(Therapeutic Relationships)
Ginny has recently lost her father due to a car accident. She is deeply grieving and often reflects daily over and over how she could have prevented it if she hadn't asked him to drive her to her softball tournament in the downpour, even reasoning with God that she would be such a kinder person if He could bring him back.
The Kubler stages of Loss are not CONCRETE. They do not necessarily occur in order, and some symptoms are not experienced at all, and some are experienced in repetition. Treat based off symptoms, not conceived model. Other feelings are most DEFINITELY felt, this list is not law (Beth). List the stages according to the model, and list which two Ginny is most likely experiencing. There are 7.
Kubler stages of Grief:
Shock
Denial
Anger
Bargaining
Depression
Testing/Reasoning
Acceptance
Ginny is experiencing bargaining and depression
Activity analysis involves?
occupational profile, performance skills, performance patterns, activity demands, client factors, contexts
When documenting, what are the necessary components? These include the date, start and stop times, objective description of an ongoing plan, and....5 more
Objective (rationale and description of activities)
Clinical assessment (reaction to treatment)
Legible signature and credentials
Patient Info (room #, record # etc)
Doccumentation appropriate to state
MOHO is used with all age groups with the core idea that humans have an inborn drive to explore and master their surroundings (OCCUPATION)
"a set of interrelated assumptions, concepts, and definitions that presents a systematic view of phenomena by specifying relationships among variables, with the purpose of explaining and predicting the phenomena"
ALSO BONUS:
What model reflects this idea? involves spirituality and emphasizes client-center care
theory
Yo, it's a set of ideas that help things
EHHHHHH, It's Canada! (CMOP) Canadian model of Occupational Performance
A complex cognitive and effective process, process of analysis using thinking and feeling.
therapeutic reasoning
Modes of Interpersonal Communication: TAYLOR'S INTENTIONAL RELATIONSHIP MODEL
https://irm.ahslabs.uic.edu/what-is-the-irm/
Listed are examples of ways someone may choose to talk and advise in each of the 6 ways (collaborating, advocating, encouraging, emphasizing, instructing, problem-solving). List what type is being used from the dialogue:
1) "I am sincerely sorry for your loss, that must be incredibly hard for you to share, thank you for trusting me and sharing with me. I cannot imagine, how are you coping with this loss and honestly, how are you doing?"
2) "Many people have recovered with a similar injury you have sustained and have made it through with dedication, hope, and persistence; would you care to speak with any of them about their healing journey, I would be happy to come with you and we can discuss ways they may have found helpful?"
3) "I cannot guarantee success, that is completely true and realistic, but I have seen how hard you work and I believe if you can continue to work as hard as you have been doing you will continue to see progress, however small. You have incredible strength to cope with this injury and still come see me, I know you know, that, too."
4) "You have a significant injury. Your healing progress depends on knowledge of what you can do for it. Your exercises and participation will dictate your recovery."
5) "I hear that you have doubts that you will never be able to do this on your own again? Could we explore where that idea is coming from and possible ways to explore why you can?"
6) "I realize that you have some frustration with your progress, do you have any methods or ideas you would like to try that you'd consider adding to our program? I'm open to suggestions to help you with your progress."
1. Emphasizing
2. Advocating
3. Encouraging
4. Instructing
5. Problem-Solving
6) Collaborating
What is activity synthesis?
Make activity easier or more difficult (just right challenge)
change activity so the client can be successful
grading: changing the process, environment, tools, and materials
Initially
Daily (when we see the patient)
Weekly/monthly (progress summaries)
Discharge
_________are ideas that represent something in the mind of the individual and _______ explain their relationship.
concepts...................principles
prag·mat·ic
/praɡˈmadik/
adjective
dealing with things sensibly and realistically in a way that is based on practical rather than theoretical considerations.
focuses on the current treatment environment and resources available, including physical, social, and financial as well as therapist skills.
Which focuses on the clients own perception of the injury, illness, or barrier and its meaning?
Interactive reasoning
We tend to see ourselves in 3 different ways. What are the ways we see ourself and ways that we actually are?
Working with a client involves being aware of yourself. Verbal and non-verbal cues, understanding what the client needs, involving them, using groups to help, changing techniques and reflections on progress.
Ideal or perfect self (never achieved but always working toward)
Perceived self (how do other people see me?)
Real self
1. Define media:
2. Define: modality
3. Define: orthotic device
4. Define method:
1. the means by which a therapeutic effect is transmitted (vestibular ball)
2. the employment of, or method of employment of, a therapeutic agent
3. for supporting, immobilizing, or treating muscles, joints, or skeletal parts which are weak, ineffective, deformed, or injured.
4. Method: steps sequence or approach used to activate the therapeutic effect of medium. (handling of vestibular ball)
Define the parts of a soap note:
(S) Subjective: what patient, family, or chart "says"
(O) Objective: observable and measurable data and description
(A) Assessment: interpretation of pt functional performance, problem list, rational to continue skilled OT
(P) Plan: the treatment plan, frequency and duration, goals, recommendations
Most appropriate approach for clients whose CNS is intact but who may suffer from orthopedic issues. PLUS: which teacher is associated with this?'
Most appropriate approach for clients whose CNS is not intact, practice and feedback, the task assembles its skill. Teacher associated?
Biomechanical Approach Model; Courtney H (Courtney 2)
Motor Control/Motor Learning; Courtney B
focusing on the planning needed to focus within their future environment (discharge)
conditional reasoning
Active listening has skills, it is truly hard to be an active listener. What skills are required and often used?
Paraphrasing (avoid parroting), restatement, reflection, clarification
Examples of adapting an activity?
Which realm of occupational performance involves tools, objects, and environments?
provide changes to environment, tools, assistive technology, modify the environment, eliminate/add steps
Exocentric. Egocentric involves client factors and self, Consensual involves people society and culture.
Why do we document? To provide a legal paper trail of services and their reasoning, communication with the team, tracking progress, provide a record, and...?
justify therapy
Referring to the Kawa method (BETH), a client-centered approach to OT, the environments/contexts, social or physical are represented by what?
If a client had "driftwood" in his/her river (his/her life-flow and overall expectations) what would that represent?
The river banks.
Personal resources that can be assets or liabilities
Focusing of clinical inquiry, there are 3 main questions that are asked:
1) What is the patient status?
2) What are the available options?
3) What ought to be done?
Which of these questions involves questioning the outcomes predicted as well as the expectation of results?
2) What are the available options:
--approaches avaliable
--outcome predictions and results
--how much time
What is patient status involves: occupation, problems they have, the strengths they have, and their motivation.
What ought to be done involves: options considering values, informed of the consequences of different treatments and allowed to choose.
Trust can take years and years to form and seconds to break. In any relationship, what are good ways to develop trust?
Genuineness, listening, self-disclosure, nonverbal communication, consistency, follow-through
PAMS are not considered an entry-level skill. Physical agent modalities should only be used for which activity?
Prep for purposeful active occupation (not a substitute)
A good note is organized, concise but with good information, clear, legible, spelling and grammar on point, no CRITICISMS, JUDGEMENTS, OR DIAGNOSES and references the OTPF. SOAP!
Range of motion results, as well as MMT records, belong in which part of a soap note?
(O) Objective
describes the process for change in the client, as well as principles for moving a client along a continuum from dysfunction to function.
Being motivated by playing piano, as well as valuing playing for church, reflects which area of occupational performance? Habituation, Performance Capacity, Volition, or Environment?
Frames of Reference (FOR)
Volition.
Habituation is routine and roles
Performance Capacity is motor, cognitive, and emotional aspects acting on the environment
roles, tasks, and activities that are valued by the client involve:
functional limitations, focusing on clients illness, injury or disease.
narrative reasoning
procedural reasoning