copyright 2008 Cheryl K. Hosken, BSN, MS Psych.
7. Limitation of Restricted Environment
A "restricted environment" is a barrier resulting from a disability that so that a person cannot live freely with in normal life space. These may be architectural barriers, home-boundedness, social rejection, institutional living, and over-protection by parents or relatives. These barriers may be subtle or blatant. They may affect only one part of a person's life or his entire life.
Perhaps the most dramatic is environmental restriction for those confined to institutions such as hospitals, training schools, sanitariums, and nursing homes for the elderly and/or mentally ill. Such living cuts people off from the rest of society and their human needs are administered by bureaucratic methods. There is little human touch and love. There may be privilege systems, off-grounds passes, and locked doors. People may be limited to living in the country instead of the city because of the locations of the institutions. There are times when such institutionalization is necessary, but for most people this is not the case.
Meditate Word By Word On These Verses:
1 Jn. 3:16-18.
Psychologically, institutionalization brings loss of independence. Every day, choices of what to eat and when to sleep are pre-determined. This dependency role is not accepted by potential employers since a person usually must be able to work independently and work with others as an equal.
Question:
1. The most common form of restricted environment is:
(Only one of the following answers is correct.)
a camp,
an institution such as an orphanage or hospital,
a private apartment.
Since there is no family in an institution, the person does not know about normal life within a family in relation to social functioning, sexuality, and relationships between family members. If an institution has recreational programs, participants may learn about teamwork and relaxation. Another optimum program within an institution that may help adjustment is an employment opportunity within the facility. Some institutions have small factories where people can work every day as in the real world of work.
Question:
2. In an institution, one thing that helps a person learn independence is:
(Only one of the following answers is correct.)
doing some sort of job within the institution,
eating at the same time every day,
having normal exercise.
The limitation is not confined to institutions. It may also be part of the work place. An occupationally restricted environment means working in a place where one is restricted posturally or has limited ability to move about. Think of a miner in a tunnel as an example of this limitation. Therefore, improvement in various environments has included such things as ventilation, noise control, decreased exposure to extremes of temperature and chemicals.
Question:
3. Limitations in a work place are improved if:
(One or more of the following answers may be correct.)
workers have their own food,
workers can change their position periodically,
there is good ventilation, control of noise level, decrease in exposure to chemicals.
8. Mental Limitations
A mentally deficient individual has deficits in learning or thinking processes. The causes of limitation in mental function are mental retardation (Down's syndrome), autism, and environmental conditions that cause the brain to deteriorate (exposure to chemicals or other toxic materials).
The stages of the cognitive process are motivation, apprehension, acquisition, retention, recall, generalization, performance, and feedback.
- Motivation is expectation of a desired reward. This allows a person to accept a work task and complete it without other guidance. The expectation of a reward assists the learner to stay with a task and maintain the behaviors required to learn a new skill.
- Apprehension requires that the person learn the parts of solving a new situation or work problem.
- Acquisition the center of the learning process. At this stage the new material to be learned must enter the person's memory so that it can be recalled and used again.
- Retention and recall are internal processes of the brain and necessary for repeating a job or performance. With these two processes a person can follow directions.
- Generalization is the ability to use one learned task and apply it to new tasks.
- Performance relates to ability to come to work on time, appearance, ability to complete tasks, and confidence to do a job well.
Question:
4. The definition of motivation in the thinking process is:
(Only one of the following answers is correct.)
giving someone a piece of candy for good behavior,
expectation of reward,
making a person do something he does not want to do.
The retarded person learns new information more slowly than the general population. There is a lag in speaking, balance, walking, toilet training, and social habits of a young child that may foretell retardation.
The causes of mental retardation are genetic, socio-cultural, and psychological. One or a combination of these factors may result in the inability to function normally. Genetic factors cause Down's syndrome, and some mild retardation is caused by before-, during- and after-birth events.
Lack of stimulation is the most frequent socio-cultural cause of mild retardation. This occurs when the family is impoverished mentally and physically. Such families may not be able to provide a stimulating environment for their children because they lack the means and ability to do so.
The psychological factors involve a family crisis when a child is young - under the age of two. This happens when the relationship with parents is severed due to death, absence, or mental illness.
The goal for these people is to learn adaptive behavior - that is, behavior that helps them live and work in society.
Question:
5. The causes of mental retardation are:
(One or more of the following answers may be correct.)
environmental, genetic and psychological,
environmental, genetic and birth trauma,
environmental, genetic, and a death in the family.
9. Substance Dependency
There are two types of substance dependency:
a) "habituation" which is a psychological need to take a drug for relief of tension, pain, discomfort, or for pleasure and
b) "addiction" which is a physical dependence, a biochemical reaction causing unpleasant physical symptoms when the drug is withdrawn from the body. The addict also develops a physical tolerance for the drug so that ever-larger doses are needed to satisfy the body's need and prevent withdrawal. Habituation and addiction are not mutually exclusive classifications.
Question:
6. What is the difference between habituation and addiction?
Drug abuse harms the body and the mind and harms relationships with other people. The drug can become an all-consuming interest, destroying other values. Commonly abused drugs are as follows:
- alcohol
- nicotine as found in cigarettes
- hallucinogenic (vision producing drugs) such as LSD and mescaline
- marijuana
- opiates such heroin and morphine
- sedatives found in barbiturates and other sleeping medications
- stimulants such as cocaine and amphetamines
- inhalants such as glue and cleaning fluids
There are many other substances that are commonly abused.
Habituation may be mild or severe. In mild dependence, people are accustomed to taking a drug that gives them a sense of well-being. For example, there is caffeine in coffee or the nicotine in a cigarette. Such people are said to be habituated and will not readily give up the drug. They tend to feel uneasy when deprived of it. Yet, if they wish, these people can, with their own will, give up the drug without having professional help.
Habituation is a very human trait and is often accepted by society. Examples of habituation in addition to substance abuse that are obsessive are gambling, sports, and collecting things. These things are not problems seen in perspective, but if they are pursued, they can ruin a life. Treatment for habituation is usually as necessary as treatment for addictions.
Severe psychological dependence on drugs is a neurotic reaction in people. Once they have experienced a drug that is particularly satisfying, they will continue to compulsively seek the drug. Such an example is heroin addiction. Addiction results in an alteration of the body because continued use of a drug is required for the body to function normally. The withdrawal of narcotics results in increased nervous system activity and excitability. Withdrawal from depressants (barbiturates, sedatives, and anti-anxiety medications) can cause excitability of the centers that control motor and mental functions of the brain. The person on withdrawal of these drugs has tremors and confusion, is disoriented and psychotic.
Why does addiction result in an alteration of the body?
A. Treatment for habituation is usually necessary.
B. Continued use of a drug is required for the body to function normally.
C. It is a severe psychological dependence.
In physical dependence, which is true addiction, there are 2 elements: habituation and tolerance or chemical dependence on a drug. The addicting drugs provide swift relief for the anguish and pain the body has when the drugs are not given. These drugs produce a physical tolerance that requires ever increasing dosages to calm the body. There is a continuing need for the drug since it becomes a biochemical component of the brain and is needed for its function. Sudden withdrawal of the drug causes a disruption of the brain chemistry causing mental and physical pain.
The opiates of heroin and morphine leave the blood stream very quickly and concentrate in the liver and spleen. They have a long half-life and can easily build to toxic proportions in the body. Withdrawal from these drugs is painful and difficult, though it is not life threatening. If death results from these drugs, it is usually caused by overdosing that leads to respiratory failure.
Amphetamines speed up the body functions. Regular use of these drugs causes weight loss, skin reactions, and ulcers. Long-term use causes heart failure and damage to the arteries and veins. Death from this drug group is the result of physical and mental deterioration.
During the addiction period, substance-dependent people are mainly concerned with continuing the habit they have. Their whole lives are centered around the need for drugs. Money is used purely to meet this need. Other aspects of life and obligations hardly exist since time is spent searching for drugs.
Alcohol is the most lethal drug in this category. Withdrawal produces blackouts, seizures, and tremors. Alcohol also affects the liver, nervous system, heart, and may produce cancer of the esophagus and intestines.
Withdrawal from barbiturates causes the same symptoms as alcoholism and is life threatening.
The need for most people is a change in life style and redemption. Many alcoholics in Russia have been healed by the power of God. The person must not return to his old lifestyle after withdrawal of the drugs, or else his chances of success are minimal.
Question:
7. Why is alcoholism a lethal addiction?