From Medication to Education Eve Mandre, doctoral dissertation Lund University 2002.
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Transcript of From Medication to Education Eve Mandre, doctoral dissertation Lund University 2002.
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From Medication to Education
Eve Mandre, doctoral dissertation
Lund University 2002
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Problem area
Suspected autism spectrum disorders in longterm psychiatric patientsPatients can not be understood or treated from existing diagnosesGeneral psychologic knowledge insufficient for understanding behaviour
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Educational programmeIn 8 clinical psychiatric units in different areas of Sweden(in-patient, out-patient, forensic)6 two-hour-long sessions in the course of 8-12 monthsTotal of 100 participators: 60 on a more regular basisLearning process evaluated through documentation, interviews, questionnaires
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The learning process documented
This was new for me in to-day´s session…I did not previously think that…There was really nothing new for me in to-day´s discussionsIn other respects, I thought/was of the opinion…
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Training sessions based on
The needs of each unitProblem oriented Patient focusedAnchored in the daily reality
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Understanding autism as atypical psychological
development
Can not be understood from general psychological knowledgeSocial dimension of learning is lackingConsequences for personality developmentConsequences for cognitive development
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Early developmentFace-to-face interactionRythm, turn taking, expectations on others´actionsDevelops and consolidates non verbal communicationAssimilates inner image of The Other as partner in interaction
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Social learning
Perception is social and culturalSocial learning crucial for personality developmentSelf-image develops in dialogueCommon meaning and symbols develop through social learning
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The world of objects
Assimilation through social interactionThe child seeks The Other´s reactionEmotion+object= new concept
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Concept formation
Is social and cultural – not only developmentalThrough imitation and social interactionThrough language useThrough variation
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Early symbolization and generalization
Example (blocks on a slanting surface)Imitation (trial, new experience)Abstraction (the principle of slanting surface)Generalization (slanting surface =slide on the playground)
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Inner speech
Develops thinkingInhibits impulsivity Tries out possibilities before actingAnalyses, recreates new entitiesOrientation towards future
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Higher mental processes
Inner speech directs perception and organizes actionsCompares present to past and futureThe symbols of language can select parts and reconstruct eventsAbility for self-reflection
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Thinking in complexes
Thought is tied to the concrete and realUnable to abstract elements and use in other contextCan not mentally reconstruct into new combinations
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Consequences for learning
Obstacle for in-depth learningInability to move out of own frame of referenceDifficulties adapting to new demandsAbsence of self-awareness
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Quantitative results for patients
Re-evaluations (6 cases)New diagnosis (2 cases)Changes in treatment/new treatment plans (all cases)Referred to community services (LSS)
(3 cases, 2 from forensic psychiatry)Referred from outpatient to inpatient unit (1 case)
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Qualitative results: staff reorientation
Staff gained useful knowledge of autism and educational approachesBetter understanding of patients leads to more adequate treatment”Unlearning” of previous knowledgeIncreased staff´s behavioral repertoire
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Qualitative results: new knowledge in old
organizations
New assessment creates problemsIndividualized treatment problematic in existing organizationsStaff education problematic in existing organizations
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From Medication to Education-People with
Autism in Adult Psychiatry
http://www.english.certec.lth.se/doc/frommedicationto/