What is psychosis
- a mental state that is characterized by a disturbance in reality
- common disturbances include:
- > hallucinations
- > delusions
- > associated speech or behaviour disruptions
What other mental health conditions is psychosis associated with
- schizophrenia
- mood disorder
- substance use
- disorders of personality
- disorders of eating
- response to some drugs
What is the challenge of labelling psychosis
- it can appear to be a normal human adaptive response to extreme survival conditions
- many collective human beliefs can be interpreted by outsiders as similar to psychosis
What are practice dilemmas
-what we see or receive from the individual may not reflect their experience
What are the approaching to enabling relationship with someone who has psychosis
1) True empathy
2) Finding shared meanings, points of interface and engaging in meaningful conversations
3) Comfort in developing relationships where some of our norms in social relations are compromised
What is the ideal transition in psychosis over time
- initial stage is acute
- middle stage is present but less interfering(low burner)
- last stage is where psychosis is absent but always possible
What are common approaches for individuals with psychosis
- cognitive remediation, cognitive-adaptative, cognitive disability
- CBT
- > become more cognitively flexible
- > change the way they evaluate the symptoms
- > consider alternative explanations
- > 3 C’s-catch it, check it, change it
- sensory motor approach
- social skills training
- supportive housing
- peer support
- community based intervention
- supported education, supported employment
What is the OT role for an individual with psychosis
- social support
- intervention that help people feel as if they matter
What is ACIS
-to evaluate social skills of individuals in a social interaction
Describe social interaction from the lens of MOHO when it comes to volition
Volition
->what do we expect, how do we experience behaviour and how do we interpret what has to happen
- in terms of therapeutic strategies
- > select a setting or contact in which a person wants to perform and or needs to perform
Describes social interaction from the lens of MOHO when it comes to habituation
- the habit map
- > your experience in the environment generates a set of internalized rules
- > these rules serves as a map for giving you a way of interaction with the external world
- the internalized role allows a person to automatically assemble behaviours appropriately in a social event
- so the therapeutic strategy here is to appropriate habitual behaviour and role behaviour through doing
Describe the social interaction from the lens of MOHO when it comes to performance skills
- the term social pragmatics applies to performance skills
- > social pragmatics is the ability to use skills effectively and adhere to the rule of social language in different social contexts
Pragmatic competencies include
- > polite speech
- > turn-taking
- > eye-contact
- > respect for personal space
- > use of acceptable strategies to gain attention
- > asking questions
Outline the Assessment of Communication and Interaction Skills
- it measures interaction and communication skills during the context of carrying out an occupation
- > it is an observational assessment(based on MOHO)
- > it gathers data on the skills that people demonstrate when communicating and interacting with others in an occupation
What important outcomes do communication and interaction skills in occupation have? Refer to ACIS
- the accomplishment of the goal or purpose of the occupation
- the social or interpersonal impact of the behaviour and occupation
What are the three domains of ACIS? Refer to the slides for a visual
1) Physicality
2) Information Exchange
3) Relations
What is a static theory
-statics theory means that we use the theory to analyze a phenomenon
What is an example of a static theory
Social cognition theory
- > individuals need to cognitively process social information
- difficulties in social interactions are caused by impairments in specific cognitive processes
- for example
- > individuals cannot perceive social cues
- > difficulties of understanding other peoples mental status(thoughts can differ)
- > difficulties with central coherence. this means integrating information into a whole
What is a dynamic theory
-a theory that provides an explanation for change
What is an example of a dynamic theory
- social learning theory
- > learning occurs by observing others in a social context
- first step is through attention
- > attend to and perceive the model’s behavior
- next step is retention
- > remember and retain the model’s behavior
- third step is reproduction
- > the learner has motor production of the behavior
- > the learner has the skills to imitate the action
- fourth step is reproduction
- > see the rewards associated with the action, in terms of the learner
What is the steps of the basic training model
1) What is the social situation and goal
2) What social behaviours follow standards/expectations
3) Then look at the outcome
- >looking at the outcome, it is the successful interaction
What are communicative difficulties related to cognitive deficits
- decreased speed of information processing
- > this involved understanding main points of conversations
- decreased attention
- poor planning and decreased goal-directed behaviors
- decreased abstract thought
- > cannot understand indirect messages
-difficult identifying the emotions
- poor social judgement
- > inappropriateness during interactions
- impaired reasoning
- > draw inaccurate conclusions
Describe the basic social skill model steps
1) identify the skills
2) discuss the steps of the skill
3) Model the skill
4) Practice the skill
5) Practice positive reinforcement
6) Provide corrective feedback
7) Assign homework
