Case Man. Test 2 Flashcards
Inability to conceptualize probs clearly
Conceptual disorganization
when client’s speech/language is pressured, often rapid, constantly talking, possible manic/hypomanic episode
racing thoughts
loss of language abilities
aphasia
normal mood
euthymic
when client has minimal responses, possibly due to depression b/c client is being interviewed in a language other than their native tongue, lack of facility in language
impoverished speech
severe restlessness
akathisia
broad range of moods
normal range of mood
when client makes up entirely new words w/idiosyncratic meanings
neologisms
client appears to have abnormal movements in muscles of face, mouth and tongue, tics due to antipsychotic meds
tardive dyskenesia
client becomes too close in the relationship, touchy
seductive
client’s speech is reserved, suspicious, contributes to the bare minimum
guarded speech
client knows who he is, where he’s at and when it is
client is oriented x3
trouble falling asleep
initial insomnia
client’s belief that one’s thoughts are being taken out of one’s mind by an outside force
thought withdrawal
persistant in repeating verbal/motor response to prior stimulus, gets stuck on something to get their point across
perseverating
client appears rigid of posture, may voluntarily pose in bizarre ways & attempts to reposition client are resisted
catatonic
client believes her thoughts are being taken out of her head and broadcast so that others know what she’s thinking
thought broadcast
client says they feel detached from themselves
depersonalization
inability to remember
amnesia
client pulls her gloves on and off, repeatedly in a ritualistic fashion
stereotyping
ask client to interpret several proverbs to test her
abstract thinking
client blames wife for marital problems and brings them on herself. client’s insight is
derealization
body fxning has become irregualr: sleep, appetite, weight gain/loss, enjoyment of everyday life. client shows strong signs of
neurovegetative signs of depression
the sound of a word seems to trigger your client and a new line of thinking has occured within them
clang association
MSE
mental status exam
MSE includes
- appearance
- behavior
- affect (mood)
- thought process
- insight
- judgment
- intelligence
- reality testing
- SI, HI (suicidal/ homicidal ideation)
- cognitive fxning
this is the basis for understanding client’s presenting problem and beginning to conceptualize their fxning into diagnosis
MSE
making a diagnosis for the MSE is done by
listening/watching client very carefully
test client’s abstract thinking by seeing if they understand
proverbs
example of abstract thinking
don’t put your all your eggs in one basket
when documenting, what do you need to do if you didn’t finish writing and there’s an empty space left on the line of the page?
draw a line and initial at the end
while documenting in the contact log, what should you NEVER do?
skip lines
3 types of recordings when documenting
- process
- summary
- staff notes
the most notes one takes is in the ____ recordings
process
the least notes one takes is in the ___
staff notes
when documenting impressions of the client, how should you write it?
“it appeared that the client was…”
“client appeared to be…”
Dx means
diagnosis
never have loose papers/sidenotes of interview with client
true
if there are separate notes about client, keep it in the client’s folder
true
SOLER stands for
- Sitting squarely
- Open
- Leaning in engaged posture
- Eye contact
- Relax
In order to follow the strength approach, what should you have client fill out in the intake process?
ecological model
6 steps for intake of client
- introduction of self/agency
- explain what services are available to client
- explain confidentiality, being mandated reporter, exceptions/limitations of remaining confidential
- engage client, develop rapport
- PP (presenting problem)
- SOLER
informed consent should be stated in the beginning of relationship with client
true
are you able to accept gifts from clients?
no
if a client asks you to attend a bday party, what do you do?
if you do it for one, you do it for all
establishing rapport with a client needs 2 things
- positivity
- being supportive
feeling sorry for ppl and believe they’re poor souls and their situations are w/o hope, what we often have for our friends/relations
sympathy
capacity to feel what the client feels and grasp the significance and impact the client is experiencing, comprehending client’s point of view and see clearly what they need/feel
empathy
when a client has a collection of feelings/attitudes about you, positive/negative
trasnference
when you project onto the client with certain emotions/attitudes, client may remind you of your past or situations you’ve had
countertransference
putting yourself in client’s situation
empathy
being gentle, friendly, receptive, approachable and nonjudgmental to client
warmth
listening to what client is saying w/o judgment
active listening
being present, in the moment
mindfulness
being yourself w/client
genuineness
understanding strengths/limitations of the person/family
realistic expectations
let client be who they are and start there
being where the client is
point out clients strengths
focus of strengths
understand it’s normal for clients to resist help at any given tiem
access client’s resistance
work w/client together as a team
collaborations
let client know you appreciate their efforts if they don’t succeed/succeed when they try something new
appreciation
always point out/encourage client to see their potential, show them you have confidence in them
focus of potential
things you shouldn’t do/tell client
- tell them what YOU think they should do
- pressure them when they’re not ready
- use guilt statements
- shame client by comparing them to others
- don’t make assumptions
client’s reaction/attitudes towards you b/c you remind them of someone in their life
transference
this gives client responsibility for solving the prob, provides ways to help with the prob, and gives client opportunity to grow
ownership
when you do a recall/memory test of client, you can test them by making an app. and ask them when that app. was made at end of session
true
if it’s not documented, it didn’t happen
true
someone other than the client, such as mother, nurse, minister
collateral contact
summary recording is done after the client leaves
true
gives a concise presentation of the content of the interview, focus remains on client
summary recording
narrative telling of an interaction with another individual, accurate account of verbal exchange and interviewer’s analysis of observations
process recording
aka case notes, written at the time of contact with client in chronological order
staff notes
staff notes are important b/c
- confirmed services
- connecting service to client’s needs
- recording client’s response
- describing client’s status
- providing direction for ongoing treatment
communication skills include
- comfort
- verbal/nonverbal
- active listening
- presenting vs. underlying prob
culture, religion, ethnicity, gender and lifestyle is a pattern of
communication
assessement/interviewing skills include
- listening
- responding
- questioning
- roadblocks
- confronting
- disarming anger
3 types of feedback when doing active listening
- factual
- emotional
- solution-focused
saying what you mean clearly/respectfully has 3 parts
- what happened
- what you feel
- what you want
ability to hear accurately the underlying feelings/emotions client is expressing
empathy
roadblocks include
- threats
- commands
- shaming/praising
- premature prob solving
- rushing to fill silence
- over reliance on closed questions
- judging
sex, apparent age, ethnicity, weight (average, stocky, petite, healthy), physical dyformities
presenting appearence
dress, is it weather appropriate? notice accessories (glasses, cane)
basic grooming/hygiene
posture, mannerisms, gestures, motor coordination
gait/motor skills
is client oppositional, resistant, submissive, defensive, open, friendly?
interpersonal characteristics
is the client distant, unconcerned, evasive, negative, irritable, depressed, lethargic?
behavioral approach
how can you read client’s thought process?
- flight of ideas
- illogical thinking
- grandiosity
- obsessions
- perseveration
- delusions
based on explanations of what they did, what happened, expected outcome
judgment/insight
