Paperwork and the Needs of Clients Flashcards
Purpose of setting goals, objectives and plans..
-Organizations require it
progress toward goals is associated with improvement in well being
Goals
Broad stated changes the client would like to accomplish
; only can begin to set once client has accepted ownership of the difficulty/issue
Structure of acceptable goals:
- Behavioral rather than an end product
- meaninful to the client
- Continuous rather than categorical (any progress counts)
- Improve, increase, more, and better - Focus on what to improve rather than want to avoid
Importance of: Behavioral Goals
We can change behavior, we cannot change things out of our control. Ex. Increase GPA - Bad Goal
Improve study habits - Good Goal
Importance of: Goals being meaningful to the client
Empirical research demonstrates that individuals put more persistent effort into targets that are personally meaningful than those where change is motivated by external pressures or guilt
Structure of acceptable goals:
- Behavioral rather than an end product
- meaninful to the client
- Continuous rather than categorical
- Focus on what to improve rather than want to avoid
Importance of: Goals being meaningful to the client
Empirical research demonstrates that individuals put more persistent effort into targets that are personally meaningful than those where change is motivated by external pressures or guilt
Importance of: Continous rather than Categorical Goals
Categorical goals means it is either a success or a failure. NO ONE WANTS TO BE A FAILURE. Continous goals imply that any progress is a success. (better, more, increase, improve)
Imporance of: Improving rather than Avoiding
Research suggests those with avoidance goals make less progress and actually a decrease in physical and psychological health
Objectives
Subcomponents of a goal; changes that may increase the probability of accomplishing the goal
Goals v. Objectives
Can easily get confused. Sometimes goals are actually objectives and vice versa. OBJECTIVES are mini-goals/ aspects that are blocking one from achieving GOAL “what has kept you from achieving (the goal)”
Plans
Concrete actions the client (and worker) will take in order to reach objectives and eventually goals.
Structure of plans
Physical, immediate actions. “Jane will go to bed at 10 pm every night” in order to improve sleep habits (objective) to eventually improve motivation and productivity at work (goal)
Goals - Objectives - Plans Record
All of this nifty info will go into one of these. Be prepared to create one for essay question
DO NOT FORGET PROBLEM STATEMENT.
Goal Attainment Scaling
Five Levels of Attainment: expected outcome; somewhat more than expected; much more than expected; somewhat less than expected; and much less than expected
Factors affecting function of GAS
- future reports of clients bheavior
- accuracy of the staff member in defining levels –> requires mucho training which is why we did not learn how to do this. You read that. YOU DID NOT LEARN TO DO THIS
Observation Scaling
YOU DID LEARN HOW TO DO THIS. KNOW HOW TO DO THIS.
This is defined by the client’s self-observations whereasd GAS is defined by workers predictions. Client and worker both develop this.
How to create an observation scale
4 Levels: further from target, no change, normal level of success, and improved level of coping. Attainment Level: target behavior being considered. No change is where client is currently. figure 6.2 - Noah’s scaling
How to create an observation scale
4 Levels: further from target, no change, normal level of success, and improved level of coping. Attainment Level: target behavior being considered. No change is where client is currently. figure 6.2 - Noah’s scaling
Channels of Information
Smell, touch, sight, and sound
Channels of Information
Smell, touch, sight, and sound
Channel of smell
typically not too significiant, yet can be. emitting smells of alcohol, etc
Channel of touch
Meaning of a touch can easily be misunderstood; erotic contact always involves this. Workers should not touch adults; yet if a child touches you, it can be reciprocated in the best interests of the child
Channel of sight
Eye contact should always be less than 100; generally around 70-90 percent of the time
Channel of sound
This is very important; primary source of information during an interaction
Common expressions of Anxiety
faster speech and less silence; repeating phrases; frequent changes in train of thought and not completing sentences; shifting voice volume; stuttering; more gesturing; increased sweating and flushing; frequent shifting of seating position; rapid repetitive behaviors
Common expressions of anger
fast and loud speech; short durations with brief pauses; frowining; tensed lips; chin and head thurst forward; wide eyes
Common expressions of grief, sadness, and depression
slow speech; frequent pauses; sighing crying
Common expressions of control
increase in speed or volume f speech when the worker tries to talk; increase in speed or decrease in volume of sepech when discussing embarrasing topics; when the worker is speaking, the individual purposefully appears disinterested or disdainful (such as eye rolling, looking away, turning away or demonstrative sighing)
Common expression of coldness and distance
not smiling; little or no eye contact; removing corrective galsses or wearing sunglasses; closed posture
Common expression of warmth openness
smiling; making eye contact; removing sunglasses; open posture (leaning forward, uncrossed legs, and arms not folded)
Common interest and attention
timely ‘mhmmms’, appropriate head nods
Factors to consider prior to an appointment
scheduling the ineraction worker preparation arrangement of the physical setting initial client expectations potential client fears
Factors to consider prior to an appointment
scheduling the ineraction worker preparation arrangement of the physical setting initial client expectations potential client fears
Failure to appropriately schedule appointments
- Clients may not show up
- you or your client may be late
- if the meetings do take place, participants may become distracted during the interaction
Ways to increase client promptness & arrival
agency approved appointment policies
Ways to increase worker promptness and arrival
Realistically looking at responsibilities and scheduling clients at times you actually will be available to see them
Common ways to prepare for an interaction
Read the written report from the previous meeting; reviewing previously established goals, objectives, and plans, data from other professionals or organizations, assessment information and professional literature regarding topics that are relevant to the case
Interview formats
Clients name, session number, and the date, the clients birthday (if first session), words or brief phrases to indicate topics to be covered during the session
Functions of interview formats
- it serves as a plan for structuring the interaction thereby enhancing your confidence as you begin the session
- provides a method of organizaing what you write during the meeting so that you can enter notes next to the topics to which they relate
Arrangement of the Physical Setting
Auditory and visual distractions should be eliminated or reduced to their minimum, room should be free of objects that could be used as weapons
Factors that may affect client expectations
Whether the client sought out assistance for the first time or if they have struggled with prior professionals; how the person came to contact; and the nature of the individual’s previous interactions with the organization
Potential client fears
Fears of inadequacy, rejection and confidentiality
Best ways to combat potential client fears
Communicating empathy, warmth and genuineness and ensuring they are aware of confidentiality protocal. BUT between confidentiality and perserving life, the choice is to always perserve life.
Best ways to combat potential client fears
Communicating empathy, warmth and genuineness and ensuring they are aware of confidentiality protocal. BUT between confidentiality and perserving life, the choice is to always perserve life.
Establishing the tone for new clients
call adults by their last name with appropriate prefix yet complying with a preference to a different name, introducing yourself professionally and introducing them to the setting. Begin with light conversation “how was finding the building?” etc
Supportive helping addresses (2)
- the circumstances described by individuals
- the emotional reactions of clients to those situations
A supportive helper must… (in reference to range and depth of conversations)
Go for the depth, but also know what is too far and what may hinder future progress
For interactions in which wide coverage is the intent..
rely on facual reflections and on reflection interrogattion techniques that end with broad open questions
For interactions in which specific coverage is the intent..
use feeling reflections and request for specific examples
If the client asks YOU questions
Do not state “this isn’t about me” or something of that nature; provide a brief answer but immediately return the focus to the individual`
SOAP Progress Note
S- Subjective
O- Objective
A - Assessment
P - Plan
Subjective portion of SOAP note
the story told to the worker by the client and others. accounts of the past, present and expectations and goals
Objective - SOAP note
factual information; concise account of what happened during the meeting
Objective - SOAP note
factual information; concise account of what happened during the meeting
Assessment - SOAP note
your assessment of how the client is doing. Subjective information but YOUR opinion. refer to goals and objectives. Pretty much the progress in the progress note
Plans - SOAP note
immediate plans. DO NOT restateplans from goals objectives. plans pretty much in the time frames of thise session and the next
Issues with dealing with children
- children are commonly referred to you by others rather than referring themselves
- cognitive and emotional development that takes place during childhood
Areas in dealing with children that require special attention (referral related issues)
- establishing yourself as a caring adult who is not taking sides against the child
- clarifying the purpose of the interaction
- and being straightforward about confidentiality issues
Establishing yourself as a caring, neutral adult (for children)
Use of positive statements, leaving the door open and allowing the child to close it when they feel comfortable, engaging in small talk, etc
Clarifying the interactions purpose (for children)
We may report to the child observations that have been made about them, but we do not agree or disagree with them. remain impartial. Ensure the child knows if the session will be the first or the last
Providing structure issues
gathering information and fostering appropriate behavior
Gathering information from children
Request specific descriptions, be aware of leading questions since those difficulties are magnified with children, ensure that the child is telling real stories, not imaginative ones
Fostering appropriate behavior
Children have energy - let them walk around but do not let them get distracted. Appropriately discuss rules and limits if the acceptable behavior threshold is crossed. Be honest about the consequecnces of negative behavior
Fostering appropriate behavior
Children have energy - let them walk around but do not let them get distracted. Appropriately discuss rules and limits if the acceptable behavior threshold is crossed. Be honest about the consequecnces of negative behavior
Socioeconomic class differences
Middle-class: prefer delayed gratifications. Long term goals and objectives are beneficial
Lower-class: immediate gratification. Living in the moment type of goals
Suggestions on changing techniques to most benefit lower class clients
Demonstrate respect
Mantain a professional demeanor
Provide direction as needed
Suggestions of smoothing interactions with individuals in a psychotic state
Use an even calm voice
Discuss concrete realities on which you both can agree
be willing to provide struction and guidance but AVOID confrontation
Do not get caught up in “flights of fancy” if you do not understand, get clarification
Miller and Rollnick
They coined Motivational Interviewing - empirically supported technique to treat long-term maladaptive behaviors (such as addiction)
Motivational Interviewing Components: Avoiding Arguments
We actually listen to ourselves more when we argue with someone, thus this may solidify a client’s argument to themselves. BACK DOWN.
Motivational Interviewing Components: Expressing Empathy
We argue b/c we are not being understood. if you want someone to listen to you, listen first. Be careful - empathizing too much and may enablethe client to continue behavior. Validate EXPERIENCE not the BEHAVIOR
Motivational Interview: Highlighting Differences
the difference between the persons behavior and where the would like it to be
- concern/ dissatisfactions
- consequences/ recognition of problem
Motitvational Interviewing: Final Components
Rolling with resistence
Supporting self-efficacy
Motitvational Interviewing: Final Components
Rolling with. resistence
Supporting self-efficacy
Prochaska and DiClemente
Theorized Stages of Change
Stages of Change
- Precontemplation
- Contemplation
- Prepartion (less research)
- Action
- Maintence
- Termination
