Counseling and Mental Health Online Course

  • Counseling and Mental Health Online Course Introduction

    This self-paced professional development course will provide you with a thorough overview of the TEKS for the Counseling and Mental Health course (one to two credits). The suggested scope and sequence for this course is divided into eight modules. Each module will be explored and you will be provided with resources, references, suggested teaching strategies, and a brief assessment.

    Students model the knowledge and skills necessary to pursue a counseling and mental health career through simulated environments. Students are expected to apply knowledge of ethical and legal responsibilities, limitations, and the implications of their actions. Professional integrity in counseling and mental health care is dependent on acceptance of ethical and legal responsibilities.

    Students will identify this course as part of a Career and Technical Education (CTE) program of study, understand that CTE in Texas is organized around 16 career clusters and 79 career pathways, and that Counseling and Mental Health is one of 12 courses in the Human Services career cluster that equips students with:

    • core academic skills
    • employability skills
    • job specific technical skills

    Important
    This online course consists of an introduction and eight modules. Carefully read all course content to become familiar with the TEKS, student expectations, published lessons, and suggested activities. Names of handouts, graphic organizers, slide presentations appear in bold letters. Refer to attachments at the end of each module for additional information. Twelve pre-assessment multiple choice statements can be found at the end of the introduction. Each module ends with five multiple choice statements.

    After completing the course you will be required to complete a 50 question quiz and submit your name and email address. You will receive a certificate of completion at that address.

    The certificates for the successful completion of the online courses are NOT automatically computer generated and are reviewed individually. Certificates will be generated Monday through Friday between the hours of 8:00am and 5:00pm.
    For questions, contact: sfacte@gmail.com

    As approved by the Texas Education Agency, a passing score of 80 is required to receive a certificate equalling six (6) Continuing Professional Education (CPE) credits.

    Refer to Introductory Lesson: Counseling and Mental Health for an introduction to Career and Technical Education, Career Clusters™, coherent sequence of courses, and programs of study.
    http://cte.sfasu.edu/lesson-plans/introductory-lesson-principles-of-education-and-training/

  • I. Perspectives of Mental Health

    TEKS Addressed

    (1) The student applies mathematics, science, English language arts and social studies in health science.

    • (C) identify societal perspectives related to mental health

    (3) The student researches career options and the preparation necessary for employment in mental health.

    • (C) justify the consequences of decisions

    (4) The student models the ethical behavior standards and legal responsibilities related to mental health.

    • (A) display ethical practices and the principles of confidentiality
    • (C) examine designated scope of practice of professionals

    Module Content

    Perspectives of Mental Health is the first unit of study in the Counseling and Mental Health course. This section contains two units of study that include:

    • A. Historical Treatments for the Mentally Ill
    • B. Theoretical Perspectives on Mental Illness in the Twentieth Century

    —-

    Historical Treatments for the Mentally Ill

    From drills to pills, mental illness has been observed and treated in a variety of ways throughout history. Bones found through archaeological evidence have shown that holes were drilled into skulls, called trepanation, of the mentally ill to let the evil spirits out. Treatments for the mentally disturbed consisted of rituals, potions, and even exorcisms carried out by priests, magicians, and medicine men. Today, many drugs exist to assist with all types of psychological disorders.

    Students should know the milestones throughout history to have a better understanding of the evolution of mental illness and its treatments. Historical milestones should include the following:

    • In Ancient Greece, people thought the mentally ill had been punished by the gods for doing something wrong and ceremonies were used as treatment for possession.
      • Socrates and Plato are known for the “Know thyself” advice which suggests we can learn a lot about ourselves by examining our thoughts and feelings, or looking within which is called introspection.
      • Aristotle, a Greek philosopher, is responsible for the laws of associationism, a learned condition between two ideas or events, which are still in use today.
      • The Greek physician, Hippocrates, proposed that mental disorders were brought about by abnormalities of the brain and an imbalance of four body fluids – blood, phlegm, yellow bile and black bile. He believed that an excess of black bile resulted in depression or melancholy. Melancholy is derived from the words melan, meaning black, and chole, meaning bile.
    • The Middle Ages brought about beliefs in witchcraft and demonic possession and were thought to be the cause of insanity. There were several popular treatments such as persecution, starvation, restraints, beatings, and even drowning.
    • In Renaissance times, people believed that the moon and stars caused madness. The terms lunacy and lunatic were derived from the Latin word luna, meaning moon.
    • During Colonial times, people who were mentally ill were often accused of being witches and of witchcraft. The question of being a witch was resolved by a “dunking test” where people were thrown into deep water. If the accused drowned, then he or she was said to be pure. If the person survived the water dunking, then they were determined to be witches or in allegiance with the devil and they were stoned to death.
    • During the 1500’s, institutions were built to house the mentally ill. However, they had deplorable living conditions with filthy rooms. The mentally ill were subjected to public beatings as treatment. A famous asylum in London named Saint Mary’s of Bethlehem was nicknamed “Bedlam” due to its poor living conditions.
    • Scientific advancements in the 1600’s and 1700’s led to the beginning of modern psychiatry, stating ideas about human behavior should be supported by science.
    • In the 1700’s, a French physician, Phillipe Pinel, introduced a new concept of exercise, fresh air, and clean environment for the mentally ill.
    • In 1840’s, Dorthea Dix, an American school teacher persuaded state officials to provide funding for improved asylums, schools, and prisons.
    • In 1883, Emil Kraepelin, a German phsyciatrist developed a system for diagnosing and classifying mental illness.

    Theoretical Perspectives on Mental Illness in the Twentieth Century

    The twentieth century brought significant changes to theories and perspectives of mental illness and its treatments. The main theories and concepts in the twentieth century are:

    • Psychoanalytical Theory which states that all behavior is meaningful and is influenced by unconscious impulse and conflicts. Two important figures that practiced this theory were:
      • Sigmund Freud, a Viennese physician, is considered the founder of psychoanalysis. He believed that people were driven by hidden impulses. It is his belief that the mind has three basic structures, the id, ego, and superego.
      • Carl Gustav Jung, a Swiss psychiatrist, introduced the concept of the collective unconscious which is described as a store of ideas and images of the experiences shared by all humans called archetypes.
    • Behavioral Theory states that behavior is learned and can be reinforced or modified.
      • John B. Watson is considered to be the founder of behaviorism and defined psychology as the scientific study of behavior.
      • B. F. Skinner, a psychologist, introduced the principles of reinforcement, that behavior is learned from environmental experiences.
    • Humanistic – Existential Perspective – stresses self-fulfillment and the importance of consciousness, self-awareness, and the ability to make choices.
      • In the 1950’s through 1960’s, Carl Rogers believed that “self-actualization” was the way to live a genuine life and that treatment must be client-centered. Self-actualization is the need to become what one believes he or she is capable of being.
      • Abraham Maslow introduced a Hierarchy of Needs that stated basic needs must be met before higher level needs can be realized.
        - Physiological – air, water, food, shelter, warmth, sleep
        - Safety – security, stability, employment
        - Belonging – friends, family, and intimacy
        - Self-esteem – confidence, achievement, respect of others
        - Self-actualization – creativity, potential, purpose
      • Gestalt Therapy, founded by Fredrick Perls, is based on the idea that perceptions are more than the sums of their parts. It focuses on the here and now. He claims what someone is feeling or perceiving, or what is happening at the time, is more important than what should be or could be.
    • Cognitive Theory focuses on the function of thoughts in determining behavior. It is based on information processing for the brain and that faulty processing or thinking locks a person into dark, inflexible ways of thinking and behaving.
    • Strategic Theory states that reality for each person is created through communication with others and is a type of communication therapy. This theory emphasizes that the choice, use and order of words influences one’s perceptions of their own experiences.
    • In Neuropsychology individuals are chemically treated to behave in particular ways due to genetic makeup.
    • Psychopharmacology is the use of drugs to help maintain more “normal” neurology.

    Teaching Strategies/Lesson Ideas

    • Refer to lesson “Ethical Standards and Confidentiality”
    • Students could conduct research on the Salem Witch Trials from the perspective of mental illness.
    • Students could research the behavior at various times throughout history and compare and contrast what was considered “normal” behavior for a young person.
    • Students can research one of the people in history that had a major influence on mental illness or its treatment such as Sigmund Freud, Carl Jung, Dorthea Dix, or Emil Kraepelin. Students should make a report to the class through a poster or presentation.
    • Students can construct a timeline throughout history using the graphic organizer The Past – A Timeline in History.
    • Start where The Past – A Timeline in History organizer ended and have students construct a new timeline by having them conduct research on the Internet to add ten other significant milestones in the counseling and mental health industry. Students can then present their milestones to the class.

    References and Resources

    Textbooks

    • Barry, Patricia D., Mental Health and Mental Illness, Seventh Edition, Lippincott, 2002. Print.
    • Psychiatric Mental Health Nursing, Second Edition, Fortinash-Holoday-Worret, Mosby, Inc.
    • Rathus, Spencer A., Psychology: Principles in Practice, Holt, Rinehart and Winston, 2007. Print.

    Websites

    Perspecives of Mental Health Pre-Assessment Questions

    1. The first psychiatrist who developed a system for diagnosing and classifying mental illness is

    • a. Dorthea Dix
    • b. Sigmund Freud
    • c. Emil Kraepelin
    • d. Carl Jung

    2. The process of chipping a hole into one’s skull to let the evil spirits out is called

    • a. labotomy
    • b. craniotomy
    • c. sluicing
    • d. trepanation

    3. Saint Mary of Bethlehem was

    • a. a church in Boston
    • b. an institution to promote exercise, fresh air, and a clean environment
    • c. a school for doctors to study mental illness
    • d. an institution for the mentally ill that was disgusting and foul

    4. Behavior is learned and can be reinforced or modified is a behavior theory supported by

    • a. John Watson and B.F. Skinner
    • b. Suan Walsh and Abraham Maslow
    • c. Dorthea Dix and Carl Jung
    • d. Emil Kraepelin and Carl Rogers

    5. Which is the correct order of Maslow’s Heirarchy of Needs?

    • a. safety, physiological, belonging, self-esteem, self-actualization
    • b. physiological, safety, belonging, self-actualization, self-esteem
    • c. physiological, safety, belonging, self-esteem, self-actualization
    • d. safety, physiological, belonging, self-actualization, self-esteem

  • II. Development Stages

    TEKS Addressed

    (1) The student applies mathematics, science, English language arts and social studies in health science.

    • (C) identify societal perspectives related to mental health
    • (D) explain the physiological effects of stress and aging
    • (E) distinguish the psycholgical aspects of health and wellness across the life span
    • (F) identify socioeconomic factors that influence mental health and care

    Module Content

    Developmental Stages is the second unit of study in the Counseling and Mental Health course. This secction contains four units of study that include:

    • A. Human Development-From Infancy to Geriatrics
    • B. Geriatrics
    • C. Life Stages
    • D. Individual Differences

    —-
    Module II Handouts

    Human Development – from Infancy to Geriatrics

    Developmental psychology is the study of how people grow and change throughout life – from infancy, through childhood, adolescence, adulthood, until death. Individual needs must be met in every stage of growth and development. Normal development of personality may be hindered if distressing experiences or unsatisfied emotional needs happen in early life.

    Geriatrics

    According to the U.S. Census, in 2011 there were over 41 million people over the age of 65 in the United States or 13.3% of the population. This number is expected to grow to 20% of the population by the year 2030.

    Medical conditions that the aged will encounter are uncontrolled hypertension, arthritis, heart disease, cancer, diabetes, and sinusitis. With these conditions, and others, there is increasing concern for health care cost and insurance coverage. As our population ages those reporting minor disabilities will increase and senior citizens will require extra aid to carry out daily needs such as personal hygiene, walking, getting in and out of chairs and beds. Living arrangements also affect those in their later years. Some elderly live with family members while others live in various types of institutions like nursing homes. The poverty level of these adults also increases as they age as does the non-cash benefits like food stamps, low income tax credits and Women In Crisis (WIC).

    Life Stages

    Erik Erikson’s concept of personalities identified the stages of psychosocial development. The challenges of each developmental stage are listed in the following:

    • Early infancy (birth to 1 year-old) – trust versus mistrust – This stage is characterized by basic trust. Infants are completely at the mercy of adults. Babies who are accepted and loved develop trust and babies who are unloved or neglected develop anxieties over their own needs and begin to distrust.
    • Later infancy (1 to 3 years-old) – autonomy versus shame and doubt – This stage is characterized by autonomy or independence. While still dependent on adults, infants have more restrictions and rules and will become unruly and rebellious. Their favorite word is often “no”.
    • Early Childhood (4 to 5 years-old) – initiative versus guilt – This stage is characterized by initiative. The child expands their imagination and asks “why?” often. The child begins to adopt the mannerisms and attitudes of the parent with the same sex. Boys will imitate their fathers and girls their mothers. By taking on initiative they are assuming responsibility. If the child is irresponsible, they will experience feelings of guilt which can be eradicated by accomplishments.
    • Later Childhood (6 to 11 years-old) – industry versus inferiority – This period is characterized by industry and accomplishment. Children this age have lots of energy and should be directed toward constructive activities. Children learn to compete with peers in school. Pride develops as a result of praise and rewards for their effort. Feelings of inadequacy or inferiority occur if the child’s efforts are not recognized.
    • Puberty and adolescence (12 to 20 years-old) – ego identity versus role confusion – Characterized by a search for identity, this stage can be troublesome. Significant changes in the body, emotional roller-coasters, surges of sexual feelings, and striving for independence play a large part of the feelings of self-doubt and ambivalence. Teenagers will “try on” different mannerisms, dress, speech, and activities to gain a sense of identity and belief that he or she is a worthy person.
    • Early adulthood (20 to 40 years-old) – intimacy versus isolation – Intimacy or the capacity to love and trust oneself as well as another in a committed relationship is the characterization of this life stage. It is also essential for a long-lasting, deep friendship. When a person is incapable of intimacy, they are detached and isolated.
    • Middle adulthood (40 to 60 years-old) – generativity versus stagnation – Generativity or the ability to produce something or be productive is the characterization of this life stage. A psychologically mature adult strives to be productive and those who are not tend to be preoccupied with self to the exclusion of others and become stagnant.
    • Late adulthood (60 years to death) – ego integrity versus despair – This period is characterized by integrity or the ability to live out the later years with dignity and a sense of order and purpose. This contrasts with the despair that will develop in the elderly who are unable to accept the loss and changes that occur in late life.

    Individual Differences

    There are differences in socioeconomic factors and experiences from those factors that assist in shaping one’s character, attitudes, lifestyle, and ethics. Some of those socioeconomic factors are:

    • culture differences – customs, body language, beliefs
    • religious differences – Catholics, Jewish, Protestant, Agnostic, Buddhist, Muslim
    • ethnic differences – language, skin color, body features
    • education differences – levels of education, home school, private school, public school
    • physical differences – tall, short, skinny, fat, disabilities, hair color
    • income differences – within the U.S. creates inequalities and is a factor in determining financial status

    Handouts:

    Module II Handouts

    • KWHL Chart Roadblocks to Mental Health Wellness
    • Mental Health Wellness Presentation
    • Mental Health Wellness Toolbox
    • Rubric for Multimedia Presentation
    • Rubric for Presentation
    • SIRDC Door Hanger Pass Template
    • Slide Presentation Notes
    • Topics for Mental Health Wellness Presentation

    Teaching Strategies/Lesson Ideas

    • Students can complete personality profiles and compare the outcomes of different profiles.
    • Invite several seniors to talk to the class about what it was like to grow up with WWII, the Great Depression, Texas Oil Boom, natural disasters, and other events of the 20th century.
    • Have discussions/debates or pro/cons on various differences as mentioned in the Individual Differences section above.
    • Divide the class into subgroups of three to four and assign each group a different life stage and have them report back to the class with a poster or presentation on the research they conducted using the internet and/or library. Research should contain details on the normal growth patterns and of the physical changes and mental attitudes of the assigned stage.
    • Divide the class into no more than five groups and have students try their hand at writing a children’s book. Assign a different age to each group, years one through five.
    • Use the Early Development Activity Chart to have student research an age appropriate activity (song, toy, game, book, nursery rhyme) and then have a discussion on what makes that activity appropriate.

    References and Resources

    Textbooks

    • Rathus, Spencer A., Psychology: principles in practice, Holt, Rinehart and Winston, 2007. Print.
    • Barry, Patricia D., Mental health and mental illness, Seventh Edition, Lippincott, 2002. Print.

    Websites

    Development Stages Pre-Assessment Questions

    1. The feelings of inadequacy and insecurity arise during which stage?

    • a. late childhood
    • b. adolescence
    • c. early adulthood
    • d. early childhood

    2. People become most concerned with their health at this life stage:

    • a. early adulthood
    • b. late adulthood
    • c. middle adulthood
    • d. adolescence

    3. The need to be productive is characterized by this life stage:

    • a. early adulthood
    • b. middle adulthood
    • c. late adulthood
    • d. late childhood

    4. The percentage of population in the United States that is over the age of 65 is:

    • a. 20%
    • b. 35%
    • c. 15%
    • d. 13%

    5. Identity crisis might be used to describe this life stage:

    • a. adolescence
    • b. late childhood
    • c. early childhood
    • d. early adulthood

  • III. Stress and Coping

    TEKS Addressed

    (1) The student applies mathematics, science, English language arts and social studies in health science.

    • (A) evaluate the use of verbal and nonverbal language in a variety of mental health situations
    • (D) explain the physiological effects of stress and aging
    • (H) differentiate maladaptive conditions such as paranoia, schizophrenia and aggression

    Module Content

    Stress and Coping is the third unit of study in the Counseling and Mental Health course. This section contains four units of study that include:

    • A. Emotions
    • B. Perceptions of Control
    • C. Stress and Coping
      • 1. Defense Mechanisms
      • 2. Effective Coping Mechanisms
      • 3. Ineffective Coping
    • D. Types of Behavior

    —-

    STRESS AND COPING

    Emotions

    Emotions are states of feelings. There are positive emotions such as joy, happiness, excitement and love. These emotions make life fulfilling. Negative emotions such as hate, rage, anger, sadness and fear can make life problematic if these emotions are continuous.

    Emotions have physical, cognitive, and behavioral elements. When someone experiences anxiety, fear or nervousness, for example, the heart can race, body can sweat heavily, mouth can become dry and breathing may become rapid. The cognitive element of these emotions is an idea that something terrible is going to happen and can result in the behavioral element or the person trying to get away from the situation causing the emotion. Behavioral element is the reaction someone can experience with emotion such as violence, screaming and even facial expressions. Several research studies suggest that facial expressions of certain emotions are inborn based on the results of cross-cultural studies. In the studies, people from around the world were shown photographs of certain facial expressions and they agreed on the emotion shown in photographs. For example, those in the study agreed that a photo of someone smiling meant happiness.

    Perceptions of Control

    Every person struggles to learn how to have control over their emotions. In childhood we learn either to express our emotions or to repress them to limit the negative effects. We learn that showing hate, anger, jealousy, rage and envy may result in punishment and as such adapt to repressing those emotions. We also learn that there are emotions that are socially acceptable. Each culture has their own standard of behavior or what is considered acceptable and to live in a culture and be socially accepted, one must learn and conform to those cultural norms. Learning to control our emotions is one of life’s major tasks.

    A few commonly experienced emotions are:

    • Anxiety – an unpleasant feeling that produces many physical sensations such as tremors, rapid heartbeat, stomach tightening, restlessness and tenseness and causes feelings of apprehension, helplessness and distress – often the cause cannot be identified
    • Fear – a feeling of dread associated with a specific identifiable cause accompanied by physical changes such as increased heart rate and blood pressure, dilated pupils – if fear is acute, the person can become “frozen” or uncoordinated due to neuromuscular responses
    • Aggression – is an emotion that is a combination of frustration and hate or rage
    • Anger – and inborn emotional reaction to loss or violation and can occur at every stage of life. The physiological responses to emotion depend of the type of anger being experienced – justified anger, rage, hating anger, resentment, violence or helpless anger

    The amount of control over an event that someone perceives they have is in correlation to the stress level they feel. Below are four feelings based on a level of perceived control over an event or situation.

    • In Control – the perception that one has choices and is able to create change in an event, situation, or in life circumstances
    • Powerlessness – the perception that one’s actions cannot effect changes in the outcome of a negative event or situation
    • Hopelessness – the perception that one’s needs have no potential to be met, that there are no choices or alternatives in the life situation. A prolonged feeling of hopelessness often leads to depression.
    • Spiritual Distress – a fundamental distress that leads one to question the meaning of life, of their life or the value of living

    Stress and Coping

    Stress is the subjective feeling of tension to perceived events. Coping refers to how the mind reacts to stress. Coping mechanisms vary from person to person. Events that affect one person might not affect another. The conscious behavior of a person is usually based on the success of previous coping experiences.

    1. Defense Mechanisms
    Defense mechanisms are protective measures that develop within the unconscious mind and are ways the mind uses to defend itself from unpleasant events or situations. Sigmund Freud identified seven defense mechanisms as a way the mind avoids recognizing ideas or emotions that might cause anxiety. These mechanisms can become challenging if they are the only method used to cope with stress. The defense mechanisms are:

    • denial – refusing to admit that there is a problem
    • displacement – shifting negative impulses onto another object or person
    • projection – propelling one’s own impulses on others; seeing one’s own faults in others
    • rationalization – finding a justification for unacceptable thoughts or behaviors
    • reaction formation – acting opposite of true feeling to hide genuine feelings
    • regression – a retreat to an earlier stage of development when faced with anxiety
    • repression – a removal of the anxiety-causing idea from the conscious to the unconscious
    • sublimation – the act of channeling impulses into socially acceptable behavior

    2. Effective Coping Mechanisms
    Effective coping, or active coping, entails changing the environment or situation to remove or reduce the stress. Effective coping can also mean changing the response to the stress. Three common methods of coping with stress effectively are:

    • Changing stressful thoughts – learning to recognize and change one’s thought patterns before becoming engulfed in negative emotions. For example a stressful thought such as “there’s nothing I can do” can be changed to “just because I can’t find a solution doesn’t mean there isn’t one, just slow down and think”
    • Relaxation – stress can cause negative bodily reactions and is a sign something is wrong. Relaxation techniques can reduce or eliminate those reactions and lower the stress. Relaxation methods include meditation, biofeedback, and progressive relaxation which are the purposefully tensing and relaxing of one muscle group at a time.
    • Exercise – one of the most effective methods of coping with stress and also promotes physical health and psychological well-being.

    3. Ineffective Coping
    Ineffective coping, also referred to as defensive coping, is one way to reduce the immediate effects of the cause of stress but may also involve unacceptable behavior or self-deception.

    • Substance abuse – use of alcohol, tranquilizers and other drugs to reduce the immediate stress – can become physically or psychologically dependant
    • Aggression – violent outbursts or actions directed towards another person and carried out with the goal to cause injury – derived from frustration or differences of opinion and will often heighten conflict rather than reduce stress
    • Withdrawal – can be either emotional withdrawal such as staying away from friends or family or a loss of interest in life or it can also be a physical withdrawal such as moving to avoid dealing with a situation
    • Suicide – the ultimate form of withdrawal stemmed from a prolonged feeling of hopelessness

    Types of Behavior

    Maladaptive behavior – People who have ineffective coping skills will often exhibit maladaptive behavior to escape a negative emotional state. These maladaptive behaviors can be broken down into two perspectives: functional perspectives and syndrome perspectives. Alcohol or substance use, self-injury, and eating disorders form the functional perspective while autism and mental retardation make up the syndrome perspective.

    Psychotic behavior – Types of psychotic behaviors include:

    • Paranoia is a psychiatric personality disorder in which there is continuing doubt and distrust of others
    • Schizophrenia manifests self by the following symptoms: difficulty distinguishing between what is real and not real, trouble thinking clearly, having abnormal emotional responses, and acting unconventional in social situations

    Teaching Strategies/Lesson Ideas

    • Students can research and make a presentation of the effects of stress on health and the body and both effective and ineffective ways people use to reduce stress.
    • Guest speaker: Invite a psychologist to talk to the class about methods and strategies of coping with stress.
    • In groups of three, have students brainstorm the situations that can cause stress for teenagers, such as test taking, fights with friends, and home life. Have a representative from each group present their list to the class. Make a complete list and lead a discussion on healthy ways in which students can deal with stress.
    • Students can take a free stress test on the Internet to determine their level of coping with daily stress based on a scale. These tests are not diagnostic but should be taken as entertainment.
    • Bio dots, mood cards/squares, stress dots and other similar mood predicting products can be used by students to gauge a level of relaxation after performing stress relieving techniques and compare results to determine which technique works best for each student.

    References and Resources

    Textbooks

    • Barry, Patricia D., Mental health and mental illness, Seventh Edition, Lippincott, 2002. Print.
    • Rathus, Spencer A., Psychology: principles in practice, Holt, Rinehart and Winston, 2007. Print.

    Websites

    Stress and Coping Pre-Assessment Questions

    1. Which three are effective means of coping with stress?

    • a. changing thoughts, exercise and relaxation
    • b. deep breathing, relaxation and exercise
    • c. sleeping, exercise and relaxation
    • d. talking, exercise and relaxation

    2. Anger is an emotional reaction to:

    • a. birth
    • b. fear
    • c. loss
    • d. parents

    3. A type of maladaptive behavior is:

    • a. paranoia
    • b. schizophrenia
    • c. withdrawal
    • d. alcohol abuse

    4. Self-injury, alcohol abuse, eating disorders and substance abuse are all signs of:

    • a. schizophrenia
    • b. maladaptive behavior
    • c. paranoia
    • d. psychotic behavior

    5. Displacement, denial, rationalization, regression and repression are all:

    • a. maladaptive behavior
    • b. psychotic behavior
    • c. defense mechanisms
    • d. paranoia syndrome

  • IV. Communication

    TEKS Addressed

    (1) The student applies mathematics, science, English language arts and social studies in health science.

    • (A) evaluate the use of verbal and nonverbal language in a variety of mental health situations

    (2) The student demonstrates verbal and nonverbal communication skills.

    • (A) interpret verbal and nonverbal messages and adapt communication to the needs of the individual
    • (B) demonstrate listening skills and techniques to minimize communication barriers
    • (C) implement communication skills that are responsive rather than reactive

    (3) The student researches career options and the preparation necessary for employment in mental health.

    • (D) demonstrate techniques of peer mediation, problem solving and negotiation
    • (E) interpret, transcribe, and communicate mental health vocabulary

    Module Content

    Communication is the fourth unit of study in the Counseling and Mental Health course. This section contains six units of study that include:

    • A. Impersonal Communication
    • B. Interpersonal Communication
    • C. Communication Filters
    • D. Nonverbal Communication
    • E. Effective Communication
      • 1. Who is responsible
      • 2. Improving personal communication
      • 3. Active listening
      • 4. Empathic listening
    • F. Peer Mediation, Problem Solving, and Negotiation

    —-

    Module IV Handouts

    COMMUNICATION

    Communication is a process and not a skill. The process involves a sender and a receiver, encoding and decoding of messages, the channel or media in which the message travels, and barriers or filters. Communication involves a layering of many skills in an effort to be successful.

    Impersonal Communication

    This type of communication is typically superficial and is limited to subject matter only. It is the type of communication between a shopper and a sales person. The interaction of those involved is based on social roles. Impersonal communication can also be in written form such as the communication of rules and policies.

    Interpersonal Communication

    Interpersonal communication is generally defined as communicating one-on-one with others, or in small groups. Reasons for interpersonal communication: to gain information about another individual, to better understand an individual, to establish an identity or role within the relationship, and to fulfill interpersonal needs such as control, inclusion, or affection. Whichever the reason, there are skills that are required to be successful at interpersonal communications and eventual relationship development. Relationships are built over time and are based in trust. Successful interpersonal communication requires listening, tact, and courtesy. A display of genuine interest, self control over emotions, awareness and willingness to change, a respect and value of others and know-how to respond in socially acceptable ways are also key in successful interpersonal communication and relationships.

    Communication Filters

    Communication filters are similar to communication barriers. They both interfere with understanding the message being sent. Some of those filters are:

    • emotional state – whether it is happiness, anger, grief, joy or any other strong emotion, it will influence one’s ability to receive the message as it was intended
    • personal beliefs – perceptions and beliefs are strong filters for intended messages – it often involves trying to persuade a listener
    • culture – one’s upbringing and cultural rituals and even language and slang can have an impact on messages
    • experiences – one’s own experiences are frequent filters – everyone judges or relates a message based on past experiences
    • environment – the environment or surroundings can act as a filter or even barrier to communication – examples are distractions such as outside noises, cell phones, temperature of the room, too light or dark in the room, the vocabulary used is too complex or simplistic, or too many people talking

    Nonverbal Communication

    Nonverbal means without words. Nonverbal communication is the transfer of a message, information, and feelings without using words. This type of communication includes body language such as facial expressions, hand or arm gestures, posture and tone of voice. Color and design are also means of nonverbal communication which are used in written communication and in the media. Physical touch is another way in which people communicate. Studies show that people respond more favorably when touched slightly on the hand or shoulder. However, touching can be viewed negatively when touched inappropriately or too harshly. Eye contact and the avoidance of eye contact are also considered to be a form of nonverbal communication and can communicate a great deal of emotion and feeling. This nonverbal communication is often a better indicator of the person’s true feelings.

    Effective Communication

    1. Who is responsible for effective communication? Some people would answer that question with “the one who is sending the message.” However, communication is a two-way process and all people involved are responsible if communication is to be effective. There is a sender and at least one receiver. In face-to-face meetings, people are both sender and receiver in a back-and-forth conversation. Whether it is a verbal communication or written, there are skills required to be effective.

    • Diplomacy
    • Dynamic or active listening
    • Eye contact (without staring)
    • Knowing and reading the audience
    • Negotiation
    • Reducing defensiveness
    • Respect for others
    • Showing interest
    • Tact
    • Understanding cross-cultural needs and influences
    • Understanding gender and generation differences
    • Understanding perceptions

    2. Improving personal communication is a continual practice.

    3. Active listening involves a mental process to not only hear the meaning but to also assimilate the information and provide feedback. Hearing is only the physical act of the ear.

    4. Empathic listening is also referred to as reflective listening. It is derived from the word empathy. It goes beyond active listening and involves listening to others and responding in a manner that builds trust and understanding. It is an essential skill for building personal or business relationships. Empathic listening employs a safe and protected atmosphere for constructive communication, one that reduces negative conflict and encourages problem solving.

    Peer Mediation, Problem Solving, and Negotiation

    Peer mediation is a process to resolve disputes between two people or small groups by person or persons of the same age-group to facilitate the resolution. This process has proven effective for years in all age groups, particularly in younger groups. Benefits of using peer mediation among the young have been proven throughout the United States. Changes include improved self-esteem, building of listening skills and critical thinking skills. Peer mediators do not place blame but rather they look for solutions for all those involved. This type of problem solving method uses many skills to bring parties “to the table” in a calm, voluntary, and cooperative manner. Negotiations are a common method used in mediation and decision making.

    Handouts:

    Module IV Handouts

    • Article Evaluation
    • Charade Topics
    • Conflict Resolution Scenarios – Counseling and Mental Health
    • Conflict Resolutions
    • Sample of Charade Topics
    • Self Assessment Communication Survey
    • Service Learning Demonstrating Communication Skills
    • Slide Presentation Notes
    • Steps to Resolve Conflict
    • Word Chain Activity

    Teaching Strategies/Lesson Ideas

    • As a class, allow students to brainstorm, list, and demonstrate several types of nonverbal communication such as hand gestures, facial expressions, and body positions and have other students interpret the cues.
    • Have students pair up and sit back to back. One in the pair is given a design and must describe that design to the other student to duplicate. This an activity that demonstronstates the challenges of listening and choosing words carefully.
    • Become familiar with Glogster EDU before assigning a poster to your students. Assign students methods of communicating and have them create a virtual poster on ways to communicate effectively with the assigned method.
    • Make up different scenarios and practice telephone skills with your students.
    • Watch episodes of Lie to Me. It is a television fictional undercover series that has the main characater watching for nonverbal cues to catch people in lies.
    • Divide the class and have a debate over the topic “Digital Communication: Is it Personal or Nonpersonal?”.

    References and Resources

    Textbooks

    • Barry, Patricia D., Mental health and mental illness, Seventh Edition, Lippincott, 2002. Print.
    • Rathus, Spencer A., Psychology: principles in practice, Holt, Rinehart and Winston, 2007. Print.

    Websites

    • Queendom: The land of tests
      This website allows visitors to take a variety of tests such as a Listening Test, Emotional Intelligence Test, Career Personality and Aptitude Test, Depression Test or a Social Skills Test.
      http://www.queendom.com/

    Communication Pre-Assessment Questions

    1. The superficial communication that is limited to subject matter only is called:

    • a. interpersonal communication
    • b. interaction communication
    • c. impersonal communication
    • d. personal communication

    2. Successful interpersonal communication consists of:

    • a. listening
    • b. tact
    • c. courtesy
    • d. all of the above

    3. Both communication filters and communication barriers can interfere with undertanding a message being sent.

    • a. True
    • b. False

    4. Communication that includes facial expression, hand gestures, and body positions is called:

    • a. nonverbal communication
    • b. impersonal communication
    • c. active communication
    • d. interpersonal communication

    5. Infracted listening employs a safe and protected atmosphere for constructive communication.

    • a. True
    • b. False

  • V. The Brain: Biological Basis of Behavior

    TEKS Addressed

    (1) The student applies mathematics, science, English language arts and social studies in health science.

    • (B) explain the nervous system of the human body

    (6) The student analyzes the technology related to information services

    • (A) review the processes for collection and dissemination of health care data
    • (B) classify equipment used in the delivery of mental health services
    • (C) employ technology consistent with the student’s level of training

    Module Content

    The Brain: Biological Basis of Behavior is the fifth unit of study in the Counseling and Mental Health course. This section contains two units of study that include:

    • A. Central Nervous System
      • 1. Parts and Functions
      • 2. Neurophysiology: Chemical Events at the Synapse
      • 3. Imaging of the Brain
    • B. Equipment and Technology

    —-

    THE BRAIN: BIOLOGICAL BASIS OF BEHAVIOR

    The human nervous system is an intricate network of nerve cells called neurons and are similar to a tree in their structure. Part of this structure is an axon, also called a nerve fiber. It transmitts impulses or information away from the cell body and to the nerve cells, muscles and glands.

    The nervous system carries messages to and from the brain and spinal cord to various parts of the body. The human nervous system consists of two parts: the central nervous system and the peripheral nervous system. To understand mental disorders one must first know the structure and functions of the nervous system.

    Central Nervous System

    1. Parts and Functions

    • The peripheral nervous system (PNS) lies outside the central nervous system and is made up of two parts: the somatic nervous system and the autonomic nervous system. The somatic nervous system transmits sensory information or sensations from distant organs such as legs and arms. These nerve fibers allow us to feel hot and cold and pain and pressure. The somatic system also has motor nerve fibers that tell us that the body or parts of the body has changed position or moved. These fibers assist in maintaining posture and balance. The autonomic (involuntary) nervous system regulates the body’s vital functions such as digestion, blood pressure, and heartbeat.
    • The central nervous system (CNS) is made up of two parts, the brain and the spinal cord. The spinal cord extends from the brain down the back and is a column or tube of nerves about as thick as an adult finger. This column is protected by vertebrae which are the bones that make up the spine. The spinal cord is responsible for transmitting messages between the brain and the muscles and glands throughout the body. It is also involved in spinal reflexes which are automatic, simple response to stimuli. For example, the reflex of quickly removing the hand after it touches something hot.

    • Differences between the two nervous systems are:
      1a. CNS: collections of neurons are called nuclei
      1b. PNS: collections of neurons are called ganglia
      2a. CNS: collections of axons are called tracks
      2b. PNS: collections of axons are called nerves

    • The brain is made up of many parts that work together. The three main sections of the brain are the hindbrain, the midbrain, and the forebrain.
      • The hindbrain is involved in vital functions such as heart rate and balance. It contains the medulla which is responsible for heart rate, respiration, and blood pressure, the Pons which is involved with body movement, attention, sleep, and alertness, and the cerebellum which is involved with balance and coordination.
      • The midbrain is located between the hindbrain and forebrain and controls vision, hearing, and eye and body movement. It also contains part of the reticular activating system (part of this system is located in the hindbrain and forebrain) and together with Pons is responsible for body movement, attention, sleep, alertness.
      • The forebrain, also known as the diencephalon, is the largest part of the brain and has four key areas: the thalamus which acts as a relay station for sensory information and stimulation, the hypothalamus (about the size of a pea) is vital to the regulation of body temperature, hunger, thirst, and is involved in behavior and emotions such as sexual behavior, caring for a child, and aggression. Disorder in this area can lead to unusual drinking and eating behaviors. The third area in the forebrain is the limbic system, which contains the hippocampus and is important for learning and memory. This area is also responsible for controlling the emotional response to situations. The last area of the forebrain is the cerebrum and makes up the largest part of the brain. The outer layer of the cerebrum is wrinkled with bumps and valleys and is called the cerebral cortex (cortex is the Latin word for bark, as in tree bark). The cerebrum is divided into two halves called hemispheres. Each hemisphere controls the opposing side of the body from which it is located, in other words, the right side or hemisphere controls the left side of the body. The two hemispheres communicate through a bundle of nerves called corpus callosum. Each hemisphere is further divided into four parts, or lobes: the frontal lobe, temporal lobe, the parietal lobe, and the occipital lobe. Together these lobes control thought, language, reasoning, perceptions, associations, and sensory and motor skills.

    2. Neurophysiology: Chemical Events at the Synapse
    Neurophysiology is the study of the nervous system functions. The human body is made up of trillions of cells. Those cells specific to the nervous system are called nerve cells, or neurons. Neurons lay end to end within the body. These neurons communicate with each other by carrying messages through an electrochemical process. In other words, chemicals cause an electrical signal. These chemicals are called neurotransmitters. The communication happens across a synapse which is a gap between the neurons. Neurotransmitters (chemicals) are released from one neuron to another across the synapse (gap) and will be accepted (received) by another neuron. Some of the better known transmitters are:

    • Acetycholine – contributes to control of muscle, memory processes, sleep, and movement
    • Dopamine – used by neurons-important primarily for motor behavior, learning, attention, thought, and emotion. Too much dopamine is linked to schizophrenia and too little dopamine is linked to Parkinson’s disease.
    • Serotonin and Norepinephrine – linked with mood control, sleep, pain perception, body temperature, blood pressure, hormonal activity as well as affects gastrointestinal and cardiovascular systems
    • Noradrenaline – coordinates “fight or flight” response, may also induce changes in heart rate, blood pressure and gastrointestinal activity
    • Gamma-Aminobutyric Acid (GABA) – assists in regulation of anxiety and lowers level of activity related to anxiety – abnormality in GABA linked to epilepsy
    • Endorphins (endogenous morphine) – the body’s natural opiate – assists to reduce pain and produce pleasure feelings

    3. Imaging of the Brain
    Brain imaging allows physicians and scientists to “see” inside the head at the brain. Imaging has several benefits. It permits the study of the relationship of a brain area to function, assists with the location of neurological disorders, and helps with the treatment of those disorders.

    • Skull radiograph – X-rays – a one dimensional x-ray of the skull, must take at least three angles (front, side, and 45 degree angle) to determine abnormalities and fractures
    • Computerized Axial Tomography scan (CAT scan) or (CT scan-computed tomography scan)- a moving ring around the head sends x-ray beams around and through the head to create cross-sectional images to show a three dimensional structure but not function
    • Magnetic Resonance Imaging (MRI) – the use of radio frequency signals produced by displaced radio waves within a powerful magnetic field which the person lies in provides an anatomical view of the brain but not function.
      These methods of imaging will show snapshots of the brain but not the function of the brain. To view the brain at work two types of imaging are used:
    • Positron Emission Tomography (PET) – radioactive sugar is injected into the person receiving the PET scan – the sugar is used more where the brain activity is higher – the PET scan will show the various levels of activity
    • Fast Magnetic Resonance Imaging (fMRI) – a functional MRI or fast type of MRI will also show the location of brain activity when performing different activities or listening to various sounds

    Equipment and Technology

    Different types of imaging are used to look at and study brain structure or the anatomy, physiology or the functions, and biochemical actions of the brain down to the individual cells and molecules. The three main categories, therefore, are often referred to as structural, functional and molecular imaging. The explosion of technology in recent years has allowed research to improve at an exponential rate. Imaging equipment now allows the viewing of the brain and the brain on different medications at work at the molecular level.

    Teaching Strategies/Lesson Ideas

    • See lesson plan Brain Power at http://cte.sfasu.edu/lesson-plans/brain-power/
    • Students can label an inflated balloon with the parts of the brain using a marker. Then students can attach an index card or piece of paper to the balloon with a string. Each student should then take the balloon to different teachers and describe a part of the brain with its function and have the teacher sign off on the description.
    • Design a crossword puzzle with the terms and vocabulary from this unit. There is a free puzzlemaker at http://puzzlemaker.discoveryeducation.com/WordSearchSetupForm.asp
    • Have students create a song or rap using the parts of the nervous system.
    • There is a lot of vocabulary in this lesson. Any type of vocabulary practice would be helpful.
    • Divide the class in half. Have each student in one half take a vocabulary word and write it on a piece of paper. The other half can write the definition for the corresponding vocabulary word. Instruct the students to wad up the piece of paper and have a paper ball fight. You must monitor the students so they do this in a safe manner. Call a halt to the “fight” after one minute, then have the students take one ball each, undo the ball and find the matches, word to definition and each pair will read the word and definition in turn. This game should be played multiple times.
    • Write each vocabulary word on a separate piece of paper and attach to various surfaces/walls in the classroom. Hand an index card with a definition on it and have the students find their word and stand next to it. This also can be done several times.

    References and Resources

    Textbooks

    • Barry, Patricia D., Mental health and mental illness, Seventh Edition, Lippincott, 2002. Print.
    • Rathus, Spencer A., Psychology: principles in practice, Holt, Rinehart and Winston, 2007. Print.

    Websites

    The Brain: Biological Basis of Behavior Pre-Assessment Questions

    1. The medulla is located in which part of the brain?

    • a. diencephalon
    • b. midbrain
    • c. forebrain
    • d. hindbrain

    2. Which is the largest part of the brain?

    • a. cerebellum
    • b. cerebrum
    • c. thalamus
    • d. medulla

    3. The central nervous system is made up of which two parts?

    • a. brain and spinal cord
    • b. nerve endings and nerve cells
    • c. nuclei and ganglia
    • d. somatic and autonomic nerves

    4.The diencephalon is also known as the:

    • a. midbrain
    • b. hindbrain
    • c. forebrain
    • d. brain stem

    5. Two methods of brain imaging that allow viewing of the brain at work.

    • a. PET scan and fMRI
    • b. CAT scan and PET Scan
    • c. MRI and CAT scan
    • d. fMRI and CT scan

  • VI. Maladaptive Conditions and Disorders

    TEKS Addressed

    (1) The student applies mathematics, science, English language arts and social studies in health science.

    • (F) identify socioeconomic factors that influence mental health and care
    • (G) compare social services such as drug dependency rehabilitation centers
    • (H) differentiate maladaptive conditions such as paranoia, schizophrenia and aggression

    (2) the student demonstrates verbal and nonverbal communication skills.

    • (C) implement communication skills that are responsive rather than reactive

    (3) The student researches career options and the preparation necessary for employment in mental health.

    • (F) investigate treatment options

    Module Content

    Maladaptive Conditions and Disorders is the sixth unit of study in the Counseling and Mental Health course. This section contains nine units of study that include:

    • A. Personality Disorders
    • B. Anxiety Disorder
    • C. Somatoform Disorders
    • D. Dissociative Disorders
    • E. Mood Disorders
    • F. Psychotic Disorders
    • G. Substance-related Disorders
    • H. Eating Disorders
    • I. Other Addictive Disorders

    —-

    A. Personality Disorders

    A personality disorder is an enduring pattern of maladaptive behavior. Features of these disorders usually become recognizable during adolescence or early adult life. Personality disorders should not be confused with personality trait – A personality trait is an individual quality that makes one person different from another, but does not constitute abnormal or dysfunctional behavior and never reaches the threshold of personality disorder.

    Three Types of Personality Disorders – Arranged in Clusters:

    1. Cluster A – Paranoid, Schizoid, Schizotypal
    Defining characteristics of Cluster A:

    • Eccentric
    • Withdrawal behavior

    Paranoid Personality Disorder – Pervasive distrust and suspiciousness of others

    • hypersensitive (reads hidden demeaning or threatening meanings into benign remarks or events)
    • jealous and envious
    • rigid
    • persistently bears grudges (i.e. unforgiving of insults, injuries or slights)
    • suspects exploitation or deception of others

    Schizoid Personality Disorder – Pattern of detachment from social relationships and restricted range of expressions of emotions (cool, aloof, does not react)

    • almost always chooses solitary activities
    • appears indifferent to praise or criticism of others
    • has little interest in sexual encounters
    • neither desires nor enjoys close relationships (including being part of a family)
    • takes pleasure in few, if any activities

    Schizotypal Personality Disorder – Demonstrates many symptoms related to those of schizophrenia but of less severe nature

    • appearance is odd, eccentric or peculiar
    • tends to be a loner; excessive social anxiety
    • unusual pattern of talking that is vague and abstract

    2. Cluster B – Antisocial, Borderline, Histrionic, Narcissistic
    Defining characteristics of Cluster B:

    • dramatic
    • emotional
    • erratic/explosive
    • likes to be center of attention

    Antisocial Personality Disorder – Disregard for and violation of rights of others

    • deceitfulness (repeated lying, use of aliases, conning for personal profit or pleasure)
    • repeated physical fights or assaults
    • unlawful behavior despite potential for arrest

    Borderline Personality Disorder – Demonstrates unpredictability of self-image, in relationships and emotions

    • frantic efforts to avoid real or imagined abandonment
    • impulsivity that is potentially self-damaging (spending, sex, substance abuse, reckless driving, binge eating)
    • pattern of intense and unstable interpersonal relationships (idealization and devaluation)

    Histrionic Personality Disorder – Excessive emotions and attention seeking behavior

    • always wants to be center of attention
    • inappropriate sexually seductive or provocative behavior
    • rapidly shifting and shallow expression of emotions

    Narcissistic Personality Disorder – Attitude that the world exists to meet his/her needs

    • arrogant, haughty behavior or attitude
    • believes he/she is “special”
    • has sense of entitlement
    • lacks empathy
    • often envious of others or believes that others are envious of him/her
    • preoccupied with fantasies of unlimited success, power, beauty or ideal love
    • requires excessive admiration
    • sense of self-importance (exaggerates achievements and talents)
    • takes advantage of others to achieve own ends

    3. Cluster C – Avoidant, Dependent, Obsessive-Compulsive
    Defining characteristics of Cluster C:

    • anxious
    • fearful

    Avoidant Personality Disorder – Demonstrates pattern of social inhibition, feelings of inadequacy, hypersensitivity to negative situations

    • avoids interpersonal activities (occupational and social)
    • shows restraint within intimate relationships (fear of ridicule)
    • unwilling to get involved unless certain of being liked

    Dependent Personality Disorder – Excessive need to be taken care of that leads to submissive and clinging behavior

    • difficulty expressing disagreement with others
    • difficulty making decisions without advice and reassurance
    • needs others to assume responsibility for most major areas of life

    Obsessive-Compulsive Personality Disorder – Preoccupation with orderliness and perfectionism

    • excessively devoted to work to exclusion of leisure activities and friendships
    • over conscientious, inflexible about matters of morality, ethics or values
    • preoccupied with details, rules, lists, order, organization or schedules to extent that major point of activity is lost
    • reluctant to delegate tasks
    • rigid and stubborn
    • shows perfectionism that interferes with task completion
    • unable to discard worn-out worthless objects

    B. Anxiety Disorders

    Anxiety is a feeling that arises from an ambiguous, unspecific cause which is disproportionate to danger. It differs from fear which is an uneasy feeling from a known cause; a feeling that arises from a concrete, real danger. Anxiety disorders generally develop during adolescence and/or early childhood. Women are more two to three times more likely to be effected than men.

    Physiological Responses to Anxiety

    • dizziness
    • elevated blood pressure
    • increased perspiration
    • rapid heart beat
    • shortness of breath
    • trembling (first in the lips, then extremities)
    • upset stomach or “butterflies” in stomach

    Types of Anxiety Disorders

    1. Panic Disorder
    A panic disorder is different from panic attack by an increase in frequency and redundancy. A person will experience intense fear and there will be at least four panic attack symptoms that will develop abruptly, peak within ten minutes and typically last another ten minutes.

    Two Main Subtypes of Panic Disorder

    • panic disorder without agoraphobia
    • panic disorder with agoraphobia
      • Agoraphobia is the fear of being outside home alone, being in a crowd or standing in line, being on a bridge or other high places, or traveling on bus, train, air plane, or in automobile. These fears stem from primary fear of being “trapped” and unable to get back to safe place.

    2. Social Phobia and Specific Phobia

    Socal phobia is a persistent fear of one or more social or performance situations

    • fears he/she will act in way (or show anxiety) that will be humiliating or embarrassing, i.e. – fear of fainting, losing control of bowel or bladder function or the fear of having one’s mind go blank when faced with dreaded social situation
    • typically begins in childhood or adolescence
    • often associated with traits of shyness and social inhibition
    • public humiliation, severe embarrassment may initiate a social phobia
    • once established, complete remissions are uncommon without treatment

    Specific phobia is a condition in which an object such as spiders or snakes or a situation such as flying stimulates overwhelming anxiety. Examples are:

    • acrophobia: a fear of heights
    • arachnophobia: a fear of spiders
    • zoophobia: a fear of animals

    3. Acute Stress Disorder
    Acute stress disorder follows a traumatic event but symptoms may last from only two days to one month. Psychological trauma initially keeps individual from pursuing necessary help (medical or legal assistance).

    4. Post-Traumatic Stress Disorder (PTSD)
    Post-Traumatic Stress Disorder (PTSD) is a condition that develop during or shortly following extreme trauma or catastrophic event. A person with PTSD is unable to work through the feelings and thoughts that follow the event and suppresses them. This disorder is historically identified in soldiers as “shell shock” or “combat fatigue” syndrome. Other traumatic events such as rape, plane crash, physical assault, near-death experience, witnessing a murder and natural disasters can cause PTSD.

    Key Features of PTSD

    • symptoms of hyper-arousal and generalized anxiety
    • emotional detachment from people and activities
    • avoidance of situations that elicit memories of trauma
    • persistent, intrusive recollections of event via flashbacks, dreams and/or thoughts
    • post-traumatic stress symptoms persist for more than one month and are associated with functional impairment
    • about 50% of cases remit within six months

    5. Obsessive-Compulsive Disorder (OCD)
    Obsessions are recurrent, intrusive thoughts, impulses, or images that are perceived as inappropriate, grotesque, or forbidden. Compulsions are repetitive behaviors or mental acts that reduce anxiety that accompany an obsession. For example, a person with OCD might believe that everything they touch will give them germs (obsession) so they continually wash their hands, sometimes 300-400 times a day (compulsion). This disorder is equally common among men and women and typically begins in adolescence to young adulthood. The symptoms are usually associated with stress; many people with OCD have or develop tics. There is a pattern among 1st degree relatives which suggests it can be inherited but it is not the only cause.

    Common Obsessive Themes

    • constantly organizing and cleaning
    • doubts that important task was overlooked such as locking doors and windows at night
    • germ or body fluid contamination
    • unbending order or symmetry
    • worry that unintentional act inflicted harm on someone

    6. Generalized Anxiety Disorder (GAD)
    A condition which exhibits excessive anxiety and worry that occurs more days than not and lasts up to six months. It is accompanied by at least three symptoms: muscle tension, tires easily, poor concentration, insomnia, irritability, and restlessness. Excessive worries pertain to many areas of life such as work, relationships, money, and potential misfortunes, etc. GAD occurs more often in women than men.

    C. Somatoform Disorders

    Somatization is derived from the Greek word meaning ”body”. People that experience somatoform disorders have inexplicable physical symptoms and sometimes suffer from psychological problems. People with this disorder are not faking their illness or pain which is called malingering, they honestly feel pain or other systems. The two most common types of somatoform disorders are conversion disorder and hypochondriasis, described below.

    Types of Somatoform Disorders

    1. Body Dysmorphic Disorder
    A condition in which a normal-appearing person is preoccupied with imagined or minor physical defect. The person has a pervasive feeling of ugliness and that some part(s) of their body are inferior. These people may appear shy, narcissistic or obsessive and will seek plastic surgery as the cure.

    2. Hypochondriasis (Hypochondria)
    A condition in which a person has unrealistic preoccupation with fears of having a serious disease or chronic belief they have a serious illness. These people become absorbed by minor or imagined physical systems and sensations such as their heartbeat or breathing and are convinced they are sick. They will visit doctor after doctor until they find one that will find the cause of their illness.

    3. Conversion Disorder
    A condition in which a person experiences a change in or loss of the physical functioning of a major part of the body and there is no medical explanation for the change or loss. For example, they may suddenly develop the inability to move their right arm or leg, or they may suddenly lose their sight or hearing function. This condition is further complicated by the person showing little concern over the loss. This disorder is sometimes precipitated by a severe trauma or stress. The disorder will usually end as suddenly as it appears.

    4. Pain Disorder
    A condition is which a person is experiencing pain for which there is no medical cause and which lasts for a period of over six months. Can result in person missing work or school, frequent medication use, relationship problems, work disability, depression, social isolation, and even suicide.

    5. Somatization Disorder
    A condition that usually manifests in a person before the age of 30. The person will have a history of indefinite symptoms for a specific body part/system and will see multiple physicians. The most common body systems are gastrointestinal, sexual/reproductive, and neurological. The person may also be experiencing pain which cannot be explained.

    D. Dissociative Disorders

    Dissociative Disorders involve the separation of components of the personality that are normally integrated. The dissociation or separation occurs as a way of avoiding stressful events, situations, or feelings. These are rare disorders in which there is confusion or inability of a person to recall who or where they are, or how they got there. The onset of these disorders could be sudden or gradual and the condition could be transient or chronic.

    Types of Dissociative Disorders

    1. Dissociative Amnesia

    • inability to recall important personal information
    • recovery of lost memories is through the use of hypnosis, free association, or thiopental (also known as Sodium Pentothal which is a trademark of Abbott Laboratories) – controversy among health professionals as to validity of “recovered” memories
    • repressed information usually of a stressful or traumatic nature (such as child abuse)

    2. Dissociative Fugue

    • generally fugue state spontaneously remits and rarely occurs
    • individual is unable to recall his/her former identify
    • mental state that results in person suddenly and unexpectedly traveling to new location and assuming new identity
    • rare disorder that occurs mostly in men

    3. Dissociative Identity Disorder (Multiple Personality Disorder)

    • different personalities alternate dominating and controlling individual
    • exhibit varying degrees of amnesia for existence and mental well-being of “others”
    • manifests two or more distinct personalities (each usually identified by unique name)
    • symptoms often appear in adolescence and run long fluctuating course
    • treatment mainly consists of extended psychotherapy with aim of merging different personalities into unified personality
    • 90% of these patients have history of childhood physical and/or sexual abuse

    4. Depersonalization Disorder

    • about 50% cases become chronic
    • disorder may occur at times of traumatic events
    • rarely occurs in people over 40 years
    • twice as common in men

    E. Mood Disorders

    Mood changes that reflect normal ups and downs in daily life are experienced by everyone. However, mood changes that seem inappropriate or inconsistent with a situation could indicate a mood disorder.

    Two General Types of Mood Disorders

    1. Depressive Disorders
    Major depression exists/is diagnosed when five or more of the following nine systems occur with at least one of the symptoms being one of the first two on the list:

    • fatigue or loss of energy
    • feelings of worthlessness or unfounded guilt
    • loss or diminished interest or pleasure in all, or almost all, activities
    • persistent depressed mood for most of the day, nearly every day
    • recurrent thoughts of death or suicide
    • reduced ability to concentrate or make meaningful decisions
    • significant weight loss or gain due to changes in appetite
    • sleeping more or less than normal
    • speeding up or slowing down of physical and emotional reactions

    2. Bipolar Disorders
    Bipolar disorder is a condition which is characterized by strong, exaggerated, and cyclic (up and down) mood swings. As stated earlier, all people face some degree of mood changes but the swing with this disorder is dramatic. Periods of mania, or extreme excitement, restlessness, talkativeness can quickly change into depression for no apparent reason. These swings will last for weeks or months at a time.

    F. Psychotic Disorders

    There are two general types of psychotic disorders, schizophrenic disorders and delusional disorders. To understand these disorders, a person must know the difference between delusion and hallucination. A delusion is a fixed, false belief usually based on a misinterpretation of a fact; tend to center on themes of persecution, grandeur, sex, or religion. A hallucination is false sensory perceptions such as hearing and seeing things that are not really happening.

    Symptoms of schizophrenia include thought disorder, spoken thoughts that are unrealistic and irrational, neologisms (the creation of new words), blunting (coldness of emotion), withdrawal, regression, delusional, and hallucinations.

    Major Subtypes of Schizophrenia

    1. Paranoid Schizophrenia

    • aggressive and sometimes combative
    • does NOT display incoherence, loosening of associations, catatonic behavior or disorganized behavior
    • hallucinations tied to delusions
    • highly verbal
    • suspiciousness, projection and delusions
    • Example: person may not eat for fear of being poisoned, feels he is being followed, someone or thing is reading his mind

    2. Disorganized Schizophrenia

    • emotions are shallow and inappropriate
    • insidious onset that usually begins in adolescence
    • rarely seen today due to early intervention and phenothiazine drugs
    • speech becomes fragmented to the point of incoherence
    • withdraws from social contacts and appears preoccupied (will smile and giggle frequently)

    3. Catatonic Schizophrenia

    • activity may slow to a stupor or withdrawal then suddenly switch to agitation
    • disturbance of movement
    • may be molded into a position by another and position held for hours
    • may hold unusual position for hours even when arms/legs swell and stiffen
    • odd mannerisms, mutism, hallucinations, regression

    G. Substance-related Disorders

    Diagnosis criteria for these disorders fall under two terms: substance abuse and substance dependence. For substance dependence to exist a person must exhibit at least three symptoms for at least one month simultaneous during a 12 month period. Symptoms are:

    • great deal of time spent to obtain, use or recover from the effects
    • increasing tolerance for the substance
    • important activities given up or reduced due to the substance
    • larger amounts taken over longer periods
    • persistent desire or unsuccessful efforts to cut down or control substance
    • substance continued despite knowledge of persistent or recurrent physical or psychological problem likely to be caused by substance
    • withdrawal

    Substance abuse is a maladaptive pattern of substance use leading to clinical impairment or distress, as evident in a 12 month period by one or more of the following:

    • recurrent substance use despite having persistent or continual social or interpersonal problems caused by the effects of the substance
    • recurrent substance-related legal problems
    • recurrent substance use in situations which are physically hazardous
    • recurrent substance use resulting in a failure to fulfill major obligations

    Psychological Issues Leading to Substance Abuse

    • Affect intolerance – painful feelings may be expressed when intoxicated
    • Excessive dependence needs – leads to rejection and sense of failure, resulting anxiety relieved by abuse
    • Family systems – too flexible or too rigid leaves a vulnerability to peer pressure
    • Gender identity issues – Males more socialized to externalize stress by substance abuse, women are socialized to “treat” low self-esteem with alcohol and drugs
    • Inadequate self-care abilities – unable to self-soothe or self-regulate, abuse provides temporary resolution of psychological pain
    • Need for success or power – excessive fear of success or failure, abuse provides illusion of adequacy and power

    Predisposing Factors for Substance Abuse and Dependency

    • emotional problems
    • family history of abuse
    • health care worker (due to availability of substances-highest addiction rate is anesthesiologists))
    • history of childhood physical or sexual abuse
    • ineffective coping mechanisms

    Major Types of Substance-related Disorders

    1. Alcohol-related Disorder

    Symptoms are:

    • amnesia occurs during intoxication (blackouts)
    • binges last longer than two days
    • daily use
    • disturbance lasts longer than one month
    • social and/or occupational functioning is impaired
    • sometimes consumes as much as a fifth of liquor per day
    • unable to cut down or stop

    Treatment includes Alcoholics Anonymous, Disulfiram or Antabuse therapy, and inpatient and outpatient treatment programs

    2. Amphetamine-related Disorder

    • able to produce a toxic psychosis
    • death from overdose is associated with high temperature, convulsions, and cardiovascular shock
    • some of the main drugs included in this disorder category are: amphetamines, dextroamphetamine sulfate (Dexedrine), methamphetamine, also known as speed, and methlphenidate, also known as diet pills
    • symptoms are those listed at the beginning of this topic
    • used to stay awake, treat obesity, increase aggression, and to decrease fatigue

    3. Cannabis-related Disorder

    • adverse reactions tend to be dose related and environmentally dependent
    • effects from marijuana last two to four hours if smoked and 5 to 12 hours when ingested
    • marijuana can cause euphoria and has a tendency to produce sedation
    • marijuana contains more tars than cigarettes, elevates the heart rate and blood pressure, and can make it more difficult to retain information
    • marijuana is known as a gateway drug as it can lead to stronger more dangerous substances
    • substances included in this category are marijuana, hashish, and purified delta-9-tetrahydrocannabinol (THC)

    4. Cocaine-related Disorder

    • cocaine is an alkaloid derived from the leaf of the Erythroxylon coca plant indigenous to Bolivia and Peru
    • produces toxic psychosis with visual, auditory and tactile hallucinations
    • symptoms are those listed at the beginning of this topic, in addition there can be delusions and hallucinations
    • tolerance and physical dependency develop
    • use alters from snorting, intravenous injection and smoking, and freebasing of crack

    5. Hallucinogen-related Disorder

    • flashbacks can occur at unpredictable times for years
    • substances included in this category are those related to 5-hydroxytryptamine such as lysergic acid diethylamine (LSD), dimethltryptamine (DMT), and mescaline
    • symptoms are those listed at the beginning of this topic

    6. Nicotine-related Disorder

    • factor in the development of cardiovascular disease, cancer, and severe forms of lung disease
    • nicotine withdrawal symptoms are depressed mood, irritability, frustration, anger, anxiety, restlessness, decrease heart rate, increase appetite and weight gain

    7. Opioid-related Disorder

    • emotional control is difficult
    • heroin is outlawed in the U.S., it cannot be made, imported or sold legally because of its highly addictive power
    • higher doses can resemble alcoholic drunkenness, cause confusion, slurred speech and staggering
    • opioid substances include heroin, morphine, meperidine (Demerol) and methadone
    • medically supervised doses can mildly depress the action of the nerves, skeletal muscles, and heart muscle
    • person can find it difficult to think, concentrate, and work; can become irritable, angry and aggressive
    • slows heart rate, breathing, and lowers blood pressure
    • symptoms are those listed at the beginning of this topic

    8. Phencyclidine-related Disorder

    • can cause delirium
    • known as PCP, included are katamine (Ketalar) and TCP
    • symptoms are those listed at the beginning of this topic

    9. Sedative-related Disorder

    • most commonly abused in this category are Librium, Valium, Serax, Nebutal, Seconal, Luminal, Amytal, Placidyl, Dalamane, Doriden, Noludar, chloral hydrate, paraldehyde and methaqualone (Quaalude)
    • symptoms are those listed at the beginning of this topic
    • the sedative subcategory of these drugs are often thought to be safe as they are prescribed frequently by doctors but overdoses can cause death
    • those with dependency experience an increasing need or withdrawal symptoms

    H. Eating Disorders

    Eating disorders have been identified and recorded since the 1600’s but have been made prevalent in recent years by young people. Eating disorders is a persistent interference of one’s ability to ingest food and derive nutrition from that food due to emotional issues that last for three or more months.

    Major Types of Eating Disorders

    1. Anorexia Nervosa
    Anorexia nervosa is a life-threatening disorder characterized by self-starvation and a poor body image. This disorder strikes young people primarily between 12 and 20 but has been found as early as 9 years old and can continue past 20. Those with anorexia nervosa usually weigh less than 85% of what is considered normal weight by height and age standards.

    2. Bulimia Nervosa
    Bulimia nervosa is characterized by binge eating then purging. Binge eating is the intake of large amounts of food; greater amount than another person would eat in the same time frame. Purging is self-induced vomiting, use of laxatives, enemas, emetics and diuretics as a means to control weight gain. With bulimia nervosa there is a feeling of being out of control after and during eating. After the binge, there are repeated episodes of purging. Bulimic episodes occur over a period of three months or longer and will happen at least twice each week during that time. A bulimic person is highly influenced by body shape and weight but does not meet criteria for anorexia nervosa.

    3. Binge Eating Disorder
    Binge eating disorder is very similar to bulimia nervosa in that a person eats large amounts of food but there is no purging. There are wide variations in the weight gain and loss cycles and depression.

    I. Other Addictive Disorders

    There are other addictive disorders such as:

    • Exercising
    • Food (eating)
    • Gambling
    • Kleptomania (compulsive stealing)
    • Playing video games
    • Pornography
    • Pyromania (compulsive setting of fires)
    • Sex
    • Shopping
    • Spiritual obsession (as opposed to religious devotion)
    • Using computers / the Internet
    • Working

    Teaching Strategies/Lesson Ideas

    • The Maladaptive Conditions and Disorders unit of study is very large and should be broken into multiple lessons.
    • Have student create a chart contrasting and comparing Obsessive Compulsive Disorder and Obsessive Compulsive Personality Disorder.
    • Have the class watch the movie The Three Faces of Eve and write a brief paper summarizing it and their thoughts.
    • Divide the class and have a debate on the use of marijuana: Is marijuana dangerous or not?
    • Have the students do a compare and contrast on anorexia versus bulimia.
    • Divide the class into groups and have each group of students create a case study on a disorder such as Dissociative Amnesia or Anxiety Disorder. Then have the groups switch up their case studies and have the new group summarize and present their view of the case study.

    References and Resources

    Textbooks

    • American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th Edition). Washington, DC: Author.
    • Barry, Patricia D., Mental health and mental illness, Seventh Edition, Lippincott, 2002. Print.
    • Boyd, M., and Nihart, M. (1998). Psychiatric nursing: contemporary practice. Philadelphia; Lippincott, Williams, and Wilkins.
    • Rathus, Spencer A., Psychology: principles in practice, Holt, Rinehart and Winston, 2007. Print.

    Websites

    • International OCD Foundation
      A website designed to educate the public and professionals, to raise awareness of treatment, to support research, and to improve access to resources for OCD and related disorders.
      http://www.ocfoundation.org/index.aspx

    Maladaptive Conditions and Disorders Pre-Assessment Questions

    1. The term agoraphobia means:

    • a. fear of heights and tall places
    • b. fear of being alone
    • c. fear of outside the home alone or in a crowd
    • d. fear of spiders

    2. A common theme on obsessive compulsive disorder is a contamination of germs.

    • a. True
    • b. False

    3. What is a condition in which a normal-appearing person is preoccupied with an imagined or minor physical defect?

    • a. Body Dysmorphic Disorder
    • b. Hypochondriasis Disorder
    • c. Conversion Disorder
    • d. Somatization Disorder

    4. Which one below is a symptom of schizophrenia?

    • a. regression
    • b. hallucinations
    • c. blunting
    • d. all of the above

    5. Sedatives can depress the central nervous system, but are not addictive.

    • a. True
    • b. False

  • VII. Treatment Modalities

    TEKS Addressed

    (3) The student researches career options and the prepartation necessary for employment in mental health.

    • (B) research the role of the multidisciplinary team
    • (C) justify the consequences of decisions
    • (F) investigate treatment options

    (4) The student models the ethical behavior standards and legal responsibilities related to mental health.

    • (A) display ethical practices and the principles of confidentiality
    • (B) research and describe legal aspects and issues of malpractice, negligence, and liability
    • (D) recognize client rights and choices and circumstances that alter client rights
    • (E) dramatize case studies related to client rights and choices
    • (F) review legislation that affects standards of client care
    • (G) describe regulatory agencies such as the Department of Mental Health and Mental Retardation

    (5) The student maintains a safe environment to prevent hazardous situations.

    • (A) recognize abusive situations
    • (B) anticipate and adapt to changing situations
    • (C) demonstrate appropriate actions in emergency situations
    • (D) practice personal and client safety

    Module Content

    Treament Modalities is the seventh unit of study in the Counseling and Mental Health course. This section contains four units of study that include:

    • A. Diagnosis
    • B. Modes of Treatment
    • C. Dealing with Problem Situations and Behaviors
    • D. Ethical and Legal Responsibilities

    Refer to lesson Helping Clients: Treatment Options for Drug Dependency for additional resources, ideas and activities.
    http://cte.sfasu.edu/lesson-plans/helping-clients-treatment-options-for-drug-dependency

    —-

    Diagnosis

    Diagnosis: The First Step in Treatment
    Identification and classification of mental illness is done according to the Diagnostic Statistical Manual of Mental Disorders. DSM-IV is an acronym that stands for Diagnostic and Statistical Manual of Mental Disorders, 4th Edition. It is a manual published by the American Psychiatric Association that includes all currently recognized mental health disorders. The codes used in DSM IV are designed to correspond with the codes from the International Classification of Diseases, commonly referred to as ICD. The DSM-IV has a specific multiaxial or multidimensional approach to a comprehensive diagnosis because there are almost always other factors in the life of a person that impacts their mental health.

    DSM-IV: Provides Five Axis of Classification For Mental Disorders

    • Axis I – Clinical Disorders – top-level diagnosis that usually represents the acute symptoms; these are the most widely recognized such as panic attack or schizophrenic episode
    • Axis II – Personality Disorders and Mental Retardation – assessment of disorder and intellectual disabilities
    • Axis III – General Medical Conditions (which may be related to Axis I and Axis II conditions) – medical and neurological conditions such as diabetes or lacerations on the forearm
    • Axis IV – Psychosocial and Environmental Problems (current and recent stressors) – for example death of a loved one, job loss, divorce, etcetera.
    • Axis V – Global Assessment of Functioning (GAF) – identifies level of function on a scale of 0 to 100

    Modes of Treatment

    1. Psychotropic Medications

    • Antidepressants are used to treat major depressive illnesses. They take three to four weeks to take full effect. Side effects are dry mouth, drowsiness, weight gain. They are considered non addictive. The most common antidepressants are Elavil, Prozac, and Zoloft.
    • Mood-Stabilizing Drugs alter the function of neurotransmitters. They take about four weeks to a few months for full effect. Side effects are nausea, diarrhea, and tremors. The most common drug is Lithium.
    • Anti-anxiety Drugs lessens the level of anxiety. They are similar to CNS depressants. Side effects are sedation, decreased memory, hypotension, nausea, vertigo, drowsiness, slurred speech, paradoxical agitation and dependence. Common drugs are Xanax, Librium, Valium, Serax and BuSpar.

    2. Electroshock Therapy

    • Electroshock Therapy (EST) is reserved for specific types of mental disorders that cannot be treated with medicine.
    • Most effective in treating moderate to severe depression
    • Administration of EST:
      - Patient placed on stretcher and given general anesthetic
      - Also given muscle relaxant to counteract grand mal muscular contractions
      - Given high concentration of oxygen
      - Electric current passes between two electrodes placed on patient’s head
      - Patient experiences confusion within 5 to 15 minutes following treatment—clears within few hours

    3. Psychotherapy / Psychoanalysis

    • Procedure where person talks about problems with therapist
    • Most effective with patients who have mild forms of mental illness
    • Psychoanalysis was developed by Freud
    • Technique emphasizes analyzing unconscious mind and early childhood experiences
    • Use of “free-association” in which patient verbalizes whatever comes to mind
    • Goal is to bring repressed conflicts into conscious mind where they can be dealt with rationally
    • Major obstacle: length of time necessary (may take years to complete)

    4. Group Therapy

    • Involves patients meeting together to discuss topics that are relevant to recovery
    • Promotes problem identification, “verbal purging”, and patient bonding
    • Discussions usually facilitated by: psychiatrist, psychologist, social worker, substance abuse counselor, psychiatric nurse, chaplain

    5. Behavior Modification

    • One of the most effective ways to control behavior
    • Focuses on behavior of person rather than underlying causes like that of psychoanalytic treatment
    • Goal or target behavior is established for patient and a reward is given when goal is met
    • Methods of Behavior Modification
      - Positive reinforcement – “reward” that causes behavior to be repeated
      - Negative reinforcement – rewarding stoppage of an undesirable behavior
      - Punishment – aversive response that stops unwanted behavior
      - Extinction – ignoring behavior so that it eventually will die out

    6. Crisis Intervention

    • developmental crises
      - when normal progression of development provides issues that are not resolved
      - individual not able to progress to the next stage of development
    • situational crises
      - life changing event that can trigger a crisis (death of family or friend, divorce, marriage, birth of a child, etcetera.)

    7. Therapeutic Milieu Concept

    • milieu is a French word meaning trusted environment
    • individual’s environment within hospital or mental facility is designed to be socially therapeutic
    • patients encouraged to set, enforce, and follow their own rules
    • designed to help a person to assume responsibility, function comfortably and with confidence
    • reinforces responsible and productive behavior
    • pulls individual back into reality

    Dealing with Problem Situations and Behaviors

    1. noncompliance – failure to carry out treatment plan

    • reasons include: can’t afford medications or treatment, forget to take medications, believe they are okay when symptoms disappear with medication

    2. boundary violations

    • when mental health professional engages in a personal relationship with patient by spending their free time with patient, exchanging gifts and disclosing personal information
    • health care worker needs to be aware of the outcomes and effect on patient recovery

    3. self-destructive behaviors – deliberate acts to harm one’s own body

    • usually severe enough to cause tissue damage such as cutting or burning skin, banging the head or limbs
    • patients develop this behavior as a means to relieve tension

    4. aggressive behavior

    • groups most likely to have aggressive behavior: psychotic patients, patients with drug abuse disorders, patients with violent past
    • signs of building agitation: pacing, clenching fists, heavy breathing
    • verbal calming is tried first – “talk them down”, don’t violate their personal space, talk in calm voice
    • if verbal isn’t effective – remove others away, physical force may be necessary

    5. seclusion

    • place patient in safe, constrained environment away from others
    • protects aggressive and belligerent patient, other patients and staff
    • psychotic patients sometimes need a decrease in sensory (sounds and sights) to provide them relief
    • patient observation is important to ensure needs are met

    Ethical and Legal Responsibilities

    Most people recognize and know that patients have rights. One is the right to treatment and the other is the right to refuse treatment. However, it is this second right that is persistently questioned. There are patients that refuse treatment that may not be capable of making a competent decision. This can result in the highest ethical dilemma, a person’s right to refuse treatment versus the person’s right to autonomy and beneficence. Each case is different and must be reviewed. Things to consider are the need for treatment to continue life, patient danger to self or others, cost, power of attorney (if in place), and more.

    Patients have a right to privacy. HIPAA (Health Insurance Portability and Accountability Act of 1996) is a set of rules to be followed by health care providers. HIPAA helps ensure that all medical records, medical billing, and patient accounts meet certain consistent standards with regard to documentation, handling and privacy. HIPAA has a very specific set of rules and standards to follow in 5 areas: privacy, security, transactions, identifiers and enforcers.

    Other Patient Rights include:

    • Advanced Medical Directives
    • Consent
    • Federal Patient’s Bill of Rights
    • Informed Consent
    • Medical Experimentation (notice of)
    • Privacy and Confidentiality
    • Right to Die

    Teaching Strategies/Lesson Ideas

    • Students can complete a Personality Disorder Classification Form using the DSM-IV multiaxial classification. See case history on the Georgia Perimeter College classroom exercise listed in the website section below. There are additional case studies on the Internet.
    • Students can write a summary paper or create a PowerPoint™ presentation on the 5 rules for HIPAA.
    • Students can write a summary paper or create a PowerPoint™ presentation on the Federal Patient’s Bill of Rights.
    • Students can do research on the history of Electroshock Therapy and create a PowerPoint™ presentation on the information to present to the class.
    • Students can create a chart or grid comparing and contrasting the various Psychotropic Medications by category: Mood stabilizing, Antidepressant, Anti-anxiety.

    References and Resources

    Textbooks

    • Rathus, Spencer A., 2007. Psychology: principles in practice, Holt, Rinehart and Winston. Print.
    • Barry, Patricia D., 2002. Mental health and mental illness (Seventh Edition). Lippincott.
    • American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th Edition). Washington, DC: Author.

    Websites

    Treatment Modalities Pre-Assessment Questions

    1. One of the most effective ways to control behavior is by:

    • a. electroshock therapy
    • b. behavior modification
    • c. psychotropic medications
    • d. psychoanalysis

    2. Which type of therapy is reserved for specific types of mental disorders that cannot be treated with medicine?

    • a. electroshock therapy
    • b. behavior modification
    • c. group therapy
    • d. psychoanalysis

    3. Which type of therapy uses “free-association” in which the patient verbalizes whatever comes to mind?

    • a. group therapy
    • b. psychotropic medications
    • c. psychoanalysis
    • d. therapeutic milieu

    4. Which type of therapy encourages patients to set, enforce, and follow their own rules?

    • a. group therapy
    • b. psychotropic medications
    • c. psychoanalysis
    • d. therapeutic milieu

    5. What is the major obstacle in the use of psychotherapy and/or psychoanalysis?

    • a. cost of treatment
    • b. length of time for treatment
    • c. number of insurance companies involved
    • d. number of doctors involved

  • VIII. Counseling and Mental Health Careers

    TEKS Addressed

    (3) The student researches career options and the prepartation necessary for employment in mental health.

    • (A) identify career opportunities related to mental health

    (4) The student models the ethical behavior standards and legal responsibilities related to mental health.

    • (C) examine designated scope of practice of professionals

    Module Content

    Counseling and Mental Health Careers is the eighth unit of study in the Counseling and Mental Health course. This section contains two units of study that include:

    • A. Career Opportunities
      • 1. Psychiatrists
      • 2. Psychologists
      • 3. Related Fields
    • B. Desirable Personal Traits

    —-

    A. Career Opportunities
    There are numerous and diverse career opportunities in the field of psychology. The first step is usually a four-year degree at a university with specific and related study courses. Many of these careers require graduate study (Master’s degree) and some will require a doctoral degree (Ph.D). Graduate degree normally requires two years of study and a doctoral degree is approximately four to six years above that.

    1. Psychiatrists are medical doctors who specialize in treatment of mental disorders

    • 4 years of college followed by 4 years of medical school, then an internship and residency
    • Must be licensed by the state in which they live and practice
    • Licensed to prescribe medications

    2. Psychologists

    • Master’s or Ph.D. in psychology depending on type of specialty
    • cannot prescribe medications

    Subfields of Psychology – some listed below

    • Art Therapist
    • Clinical Psychologist
    • Criminal Psychologist
    • Counseling Psychologist
    • Developmental Psychologist
    • Educational Psychologist
    • Engineering Psychologist
    • Forensic Psychologist
    • Health Psychologist
    • Industrial/Organizational Psychologist
    • Music Therapist
    • Neuropsychologist
    • Pediatric Psychologist
    • Recreational Therapist
    • Rehabilitation Psychologist
    • School Psychologist
    • Social Psychologist
    • Sports Psychologist

    3. Related Fields

    • Childlife Activity Specialist
      - Master’s
      - Generally work in hospitals or rehab facilities
      - Focus on emotional and developmental needs of sick or disabled children
      - Use play and other activities (art, games, etcetera) to help children cope
    • Licensed Professional Counselor (LPC)
      - Master’s
      - Subfield of counseling psychology
      - Often work with students to provide career and college guidance
      - Help students with family and social problems
    • Social Worker
      - Master’s
      - Help people with social, vocational, financial, housing, and placement problems
      - Conduct individual, family, and group therapy
    • Psychiatric Nurse
      - Bachelor’s or Master’s degree
      - Nurses who are trained to work with patients who are mentally ill

    B. Desirable Personal Traits
    Desirable traits for a psychiatrist or psychologist have some common ground; however, there are a number of the specialty psychologists that will have additional or special traits related to their specialty. For example, a child psychologist must be good with children.

    Common traits are:

    • relatively outgoing
    • get along well with a variety of individuals and groups
    • dedicated
    • persistent
    • empathetic
    • strong ethics
    • critical thinking skills
    • excellent communication skills
    • listening skills

    Teaching Strategies/Lesson Ideas

    • Students could conduct Internet research on three or more careers by contrasting and comparing various requirements such as type of degree, internships, etcetera, as well as typical of places of work
    • Students can role play college interview sessions with the intent of having a health care career.

    References and Resources

    Textbooks

    • Rathus, Spencer A., 2007. Psychology: principles in practice, Holt, Rinehart and Winston. Print.

    Websites

    • Careers in Psychology
      Online source of information about psychology careers, psychology education, psychology internships, and psychology jobs, as well as licensure information.
      http://careersinpsychology.org/

    Counseling and Mental Health Careers Pre-Assessment Questions

    1. All careers related to psychology are required to have a doctoral degree.

    • a. True
    • b. False

    2. A psychologist can prescribe medicine.

    • a. True
    • b. False

    3. Which is a desired personality trait for someone in the field of psychology?

    • a. empathetic
    • b. dedicated
    • c. ethical
    • d. all of the above

    4. A psychiatrist is considered a medical doctor.

    • a. True
    • b. False

    5. All related fields in psychology (as described in this course) require at least a Bachelor’s degree.

    • a. True
    • b. False

  • Quiz

    Counseling and Mental Health Online Course

    Progress:

    1. The first psychiatrist who developed a system for diagnosing and classifying mental illness is

    2. The process of chipping a hole into one's skull to let the evil spirits out is called

    3. Saint Mary of Bethlehem was

    4. Behavior is learned and can be reinforced or modified is a behavior theory supported by

    5. Which is the correct order of Maslow's Heirarchy of Needs?

    6. The feelings of inadequacy and insecurity arise during which stage?

    7. People become most concerned with their health at this life stage:

    8. The need to be productive is characterized by this life stage:

    9. The percentage of population in the United States that is over the age of 65 is:

    10. Identity crisis might be used to describe this life stage:

    11. Which three are effective means of coping with stress?

    12. Anger is an emotional reaction to:

    13. A type of maladaptive behavior:

    14. Self-injury, alcohol abuse, eating disorders, and substance abuse are all signs of:

    15. Displacement, denial, rationalization, regression, and repression are all:

    16. The superficial communication that is limited to subject matter only is called:

    17. Successful interpersonal communication consists of:

    18. Both communication filters and communication barriers can interfere with understanding a message being sent.

    19. Communication that includes facial expression, hand gestures, and body positions is called:

    20. Infracted listening employs a safe and protected atmosphere for constructive communication.

    21. The medulla is located in which part of the brain?

    22. Which is the largest part of the brain?

    23. The central nervous system is made up of which two parts?

    24. The diencephalon is also known as the:

    25. Two methods of brain imaging that allow viewing of the brain at work.

    26. The term agoraphobia means:

    27. A common theme on obsessive compulsive disorder is a contamination of germs.

    28. What is a condition in which a normal-appearing person is preoccupied with an imagined or minor physical defect?

    29. Which one below is a symptom of schizophrenia?

    30. Sedatives can depress the central nervous system, but are not addictive.

    31. One of the most effective ways to control behavior is by:

    32. Which type of therapy is reserved for specific types of mental disorders that cannot be treated with medicine?

    33. Which type of therapy uses “free-association” in which the patient verbalizes whatever comes to mind?

    34. Which type of therapy encourages patients to set, enforce, and follow their own rules?

    35. What is the major obstacle in the use of psychotherapy and/or psychoanalysis?

    36. All careers related to psychology are required to have a doctoral degree.

    37. A psychologist can prescribe medicine.

    38. Which is a desired personality trait for someone in the field of psychology:

    39. A psychiatrist is considered a medical doctor.

    40. All related fields in psychology require at least a Bachelor’s degree.

    41. In this course students are expected to apply knowledge of:

    42. The course Counseling and Mental Health is recommended for students in grades 10 - 12.

    43. The course Counseling and Mental Health can be set up as a one or two credit course.

    44. The course Counseling and Mental Health is in the

    45. The recommended prerequisite course for Counseling and Mental Health is

    46. CTE stands for:

    47. Counseling and Mental Health is a CTE course.

    48. __________ is/are beneficial in all Counseling and Mental Health career fields.

    49. Career and Technical Education (CTE) equips students with

    50. There are __________________ Career Clusters:

    Please only click once to submit. Your answers are ready to be sent.

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