and design their unique path(s) toward those goals

many pathways

recovery pathways are highly personalized. Recovery is nonlinear, characterized by continual growth and improved functioning that may involve setbacks.

holistic

recovery includes mind, body, spirit, and community. This addresses self-care practices, family, housing, employment, transportation, education, clinical treatment, services and supports, primary health care, dental care, complementary and alternative services, faith, spirituality, creativity, social networks, and community participation

peer support

peers encourage and engage other peers, providing each other with a vital sense of belonging, supportive relationships, valued roles, and community. Through helping others and giving back to the community, one helps oneself. Peer-operated services and supports are essential resources

relational

Family members, peers, providers, faith groups, community members, and other allies form vital support networks. Through these relationships, people engage in new roles that lead to a greater sense of belonging, personhood, empowerment, autonomy, social inclusion, and community participation

culture

services should be culturally grounded, attuned, sensitive, congruent, and competent as well as personalized to meet each individual’s unique needs.

addresses trauma

services and supports should be trauma-informed to foster safety (physical and emotional) and trust, as well as promote choice, empowerment, and collaboration.

strengths and responsibility

Individuals, families, and communities have strengths and resources that serve as a foundation of recovery. All are responsible for using their strengths to provide opportunities and resources for recovery

respect

community, systems, and societal acceptance and appreciation for people affected by mental health and substance use problems – including protecting their rights and eliminating discrimination – are crucial in achieving recovery

SAMHSA dimensions: health

overcoming or managing one’s disease(s) or symptoms – for example, abstaining from use of alcohol, illicit drugs, and nonprescribed medications if one has an addiction problem – and for everyone in recovery, making informed, healthy choices that support physical and emotional well-being

SAMHSA dimensions: home

a stable and safe place to live

SAMHSA dimensions: purpose

meaningful daily activities, such as a job, school, volunteerism, family caretaking, or creative endeavors, and the independence, income, and resources to participate in society

SAMHSA dimensions: community

relationships and social networks that provide support, friendship, love, and hope

Ayers

1. Beliefs

   1. Adaptive Response or Self-Adjusting Process

   2. Sensory Modulation: the brain organizes incoming sensory Information

   3. Brain inhibits or facilitates the flow of messages across nerve junctions and synapses

2. The repeated use of nerve pathways in a sensorimotor function creates a neural memory or map of that function

   1. The brain can recreate the movement at other times

3. Hierarchical View: Must work developmentally and sequentially

Lorna Jean King

1. Focuses on schizophrenia

2. Hypotheses: schizophrenic clients have defective proprioceptive feedback mechanisms and under-reactive vestibular systems

3. Movement and sensation play central roles in altering biochemical states, and biochemistry in turn affects movement (sensory motor)

Dunn & Brown

1. Developed Adolescent and Adult Sensory Profile (A/ASP)

2. Brown et al. (2002) - found individuals with schizophrenia had higher scores on low registration and sensation avoiding, and lower scores on sensation seeking than people without a mental illness. According to the findings of this study, individuals with schizophrenia tend to miss available sensory stimuli. When stimuli are detected, they are often avoided

4 quadrants on the Sensory Profile

1. Low threshold + passive response = sensory sensitivity

2. Low threshold + active response = sensation avoiding

3. High threshold + passive response = low registration

4. High threshold + active response = sensation seeking

sensorimotor

Provides sensory stimulation and opportunities for adaptive responses. Focus on muscle tone, posture, and motor planning. Provide motivation to participate through sensory input. Start with lower cognitive skills to build higher ones. Provide multiple opportunities for practice of functional tasks. Reinforce achievements.

sensory processing

refers to the reception, modulation, integration, and organization of sensory stimuli and the resulting behavioral response

sensory modulation

The capacity to regulate and organize the degree, intensity, and nature of responses to sensory input in a graded and adapted manner. This allows the individual to achieve and maintain an optimal range of performance and to adapt to challenges in daily life

Behavioral

Interaction of the person and environment

1. Stimulus/ response

2. All behavior is learned through:

   1. Classical / respondent conditioning

   2. Operant / instrumental conditioning

   3. Modeling

Biological

beliefs in brain plasticity and that the symptoms of psychological disorders are caused by underlying biological factors, like infections, neuroanatomical defects, biochemical imbalances, and genetic predisposition. 

Humanistic

More of a philosophy; often viewed as a philosophy of life. Emphasizes value, worth, and potential of the individual. Focus on the integrity of the client-therapist relationship. Therapy is client-centered: concept of self and personal values. Moral treatment- consistent with OT

Psychodynamic

focuses on emotional and personality development of the individual. Emphasis on early childhood experience. Normal and abnormal behaviors are determined by unconscious forces and internal processes

Cognitive disability

Cognitive behavior is based on biological factors, and potential for improvement is dictated by these factors. Based on Piaget’s stages of cognitive development and neurobiological science. Once the maximum cognitive level has been achieved, compensations must be made biologically, psychologically, or environmentally

directive leadership

• therapist determines structure, activity, and processing.

• Therapist takes an active role in shaping member participation.

• Members have cognitive impairment, poor capacity for insight, immaturity, poor verbal skills, or low motivation.

• The topic is educational and requires therapist expertise/demonstration

facilitative leadership

• members have a middle-high level of cognition and capacity for insight.

• Members have at least a medium level of maturity, verbal skills, and motivation.

• Members are capable of making choices of activity, topic, and structure.

• Therapists can delegate some leadership roles to members.

• Members are encouraged to give each other feedback.

• Therapist/leader does not do anything for the group that they can do for themselves

advisory leadership

• Occupational therapist’s role is consulting, wellness, or caregiver education.

• Members have high cognition, verbal skills, insight capacity, and motivation.

• Members have selected a specific activity or topic area. Members can seek advice from leaders on an as-needed basis.

• Members lead their own group and experience natural consequences from the environment

task group

• Provide an opportunity for active involvement in occupation.

• Emphasis is on group process during completion of a task.

• provides a shared experience.

activity group

• the process of engaging in meaningful activity with others.

• Expressive arts, crafts, music, dance, role-play scenarios, and games are often used in activity groups.

• Frequently designed to build positive self-concept and improve communication skills

developmental groups: parallel

side- by-side tasks with no interaction

developmental groups: project

short-term task accomplishment with some interaction

developmental groups: egocentric-cooperative

group members select, implement, and execute long term-task jointly

developmental groups: cooperative

group members work together on task accomplishment while satisfying socio-emotional needs

developmental groups: mature

group members take on leadership roles to facilitate balance between productivity and personal need satisfaction

directive groups

Highly structured, often focus is on orientation (typically used for people who are acutely or severely ill)

neurodevelopmental groups

Use movement activities based on SI theory and techniques

mood disorders

an overarching categorical term that encapsulates conditions in which an individual has ongoing feelings of sadness, disengagement, or disinterest in once-valued occupations, or extreme fluctuations from sadness to happiness)

• OT interventions: activity scheduling and habit training, social skills training, stress management, and coping strategies

anxiety

anticipation of future threat

• Assessments: COPM, OSA, Stress Management Questionnaire

• Interventions: relaxation training, exposure, mindfulness, sensory-based approaches

OCD

Obsessions: intrusive, unwanted thoughts/urges/images. Compulsions: repetitive behaviors/mental acts to reduce distress

• Assessments: COPM, OSA, Role Checklist

• Interventions: exposure and response prevention (in collaboration), habit training, time management, sensory regulation

depression

characterized by sadness, emptiness, or irritable mood that directly impacts occupational performance

Bipolar I disorder

individual must experience 1 or more manic episodes. May have depressive episodes

• Hypomanic and depressive episodes are common but are not required criteria for a diagnosis.

• The rapid cycling specifier is given when 4 or more episodes occur in 12 months.

Bipolar II disorder

the presence of a current or past hypomanic episode and a current or past major depressive episode without the presence of a manic episode. No full mania