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Flashcards in Psychological Approaches Deck (36):

Principles of MOHO

Three elements inherent to humans:

Volition- interest and personal causation

Habituation- habits/roles

Performance Capacity- skills for producing actions


PEO Model

Occupational performance is considered the outcome of the transactional relationship between ppl, their occupations, and the environment

a person's place in their lifespan influences their roles, activities, expected skills and motivations


Ecology of Human Performance Model EHP

Emphasizes the role of an individual's context and how the environment impacts a person and their task perfomance

The 4 main constructs include the person, tasks, context, and personal-context-task transaction

Utilizes checklists that include the person, the environment, task analysis, and personal priorities


Allen Six Levels of Cognitive Abilities
Cognitive Disabilities

Lvl 1 Automatic Actions: conscious response to external environment is minimal

Lvl2 Postural Actions: movement associated with comfort, may assist caregiver with simple tasks

Lvl 3 Manual Actions: begins with use of hands to manipulate objects, able to perform a limited number of tasks with LT training

Lvl 4 Goal Directed Actions: ability to carry simple tasks to completion, relies heavily on verbal cues, may perform established routines but cannot cope with unexpected events

Lvl 5 Exploratory Actions: overt trial and error problem solving, new learning occurs

Lvl 6 Planned Actions: absence of disability, can think of hypothetical situations and mental trial and error problem solving


Allen's Cognitive Disability Levels Group Incorporation

Lvl 1 Automatic Actions: would not benefit from group dymamics

Lvl2 Postural Actions: will be successful in situations where they can move about and copy movement that is modeled

Lvl 3 Manual Actions: focus on elements of repetition and manipulation

Lvl 4 Goal Directed Actions: goal-directed activities such as craft projects

Lvl 5 Exploratory Actions: activities with graded structure such as clay modeling or mosaics


Allen Cognitive Level Screen-5 ACLS-5

observing three increasingly complex leather lacing stitches and determine the person's cognitive lvl


Allen Diagnostic Manual

provides craft projects that can be used for eval as well as treatment that can also determine the person level of skills


Routine Task Inventory

gathers data about the person's ADL performance from an informed caregiver


Cognitive Performance Test

assess functional performance of individuals with Alzheimer's disease


Cognitive Behavioral Therapy CBT

Effective in the treatment of depression and other clinical populations; works to alter neg thoughts about themselves, the world,and the future by correcting misinterpretations of life events

Uses cognitive therapy (looks at thought and beliefs) and behavioral therapy (looks at person's actions and attempts to change maladaptive behavior patterns).


Approaches Using CBT

Assist clients in ID of current problems and potential solutions

Uses active/collaborative practitioner-client interaction as part of process

Help client learn to id distorted/unhelpful thinking patterns and relate to more pos ways

Help clnt gain insight and acquire skills that max func

Provides homework and structured assignments as part of intervention


Behavioral Techniques in CBT

Scheduling activities- increasing mastery/pleasure; grade to enable client success

Cognitive Rehearsal

Self-Reliance Training- can be facilitated thru performing ADLS

Role Playing

Diversion Techniques

Engaging in physical, work, leisure/play, and/or social participation


Dialectical Behavior Therapy DBT

Addresses suicidal thoughts and actions and self-injurious behavior
Commonly used with borderline personality disorder; also depression, substance abuse, and eating disorders

Teaches assertiveness, coping, and interpersonal skills
DBT groups address how acquisition of skills affects occupational performance and provide opportunity to practice new skills


Major Concepts That Guide Recovery
Recovery Model

Individualized and person-centered


Recovery Model Intervention

The development and implementation of a Wellness Recovery Action Plan (WRAP) is essential part of the recovery process

Storytelling is means of decreasing stigma and supporting others



Areas Addressed in Psychosocial Assessment

Performance skills

Client factors and physical conditions

Impact of individual's social , cultural, spiritual, and physical contexts

Id roles and behaviors that are req of the person

Precautions and safety issues

History of behavior patterns

Goals, values, interests, attitudes


Groups VS One-To-One

Refusal to attend groups
Inability to tolerate group interaction
Disruptive behaviors
Suicide precautions or a danger to self or others
Issues needing one/one attention

More cost effective
Learn to live in social environment
Take advantage of groups dynamics and therapeutic milieu


Directive Groups

Highly structured groups designed to assist persons with limited abilities in developing basic task and social skills


Modular Groups

Focus of each session is rotated; different sessions covering one overall subject (indepen living skills covering money management, nutrition, etc)


Psychoeducational Groups

an intervention approach that uses a classroom format and principles of learning to provide info to members and to teach skills


Sensory Awareness Groups

includes activities to promote sensory func and environmental awareness


Managing Hallucinations

Create an distraction-free environment

Highly structured simple, concrete activities

Redirect when pt is focused on hallucinations

Avoid discussions that focus on or validate delusional material


Managing Akathisia

Allow the person to move around as needed w/o causing disruption

Whenever possible, select gross motor activities over fine motor or sedentary ones


Managing Offensive Behavior

Set limits and immediately address the behavior during the session

State reasons behavior is unacceptable in a nonconfrontational manner

Consequences if continued should be clearly communicated


Lack of Initiation/Participation

Together w/pt id reasons for lack of participation

Provide motivational hints


Manic/Monopolizing Behavior

Highly structured activities that hold the person's attention and req a shift of focus from pt to pt

Thank pt for participation and redirect attention to another group member

Limit setting


Escalating Behavior

Avoid what can be perceived as challenging behavior

Maintain a comfortable distance

Actively listen

Use a calm, but not patronizing voice

Do not make value judgments

Clearly present what you would like the person to do

Avoid positions where you or the pt feels trapped

If it continues to escalate, remove other pts from area and get/send for other staff


Managing Acting Out Behavior In Children

Interpretation (enable child to express feelings)


Limit Setting

Time Out


Managing The Effects Of Dementia

Make eye contact and show that you are interested

Value/validate what is being said

Maintain pos facial expression and tone of voice

Do not give orders

Use short, simple words and sentences

Do not argue/criticize

Create a familiar routine with enjoyable activities

Note effects of time of day on behavior and activity performance


RADAR Screening and Respond to Domestic Abuse

R- routinely ask; inquiring about potential abuse when interviewing

A- affirm and ask; acknowledge and support the person who discloses abuse

D- document objective findings and record client statements in quotes

A- assess and address person's safety

R- review options and referrals


Phases of Adjustment to Disability

1. Shock- emotional numbness, depersonalization, reduced speech/mobility

2. Anxiety- restlessness, confusion, racing thoughts

3. Denial- minimization, unrealistic expectations

4. Depression- helplessness, isolation, decreased self-esteem

5. Internalized Anger- blaming self for event or failure to recover

6. Externalized Anger- attempt to retaliate for imposed losses, directed against those associated w/onset or rehab

7. Acknowledgement- acceptance

8. Adjustment- pos sense of self and potentialities


Suicide OT Interventions

Id of motivation behind suicidal intent and id alternatives

Create a contract for safety

Development of problem solving and stress management skills

Id goals and interest

Create activities for expression/validation of feelings and that produce successful outcomes and are future oriented

Mod physical activ to elevate mood

Develop skills that increase func perfomance

Pt ed


OT Intervention for Self-Harm

Improve self-management by teaching stress, anger, and emotional regulation skills

Instructing clnt on using alter coping strategies (ice, rubber bands)

Interventions using CBT or DBT if appropriated

Instructing in use of sensory approaches (massage, tactile stimulation, self-soothing)

Improving problem solving and communication skills


Adjustment to Death and Dying



OT Intervention Through Stages of Death/Dying

Assist individual in maintaining as much control and independence as possible

Respond honestly and at appropriate depth to questions

Assist w/develop of coping skills

Encourage pos life review

Assist w/pursuing interests and maintaining meaningful life roles

Incorporate friends/family in treatment

While being realistic, do not deprive individual of hope


Strategy for caregivers of a client with Alzheimer's disease to assist with fall prevention

Engagement in activity-based interventions, along with daily structure, has been documented to assist in fall prevention.