Chapter 12 Flashcards
Describe an initial assessment
->psychological process based on info gathering with in a professional relationship oriented towards minimal biased portrayal of functioning
*->Purpose of assessment: screening, diagnosis, treatment planning, goal identification, and progress evaluation (just getting to know clients better)
What are the different approaches to getting to know clients better?
- person-problem-context approach
- biopsychosocial/spiritual model
Describe the person-problem-context approach
Understanding:
->Who the individual is: worldview, beliefs, values, behaviors,
self-esteem, self-efficacy, personal strengths, previous
coping abilities
->The external circumstances of the problem: presenting
source, onset, duration, level of stress
->The social, cultural, emotional, economic, physical, and
spiritual context in which individual’s live
Describe the biopsychosocial/spiritual model
BIO:
->Developmental
->Illness
->Disability
->Genetics
->what was pregnancy like? Birth? Were there any complications? Anything run in the family?
PSYCHOLOGICAL:
->Behavior (aggressive, violence, substance use)
->Personality
->Self-esteem
->Coping
->past therapies
SOCIAL:
->Family
->Peers
->School
->Community
->is your family supportive? divorced? death?
->ever been bullied? antisocial? popular?
->connected to community? sports or church?
SPIRITUAL:
->Faith practices
->Religion
What is integrated assessment?
->assessment isn’t a stand alone event, it’s integrated
->Assessment through acute observation (non-verbal’s, eye gaze posture), active listening,
remembering subjective nature of observation and
comprehension
->Assessment totally integrated into the counselling process
through the choice of interventions and evaluation of those
interventions
Describe cultural formulation in understanding and assessing clients
->Cultural identity of individual
->Cultural explanation of individual’s illness
->Cultural factors related to psychosocial environment and levels of
functioning
->Cultural elements of the relationship between the individual and
clinician
->Overall cultural assessment for diagnosis
Describe suicide risk assessment
->need to normalize suicide ideation (thoughts of dying) and open discussion about it
—>by asking and discussing it we aren’t going to push someone to do it
->suicide screening:
—>in public domain so everyone has access to it
—>issue with screening is false positives (ex pregnancy tests)
How can we manage acute risk?
Stabilization:
->Safety planning
—>helping people learn what their warning signs are (ex feeling irritable, can’t concentrate, sleeping more etc)
—>what do you do to cope with stress (ex weed, walk, veg out, friends etc)
—>who are your supports?
—>needs to be client lead
->Lethal means safety
->Crisis hotlines/text lines
->Don’t do contracting with clients (do safety planning instead)
—>makes client sign a contract promising to not kill themselves
—>do this so no liabilities (this doesn’t cover your butt)
—>no evidence it works
->if a client commits it can fall back on you-it’s about relationships, trust your clients
->if reporting, don’t pull trigger too soon or it’ll break trust
What increases someone’s risk to commit suicide?
1.if they have a plan/date and if they have the means to carry it out (gun on house, pills etc)
2.substance use
3.significant life event (fired, breakup etc)
4.family history of suicide
->lethal means safety
—>people rarely switch their plans
—>can/would you let your friend hold onto that?
What constitutes as immediate risk?
->if they will attempt within 24hrs
->if they say it’s next week you have to take it day by day and make the call in those 24hrs if it comes to that
->what are clients ambivalences/what keeps them alive?
Suicide doesn’t mean…
…suicide, it can mean coping
->take all knives out of house-copying taken away = desperate which heightens and leads to suicide
->suicide ideation isn’t a risk factor (feel powerful as they have a choice)
Describe Psychological Testing
->May be used to help
clarify a diagnosis
->Assess the credibility of
reported symptoms
->Quantify the nature and
severity of cognitive
impairments
->do scores on tests similar to what they’re telling you
->some people may need life long assistance
Describe Diagnosis
->if done correctly:
—>Describe a person’s current functioning
—->not a life sentence (people can recover)
->people can be over or under diagnosed
->Provide a common language for clinicians to use when
discussing a client
->Lead to consistent and continual care
->Help direct and focus treatment planning
Describe Case Formulation
->info on clients helps case conceptualization (what to do with a client)
STAGE 1:
->Identification
or clarification
of the problem
STAGE 2:
->Understanding or
interpretation of
the problem
STAGE 3:
->Treatment formulation
Describe stage 1 in case formulation
->what is the problem?
->Determine the nature of the client’s problem
->What is the primary presenting concern
->Differential diagnoses
->Risk and protective factors
->Developmental considerations
