Counselling, Crisis, Difficult pt + Disability Flashcards
Factors to consider when counselling pts
Set clear therapeutic goals
allow adequate time for assessment, identify context and pt’s understanding of problem, evaluate own skills, recognise when your beliefs may interfere with counselling
remain aware of risks of offering advice vs providing options
pay close attention to quality of therapeutic relationship
Recognise transference/ counter-transference
What are the aspects of counselling to educate pt on
Expectations
Timing
Frequency
Costs
Duration
Homework
Approach to pt in crisis
Acknowledge feelings + help de-escalate
Identify pt’s personal supports
Offer appropriate community resources
Assess suicidality
How to manage difficult pt
Seek out info about pt’s life circumstances, context + functional status
Remain vigilant for new sx
Identify own attitude and contribution to situation
set clear boundaries
What dz to look for in difficult pts
PDs
When to end therapeutic relationship
take steps to end physician-patient relationship when it is in pt’s best interests to
What to screen for in elderly for disability risks
falls, cognitive impairment, immobilization, decreased vision
What are the spheres of function?
emotional, physical, social
,approach to disability
orthotics, lifestyle mods, time off work, community support
When to think about driving safety
after bad news, any new meds, flying, operating heavy machinery, cancer dx, cast/mobility, eye dz
What strategies can you use for difficult pts?
Limit appointment duration + frequency, avoid polypharmacy w/ benzos, opioids, drugs of abuse, Z drugs, quetiapine, think about countertransference, consider terminating relationship, speak to CPSBC
Dx criteria for schizotypal disorder
impairments in self functioning, self direction, interpersonal function, eccentricism, cognitive dysregulation, unusual beliefs, withdrawal
What to cover in appt w/ disabled person
support and education for family, ensure FU, community engagement, monitoring for AE, monitoring for abuse
What are the criteria for disability tax benefit?
Blindness, 1+ ADLs severely impaired, 2+ ADLs significantly impaired, needs life-sustaining therapy - must be ongoing x1yr
What are the requirements for canada pension plan disability?
Mental or physical disability, prolonged and prevents any work