Chapter 16: Assessment Flashcards
aims of a recovery-focused assessment include:
- to promote and validate the development or personal meaning
- to amplify strengths rather than deficits
- to foster personal responsibility rather than passive compliance
- to support the development of a positive identity rather than an illness identity
- to develop hopefulness rather than hopelessness
exploring the importance of personal meaning in the recovery process, the focus is on…
avoiding the imposition of meaning on individuals fulfilling the role of a mental patient
Baumeisters conceptual framework: four needs for meaning
purpose
value
efficacy
self-worth
purpose: definition and implication
present events draw meaning from their connection with future events.
listen for personal meaning and meaning-making approaches in accounts of past and current events
two types of purpose
- goals (an objective outcome: getting a job, a child)
- fulfillments (a subjective anticipated state of future fulfilment -> being in love, going to heaven)
wat zijn de implications van goals & fulfillments
goals = identify personal goals, provide goal-setting and goal-striving support, facilitate access to mainstream opportunities (employment, education, leisure, social)
fulfullment = encourage optimism and hopefullness
hoe kan je optimism and hopefullness supporten
- where would you like to be in 5 years?
- how can i support you to work towards that dream?
values =
lends a sense of goodness or positivity to life, can justify certain courses of action
values implication
support spiritual development by facilitating access to groups etc.
efficacy=
a belief one can make a difference
efficacy implication=
identify and amplify times of wellbeing, when person showed mastery and coped with unanticipated difficulties.
plan ahead
identify personal and social resources
support the development of crisis plans
self-worth=
reasons for believing one is a good, worthy person
self-worth implications
actively encourage the person to take on giving back roles (voluntary, writing, becoming a mentor). foster affiliation with high status groups
cultural competence =
a means to facilitate individualized approaches, fostering recovery
3 approaches to understanding experiences of psychosis:
- finding specific and concrete meanings
- understanding metaphoric or thematic associations
- understanding the purpose and significane of a persons elaboration of their psychosis
3 levels of understanding
- understanding the meaning of madness
- understanding the meaning in madness
- understanding the meaning through madness
Lazarus cognitive appraisal model defines coping as…
constantly changing cognitive and behavioural efforts to manage demands.
coping strategies: problem-focused, emotion-focused, meaning-focused.
coping responses are further classified into avoidance (deny or seek escape) versus approach strategies (actively confront)
clinical assessment should focus on 4 dimensions:
- deficiencies and undermining characteristics of the person
- strenghts and assets of the person
- lacks and destructive factors in the environment
- resource and opportunities in the environment
emotional avoidance: coping response, thoughts, feelings, behaviours, consequences/problems
- emotionally withdrawal from a too painful reality
- there is no problem
- drained, dead inside, wrung out, heavy, anxious, depressed
- drugs, alcohol, social isolation, day-dreaming, excessive sleep, giving up
- disengaged, amotivational, affective blunting, passivity, lacking insight
reframing: coping response, thoughts, feelings, behaviours
- try to make sense of a situation in a way that fits with current beliefs
- i can make sense of whats happened without changing myself
- suspicious, anxious, afraid, alone, uncertain, angry
- odd behaviour, increased religious activity
- paranoid, delusional, reasoning bias, lacking insight
active engagement: coping response, thoughts, feelings, behaviours
- try to change the world to fit with beliefs
- i can change the situation without changing myself
- engaged, angry
- challenging
- non compliant, manipulative
integration: coping response, thoughts, feelings, behaviours
- change beliefs, values, and goals to better fit reality
- this is how things are: what now?
- acceptance, combined happiness & sadness
- ventilation of feelings, use of social support
the tendency to emphasize deficits is reinforced by…
- the structured approach of clinicians, who often overlook individuals coping abilities and positive aspects.
- the lack of a shared language for dimensions beyond deficits contributes to this imbalance
- the expectation that indiviudals are to be treated: individual and problem centered focus.
- questions clinicians ask structure the dialogue: perpetuating a deficits focused discourse
Mental Health Assessment onderdelen
- current strengths and resources
- learning from the past
- personal goals
- past coping history
- inherited resources
- family environment
- developmental history
- valued social roles
- social support
- personal gifts (forensic history, drugs and alcohol)
- personal recovery (premorbid personality)
twee soorten cycles, een is recovery en een niet
- problem focused cycle
- appreciative listening cycles
appreciative listening cycle=
listening together for passions, interests, dreams - a small/big life goal -> discover opportunities -> access resources -> face challenges -> listening…
= Discover, Dream, Design, Destiny
more consumer-led, acknowledges that these individuals hold valuable insights about their own life. it shifts responsibility to the individual, and views setbacks as opportunities for growth
welke assessment kun je nog meer gebruiken in personal recovery voor aandacht naar strenghts
the character strenghts assessment
wat is een bekend proces tijdens personal recovery
identity transformation
welke twee processen gaan ten werking tijdens identity tranformation
- redefinition (redefining existing elements)
- growth (developing new aspects)
direct meaning of mental illness: redefinition
- my mental illness means i cannot function some of the time, rather than all the time
- i have more control than anyone else over my mental illness
direct meaning of mental illness: growth
- my mental illness has led me to understand myself in new ways
- other people have been like me and recovered
indirect meaning; redefinition
- my mental illness has happened because of my childhood
- my mental illnes means i am in touch with my creativity
indirect meaning: growth
- i am more compassionate to others now
- my mental illness has given me a job, teaching about mental health issues
organizing model of hope (russinova): omschrijving
Key values, attitutes and behaviours that foster hope including: trusting the authenticity of the person, valuing the clients interpretations, maintaining cognitive flexibility.
values: using interpersonal resources
- valuing the person as a unique human being
- trust in their authenticity
values: activating internal resources
- failure is a positive sing of engagement and contributes to self-knowledge
- to be human is to have limitations - the challenge is to exceed or accept them
attitudes: using intepersonal resources
- believing the persons potential and strength
- accept the person for who they are
- view set backs and relapse as a part of therapy
attituted: activating internal resources
- losses need to be grieved for
- the person needs to find meaning in mental illness & life
attitutes: accessing external resources
- housing, employment, education are key external resources
- employ recovered consumers in services as role models
behaviours: using interpersonal resources
- listen non judgementally
- tolerate the uncertainty about the persons future
- show genuine concern for their wellbeing
- use humour appropriately
behaviours: activating internal resources
- support the person to reach goals
- support better coping strategies
- help recall previous achievements and positive experiences
- support spirituality
behaviours: accessing internal resources
- help contact with peer role models and self help groups
- be available in crisis
- support access to treatment and info
- support relationships
messages to communicate through assessment voorbeelden
- some ppl with similar experiences find it helpful to…
- whatever sense you make of it, you wil over time increasingly fit this experience in the bigger picture
