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Verkorte samenvatting van algemene & revalidatiepsychologie

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Inleiding in de algemene en revalidatiepsychologie

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Thomas More Hogeschool (tmhs)

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revalidatie psychologie
algemene psychologie
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Thomas More Hogeschool (tmhs)
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Ergotherapie
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Inleiding in de algemene en revalidatiepsychologie

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Algemene en revalidatie psychologie

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1. Summary - Algemene & revalidatie psychologie: complete samenvatting
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Inhoudsopgave
1 Wat is psychologie?............................................................................................................................................................... 7
1.1 Definitie psychologie..................................................................................................................................................................7
1.1.1 Kenmerken van gedrag (4)..................................................................................................................................................7
1.2 Psychologie & mensenkennis.....................................................................................................................................................8
1.3 Onderzoeksmethoden in de psychologie....................................................................................................................................8
1.4 Gedragswetenschappen.............................................................................................................................................................9

2 Stromingen in de psychologie................................................................................................................................................ 9
2.1 Overzicht van de stromingen in de psychologie.........................................................................................................................9
2.2 Samenvatting: stromingen.......................................................................................................................................................10
2.3 Therapieën voor psychische stoornissen..................................................................................................................................19
2.3.1 Doelstellingen therapeutische relatie...............................................................................................................................19
2.3.2 Evaluatie van therapieën..................................................................................................................................................19
2.4 Ergotherapie en de verschillende stromingen..........................................................................................................................19
2.4.1 Ergotherapeut algemeen..................................................................................................................................................19

3 Motivatie, gedragsverandering & therapietrouw in de revalidatie........................................................................................ 20
3.1 Inleiding motivatie...................................................................................................................................................................20
3.2 Motivatie voor verandering.....................................................................................................................................................20
3.3 Factoren die motivatie kunnen veranderen (6)........................................................................................................................20
3.3.1 Locus of control = mindset (1)..........................................................................................................................................20
3.3.2 Inschatting van zelfeffectiviteit (self-efficacy) = kunnen (2).............................................................................................20
3.3.3 Zelfwaardering (self-esteem) = willen (3).........................................................................................................................20
3.3.4 Sociale steun (4)................................................................................................................................................................21
3.3.5 Ziektewinst = voordelen (5)..............................................................................................................................................21
3.3.6 Andere factoren (6)..........................................................................................................................................................21
3.4 Hoe kunnen we motivatie meten?...........................................................................................................................................21
3.4.1 ASE determinantenmodel.................................................................................................................................................21
3.4.2 Model voor gedragsverandering & gedragsbehoud.........................................................................................................21
3.5 Modellen voor gedragsverandering.........................................................................................................................................21
3.5.1 Zelfdeterminatietheorie van Ryan en Deci.......................................................................................................................21
3.5.2 Transtheoretisch model van Prochaska & diclementi......................................................................................................24
3.5.2.1 Precontemplatie.......................................................................................................................................................24
3.5.2.2 Contemplatie............................................................................................................................................................25
3.5.2.3 Preparatie.................................................................................................................................................................25
3.5.2.4 Actie..........................................................................................................................................................................25
3.5.2.5 Behoud......................................................................................................................................................................25
3.6 Therapietrouw..........................................................................................................................................................................26
3.7 Tips: therapietrouw verhogen (9)............................................................................................................................................26
3.7.1 Verstrekken v duidelijke informatie..................................................................................................................................26
3.7.2 Gezondheidsgerelateerde attitudes modificeren.............................................................................................................26
3.7.3 Hulpverlener-revalidant-relatie verbeteren.....................................................................................................................26
3.7.4 Consistente aanpak v alle hulpverleners..........................................................................................................................26
3.7.5 Contract maken tussen revalidant & hulpverlener..........................................................................................................26
3.7.6 Monitoring: bijhouden v oefendagboek...........................................................................................................................26
3.7.7 Rol v sociale steun............................................................................................................................................................27
3.7.8 Positieve feedback............................................................................................................................................................27
3.7.9 Stellen van duidelijke doelen (doelbepaling in revalidatiesetting)...................................................................................27

4 Leren.................................................................................................................................................................................. 27
4.1 Verschillende leertheorieën of leerprincipes............................................................................................................................28

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4.1.1 Habituatie of gewenning..................................................................................................................................................28
4.1.2 Klassieke conditionering – Pavlov & Watson....................................................................................................................28
4.1.3 Operante conditionering – Thorndike & Skinner.............................................................................................................28
4.1.4 Sociale leertheorie: model-leren of observatieleren - Bandura.......................................................................................29
4.1.5 Cognitieve processen .......................................................................................................................................................29
4.2 Tien fundamentele leerprincipes..............................................................................................................................................29
4.2.1 Stelling 1: feedback & bekrachtiging................................................................................................................................29
4.2.2 Stelling 2: integratie & samenhangende informatie.........................................................................................................30
4.2.3 Stelling 3: activiteit...........................................................................................................................................................30
4.2.4 Stelling 4: sociale interactie..............................................................................................................................................30
4.2.5 Stelling 5: de context........................................................................................................................................................30
4.2.6 Stelling 6: de organisatie van anderszins geïsoleerde stukken informatie.......................................................................30
4.2.7 Stelling 7: de gepercipieerde relevantie...........................................................................................................................30
4.2.8 Stelling 8: de praktische & gevarieerde toepassingen......................................................................................................30
4.2.9 Stelling 9: ALS de geheugencapaciteit niet overbelast wordt..........................................................................................30
4.2.10 Stelling 10: OP voorwaarde dat de aangeboden instructie overeenstemt met de leerstijl & leersnelheid van de
leerling.......................................................................................................................................................................................31
4.3 Neurologische voorwaarden van leren (3)...............................................................................................................................31
4.3.1 Aandacht (4).....................................................................................................................................................................31
4.3.2 Snelheid van informatieverwerking..................................................................................................................................31
4.3.3 Expliciet leren & impliciet of procedureel leren...............................................................................................................31

5 Leren in de revalidatie......................................................................................................................................................... 32
5.1 Inleiding: Leren in de revalidatie..............................................................................................................................................32
5.1.1 Revalideren is een leerproces...........................................................................................................................................32
5.1.2 Generaliseren....................................................................................................................................................................32
5.1.3 Afleren..............................................................................................................................................................................32
5.2 Mentale training in de revalidatie............................................................................................................................................33
5.2.1 Verschillende vormen van mentale training.....................................................................................................................33
5.2.2 Mentale chronometrie.....................................................................................................................................................33
5.2.3 Wat kan geleerd of getraind worden door mentale voorstelling?...................................................................................33
5.2.4 Bezit iedereen de mogelijkheid tot mentale training?.....................................................................................................33
5.2.5 Effecten van mentale training bij patiënten populaties...................................................................................................34
5.2.6 Welke factoren zijn bepalend voor mentale training?.....................................................................................................34
5.2.6.1 Bekwaamheid om een motorische voorstelling te maken.......................................................................................34
5.2.6.2 Bekendheid met de voor te stellen taak...................................................................................................................34
5.2.6.3 Intact werkgeheugen................................................................................................................................................34
5.2.6.4 Motivatie...................................................................................................................................................................34
5.3 Observatieleren, modelleren & imiatieleren............................................................................................................................34
5.4 Spiegeltherapie........................................................................................................................................................................34
5.4.1 Spiegeltherapie bij fantoompijn.......................................................................................................................................34
5.4.2 Spiegeltherapie bij patiënten met hemiparese................................................................................................................34
5.4.3 Spiegeltherapie bij patiënten met een complex regionaal pijnsyndroom type I.............................................................34
5.5 Cognitieve & gedragsgerichte interventie in de revalidatie.....................................................................................................34
5.5.1 Gedragstherapeutische principes.....................................................................................................................................34
5.5.1.1 Systematische desensitisastie...................................................................................................................................34
5.5.1.2 Aversietherapie & extinctie......................................................................................................................................34
5.5.1.3 Token economy (activiteitenkaart)...........................................................................................................................34
5.5.1.4 Spierontspanning......................................................................................................................................................35
5.5.1.5 Forward chaining......................................................................................................................................................35
5.5.1.6 Backward chaining....................................................................................................................................................35
5.5.1.7 Shaping.....................................................................................................................................................................35
5.5.1.8 Latent leren – Tolman (ratten)..................................................................................................................................35
5.5.1.9 Inzichtelijk leren - Köhler..........................................................................................................................................35
5.5.1.10 Competentie ontwikkelen.......................................................................................................................................35
5.5.1.11 Leerstijlen - Kolb.....................................................................................................................................................35
5.5.1.12 Monitoren v gedrag................................................................................................................................................35
5.5.1.13 Aangeleerde inactiviteit of learned not use...........................................................................................................36
5.5.2 Cognitieve gedragstherapeutische principes...................................................................................................................36

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5.5.2.1 Evaluatie van mensen met chronische pijn..............................................................................................................36
5.5.2.2 Cognitief gedragstherapeutische interventies bij mensen met chronische lage rugpijn.........................................37
5.5.2.2.1 Model angstontwijkingsgedrag.........................................................................................................................37
5.5.2.2.2 Psycho-educatie................................................................................................................................................37
5.5.2.2.3 Exposure in vivo................................................................................................................................................37
5.5.2.2.4 Graduele activiteit.............................................................................................................................................37
5.5.2.2.5 ACT therapie......................................................................................................................................................37
5.5.2.2.6 Mindfulness: aandachtsgerichte oefeningen....................................................................................................38
5.5.2.2.7 Angstontwijkingsgedrag: opvattingen v/d hulpverlener...................................................................................38

6 Verwerken van verlieservaring............................................................................................................................................ 39
6.1 Inleiding....................................................................................................................................................................................39
6.2 Revalidatiepsychologische patiëntenzorg: reactiepatroon tijdens verschillende herstelfasen (3)..........................................39
6.3 Emoties & gevoelens................................................................................................................................................................39
6.3.1 Machteloosheid & hulpeloosheid....................................................................................................................................39
6.3.2 Boosheid & verdriet..........................................................................................................................................................39
6.3.3 Onbegrip, twijfel & onzekerheid.......................................................................................................................................39
6.3.4 Wantrouwen, neerslachtigheid, isolement & eenzaamheid............................................................................................39
6.3.5 Stress, zenuwachtigheid, rusteloosheid, angst & frustratie.............................................................................................39
6.3.6 Ontkenning, droefheid, schaamte & onzekerheid............................................................................................................40
6.3.7 Afhankelijkheid.................................................................................................................................................................40
6.3.8 Relatie-omkering...............................................................................................................................................................40
6.3.9 Zelfbeeld & eigenwaarde..................................................................................................................................................40
6.4 Verwerking v verlies: rouwproces............................................................................................................................................40
6.5 Rouwtaken model: 4 rouwtaken..............................................................................................................................................40
6.6 Resultaat van het verwerkingsproces: van negatieve naar positievere emoties en gevoelens...............................................42
6.6.1 Acceptatie & aanvaarding.................................................................................................................................................42
6.6.2 Begrip & inzicht.................................................................................................................................................................42
6.6.3 Ontspanning, opgewektheid, rust & kalmte.....................................................................................................................42
6.6.4 Zelfvertrouwen.................................................................................................................................................................42
6.6.5 Opluchting, strijdlust & assertiviteit.................................................................................................................................42
6.6.6 Kracht & overwinning.......................................................................................................................................................42
6.6.7 Zekerheid, zelfrespect & verrijking...................................................................................................................................42
6.7 Aangeboren beperking.............................................................................................................................................................42
6.8 Verworven beperking...............................................................................................................................................................42
6.9 Beperking heeft invloed op lichaamsbeleving, zelf & sociaal contact......................................................................................42
6.10 Verwerken v terminale fase....................................................................................................................................................43
6.10.1 Verschillende fasen van verwerking - Elisabeth Kübler Ross..........................................................................................43
6.10.2 Factoren van invloed op verwerkingsproces..................................................................................................................43
6.10.3 Onderwerpen uit reva die vaak aan bod komen bij personen met beperking..............................................................43
6.11 Herstellen na hersenletsel......................................................................................................................................................44
6.12 Hoe zou herstel kunnen werken?...........................................................................................................................................44
6.13 Voorspellers van herstel.........................................................................................................................................................44
6.13.1 Leeftijd............................................................................................................................................................................44
6.13.2 Opleiding & IQ................................................................................................................................................................44
6.13.3 Aandachtsproblemen.....................................................................................................................................................44

7 Invloed van stress & copingsvaardigheden........................................................................................................................... 45
7.1 Inleiding....................................................................................................................................................................................45
7.2 Betekenis v acute stress...........................................................................................................................................................45
7.3 Aard v stress: uitlokkende factoren (3)....................................................................................................................................45
7.3.1 Fysische stressoren (3)......................................................................................................................................................45
7.3.2 Psychische stressoren (4)..................................................................................................................................................45
7.3.3 Omgevingsfactoren & sociale factoren (6).......................................................................................................................46

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7.4 Stresstheorie - Seyle Hans........................................................................................................................................................46
7.5 De fysiologische gevolgen van acute stress.............................................................................................................................46
7.6 Psychologische gevolgen v stress.............................................................................................................................................46
7.6.1 Psychologische alarmfase.................................................................................................................................................46
7.6.2 Psychologische weerstandsfase........................................................................................................................................47
7.6.3 Psychologische uitputtingsfase.........................................................................................................................................47
7.7 Gevolgen v chronische stress...................................................................................................................................................47
7.7.1 Lichamelijk: lichamelijke aandoeningen...........................................................................................................................47
7.7.2 Emotioneel: angst, boosheid, verdriet & depressie.........................................................................................................47
7.7.3 Cognitief: verminderde aandacht/ geheugen bij uitvoeren, meer aandacht nr stressbron............................................47
7.7.4 Gedragsmatig: meer intolerant & vijandig gedrag...........................................................................................................47
7.8 Factoren die gevolgen v stress kunnen beïnvloeden................................................................................................................47
7.8.1 Sociale steun.....................................................................................................................................................................47
7.8.2 Persoonlijke controle........................................................................................................................................................47
7.8.3 Gehardheid.......................................................................................................................................................................47
7.9 Toepassingen in praktijk van revalidatie..................................................................................................................................47
7.9.1 Hoeveel & welke informatie verstrekken we aan revalidant............................................................................................47
7.9.2 Invloed v stress op prestatie.............................................................................................................................................48
7.9.3 Invloed v stress op leerproces..........................................................................................................................................48
7.9.4 Sociale steun.....................................................................................................................................................................48

8 Stressmanagementstrategieën & coping.............................................................................................................................. 48
8.1 Inleiding....................................................................................................................................................................................48
8.2 Theoretische opvattingen over coping.....................................................................................................................................48
8.2.1 Reductionistisch-, interactioneel- & transactioneel copingmodel...................................................................................48
8.2.2 Coping als contextueel proces..........................................................................................................................................49
8.3 Vormen van coping..................................................................................................................................................................49
8.3.1 Probleemgeoriënteerde gedragsmatige coping...............................................................................................................49
8.3.2 Probleemgeoriënteerde cognitieve coping......................................................................................................................49
8.3.3 Emotioneelgeoriënteerde gedragsmatige coping............................................................................................................49
8.3.4 Emotioneelgeoriënteerde cognitieve coping...................................................................................................................49
8.3.5 Humor, spirituele coping & proactieve coping.................................................................................................................49
8.3.5.1 Humor.......................................................................................................................................................................49
8.3.5.2 Spirituele of religieuze coping...................................................................................................................................50
8.3.5.3 Proactieve coping......................................................................................................................................................50
8.4 Stress als bron v persoonlijke groei (5).....................................................................................................................................50
8.5 Trainen v effectieve coping.......................................................................................................................................................50
8.6 Algemene stressmanagement-strategieën (5).........................................................................................................................50

9 Pijn..................................................................................................................................................................................... 50
9.1 Pijnbeleving..............................................................................................................................................................................50
9.1.1 Typen pijn.........................................................................................................................................................................50
9.1.2 Leven met pijn..................................................................................................................................................................50
9.2 Biologische modellen voor pijn................................................................................................................................................51
9.2.1 Pijn in afwezigheid van pijnreceptoren (fantoompijn).....................................................................................................51
9.2.2 Pijnreceptoren die geen pijn registreren (cuip)................................................................................................................51
9.2.3 Psychologische invloeden op pijn (3)................................................................................................................................51
9.2.3.1 Stemming & pijn: angst/ depressie vermindert pijntolerantie, dus meer pijn.........................................................51
9.2.3.2 Aandacht & pijn: concentreren op pijn verergert de beleving v pijn.......................................................................51
9.2.3.3 Cognities & pijn: verwachting over toename of daling v pijn kan zichzelf waarmaken...........................................51
9.3 Psycho-biologische theorie: Gate control theory – Melzack & Wall........................................................................................51
9.4 Toekomstige inzichten in pijn: de neuromatrix........................................................................................................................51

10 Levenskwaliteit................................................................................................................................................................. 52
10.1 Inleiding..................................................................................................................................................................................52

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