OT302 Quiz #2

Content reviewed since quiz 1 → models, FORs, therapeutic approaches; Ch. 5, 8, 9, 10, 11, 12, 45, 49, 50, 51, 52

Cognitive beliefs

Reside within person & influence person’s performance in occupations; what individuals hold as people

What can an OTP do right away if a client becomes triggered during group?

• Remove others from group

• Sit near struggling client

• Have someone else run group

Dimensions of Wellness: Emotional

Capacity to recognize & express feelings, adjust to emotional challenges, cope with stressors

Dimensions of Wellness: Environmental

Ability to feel safe, access to clean air/food/water, stimulating E’s that support well-being

Dimensions of Wellness: Financial

Objective: Income, debt, savings

Subjective: perception of satisfaction w/ current financial situation

Dimensions of Wellness: Intellectual

Recognizing one’s creative abilities, expand knowledge, lifelong learning, sharing knowledge

Reflects theoretical assumption about nature of cognitive beliefs?

Core beliefs influence our thoughts, emotions, behavior, & physiological arousal

Tactile sense

Sensory receptors in the skin; deep pressure is calming, light touch is alerting

Olfactory sense

Smell; closely tied to memories & emotions

Which principle?: An OTP working in an inpatient MH setting wants to introduce daily creative arts group. One of the goals of the group is to improve mood & experience of positive emotions by scheduling daily fun & relaxing creative activities.

Behavioral activation

You want to find a study that provides information on the incidence & prevalence of people who have experience childhood trauma. What type of study should use?

Descriptive

An individual experiences frequent episodes of intense anger & sadness that often prevent them from completing valued activities. They want to develop the ability to tolerate negative emotions better without utilizing maladaptive behaviors. What treatment?

Dialectical behavior therapy (DBT)

Dimensions of Wellness: Occupational

Meaningful & rewarding occupations, purpose, satisfaction in life from participation

Dimensions of Wellness: Physical

Need for physical activity, attention to signs of stress, daily routine

Dimensions of Wellness: Social

Communication with those who support us, personal relationships, friendships

Dimensions of Wellness: Spiritual

Personal beliefs, values, having meaning & purpose

WHO definition of Well-Being

• Positive state experienced by individuals & societies

• Similar to health, it’s a resource for daily life & determined by social, economic, & environmental conditions

Well-being’s 5 measurable elements

• Positive emotion

• Engagement

• Relationships

• Meaning

• Achievement

Describes continuum of positive & negative experiences in everyday life

• Health & wellness

• QoL

• Flourishing

Wellness

Conscious & deliberate process that requires a person to become aware of & make choices for a more satisfying lifestyle

What do you use the 8 Dimensions of Wellness for?

Guide eval, intervention, & outcome tracking b/c dimensions are dynamic & intertwined

Contributors to well-being

• Motivation

• Occupational balance

• Occupational participation

• Co-occurring health conditions

• Trauma exposure

• Health-care access & quality

• Neighborhood & built environment

Occupational balance

“Right” amount & variability between daily occupations

Diagnostic overshadowing (relates to health-care quality)

Overly focused on client’s mental disorder & overlook symptoms related to other medical condition(s)

OT Process

Doing, being, becoming, belonging

Enacted togetherness

Doing together

Interventions for Belonging

• Development of a trusting relationship with person (OTP 1st priority)

• Introception

• MBSR = 2-3 hr sessions 1x/week for 8 weeks

• CBT = gold standard

• Connection menu

• Use of animals

Pair of ACEs model: Roots represent

Community trauma

Pair of ACEs model: Soil represents

Collective trauma (systemic, natural disasters, disease)

Strengths-based way to say “Pt. is noncompliant”

Pt. politely declined to meet at this time, preferring to meet later in the day.

TIO model: Trauma Aware

OTP shares knowledge, invites others to learn, brings awareness

TIO model: Trauma Sensitive

OTP researches TI models, has advanced training, advocates/serves as an agent of change

TIO model: Trauma Responsive

OTP leads workshops, gathers information, creates TI plans

TIO model: Trauma-Informed

Implement & monitor care, adopt policy

SAMHSA’s 4 R’s

• Realize

• Recognize

• Respond

• Resist

Automatic thoughts

Outermost level; words, images, self-talk that pass through the mind

Schemas

Innermost level; cognitive templates of absolutes about how people see themselves, others, the world, & the future

What operates outside conscious awareness?

Schemas

What is at the intermediate level of beliefs?

Assumptions, attitudes, values

Beliefs + their dynamic interaction with behavior…

Comprise human functioning

What filters what people perceive & how they appraise, interpret, & give meaning to experiences?

Beliefs

What triggers an emotional response?

Moods & feelings

Beck: Anticipatory beliefs

Expect a reward (Ex. going to frat for free bar)

Beck: Relief-Oriented beliefs

Using substance(s) will alleviate discomfort

Beck: Facilitative beliefs

View use as acceptable despite potential consequences (Ex. “just one won’t hurt”)

How can thoughts be evaluated, monitored, & changed?

CBT

Acceptance & Commitment Therapy (ACT)

Mindfulness & acceptance strategies to address cognitive beliefs & help people make valued changes

Relational Frame theory (RFT)

Relating one concept to another is foundation of all human language

Core processes of ACT

• Acceptance

• Cognitive defusion

• Be present

• Self-as-context: What am I thinking"?

• Values

• Committed action: I can do hard things.

TIC-TOC technique

Reframing task-interfering cognitions & replacing them with task-oriented cognitions

Propioception

Body’s position in space

Vestibular

Head’s position in space

Introception

Awareness of bodily states & organ function

Sensory Integration (SI)

Use play activities to target specific senses to elicit adaptive responses; child gaining sensory input is more able to organize info & participate

Sensory-Based Interventions?

• Zones of regulation

• Alert program: view arousal level as an engine (12 wk w/ 3 stages)

• Deep pressure touch strategies: weighted blanket

Dunn Model of Sensory Processing

How people respond to sensory stimuli; 4 quadrants

Sensory sensitivity

Eliminate extraneous stimuli & decrease intensity; low threshold & passive

Sensation avoiding

Increase consistency & lower intesity & amount; low threshold & active

Low registration

High contrast & intensity but lower predictability & speed; high threshold & passive

Sensation seeking

High intensity, amount & speed; high threshold & active

Coping

Process, strategies, & behaviors that individuals use to adapt, adjust, & manage challenges & demands of daily life

Resilience

Ability to adapt to challenges, trauma, & life changes to maintain well-being in everyday life

Acute Stress/Fear Response

Good for situational challenges

Diathesis-Stress Model

Environmental stressors contribute to development of psychiatric conditions when a person is biologically vulnerable

Transactional Model of Stress & Coping

Describes process by which people deal with stressful situations; people constantly appraising their E

Emotion-focused coping

Uses strategies that reduce negative emotions associated with stressor (Ex. not thinking about phobia during exam)

Problem-focused coping

Resolves stressful situation or alters source of stress (Ex. telling your boss that you are unhappy with schedule)

Salutogenesis & Sense of Coherence

Understanding health instead of disease to explain how some people adapt & survive in face of adversity

Sense of coherence

People can better manage stress when they have a sense of it & are confident they can deal with it

Is situation worth engaging in & does person care about what will happen?

Meaningfulness

CBT goal

Increase positive experiences & build sense of achievement & momentum

__ uses extrinsic motivation like rewards or punishments

Operant conditioning

Maslow’s relation to occupation?

Understanding that each level of unmet needs influences what people do in order to satisfy them

Self-Determination Theory (SDT)

Human beings seek psychological growing & well-being; humans are intrinsically motivated

SDT relation to occupation?

Argues intrinsically satisfying goals make people continue to participate

Flow theory

Optimal personal experience that occurs while participating in any intrinsically motivating task

Flow theory relation to occupation?

Giving clients that just-right challenge & knowing clients subjective perception of their capacities & interests

Self-efficiacy theory

Self-efficacy is primary driver for humans to act

Transtheoretical Model of Change (TTC)

Approach to health behavior change: pre-contemplation, contemplation, preparation, action, maintenance

TTC relation to occupation?

Promotes behavioral change to enhance healthy lifestyles & consideration of decision-making process

MOHO

Focus on people’s occupational needs rather than their impairments; promote individuals participation to achieve meaningful & satisfying lifestyles that support their QoL

MOHO elements that transform partcipation

• Habituation

• Performance capacity

• Volition

• Environment

Occupational competence

Extent to which individuals maintain a meaningful & satisfactory lifestyle that reflects their occupational identity

Motivational interviewing

Collaborative, goal-oriented style of communication with particular attention to language of change

Re-motivation process (RP)

MOHO protocol-based for people whose volition inhibit their participation; gradually increases sense of self-worth, effectiveness, & belonging

Phases: exploratory, competency, achievement

__ is socially constructed & embedded in environment

Volitional process

Feelings

Purely conscious mental understanding of an emotional state (Ex. I have a pit in my stomach)

Mood

State that lasts for longer period of time & is more comprehensive than feelings

Modal Model of Emotions

situation → attention → appraisal → response

Necessary for successful participation?

Emotional expression, management, & regulation

Process Model of Emotional Regulation

How strategies can be used to modulate emotional experience while it’s happening

Process Model of Emotional Regulation

• Situation selection

• Situation modification

• Attentional deployment

• Cognitive reappraisal

• Response modulation

Lability

Full range of emotions, strong fluctuations

Emotional dysregulation

Emotional response that is not adapted to current situation; occurs when negative emotions interfere with completion of goal-directed activity

Emotional misregulation

Uses a strategy that is poorly matched to situation

Emotional regulation failures

Fails to engage in strategy at all

Alexithymia

Trouble identifying, describing, & differentiating emotions & recognizing physical sensations associated with emotions

Temperament

How an infant is predisposed to react to the environment & their ability to self-regulate core responses

When do emotion regulation skills solidify?

During early-middle adulthood

When is a key time for interventions that support emotional skill development to occur?

Adolescence