Assessment and Intervention Planning Flashcards
Biopsychosocial assessment
Bio - medical and physical health, developmental history, medication history, substance use history, family illness history
Pscyho - present psychiatric illness or sumptoms
Social - client systems and client context within those systems
Organic brain syndrome
physical disorders that impair mental function
Alcoholism, Alzheimer’s, Fetal Alcohol Spectrum Disorders, Parkinson’s and stroke
Traumatization
Results in neurological distress that does not go away/client is unable to return to equilibrium; can lead to mental, social, emotional and physical disability
Antipsychotics
Used for treatment of Schizophrenia and mania
Typical - Haldol, Thorazine
Atypical- Risperdal, Seroquel
**Tardive dyskinesia - abnormal, involuntary movements of the tongue, lips, jaw, and face as well as twitching
Mood stabilizers - antimanic agents
Treat BP disorders
Lithium
**Thyroid and kidney functions must be regularly checked
Antidepressants
Used to treat depressions
SSRIs - Lexapro, Paxil, Prozac, Zoloft
Tricyclics - Anafranil, Elavil
Monoamine Oxidase Inhibitors - Nardil, Parnate
**Dietary restrictions - limit foods that have high levels of tyramine (cheese, beer, wine, smoked fish)
Anti-anxiety drugs
Used to treat Anxiety Disorders
Benzodiazepines - primarily use is for anxiety, but they can treat several other conditions - Ativan, Klonopin, Valium, Xanax
Stimulants
Used to treat ADHD
Adderall, Concerta, Ritalin
Collateral sources
Family, friends, other agencies, doctors, etc
Used when the credibility and validity of information obtained from a client or others is questionable
Beck Depression Inquiry
21-item test, assesses presence and degree of depression in teens and adults
Minnesota Multiphasic Personality Inventory - MMPI
Objective verbal inventory designed as a personality test for the assessment of psychopathology consisting of 500 statements
Myers-Briggs Type Indicator - MBTI
Forced-choice, self-report inventory that attempts to classify individuals across 4 dimensions
- General attitude - Extravert vs. intravert
- Perception - Sensation vs. intuition
- Processing - Thinking vs. feeling
- Judging vs. perceiving
Stanford-Binet Intelligence Scale
Designed to test cognitive abilities for children and adults
Thematic Apperception Test - TAT
Widely used projective test; consists of series of pictures of ambiguous scenes and clients are asked to tell stories about the pictures
Inkblot test
Projective test
Wechsler Intelligence Scale - WISC
Measures child’s intellectual and cognitive ability
Risk assessment
Frequency and duration of violent thoughts
Access of methods
Ability to control violent or suicidal thoughts
Factors making the client feel better or worse
Deterrents
Use of drugs and alcohol
Suicide risks
Previous attempts, living alone, presence of psychiatric disorders, substance use, history of suicide in family, exposure to suicidal behavior, losses, presence of firearm or easy access to other lethal methods
Suicide protective factors
Clinical care for disorders, access to clinical support and interventions, family and community support, learned cooing skills, cultural and religious beliefs that discourage suicide
Violence risk factors
Onset before the age of 13, child behavior disorders, associations with guns and drugs, involvement in delinquent peer groups
Violence protective factors
Programs that focus on individual and environment, clinical care, access to interventions and support, family and community support, restricted access, learned coping skills
Readiness to change
- Precontemplation
- Contemplation
- Preparation
- Action
- Maintenance
Ego strengths
The ability of the ego to effectively deal with the demands of the id, the superego, and the reality
Basis for resilience
Tolerance of pain associated with loss, disappointment, shame and guilt; forgiveness; persistence and perseverance; openness, flexibility and creativity in learning to adapt
DSM 5 Changes
Published in 2013
- deleted the section Disorders Usually 1st Diagnosed in Infancy, Childhood and Adolescence
- NOS replaced with Other Specified (explains why the criteria for a specific disorder is not met) and Unspecified (no explanation left)
- got rid of the multi-axial system of diagnosis
- WHODAS added
- Substance abuse and dependence combined into 1 category
- Greater cultural sensitivity
Schizoid PD
Introverted, withdrawn, solitary, emotionally cold, distant
Schizotypal
Peculiar, odd or eccentric manners; magical thinking; some paranoia
Crisis
disruption of psychological homeostasis in which usual coping mechanisms fail
Crisis Planning and Assessment
- Conduct a biopsychosocial assessment, assessing for imminent danger
- Make contract and rapidly establish a working relationship
- Identify major problems, including the crisis precipitants
- Encourage to explore feeling and emotions
- Explore alternatives and new coping strategies
- Restore functioning through an action plan
- Plan a follow-up
SOAP format
S - subjective - client’s report on how they are doing
O-objevtive - health data, documentation, hard evidence
A-assessment - using subjective and objective findings to form an assessment
P-plan - what will be done next
Types of research
- Experimental - control and experimental groups present
- Quasi-experimental - experimental group present but there is no random assignment
- Pre-experimental - no control group present
Single subject research
Aims to determine whether an intervention has the intended impact on a client or group of clients
Ex: pre and post test, single study
single case study - AB
reversal - ABA
multiple baseline - ABAB
Ideal for showing cause and effect and for studying behavioral change
Internal validity
Extent to which causal inferences can be made about the treatment and the targeted behavior, did a cause b?
External validity
How generalizable are the findings to a general population
Interrater reliability
Would different raters give consistent estimates of the same phenomenon
Test-retest reliability
Subjects can take the test more than once and have a consistent score
Internal consistency reliabillity
Assesses consistency of results across items within a test
Parallel forms reliability
Assesses consistency of the results of 2 tests constructed in the same way and from the same content domain
Reliability
Consistency, reducing random errors
Validity
Degree to which the test measures what it’s actually supposed to measure, aims to minimize systemic errors
Face validity
Does the assessment actually measure the constructs
Content validity
Are all of the relevant content domains covered
Criterion related validity
Predictive, concurrent, convergent, and discriminant
Involving clients/client systems in intervention planning
- Engagement
- Assessment
- Planning
- Intervention - should be revisited and reviewed
- Evaluation
- Termination
Reasons for d/c and termination
- client met goals, no longer needs services
- client decides not to continue
- client requires different care
- sw leaves the agency and client must transition to work with someone else
**Code of ethics: terminate when services are no longer needed/services are no longer serving the needs of the client; termination has to be planned and sw should assist in making appropriate arrangements for service continuation when necessary (sw should make reasonable arrangements to ensure continuity of services if sw is terminating due to personal reasons), clients must be notified promptly
**It is unethical to continue treatment if services are NO longer needed
$ and services
You can terminate if a client is not paying for the services if the financial contract has been made clear to the client AND if the client does not pose an imminent threat to themselves and others AND if clinical and other consequences of nonpayment have been clearly discussed
Social relationships and services
NOT allowed = social, financial, sexual
High risk clients and termination
Continue receiving regular assessments after discharge to determine whether services are needed or if d/c plans should be put forward as planned
