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25 Cards in this Set
- Front
- Back
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What is confidentiality? |
Confidentiality is the responsibility not to give client information to people outside of the mental health staff, unless told to do so by an involved staff person.
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What is continuity of care? |
Continuity of care is the responsibility to give relevant information received from or about a client to other involved staff, or in their absence, any clinical staff within the mental health service. |
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What is duty to warn? |
Duty to warn is the legal obligation to inform involved staff whenever you think a peer/client may be a danger to themselves or others. It is also the legal obligation to inform relevant authorities whenever one has information that a child may be in danger of being abused or has been abused. |
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What is a reflective response? Be able to define and also provide one in response to a scenario. |
A reflective response reiterates content in your own words, without adding your own thoughts or feelings. This is done in order to indicate understanding or to clarify what has been communicated. (It does not give advice, make a value judgment, or make a prediction.)
E.g.:
Peer/client: “What am I supposed to do about Joyce? She throws more work at me than I can possibly handle. I’ve told her but she won’t listen. I don’t want people to think I’m trying to get out of doing my job but she’s really got me totally buried.”
PSW: “It sounds like this is really getting you down?” or PSW: “You’re worried people will think you are a slacker?” or PSW: “You were discouraged when Joyce didn’t listen?”
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What is an empathetic response? Be able to define and also provide one in response to a scenario. |
An empathetic response mirrors back both the emotion and content being communicated. It requires that one parse for the feelings of the speaker.
E.g.:
Peer/client: “I got to the bus but the bus driver didn’t open the door and drove away.”
PSW: “You were probably feeling frustrated when the bus driver wouldn’t open the door and drove away.”
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Be familiar with common types of mental illness. |
Psychotic disorders; 2) Mood disorders; 3) Anxiety disorders; 4) Personality disorders:
Psychotic disorders: A mental disorder characterized by delusions, hallucinations, or other symptoms of lack of contact with reality. Includes schizophrenia, bipolar, and major depression.
Mood disorders: A group of psychiatric disorders characterized by a pervasive disturbance of mood or affect. Includes bipolar, depression, and schizoaffective disorders.
Anxiety disorders: A chronic condition characterized by an excessive and persistent sense of fear and apprehension, with physical symptoms such as sweating, palpitations, and feelings of stress. Includes obsessive-compulsive disorders, panic disorders, phobias, and PTSD.
Personality disorders: Personality disorders are a class of mental disorders characterized by enduring maladaptive patterns of behavior, cognition, and inner experience, exhibited across many contexts and deviating markedly from those accepted by the individual's culture. These patterns develop early, are inflexible, and are associated with significant distress or disability. They are divided into 3 clusters:
Cluster A (Odd, bizarre, eccentric) Paranoid PD, Schizoid PD, Schizotypal PD Cluster B (Dramatic, erratic) Antisocial PD, Borderline PD, Histrionic PD, Narcissistic PD Cluster C (Anxious, fearful) Avoidant PD, Dependent PD, Obsessive-compulsive PD
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What is dementia? |
A syndrome. A chronic or persistent disorder of the mental processes caused by brain disease or injury and marked by chronic memory impairment, deterioration of cognitive function, personality changes, and impaired reasoning. It causes difficulty in functioning due to things like wandering, agitation, aggression, perseverating, psychotic symptoms, sexually inappropriate behavior, and mood disturbance. Treatment options include cognitive enhancement or compensation strategies, environmental adaptation, pharmacological interventions, and supportive social strategies that maintain in day to day living. |
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What is delirium?
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A syndrome. An acute onset of confusion due to rapid changes in brain function that occur with physical or mental illness. Often due to underlying medical illness that is often treatable. Delirium is similar to dementia but it is reversible and sudden. It causes cognitive impairment, attention problems, reduced levels of consciousness, transient, disorientation which is usually reversible, fluctuating symptoms, and various behavioral symptoms like hallucinations, delusion, agitation, and changes in sleep/wake cycle. It is often due to underlying medical illness that is often treatable such as untreated u.t.i. or med toxicity. Consequences include increased mortality and morbidity. Treatment includes assessing and treating underlying cause and controlling environmental issues such as too much stimulation. |
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What are some things that should be covered at the beginning of a peer support relationship?
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What does the client know about peer support? What a peer support worker is and what you will be working on. (SMART goals are advisable) This is a professional relationship, not a friendship. Explain the difference. Remind the peer that the peer support relationship will be a time-limited relationship. Explain activity log. that you will be making a short report about your time together, the things we do, and how we are working towards achieving our goals. it’s good if you can fill out activity log with peer. Talk about confidentiality and continuity of care. Ask any questions you need to ask about situations that might come up. For example, how would the client like to be introduced in public? If you think you will be coming into contact with families, is it ok to share things with family if you are asked or would you prefer you don’t? Share a little about yourself and ask a few questions to begin to get to know your peer. Scenario:
“C, what do you know about peer support work? Peer support workers are people who have experienced receiving mental health services. We help others who are receiving mental health services reach a goal that they have set for themselves. We have a professional relationship, so this isn’t a friendship. PSW’s are “friendly but not friends.” We have 6 months to complete your goal. I am supposed to fill out an activity log for each of our sessions. If you want we can fill out the activity log together. The activity log is meant to keep track of our progress toward your goal. The staff at the mental health centre will have access to it. Our relationship is confidential, so I won’t be mentioning anything about you to anyone outside of the mental health centre. I will have to tell the Team if I think you are a danger to yourself or others. If we meet some either of us know, how would you like to be introduced? If your family ask questions about you want kind of questions should I answer or not answer? I used to also feel anxious about taking transit and sometime I still feel anxious. I look forward to helping you reach your goal.”
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Respond to a scenario where you will be finishing with a client, keeping in mind that you want to “end well”.
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Remind client during earlier sessions that end of work is coming.
The kinds of questions a PSW might be asking the peer/client are: (goal related questions) What has changed since we first met? What have you got from peer support services? Where else can you get some of these things? How can you be the best that you can be once peer support services come to an end? Have peer support services helped? If not, what would be more helpful? If it has helped, has it helped enough? Is there work still to do that needs doing now?
3) PSW can tell the peer/client what they have gotten from the sessions.
4) PSW can tell peer/client the values and strengths they value in the client.
5) With permission from supervisor PSW and peer client can celebrate ending with a lunch, a card, a coffee.
Scenerio: “M, we have 3 sessions left before we finish our peer support work at the end of the month. What have you gotten from our sessions so far? Has the peer support helped you enough? Are there places where you could get some of these things for yourself? I’ve gotten a lot from our sessions. I’ve enjoyed going to the community centre and having coffee afterwards. You have inspired me with your insight, resourcefulness, and positive attitude. The mental health centre is giving us extra money to have a lunch for our last session. Where would you want to go?”
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What is culture? |
Everything distinctive to a particular group.
It is a shared system of: values, rituals, traditions, shared customs Social rules of behavior perceptions of human nature and of natural events Influenced by individual and collective collective experience, history and tradition It’s dynamic Has internal variation. (subcultures, individual differences)
It is visible and invisible.
It influences what people think and believe. It is everything distinctive to a particular group including: beliefs, values, perceptions, customs, history, traditions, religion,ceremonies, social habits, language, arts, dress, cuisine, and perceptions of human nature and natural events. Culture is dynamic and is influenced by history. It also has internal variations.
Culture identity includes: language, ethnicity, migration history, acculturation, gender, age, health, sexual orientation, religion, and spirituality.
Don’t make assumptions about a person’s identity.
Goal of cultural competence: Recognize and respect differences offer a safe environment where individuals can voice concerns that he or she may deem unsafe.
Some people experience mental health symptoms somatically. In some cultures hallucinations are seen as a gift. Culture defines what is considered a mental health problem
Be open to cultural differences.
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Does trauma informed practice require the disclosure of trauma? |
No. TIP does not require disclosure of trauma. It is more about safety in the relationship, empowerment for the clients, and focus on engagement. Avoids re-traumatization, supports treatment at a safe pace. It puts priority on a client’s safety, choice, and, control. It is important to maintain safety and avoid re-traumatization.
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What is psychosis? |
A neurobiological condition which affects the brain, in which there is some loss of contact with reality. It occurs in “episode(s)” It includes a range of different symptoms It can be part of many different mental disorders |
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List 5 signs of emerging psychosis. |
Behavioral; 2. Thinking and speech; 3. Personality; 4. Emotional; 5. Social.
Behavioral Deterioration of work or study habits Sleep disturbances Appetite changes
Thinking and Speech Suspiciousness Perceptual changes Unusual beliefs Change in speech pattern Memory problems “Word Salad”
Personality Anger Irritability Avoidant
Emotional Mood swings Loss of energy or motivation Sad Anxiety Mania
Social Social withdrawal Gregarious
Prodromal phase: phase where “early symptoms” appear. |
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What will you say to someone who tells you that they are feeling suicidal? Write the actual words you might say.
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“What do you mean when you say you are suicidal?” (negotiate for clarity so the person can tell you what they really need)
“Thank you for telling me how you are feeling. It’s brave of you to speak about this and I appreciate your trust in saying that.”
“I think you should talk to your caseworker about this. I will talk to them about what you have told me because I care about you and want you to be safe.”
"If you want we could go together to the m.h. Centre and talk to your worker about this."
“Is there someone on the Team you’d prefer I talk to about your feelings in this situation?”
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List 3 warning signs of suicide.
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Talk about suicide Giving away belongings Recent loss Saying goodbye prematurely or out of context Self-hate Low energy
others:
Previous attempt Signs of depression withdrawal/isolating sleep and dietary disturbance poor concentration feeling guilty and worthless feeling of hopelessness no pleasure in formerly enjoyable activities Final arrangements Stockpiling means, meds Putting affairs in order Sudden state of calm Uncharacteristic behaviour changes
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Be familiar with facts and myths related to suicide.
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Myth ------------------------------------------------------------------------> Fact
People who talk about suicide rarely attempt or die by suicide. ------------> 70/75% of attempted or died by suicide have given some verbal clue.
Asking the question “Are you thinking about suicide?” will put the idea in someone’s mind or encourage them to do it. ------------> The opposite is true. Asking is the first step in prevention. It will encourage discussion and reduce anxiety.
A suicidal person always wants to die ------------> Most suicidal persons are ambivalent. They want their pain to stop. If they could see another way to make this happen they might not choose suicide.
Improvement in the suicidal person means the risk is over. ------------> Significant risk remains in the first 90 days after someone is released from hospital. While the will to live can reassert itself so can feeling suicidal.
Suicidal behavior can be viewed as merely manipulative. ------------> We must always take suicidal theats seriously. Err on the side of safety.
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List three things that grief may include.
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Bodily difficulties Preoccupation Guilt Hostility Inability to function Taking on traits of the deceased Intense feelings/feeling overwhelmed Grief may be all consuming for a time and can feel obsessive |
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Be able to identify the kinds of things worth noting in an activity log.
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Progress on goal Any change from the plan that took place Peer Strengths Info that may be significant to the treatment team Unusual incidents Behavioural or physical changes in the client - objective observations Safety concerns If you describe peer/client’s mood say objectively how you know.
Keep daily log within to 2 - 3 sentences. M.H. staff don’t want long notes and are happy to get info verbally. Important matters should be shared verbally.
Optional headings: Observations Actions Peer/client response
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As a PSW, do you ever use your client’s name in your documentation?
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No. The peer/client’s confidentiality must be protected by using their initials only. |
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Can you smoke with a peer/client? |
No. VCH policy prohibits smoking with a peer/client. |
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Can you enter a client’s residence without permission from your supervisor? |
No. |
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What, from class, are you going to bring with you to your practicum? |
The Practicum Package |
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Bonus question: List 3 ways you can support the empowerment and self-determination of your peer/client as a Peer Support Worker.
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Support people to come up with their own solutions. Not giving advice. The ideal goal comes from the client. People are most motivated when their goals come from themselves that they have chosen. If you get a sense that the goal doesn’t come from the peer/client, mention it to supervisor at m.h. team. Offer many choices. Maximize choices. Focus on their strengths. Look for opportunities to validate. Drawing on attention to successes. Strengths based questions. Draw attention to person’s successes even if goal is not attained. Bad days are part of the process. Non-judgemental communication. Really listening deeply without interrupting. Stay curious. Minimize power imbalance. Leave it to peer/client to divulge diagnosis and personal history as much as possible. Leave it to peer to share what they want. Have the peer document with you - do it together.
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What mark will I get on this exam? |
100% |
