Assessment and Diagnosis Flashcards
Informants (family, friends, other agencies, physicians, etc.) used when collecting information to effectively treat clients.
Collateral sources
Using multiple information sources
Triangulation
Structured way of observing and describing a client’s current state under domains of appearance, attitude, behavior, mood and affect, speech, thought process, thought content, perception, cognition, insight, and judgement.
Mental status exam
Facial expression, grooming, dress, gait, etc.
Appearance
Awareness of time and place, events, etc.
Orientation
Slurred, pressured, slow, flat tone, calm, etc.
Speech pattern
Mood as evidenced in both behavior and client’s statements (sad, jittery, manic, placid, etc.)
Affect
Impulse control with special attention to potential suicidality and/or harm to others
Impulsive/potential for harm
Ability to predict the consequences of their behavior, to make “sensible” decisions, to recognize contribution to their problem
Judgment/insight
Thinking style and ability to know reality, including the difference between stimuli coming from inside or outside oneself
Thought processes/reality testing
Level of intelligence and of recent and remote memory functions
Intellectual functioning/memory
Instruments used to measure an assortment of mental abilities and characteristics, such as personality, achievement, intelligence and neurological functioning.
Psychological tests
Measure cognitive (thinking) abilities and academic achievement
Educational tests
Comprehensive process that may utilize the results from educational and psychological tests, but can also involve interviewing the client and/or family, reviewing client history, checking existing records, consulting with other providers
Social Work assessment
