Communication and Psychology

Interacting
with
Patients
WORKSHEET:
“Communicati
on:
Interacting
with Patients”
Importance of Communication

1. Communication and interpersonal

relationships are the most important part
of life for most people
2. Communication is an important part of the
care you give. Effective communication
can improve your relationships with
patients, make your job easier, and save
wasted time
3. Communication is also an important part
of your personal life. Effective
communication can improve relationships
with your family friends, and co-workers.
Medical assistants must:

Communicate effectively:
• Professionally
• Without judgement
– patients from different cultures, socioeconomic
backgrounds, educational levels, ages and
lifestyles.
• MA’s set the tone for the communication
circle
• Be able to recognize obstacles that affect
communication
Ultimately, it is important for patients to develop a good
rapport and feel confident about the care they are
receiving.
Be able to recognize obstacles that affect
communication
BARRIERS TO COMMUNICATION CAN
INCLUDE: (add these barriers to your
notes)
• Disabilities such as hearing loss / vision
loss / certain physical disabilities / certain
emotional or mental health disabilities
• language
• cultural differences
• stereotypes and prejudice
• conflict
Elements of Communication:
The Communication Process

Defined as the way we exchange messages with each other.

The communication process involves both sending and
receiving messages.
1. Sender of Messages
Verbal – what we say
Non-verbal – messages we send without words; such as facial
expression, gestures, nods, posture and personal appearance.

2. Receiver of Messages
Effective listening
Reading body language

3. Feedback
Acknowledging the message
Elements of Communication:
The Communication Cycle
Elements of Communication:
The Communication Process

• Feedback: determines what the receiver received

and how it was interpreted
MA’s should always look for feedback when
communicating with patients
– receiver’s response using Verbal or nonverbal cues
– Validation of understanding is called decoding
• Noise:
– anything that changes the message in any way ADD
TO NOTES!
– Sounds but also other types of discomfort
– Such as room temperature, physical discomfort, pain

How do these relate to the communication circle?

Why is feedback important for the medical assistant?
 Example

In this interaction, a simple message is conveyed and understood, completing the

sender-message-receiver-feedback loop. In health care, the messages can be complex.
For example:

1. Sender: “Remember not to eat or drink anything on the morning of your

procedure. Bring your medications with you when you arrive, and check in at the
registration desk at 6:30 a.m.”
2. Message: Do not eat or drink on the morning of your procedure, bring
medications, and check in at 6:30.
3. Receiver: Nods and acknowledges the message.
4. Feedback: “I should not eat or drink anything on the morning of my surgery, and I
should bring my medicines when I check in at 6:30 a.m. Where did you say I was
supposed to go?”

STOP AND THINK: Were all elements of the communication loop completed?
Was the entire message clearly conveyed to the receiver?
In the example, the feedback did not include where the receiver was supposed to
go (i.e., the registration desk), so more interaction is needed.
• If there are any parts of the message that are not clear, the sender must modify or
repeat the message.
• If the message is complex, the sender may need to write down instructions or
convey the overall message as a series of smaller messages.
 Types of Information
When obtaining information from a patient, the medical assistant will
gather it through either communication or observation. Subjective
information is gathered from what the patient communicates to the
medical assistant. This includes experiences the patient has
encountered. Objective information is information that can be observed
or measured. This includes information that can be gathered through
observing.

Subjective Objective
Pain Rash

Nausea Rapid respirations

Weakness Sweating

Vertigo Cough
Effective Communication

Effective communication requires

conveying information in a clear and understandable manner.

This can help ensure accurate transfer of information as well as

minimize the possibility of miscommunication. Effectively
communicating with patients establishes trust.

Professional Communication
Effective communication skills play a key role in collaborating with team
members. When communicating in the workplace, remember to be
professional. Knowing when to use formal and informal
communication is important. It is essential to use tact when
professional communication is necessary. Tact refers to doing and
saying the right things at the right time; this also includes knowing
when it is best to say nothing.
5 C’s of Communication

In order for communication to be

effective, it must be:
Clear
Concise
Concrete
Correct
Coherent
Types of Communication:
Positive Verbal Communication

• Communication that promotes the patient’s

comfort and well-being is essential
add to notes if not already printed in notes
Examples of positive verbal communication
• Being friendly, warm, and attentive
• Verbalizing concern for patients
• Encouraging patients to ask questions
• Asking patients to repeat your instructions to be sure
they understand
• Looking directly at patients when you speak to them
• Smiling naturally (not forced)
• Speaking slowly and clearly; pronounce words correctly
• Listening carefully
• EX: “can you share what you feel ……”
add to notes
Types of Communication:
Negative Verbal Communication

• Most people may not realize that their

communication style has a negative impact on
others.
• Ask for feedback to curb negative communication
habits

Examples of negative verbal communication:

• Mumbling
• Interrupting patients
• Avoiding eye contact
• Rushing through explanations

• Pay attention to others in service-oriented workplaces;

can always improve your communication skills and
learn by observing others.
Types of Communication: Nonverbal
Communication
• Also referred to as body language
• Consists of:
• Facial expression
• Eye contact
• Posture
• Touch
• Attention to personal space

4-15
 YEA!
Apply Your Knowledge
Mr. Garcia comes to the desk to check in and
asks if he will be seen on time. The MA
receptionist continues with her paperwork,
points to the sign-in sheet, and tells Mr. Garcia:
“Just sign in. The doctor will be with you when
he can.” Explain why this is an example of
negative communication.
 YEA!
Apply Your Knowledge
Mr. Garcia comes to the desk to check in and asks if he will be seen on
time. The MA receptionist continues with her paperwork, points to the sign-in
sheet, and tells Mr. Garcia: “Just sign in. The doctor will be with you when
he can.” Explain why this is an example of negative communication.

ANSWER: This is an example of negative communication

because the receptionist:
• Did not stop what he or she was doing – was not
friendly or attentive
• Did not greet Mr. Garcia or make eye contact with him
• Did not give a satisfactory answer to Mr. Garcia’s
question
• Did not make sure Mr. Garcia understood when he
would be seen
 Therapeutic Communication
Therapeutic communication occurs when communicating with patients and family members
in health care. It requires a strong knowledge and ability to engage in effective
communication.

It is important that patients not feel judged or blamed during their patient experience.
Establishing rapport with your patient is essential in conquering therapeutic
communication. Techniques that can be used to establish therapeutic communication include
the following.
● Respect privacy
● Minimize interruptions
● Introduce yourself
● Ask open-ended questions

For example, do not ask a patient, “Are you sleeping well?” Instead, ask, “Tell me about your
sleeping habits.” This encourages the patient to answer more openly. Use nonverbal
communication to show that you are interested in listening to what the patient is saying.

Focusing on active listening while the patient is speaking and displaying empathy when
appropriate are key components of therapeutic communication.
 Therapeutic Communication

Avoid using the following communication techniques in therapeutic

communication

● Agreeing or disagreeing. Maintain dialogue with the patient and listen

with an open mind.

● Providing unsolicited advice. The purpose of therapeutic

communication is not to provide guidance, but to establish a
relationship. Listening to and understanding what is being said is the
goal, and the MA should never give advice.

● Judging. The MA should not judge or offer a perspective on what the

patient is describing.

● Responding defensively. The communication is not about you. Do not

adopt a defensive response to the communication.
 Interviewing Styles

Typically, when interviewing a patient to obtain information, open-ended questions

are preferred over closed-ended questions. Open-ended questions will gather
the most detail. It is important to understand when to use each style.

● Open-ended questions. These types of questions allow patients to

provide descriptions of their perceptions and explanations.

● Closed-ended questions. These questions are simple yes/no or other types

of questions requiring a one-word response.

Open-Ended Questions Closed-Ended Questions

What brings you in today? Do you have insurance?

Can you describe your pain? Who referred you to this provider?

How is your new medication? Did you take your medication this morning?
Improving Your Communication
Skills

Active Listening
-involves two way
communication
actively involved in the
process

-Most people listen to

reply, not to understand
Improving Communication Skills:
Listening Skills
Ways to improve Active listening
What traits does an individual who is listening have? Are they looking at
their watch? Are they focused on the speaker? The following are key
nonverbal behaviors that demonstrate active listening.
● Eye contact. Look directly at the person speaking.
● Facial expressions. Your face is the most expressive part of your body.
● Posture. Be aware of how you hold your head, arms, and hands.
● Personal space. Be aware of personal space. Respect the other person’s
privacy. This is especially important with individuals who have different
cultural backgrounds.

What are some traits of individuals when they are not listening?
● Interrupting while the other person is speaking
● Displaying boredom by staring off into the distance
● Forgetting common courtesies (e.g., not interrupting the speaker)
● Avoiding eye contact
 Feedback Techniques
Clarifying that the message was received and understood is an important step in
effective communication. The receiver can provide feedback using different
techniques.
Clarifying/offering Reflecting Restating
feedback
(repeating or reiterating the message (stating the message as it was
to indicate understanding). understood).
• lets the sender know
the message has not ● can assure the sender ● encourages the
been understood and that the message was sender to agree,
may show the patient received and disagree, or clarify
how to make the understood correctly. the message.
message clearer to the
receiver.
For example, the medical For example, the patient says, For example, the medical
assistant says, “It is not clear “Would you take this assistant says, “So, the
to me how long you have had medication if it were you?” The lower back pain started
the lower back pain. Did it medical assistant may say, three days ago and has
start recently?” “What do you think about not improved.”
having to take the
medication?”
 Clarity of Verbal Communication

Telephone Etiquette
When answering the phone, it is important to smile. This physical action results in a positive
tone. Speak clearly and identify yourself and the organization. For example, “Round Rock
Family Practice, this is Kayla. How may I be of assistance?” When taking a message,
document it immediately, then repeat the message back to the caller to verify the
information is correct.

Always verify the caller’s name and contact number in case the call is accidently dropped.

Accurate message documentation includes the following:

● Whom the message is for
● Person and/or company calling
● Patient name, contact number, and date of birth
● Day, date, and time of the call
● Contact phone number for a return call
● Best time to return the call
● A brief yet inclusive message
● Action to be taken after the call
● Name and title of individual who took the message
Written Communication
Written communication is a type of verbal communication. A written message is created for the receiver,
such as written thank-you notes, emails, letters, or text messages. When using handwritten communication,
it is important to write legibly so the message is relayed clearly. Other important tips to check are grammar,
spelling, and sentence structure.

Medical assistants will encounter many types of written correspondence such as message
taking, emails, business letters, or documentation in a health record.

● Use proper grammar and spelling and accurate spacing in written correspondence.
Sentence structure is important to the receiver.

When documenting in a patient's chart, be sure to follow these general guidelines:

• Before making an entry, ensure you have the correct patient’s medical record
using two patient identifiers.
• Document information in the correct location using clear and concise phrases. The
patient’s words are important; they must be put in quotation marks to indicate the
information was stated by the patient.
• Only present facts, not your opinions.
• Document information in chronological order
• Always remember to follow patient privacy rules.
• Use correct spelling without abbreviations.
• Always document immediately. Do not wait to document in a patient’s medical
record, as some information may be forgotten over time.
• Do not document in advance.
 Patients with Physical Impairment or
Sensory Loss
When a patient has sensory loss, such as vision or hearing loss, they require the same care and
respect as all other patients.

The MA should always notify a patient with vision loss when they are entering the room

• It is helpful to explain what is being done to a person who has vision loss and encourage
the patient to assist.

Patients with hearing loss may be able to read lips or may prefer to write messages.

• If the MA writes a message to a patient, questions should be short and simple, preferably
yes-or-no questions, to minimize effort on the part of the patient.
• If a patient reads lips, the MA should position themself so that the patient can see
their face. Speak clearly, but do not shout.
• Use a sign language interpreters who can help with communication.
 Patients who speak a nonshared
language
Communication with patients who don’t speak
the same language as the MA can also
present a challenge.

Many times, the patient will have a family

member who can serve as an interpreter.
• Be sure to obtain the patient’s permission
When asking a to use a family member to translate.
family member to • When complex medical information, such
translate, the family as pre-operative instructions or obtaining
member should be consent for procedures, a translator
an adult. must be used.
Children/Teens • Allow time for the translator to speak to
should not be asked the patient, then respond.
to translate • Maintain eye contact and communicate
with the patient, not the translator.
 Environmental and Socioeconomic
Stressors

A stressor is anything that causes anxiety

or stress. Coming to a healthcare facility can
create a great deal of stress for a patient.

This can be reflected by an increase in

blood pressure in the office that is not
reflected in the patient’s readings from
home, commonly called “white-coat
syndrome”. This is an objective indication
of the patient’s anxiety.
 Environmental and Socioeconomic
Stressors

Environmental
Stressors:
● Overcrowding Socioeconomi
● language and c Stressors:
cultural barriers ● Finances
● death of a loved ● Loss of a job
one
● traumatic events,
● Loss of a
etc. home
 Nonverbal adaptations
Nonverbal behaviors differ within and among various cultural groups.
What one person accepts as appropriate communication, another might find
offensive. Be aware of and sensitive to nonverbal communication cues
to reduce the chances of unintentionally offending others.

Key factors to consider when displaying nonverbal communication with

different cultures include the following:
● Follow the other individual’s lead in terms of personal space and
nonverbal behaviors.
● Use gestures with caution. Some gestures can be considered
offensive or relay various meanings.
● Avoid touching the head of an infant or child accompanying an
adult patient.
● Eye contact can be considered rude or offensive.

***ADD THE INFORMATION IN RED TO

YOUR NOTES
4 Styles of Communication

● Aggressive. This is when an individual

verbally attacks others. For example,
“I knew you were going to charge me too
much on my last bill! I won’t pay it!”
● Passive-aggressive. An individual
● Passive. A reaction in which an gives the appearance of going along
individual does not respond and just with what is happening but may say or
allows things to happen. For example, do things that are resistant or
“That’s fine.” aggressive. For example, if you ask a
patient to change into a gown, a
passive-aggressive response might be
“Oh, sure. Whatever you say. It’s not
like I get to make any decisions.”

● Assertive. Includes stating opinions

and standing up for oneself in a calm
and constructive manner, while being
respectful to others. This is the
healthiest reaction.
Relational Aspects of
Communication
The patient experience extends beyond the basics of customer service.
Health care is very complex; its experiences and challenges are much
more intricate than, for example, a bad experience at a restaurant.

The MA can greatly influence the patient’s experience. MAs spend the
most time with patients during their visits. It is important to interact with
patients and visitors in a way that lets them know that they are valued.

The MA should think about opportunities to improve the patient

experience. Consider the encounter from start to finish, keeping the
perspective of the patient in mind.

• Be sensitive and attentive to wait times

• How patients are called into the exam rooms
• The communication process before, during, and after the scheduled
appointment.
 Human Growth and
Development
Psychology
In order to have an
understanding of human
behavior it is important to
realize that each person is
motivated by needs.
ERIKSON
 Cognitive and Psychosocial
Adaptations
In your work as a medical professional, you will need to adapt your communication style
and method based on the individual’s cognitive and psychosocial stages of development.

Psychologist Erik Erikson developed the concept of stages of conflict based on an

individual’s age, as listed below. These stages represent what an individual will face as
they grow and develop.
click the link
Erik Erikson's Theor
y of Psychosocial De
velopment
UPDATE YOUR ERIKSON
NOTES:
SEE THE CHANGES IN THE
NEXT TWO SLIDES -
UPDATE YOUR WS WITH
THE NOTES HIGHLIGHTED
IN YELLOW
 Erikson’s Psychosocial Stages of Development

Infancy 0-1 year

CRISIS: Trust versus mistrust
● Major Life event: Feeding
● Main Relationship: Mother
● Successful Outcome: Being comforted after crying to develop trust
● Unsuccessful Outcome: Being left to cry results in feeling mistrust

Early Childhood 1-6 years

CRISIS: Autonomy vs Shame and Doubt (1-3 years)
● Major Life event: Toilet Training
● Main Relationship: Parents
● Successful Outcome: Learns control while mastering skills with direction
● Unsuccessful Outcome: Can feel anger, lack of self confidence, no sense of self pride
CRISIS: Initiative vs Guilt (3-6 years)
– Major Life event: Independence
– Main Relationship: Family
– Successful Outcome: Child begins to initiate activities ; allowed responsibility
– Unsuccessful Outcome: Child can feel guilty and thinks everything they do is wrong

Late Childhood 6-12 years

CRISIS: Industry vs Inferiority
● Major Life event: School
● Main Relationship: Peers
● Successful Outcome: Feelings of competence, self satisfaction, trustworthiness
● Unsuccessful Outcome: Develops a sense of inferiority and incompetence, feelings of inadequacy
 Erikson’s Psychosocial Stages of Development

Adolescent 12-20 years

CRISIS: Identity vs Role Confusion
● Major Life event: Acceptance
● Main Relationship: Peers
● Successful Outcome: Emotional stability, ability to form relationships and make sound choices
● Unsuccessful Outcome: Feels a loss of self belief and confusion of own identity

Early Adulthood 20-40 years

CRISIS: Intimacy vs Isolation
● Major Life event: Love Relationships
● Main Relationship: Significant Other
● Successful Outcome: Mutual self respect and love, intimacy, and commitment to others and to a career
● Unsuccessful Outcome: Leads to social isolation and withdrawal; multiple job changes, inability to form long
lasting relationships

Middle Adulthood 40-65 years

CRISIS: Generativity vs Stagnation
● Major Life event: Parenting/Purpose
● Main Relationship: Family
● Successful Outcome: Settled in life and enjoys raising children; has a sense of purpose
● Unsuccessful Outcome: Can feel regretful and sense of uselessness if not comfortable with progression of life

Late Adulthood 65 years to death

CRISIS: Ego Integrity vs Despair
● Major Life event: Reflection and Acceptance of life
● Main Relationship: Family
● Successful Outcome: Feels fulfilled with life and accomplishments, deals with loses, prepares for death
● Unsuccessful Outcome: Feels despair about life and fearful of death
MASLOW’S HIERARCHY
OF NEEDS
What is Maslow’s Hierarchy of
Needs?
● Medical Assistants are exposed to many different
personality types in addition to many different diseases and
illnesses.
● When you understand why a person is behaving a
certain way, you can adjust your communication style to
adapt to that person.
● Many patients feel that health care is becoming impersonal
and consequently may be difficult.
● Everytime you COMMUNICATE with a patient, you can
counteract this perception by playing a HUMANISTIC
ROLE. Being humanistic means treating and respecting
patients as individuals and not as a disease, condition or
illness.
 How are we motivated?
● One of the best-known
theories of motivation
● This is based upon the
idea that all individuals
have needs ranging
from basic to complex
● Represented by a
triangle/pyramid with
each step becoming
smaller going up to
represent the fact that not
all individuals will achieve
the higher and more
complex needs.

Video: Maslow’s Hierarchy of Need

How are we motivated?

click the link

Video: Maslow’s
Hierarchy of Ne
eds
 The Theory
⚫ First concern is to fulfill the lowest level of
unsatisfied need
⚫ Motivation to satisfy needs produces growth
⚫ When need is met, it becomes less important
and the next level of need becomes the focus.
⚫ If needs are not met, misbehavior or mental illness
may
ADDoccur
INFORMATION BOLD IN RED TO
NOTES!
⚫ During crisis decisions will be made to secure basic
The Theory
MAKE SURE YOU ADD
SOME EXAMPLES OF
EACH LEVEL TO YOUR
NOTES. SEE THE
Basic level needs
These are biological requirements for human survival
like:
Food
Air
Water
Shelter: protection from extreme
temperatures
Rest/Sleep
Health
Clothing

Physiological Needs
Basic level needs
Individual feels emotionally and physically safer in their
environment, there is level of protection in their
surroundings and they have adequate housing and a
safe
work environment

Safety
Safety of employment
Freedom from Danger/Fear
Financial Security

Personal Safety
Safety and Security
Social Needs
The need for interpersonal/meaningful
relationships
and connections with others

Affection/Intimacy
Approval
Companionship
Acceptance (being a part of a
group)
Friendship/Trust
Love/Affection
and Belonging
Esteem Needs
Maslow categorizes this into two
categories:
⚫ Esteem for oneself (dignity, achievement, mastery,
independence)
⚫ Desire for reputation or respect from others (status,
prestige)

Power
Recognition
Prestige
Self-
Esteem
Full Potential
⚫ Realizing personal potential, self-fulfillment,
seeking personal growth and peak experiences.
⚫ A “desire” to become everything one is capable of
becoming

Developed wisdom
Concern for Humanity
Compassionate
Creative

Self-
Actualizatio
n
WORKSHEET:
“End of Life
and Grief”
KUBLER-ROSS
 End of Life and Grief

Loss and grief can occur at any time. An individual may lose a loved one,
face their own declining health, or struggle at the end of life. A dying person
has many fears—mainly, the fear of the unknown. It is challenging for
individuals to accept fear.

With these patients, it is important for the MA to listen closely, learning the
actual problems the patient has. When a patient is facing death, the MA
should show sensitivity and listen to the concerns of the patient and family.
The MA should advocate for the patient to make sure their wishes are
respected and followed.

If the patient is agreeable, information about community resources, such as

hospice, or peer groups can provide much-needed support and relief. It is
important for the MA to be aware of community resources that can assist with
any needs the patient may have.
End of life struggles
⚫ Chronic or terminal illness
⚫ Must face getting affairs in order
⚫ Including advanced directives and durable
power of attorney for health care
Just like with developmental stages, several
theorists have defined the various stages of grief.

DO NOT WATCH THESE VIDEOS

ON YOUR OWN - WE WILL
WATCH THEM AS A CLASS

Video:Teen Titans
Giraffe
Kubler Ross: Stages of Grief
Although there are five stages, not everyone will go through the stages in a linear
way, and not everyone will go through all five stages.

The stages are the following:

Denial= “No, not me” “I can’t have

cancer”
it’s not true!

Anger= “Why me?” “It’s not fair!”

Bargaining= “Yes, me, but…..” “I’ll do

anything”

Depression= “Yes, it’s me (sigh)”;

crying; “What’s the point !
5 stages of grief…
explained…
Denial is usually only a temporary defense for the
individual. This feeling is generally replaced with heightened awareness of situations and
individuals that will be left behind after death.

Once in the second stage, the individual recognizes that denial cannot continue. Because
of anger, the person is very difficult to care for due to misplaced feelings of rage and
envy. Any individual that symbolizes life or energy is subject to projected resentment and
jealousy.

The third stage involves the hope that the individual can somehow postpone or
delay death. Usually, the negotiation for an extended life is made with a higher power
in exchange for a reformed lifestyle. Psychologically, the individual is saying, "I
understand I will die, but if I could just have more time..."
During the fourth stage, the dying person begins to understand the certainty of
death. Because of this, the individual may become silent, refuse visitors and
spend much of the time crying and grieving. This process allows the dying person
to disconnect one self from things of love and affection. It is not recommended to
attempt to cheer up an individual who is in this stage. It is an important time for grieving
that must be processed.
In this last stage, the individual begins to come to terms with their mortality or
that of their loved one.
Stereotypes and Biases
Stereotypes are generalized assumptions about a person or group of people.

Biases are prejudice against a person or group of people.

Both can enter the communication process and should be identified and
eliminated to ensure effective communication with patients, families, and medical
professionals.

VERY IMPORTANT! **WE MUST ALWAYS EXAMINE OUR

BIASES**

Gender Identity and Expression

• When addressing patients and other medical professionals, ask them their
preferred name, preferred title, and what pronouns to use. Do not
assume a person is married or single.
 Cultural, Religious, Psychosocial, and Economic
Considerations

The patient population is diverse. ***Patients

will have different
backgrounds, traditions, values, and beliefs. Knowledge and
understanding of different cultures*** can help to prevent the possibility
of stereotyping and offensive assumptions.

However, be careful not to generalize about patient care based on your understanding.
Generalizing is making a general assumption based on a small amount of information.

• An example of a generalization is assuming that a patient will not accept blood

transfusions or organ donations based on their religion. Always verify with the
patient in a professional and unassuming way their treatment preferences.

Affiliation with a group does not always direct an individual's behaviors or choices, so all
treatment options should be presented.
WORKSHEET:
“Defense
Mechanisms
Definitions”
 DEFENSE MECHANISMS

***DEFENSE MECHANISMS are unconscious behaviors

used to release tension or cope with stress.***
• Defense mechanisms help block uncomfortable or
threatening feelings.
• All people use defense mechanisms at times.
• People who have mental health disorders may use them
to a greater degree than others.
• An overuse of these mechanisms prevents a person
from understanding their emotional problems and
behaviors.
• If a person is unable to recognize problems, they will
not address the them and the problems may get worse.
Defense Mechanisms
-coping strategies used to protect self from negative emotions
such as guilt, anxiety, fear, and shame.

-generally unaware

-some use them adaptively, in a positive way, and still have the
ability to change or adjust as they come to terms with the
stressor.

-others use them negatively and lack the ability to change or adjust
 DEFENSE MECHANISMS

Identify and define common defense mechanisms

MAs should recognize these categories of defense
mechanisms:
•Denial ● compensation
•Projection ● sublimation
● identification
•Displacement
● introjection
•Rationalization ● dissociation
•Repression ● suppression
•Regression
•Reaction formation
THE FOLLOWING SLIDES ARE NOT IN ORDER WITH YOUR WORKSHEET - YOU
WILL HAVE TO JUMP AROUND

Denial Repression

-Most basic -Elimination of unpleasant emotions,

desires, or problems from the conscious
-Avoidance of unpleasant ideas or mind. Blocking unacceptable thoughts or
thoughts by rejecting them or ignoring feelings from the conscious mind.
them. Completely rejecting the thought
“EX avoiding thoughts about a traumatic
or feeling experience”

EX:
I’m not
upset with
you.
 Compensation Displacement

-balancing a failure/inadequacy with an -the redirection of emotions away from its

accomplishment original subject onto another less threatening
subject . -Transferring a strong negative
feeling to a safer situation.

EX: an unhappy employee cannot yell at his

boss so he goes home and yells at his wife
instead.
 Projection Rationalization

-Transferring one’s own feelings onto -an explanation that makes something
another person in order to avoid negative or unacceptable seem
accountability justifiable or acceptable

-seeing feelings in others that are -making excuses to justify a situation

really one’s own
EX: after stealing something, saying
“everybody does it!”
 Regression Reaction Formation

-Unconsciously returning to an earlier, -belief in and expression of the opposite

more childlike, developmental behavior of one’s true feelings

ES: throwing a temper tantrum as an

adult

expressing the opposite of what

you actually feel
 Sublimation

-Rechanneling unacceptable urges or

drives into something constructive or
acceptable
 Identification Introjection

-mimicking the behavior of another to -adoption of the positive qualities of

cope with feelings of inadequacy another person into their own ego
 Dissociation

-disconnecting emotional significance

from specific ideas or events
DELETE SUPPRESSION
“SUBSTITUTI
Voluntary blocking of an
ON” ON unpleasant experience from one’s
YOUR awareness

WORKSHEET. -a condition in which the person

becomes purposely involved in a
project, hobby, etc. so that a painful
REPLACE IT situation can be avoided.
WITH
“SUPPRESSIO
N”
 WORKSHEET:
“DEFENSE
MECHANISMS
WORKSHEET”
Using the information you have just
learned, now complete the
worksheet. Identify the scenarios
listed with the appropriate defense
mechanism.
 WORKSHEET:
“Communicati
ng in Special
Circumstances
”
SKIP THIS IN YOUR PACKET
- WE ARE NOT DOING THIS
WORKSHEET
WORKSHEET:
“Mental Health
Screenings”
Mental Health Screenings
Common Mental Health Screenings
used in medical practices
● Depression --> PHQ-2 and PHQ-
9 PQH 9 from NHA The PHQ 2 includes the first 2 items of the
PHQ-9

● Anxiety --> GAD-7 GAD 7 from NHA

● Dementia or other degenerative
disorders --> MMSE (Mini-Mental
State Examination)
 Mini-Mental State Exam, Anxiety and
Depression Screening Tools
Mental health screenings assess the patient’s safety and
mental status. Depression screening asks questions about the
patient’s moods, thoughts, and feelings.
● The Patient Health Questionnaire-2 (PHQ-2) focuses on
the patient’s frequency of depressed mood over two
weeks. If the patient’s answers reflect a positive response
to depression, the medical assistant can proceed to the
PHQ-9
● The PQH-2 includes the first two items of the PHQ -9.
 Mini-Mental State Exam, Anxiety and
Depression Screening Tools
Mental health screenings assess the patient’s safety and
mental status. Depression screening asks questions about the
patient’s moods, thoughts, and feelings.
● The Patient Health Questionnaire-2 (PHQ-2) focuses on
the patient’s frequency of depressed mood over two
weeks. If the patient’s answers reflect a positive response
to depression, the medical assistant can proceed to the
PHQ-9
● Patient Health Questionnaire-9 (PHQ-9). This screening
asks additional questions to assess if the patient meets
the criteria for a depressive disorder diagnosis.
Mini-Mental State Exam, Anxiety and Depression Screening
Tools

Older adult patients could require a mini-mental examination

to evaluate for dementia or other degenerative disorders.

A Mini-Mental State Examination (MMSE) is a set of 11

questions that doctors and other healthcare professionals
commonly use to check for cognitive impairment
(problems with thinking, communication, understanding
and memory).
Mini-Mental State Exam, Anxiety and Depression Screening
Tools
Anxiety is a common emotional response for many people.
Anxiety can be a response to fear or an unfamiliar situation. For
example, some patients have “white coat syndrome," which is
anxiety related to seeing a health care provider for an evaluation.

Anxiety can vary from mild to severe symptoms. The GAD-7

questionnaire is for general anxiety and used to screen patients
for anxiety. The Generalised Anxiety Disorder Assessment
(GAD-7) is a seven-item instrument that is used to measure or
assess the severity of generalised anxiety disorder (GAD).
Each item asks the individual to rate the severity of his or her
symptoms over the past two weeks.
Common Depression Symptoms

●Difficulty going to sleep, staying asleep, or getting up in the

morning

●Profound sadness and fatigue

●Change in appetite​​

●Loss of energy
Common Anxiety Symptoms

●Heightened ability to observe or make connections

●Difficulty focusing on details

●A sense of panic

●Irritability

●Feeling cold, sweaty

●Heart palpitations​​
WORKSHEET:
“Common
Mental Health
Disorders”
A mental health disorder disrupts a person’s ability to 4
function and can be made worse by:

● Physical factors such as brain structure, function, or

Psychology and Human Needs and

Development
any type of brain injury

● Environmental factors such as weak relationships or

experiencing a traumatic event

● Heredity - inherited traits; mental health disorders can

occur repeatedly in families

● Stress- people cope differently

88
Describe causes and types of mental health disorders
4
● Resource page HERE
Define the following terms:

Psychology and Human Needs and

Development
anxiety
uneasiness, worry, or fear, often about a situation or condition.
generalized anxiety disorder (GAD)
an anxiety disorder that is characterized by chronic anxiety and
worry, even when there is no cause for these feelings.
panic disorder
disorder characterized by a person having regular panic
attacks or living with chronic anxiety about having another
attack.
social anxiety disorder
a disorder in which a person has excessive anxiety about
social situations.
89
 4
Describe causes and types of mental health disorders

Define the following terms:

Psychology and Human Needs and

Development
phobia
an intense, irrational fear of or anxiety about an object, place, or
situation.
obsessive-compulsive disorder (OCD)
a disorder characterized by recurring intrusive behavior or
thoughts that cause anxiety or stress.
posttraumatic stress disorder (PTSD)
a mental health disorder caused by experiencing or witnessing a
traumatic event or series of events.
major depressive disorder/depression
a type of depressive disorder that causes pain, fatigue, apathy,
sadness, irritability, anxiety, sleeplessness, and loss of appetite, as
well as other symptoms; also called depression or clinical
depression.
90
 4
Describe causes and types of mental health disorders

Define the following terms:

Psychology and Human Needs and

Development
postpartum depression
depression experienced after the birth of a child.
bipolar disorder
a mental health disorder that causes a person to swing from
periods of deep depression (a depressive episode) to periods of
extreme activity (a manic episode).
schizophrenia
a type of psychotic disorder that causes problems with thinking,
communication, and the ability to manage emotions, make
decisions, and understand reality.
hallucination
a false or distorted sensory perception.
delusion
a persistent false belief.
91
 4
Describe causes and types of mental health disorders

Remember:

Psychology and Human Needs and

Development
Mental health disorders are like physical disorders in that they
cause symptoms, affect the body’s ability to function, and can be
responsive to treatment.

92
Follow teacher instructions:

➢ With a partner, you will take turns interviewing

each other and completing the Mental Health
Screenings

➢ YOU MAKE UP/INVENT YOUR RESPONSES. The

idea here is NOT to share or disclose your own
personal feelings and information (although you
are welcome to do so if you like)

➢ PLEASE NOTE: if you are uncomfortable with this

WORKSHEET:
“Psychology
and
Human Needs
and
Development”
WORKSHEET: Psychology and Human Needs and
Development
This 2-page worksheet is somewhat introduces new
concepts and information about Life stages and
COMMON DISORDERS for each stage
The Human Development content is extensive, so it is
important to review.
COMPLETE PART 1 “Stages of Growth and Development
+ Common disorders for each state” of the worksheet using
the resource information on the NEXT SLIDE - page
40 #2

YOU DO NOT NEED TO DO Part III Defense Mechanisms unless

you want to review
Psychology and Human Needs and
Devlopment (Hartman)

PSYCHOLOGY AND HUMAN

DEVELOPMENT RESOURCE
INFORMATION PACKET CLI
CK HERE

*If there are any problems with this link,

the packet is also available in Schoology
in the “PPT for Unit 2” folder
 Life Stage Development
Infancy 0-1 year
● Trust versus mistrust
● Major Life event: Feeding
● Main Relationship: Mother
● Successful Outcome: Being comforted after crying to develop trust
● Unsuccessful Outcome: Being left to cry results in feeling mistrust

Early Childhood 1-6 years

● Autonomy vs Shame and Doubt (1-3 years)
a. Major Life event: Toilet Training
b. Main Relationship: Parents
c. Successful Outcome: Learns control while mastering skills with direction
d. Unsuccessful Outcome: Can feel ashamed and doubt own abilities
● Initiative vs Guilt (3-6 years)
a. Major Life event: Independence
b. Main Relationship: Family
c. Successful Outcome: Child begins to initiate activities ; allowed responsibility
d. Unsuccessful Outcome: Child can feel guilty and thinks everything they do is wrong

Late Childhood 6-12 years

• Industry vs Inferiority
a. Major Life event: School
b. Main Relationship: Peers
c. Successful Outcome: Becomes productive by mastering learning and obtaining success
d. Unsuccessful Outcome: Develops a sense of inferiority and incompetence
 Life Stage Development
Adolescent 12-20 years
● Identity vs Role Confusion
a. Major Life event: Acceptance
b. Main Relationship: Peers
c. Successful Outcome: Searches for self identity by making choices; relies on parents and peers for reassurance
d. Unsuccessful Outcome: feels a loss of self belief and confusion of own identity

Early Adulthood 20-40 years

● Intimacy vs Isolation
a. Major Life event: Love Relationships
b. Main Relationship: Significant Other
c. Successful Outcome: Engaged in successful relationships that allow the experience of love and intimacy
d. Unsuccessful Outcome: When relationships fail, they experience isolation and loneliness

Middle Adulthood 40-65 years

● Generativity vs Stagnation
a. Major Life event: Parenting/Purpose
b. Main Relationship: Family
c. Successful Outcome: Settled in life and enjoys raising children; has a sense of purpose
d. Unsuccessful Outcome: Can feel regretful and sense of uselessness if not comfortable with progression of life

Late Adulthood 65 years to death

● Ego Integrity vs Despair
a. Major Life event: Reflection and Acceptance of life
b. Main Relationship: Family
c. Successful Outcome: Feels fulfilled with life and accomplishments, deals with loses, prepares for death
d. Unsuccessful Outcome: Feels despair about life and fearful of death