Pass the OT



Adult and Geriatrics

|Dx |Description and Manifestation |Assoc. dx |Key elements of therapeutic approach |Key elements to therapeutic environment|Sample activities |Performance patterns |

|Anxiety |State of tension and uneasiness that|Found in almost every dx |Allow them to express themselves |Calm, comfortable |Yoga | |

| |the ego is unable to resolve |Psychopaths and criminals|Concentrate on productive activities |Decrease amount of people |Progressive relaxation | |

| |Everyone can control their anxiety |do not experience anxiety|Help them learn how to express themselves |Schedule of activities |Journaling with structure- helps to see| |

| |but some people cannot control | |Listen to their fears |Give a tour of the therapy |antecedents | |

| | | |Redirect their attention to a neutral topic |Help them feel secure |Just right challenge | |

| | | |Different responses are needed for different | |Guide pts. to choose activities | |

| | | |pts. | |Simple cooking tasks | |

| | | | | |Response: | |

| | | | | |Ritualistic: never criticize | |

| | | | | |Phobic: encourage pts. To talk about | |

| | | | | |fears | |

| | | | | |Intrusive: reassure you will be | |

| | | | | |available | |

|Depression |Feeling intense sadness, despair, |Wide range of d/o |Allow the pt. to talk about themselves |Decrease any stimulus |Thought and behavior chart | |

| |and hopelessness |Primary sx of affective |Avoid being overly protective/helpful |Increase opportunity for decision |Replace harmful thoughts with positive | |

| |Occasionally affects most people |(mood) d/o |Reinforce personal appearance |Forced choice* |thoughts | |

| |Most people recover |Schizophrenia |Avoid too many choices |Calming – constant worry |Incorporating relaxation or tai chi or | |

| |Feel hopeless and helpless |Most personality d/o |Do not over plan |Match tempo- speak slowly, softly and |yoga | |

| |Possibly worthless and guilty |Normal response to loss, |Recognize negative feeling |matter of fact |Decrease stress | |

| | |and adjustment |Notify staff of suicidal ideation |Avoid being overprotective |Painting by numbers- with raised lines | |

| | | | |Show decrease in depressive sx |Gross motor activity- improve | |

| | | | | |depression | |

| | | | | |Sleep hygiene | |

| | | | | |Like to do things for others | |

|Mania |Disturbance in mood | |Be cautious on giving criticism |Work alone |Exercise bike | |

| |Excessively happy | |Be firm, consistent |Decrease stimulus |Gross motor activities | |

| |Operating at a higher speed | |Reinforce limits | |Structured activities | |

| | | |Behaviors are caused by dx and/or meds | |Making a sandwich | |

| | | |Be aware of flattery- control they will try | |Soccer- sport activity | |

| | | |to gain control or manipulate you | | | |

|Hallucination|Sensory experience that doess NOT |Wide range of psychiatric|Help understand what is happening |Remove external stimulating environment|Karaoke | |

|s |correspond to external reality |d/o |Communicate in calm, clear, firm, natural, | |Songs that people should know | |

| |Appear as sight, hear, feel, smell, |Schizophrenia |rhythmic, soothing, manner |Keep alone but not permanently |Make a pizza- premade dough and put | |

| |or tastes things that aren’t there |Manic and depressive |Keep person in reality |Move to less overwhelming area |toppings on that they want | |

| |Arise from a temporary or permanent |psychoses |Mtn. personal space | |Stimulating other sensations | |

| |deficit in the brain function |Organic mental d/o |“how very interesting, tell me more about | |Play Wii | |

| | |Substance abuse d/o |it.” | |Age involvement with other trusted | |

| | | | | |people | |

| | | | | |Use bright colors | |

|Delusions |Wrong idea |Psychotic d/o |avoid discussing delusions directly |Stimulating and involve real life |Participate in a national weekly trivia| |

| |A belief that is contrary to reality|Schizophrenia |avoid looking frustrated |activities |game in order to keep up with real | |

| |as experienced by others in a |Bipolar (depressive or |meet them at their intellectual level | |life/reality based | |

| |cultural group |manic) |developing and organizing delusions | |Watching and summarizing the movie | |

| |Belief NOT based in reality |Eating d/o | | |Playing cards with friends | |

| |Beliefs: ideas of reference |Pts. with no other known | | |Activities should meet the pt.’s | |

| |Ie. The FBI is taking thoughts from |psychopathology | | |intellectual level | |

| |you | | | | | |

| |Inaccurate thought | | | | | |

| |May give clues to the pt.’s needs | | | | | |

|Paranoia |description: type of thinking in |- paranoid schizophrenia |- look at the world from their point of view |- when in a group, let the pt. sit at a|- must be activities that the person |- roles: participant, |

| |which persecutory and grandiose |- psychotic depression |- avoid approaching from behind or suddenly |separate table but with whomever they |can control, meet at intellectual level|helper, director |

| |ideas predominate. |- borderline and |- do not whisper- they will think you are |wish |without getting competitive |- routines: standard, no|

| |manifestation: general |narcissistic personality |talking about them |- keep the environment as stable as |-1. cooper tooling: select the design,|surprises, know well in |

| |suspiciousness and very extreme and | |- be clear, concise, directive |possible |still level of direction from the |advance about changes, |

| |unbelievable ideas (paranoid | |- avoid arguing |- prepare the pt. for any changes in |leader |need structure |

| |ideation), feel suspicious of those | |be truthful and do not make empty promises |their environment well in advance | |- habits: for a group, |

| |around them, constantly alert and | |- the pt. may try to make a special |- maintain the same people in a group |- 2. relaxation techniques: guided |make sure set-up is |

| |concerned about whether others are | |relationship with staff |so they gradually build trust |imagery: person with paranoia writes |consistent and people |

| |harassing them, persecuting them, | | |- don't force socialization |down what people say on the board |put away materials in |

| |taking advantage, or treating them | | | | |the same spots |

| |unfairly. | | | |- 3. pasta salad: planning and making: | |

| | | | | |have materials listed and they make it.| |

|Anger/hostili|Man: through px or verbal violence, |Psychotic d/o |tasks sensitive to the pt. |stay a few feet away and do not face |- journaling | |

|ty |stiffening, destruction, sarcasm may|Schizophrenia |get them to talk |them directly |- give a feelings worksheet | |

| |be the beginning. Know what the px |Manic-depressive |use your words instead of acting out |stay closer to the door |- Wii for boxing | |

| |signs are- prevention is best. |psychosis |speak to pt. individually |keep door open |- collage | |

| |Anger: strong feeling of displeasure|Psychotic depression |avoid punishing or criticizing |do not be alone |- art | |

| | |Organic mental d/o |tell them how to correct behavior |remove all weapons or potential weapons|- ripping magazines for pictures | |

| |Hostility: unfriendly and |Some brain d/o |be direct and clear about what is expected | |- have a theme for them to follow | |

| |threatening attitude directed toward| | |stay out of person’s reach |during art | |

| |others | | |no brooms or mops |- destructive activity then | |

| |Verbally or px abusive: expressing | | | |constructive activity | |

| |unmet needs | | | | | |

|Seductive/sex|Man: touching shoulder, loosing |Usually occur in pts. who|Approach in calm, non-judgmental way, strict |non-crowded environment |safe sex is enforced | |

|ual acting |ties, masturbating in public, pt. ( |are psychotic |enforcement, explain the rules of therapy. Be|non judgmental |sanding, px exertion | |

|out |pt. |Assoc. with psychosexual |clear about limits but mtn. therapeutic |pt. should have personal space |no contact sports | |

| |Any behavior that would normally be |d/o |relationship, |protected form sudden touch, smell, |gross motor activities | |

| |seen as explicitly sexual or | |Last resort: get someone else to work with |warmth of others | | |

| |provoking a sexual response | |them | | | |

| | | |May confuse therapeutic relationship | | | |

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