Assessment and Intervention Planning Flashcards
case management
works to respond to issues of service duplication and gaps in treatment
case management created to
deinstitutionalize MH patients, help them be able to live independently, work to cover gaps in treatment/care
BPS Model
looks at full picture, holistic way of understanding clients and their issues
BPS model partly based on
social cognitive theory-need team to address all influence on functioning
for BPS intake
requires more info for assessment; looking at bio, psycho history, social back ground, barriers, etc
components of a sexual history
-age sex began
-SA history
-# partners; casual or serious
-frequency
-protection use
-type of sex
-medical/drug history
-recent history of STI’s
-pregnancy
components of a family history
-get info from parents, older relatives, family tree, medical records, medical issues
Mental Health Warning Signs: in adults
-substance use
-denying obvious probs
-excessive fear/worry/anxiety
-strong feelings of anger
-confused thinking
-dramatic changes in eating/sleeping
-worsening inability to cope with daily probs
-SI
-delusions/hallucinations
-extreme highs and lows in mood
-long lasting sadness and irritability
-unexplained physical problems
-social withdrawal
Mental Health Warning Signs: in older kids/preteens
-substance use
-excessive complaints of physical problems
-ongoing negative mood, thoughts of death
-changes in eating/sleeping habits
-frequent anger outbursts
-intense fear of weight gain
-defying authority/skipping school/theft/damaging property
-inability to cope with daily activities and problems
Mental Health Warning Signs: in younger kids
-changes in school performance; poor grades despite strong effort
-hyperactivity
-poor grades despite strong efforts
-excessive worry/anxiety
-persistent nightmares
-frequent tantrums
-persistent disobedience/aggression
symptoms of hypomania
-persistent hyperactivity
-excessive inappropriate cheerfulness, silliness, intrusive/disruptive behavior
-flight of ideas
-decreased need for sleep
symptoms of mania
-hostile thoughts
-euphoria
-denial of problems
-grandiosity
symptoms of depression
-abnormal moods, feelings, sadness, hopelessness, negativity
-self deprecation, low self esteem
-agitation, restlessness, irritable
-insomnia
-decreased school performance, socialization
-anhedonia
-somatic complaints without explanation
-change in appetite/weight
organic mental syndromes: depression
-most dementias (vascular and Huntington’s especially)
-Parkinsons
-multiple sclerosis
-cushing syndrome
-hypopituitarism
-hyperparathyroidism
-Addison’s disease
-anemia
-infections
-carcinomatosis
-porphyria
-corticosteroids
-beta-blockers
-calcium channel blockers
organic mental syndromes: anxiety
-Parkinson’s
-CVA
-brain injury
-hyperthyroidism
-hypoglycemia
-pheochromocytoma
-anemia
-SSRI antidepressants
-anticonvulsants
organic mental syndromes: psychosis
-Huntington’s
-multiple sclerosis
-space occupying lesion
-CNS infection
-cushings disease
-acute pyphyria
-corticosteroids
-beta blockers
-L dopa
-sympathomimetics
organic mental syndromes is a term used when
there’s disease of the body that presents with psychological symptoms
organic mental syndromes: elation/hypomania/mania
-multiple sclerosis
-neurosyphilis
-cushings syndrome
-carcinoma
-CNS infections
-corticosteroids
-antidepressants
organic mental syndromes: ICD 10 classifies theses as
other mental disorder due to brain damage and dysfunction and physical disease
organic mental syndromes: subgroups that include other than which disorders
-dementia, amnesia, delirium
-organic hallucinations; organic delusional disorder; organic mood disorder; organic anxiety disorder
for assessment, keep in mind what could be the cause of psychological symptoms
organic causes
factors that suggest organic cause of psychological symptoms
-failure to respond to treatment
-different to previous presentations
-abnormal physical exam
-no clear etiology
-other symptoms of organic illness
-atypical psychological presentation
-unusual presentation
relationship of psychiatric illness occurring as indirect result of organic illness
-patient at risk (past personal or family history) more likely to develop psych illness when medically ill
-psych issues can exacerbate physical illness
-use specific/standard treatment for psych disorder as long as not contraindicated with physical illness treatment
symptoms of neurological problems
-slow loss of coordination, balance
-tremors
-difficulty swallowing
-symptoms often start with mild/intermittent twitching/numbness in 1 extremity
-rigid muscles
-loss of auto movements (blinking, arm swinging, unconscious acts, eventually dementia)
-ability to speak
-slowed motion
physical signs of drug use
-appetite/weight change
-slow/staggering walk, uncoordinated
-sleep changes
-red/water eyes, pupils different sizes
-cold, sweaty palms, shaky hands
-puffy face, blushing, pale
-smells like the substance
-runny nose, hacking cough
-needle marks
-nausea, vomit, sweaty
-treamors/shaky
-irregular heart rate
behavioral signs of drug use
-changes in attitude/personality
-change in friends, hobbies
-school/work performance changes
-change in habits at home
-inattention/forgetful
-lack of motivation
-oversensitive, paranoia
-moody, irritable, silly
-excessive need for privacy, secretive
-unexplained theft, need for money
-grooming habits
alcoholism and signs of denial
-seemingly logical rationalizations
-projecting problems onto others
-withdrawal, escape
-only admit it when ready for help (only time something can be done)
drug specific manifestations of physical symptoms: weed
glassy/red eyes, sleepy, loss of motivation
drug specific manifestations of physical symptoms: alcohol
lack of coordination, slurred speech, poor judgement
drug specific manifestations of physical symptoms: depressants
seem drunk, difficulty concentrating, poor judgement, contracted pupils, sleepy
drug specific manifestations of physical symptoms: stimulants
hyperactive, euphoria, irritable, excessive talking followed by depression/excessive sleep, may go long time without sleeping/eating, dry mouth/nose
drug specific manifestations of physical symptoms: inhalents
watery eyes/impaired vision/memory/thought, secretions/rashes around nose/mouth, headaches, nausea, seem drunk, irritable
drug specific manifestations of physical symptoms: hallucinogens
dilated pupils, bizarre/irrational behavior, mood swings, confusion, paranoia, hallucinations
drug specific manifestations of physical symptoms: heroin
needle marks, sleeping at odd times, twitching, dilated pupils unresponsive to light
PTSD DSM5 definition
-personally experienced or witnessed an actual or threatened death, injury or damage to physical integrity
-re-experiencing the event
-avoidance of reminders of events
-hyperarousal symptoms
-negative thoughts/moods/feelings
promising medication for PTSD nightmares
prazosin, primarily used for high blood pressure
acute stress disorder
having some PTSD symptoms after stressful event, usually goes away after a few weeks
psychosocial stress
-result of cognitive appraisal of whats at stake and what can be done about it
-when we look at perceived threat (real or imagined) and discern it may require resources that we don’t have
-threats can lead to stress response in body (cortisol-energy burst; epinephrine-adrenaline)
-prolonged exposure of stress has negative effects on body
fight or flight response
increase heartrate, slow down digestion, divert blood flow to major muscle groups, change automatic nervous function to give body strength
secondary traumatic stress
compassion fatigue, secondary victimization, vicarious trauma
**practice self care
problem solving framework
- problem definition
- problem analysis (spend time to assess situation and what actually needs to be changed, investigate climate of current situation, look at who/what/when/where/why)
- generating possible solutions
- analyze the solutions
- selecting the best solutions
- implementing
- evaluating solutions
mini-mental status exam
way to quantify cognitive function and screen for loss; test orientation, attention, calculation, recall, language and motor skills; score below 20 usually indicates impairment
mini-mental status exam: orientation to time
todays date, month, year, day of week, season
mini-mental status exam: orientation to place
whose house, what room, city, county, state
mini-mental status exam: immediate recall
say 3 words, ask them to repeat: ball, flag, tree
mini-mental status exam: attention
start at 100 count backward by 7 for 5 times, spell world backwards
mini-mental status exam: delayed recall
repeat 3 words; ball, flag, tree
mini-mental status exam: naming
show a watch and a pencil, ask what each of them are
mini-mental status exam: repitition
repeat after me “no ifs, ands, or buts”
mini-mental status exam: 3 stage command
give piece of paper and ask them to take it in hand, fold in half and put it on the floor; they get 1 point for taking it, 1 for folding, and 1 for putting on floor
mini-mental status exam: reading
show card that says to close their eyes, ask them to do what the card says
mini-mental status exam: writing
have them write a sentence
WISC-R
Weschler intelligence scale for kids revised (adolescents)
WAIS
Weschler adult intelligence scale (adults and adolescents)
Stanford-Binet
Intelligence test for kids
Draw a person test
Info about kids self image
MMPI/MMPI2
Predominant personality traits
HTP (house, tree, person)
Draw to get info about self image
Rorschach test and thematic apperception test
Projective tests
Beck depression inventory
Depression self assessment
Strengths perspective
Identify and assess strengths, build on them, avoid stigmatizing language; use strengths to get through stresses
principles of strengths perspective
-everyone has strengths
-things can be difficult and overwhelming but can use as source of challenge and opportunity
-assume upper limits of capacity to grow/change aren’t known yet
-collaboration best way to work with clients
-every environment has resources to use for help
-emphasis on caring/caretaking of group members
