Psychopathology MIDTERM Summer 2020 Flashcards
T/F: Counselors should never develop a safety plan with a client exhibiting suicidal ideation.
False
Involuntary or intentional passage of fecal matter into inappropriate places, such as clothing or onto floors, is:
Encopresis
At least once per month for three months
Age 4 or older
With/Without constipation and overflow incontinence
Name the disorder: Recurrent episodes of binge eating, with recurrent inappropriate compensatory behaviors in order to prevent weight gain, at least once a week for 3 months
Bulimia Nervosa
The neurotransmitter responsible for wakefulness and alertness is (it impacts the limbic (emotion) system and frontal lobes (cognition):
Norepinephrine
Medication(s) recommended for Eating Disorders include:
Anorexia Nervosa (In maintenance phase):
- TCAs
- Fluoxetine (Prozac)
- Atypical Antipsychotics (for delusional beliefs)
Bulimia Nervosa
- Fluoxetine (Prozac)
- Ondansetron (Zofran) and topiramate (Topamax)
Binge Eating Disorders
- Lisdexafetamine (Vyvanse) [Others are not yet confirmed]
A disorder that includes preoccupation with having or acquiring a serious illness
Illness Anxiety Disorder
What are some treatment constraints within the managed care system?
Accrediting bodies and state-level governing bodies and agencies
Agency Settings and Available Services
Diagnosis and Reimbursement
Payer Source, Session Number, and Service Restraints
Treatment Teams - MDs, psychiatrists, social workers, and behavioral specialists that have different convictions about what the client needs
A mnemonic for both Suicidal and Homicidal Ideation assessment is:
SIMPLE STEPS
S = Suicidal I = Ideation M = Method P = Perturbation L= Loss E = Earlier Attempts S = Substance Use T = (Lack of) Troubleshooting Skills E = Emotions / Diagnosis P = (Lack of) Protective Factors S = Stressors and Life Events
Disorders within Obsessive-Compulsive and Related Disorders include:
Obsessive-compulsive Disorder
Body dysmorphic Disorder
Hoarding Disorder
Trichotillomania Disorder
Excoriation Disorder
Substance/medication-induced Obsessive-compulsive and related Disorder
Obsessive-compulsive and related Disorder d/t another medical condition
Other Specified OCRD
Unspecified OCRD
An example of a TCA drug is:
Norpramin
Elavil
Anafranil
Tofranil
The group of disorders typically diagnosed during infancy or early childhood is:
a) Feeding Disorders
b) Eating Disorders
c) Both Feeding and Eating Disorders
d) None of the above
a) Feeding Disorders
Treatment strategies for dissociative disorders include:
Accurate assessment of disorder (various scales)
Dissociative Identity Disorder:
Phase-oriented approach
Dissociative Amnesia and Depersonalization/Derealization:
Sequential treatment: Symptom regulation and narrative therapy
Dissociative Amnesia:
Mindfulness-based therapy (MBT)
Depersonalization/Derealization:
Eye Closure, Eye Movements (ECEM)
The neurotransmitter that hyperpolarizes cells to restrict signal transmission is:
Glycine
A disorder including one or more symptoms of altered voluntary motor or sensory function
Conversion Disorder
Some contraindications for SSRI antidepressants are:
NSAIDs
Antiplatelets
Schizophrenia and psychosis drugs
Lithium
bipolar disorder and in a manic phase, although they can be useful for depressive phases
a bleeding disorder, such as hemophilia
type 1 diabetes or type 2 diabetes
epilepsy unless well-controlled
narrow angle glaucoma
serious kidney, liver or heart problems
The neurotransmitter that increases neurotransmission by lowering the threshold for neural excitation is:
Glutamate
T/F: Fluoxetine (Prozac) can be used to treat Anorexia Nervosa during a client’s weight-restored/maintenance phase.
True
A drug that decreases the availability or action of a neurotransmitter is:
Antagonist
Some treatment strategies for somatic symptom and related disorders include:
Brief Psychodynamic Therapy
CBT and Affective-CBT
Mindfulness-Based Therapy
Exposure-Based Therapy
Transcranial Magnetic Stimulation (TMS)
The classification of drug used to treat psychotic features is:
Antipsychotic
Name the term: Symptoms may occur when a drug is abruptly discontinued after tolerance or dependence has been built
Withdrawal
A drug that increases the availability or action of a neurotransmitter is:
Agonist
A SMART goal is:
Part of the A (Aim) of I CAN START. Specific Measurable Achievable Realistic Timeboxed
The four phases of neurotransmission are:
Stimulation
Rising
Peak and Falling
Undershoot and Refactory
Name the term: One drug significantly enhances the effect of another drug (ex: alcohol and sedatives)
Synergism
Medications which alter one’s mental state are called:
Psychotropics
What are some gray areas for counselors creating and implementing treatment plans?
Legislation makes reimbursement possible, but counselors have to keep up with bureaucratic documentation and record keeping.
In order for clients to be reimbursed, counselors must prove that the clients needed the treatment, which can be subjective. This increases the demand for assessment, diagnosis, and the proof of treatment outcomes.
With reimbursement possible, managed care companies require an authorization for services.
Counselors have to navigate third-party payer expectations.
The elements of I CAN START are:
I = Individual Counselor C = Contextual Assessment A = Assessment and Diagnosis N = Necessary Level of Care S = Strengths T = Treatment Approach A = Aim and Objectives of Treatment R = Research-Based Intervention T = Therapeutic Support Services
GABA, Serotonin, and Norepinephrine are examples of:
Neurotransmitters
Repetitive behaviors or mental acts that an individual feels driven to perform in response to an obsession or according to rigid rules
Compulsions
A “contract for safety” is:
A no-suicide contract where the client agrees not to kill himself or herself for a period of time.
Inappropriate elimination of urine into bedding or clothing is:
Enuresis
At least twice per week for three consecutive months
Nocturnal, diurnal, and both
Can affect 19% of 5-12 yo
Primarily genetic and biological
What are some of the accrediting bodies, state-level governing bodies and agencies?
Commission on Accreditation of Rehabilitation Facilities (CARF)
Joint Commission International (JCO)
Council on Accreditation (COA)
**In order to maintain accreditation from these nonprofits, counselors must adhere to their standards of care and meet the criteria for effective treatment
Possible diagnoses where similar symptoms have been observed is called:
Differential diagnosis
Name the disorder: Repeated regurgitation of food over a period of at least 1 month. Regurgitated food may be re-chewed, re-swallowed, or spit out
Rumination Disorder
Alteration in perception or experience of the external world so that it seems unreal. Also feeling “flat” as if one’s environment lacks in spontaneity, emotional coloring, and depth. What is happening around is not real.
Derealization
Persistent difficulty discarding or parting with possessions, regardless of their actual value, is:
Hoarding disorder
In the Contextual Assessment of I CAN START, the three contexts that should be considered are:
- Intrapersonal context (Attachment, development, personality, etc.)
- Interpersonal context (Microsystem → Chronosystem, people interacting with one another)
- Superordinate context or social identities (Age, gender, race, etc.)
What legislation led to our current managed care system?
Mental Health Parity and Addiction Equity Act of 1996
Patient Protection and Affordable Care Act (2010)
Types of medications that can be used to treat comorbid symptoms seen in dissociative disorders include:
Mood stabilizers
Antianxiety / Anxiolytics
Some antidepressants and opioid antagonists have been found to be helpful
Treatment strategies for Feeding Disorders include:
Primarily behavioral interventions (e.g., Diaphragmic breathing and distraction, self-regulation/monitoring) and environmental structuring
Family counseling and parenting training
Suggestions for working with people from other cultures.
Be aware of the limitations of the DSM
Conduct thorough and sensitive cultural assessments
Be aware of your personal and professional biases
Collaborate with other culturally sensitive professionals and your clients in diagnosis and treatment
Practice contextual sensitivity (as prescribed by the ACA Code of Ethics)
Recurrent and persistent thoughts, urges, or images that are experienced as intrusive and unwanted
Obsessions
Elements of the T in I CAN START. (Therapeutic Support Services)
Case management, support groups, sponsor, nutritionist, occupational therapist, social worker, etc
Includes psychopharmacology
Specifiers of several obsessive-compulsive disorders, with regards to insight, are:
Good or fair insight
Poor insight
Absent insight/delusional beliefs
A disorder including falsification of physical or psychological signs or symptoms, or induction of injury or disease, associated with identified deception
Factitious Disorder
Recurrent pulling out of one’s hair, resulting in hair loss
Trichotillomania
Choose the best response: The difference between an agonist and an antagonist in pharmacological medications is:
a. Agonists support action; antagonists block action
b. Agonists are made within the body; antagonists are made outside of the body
c. Agonists block action; antagonists support action
d. Agonists are neurotransmitters that go directly to the brain; antagonists go directly to vital organs related to psychological responses
a. Agonists support action; antagonists block action
Some contraindications for medications used to treat elimination disorders are:
overactive thyroid gland schizophrenia manic-depression suicidal thoughts alcoholism alcohol intoxication serotonin syndrome a type of disorder with high serotonin levels
The three areas of the DSM are:
Section I: DSM-5 Basics
Section II: Diagnostic Criteria and Codes
Section III: Emerging Measures and Models
Elements of the C in I CAN START. (Contextual Factors)
Client’s intrapersonal and interpersonal characteristics, demographics
I CAN START is:
A model containing the elements to construct a comprehensive, strengths-based treatment plan.
One or more somatic symptoms that are distressing or result in significant disruption of daily life.
Somatic Symptom Disorder
Typically more than 6 months
Intimate Partner Violence is:
Physical, sexual, or threatened abuse that is perpetuated by current or former romantic partner
Name the term: Enhancement of a drug’s effects through interaction with another drug (ex: stimulants and antidepressants)
Potentiation
DSM stands for:
Diagnostics and Statistical Manual of Mental Disorders
A psychiatrist can assess that a client has begun to build a tolerance for a drug when…
…higher doses of a medication are required to maintain the same effects
T/F: In homicidal clients, you must document the discussion, develop a safety plan in cases of lower risk, and consult with peers or supervisors
True
Name the term: When the body requires a greater amount to produce the desired effect
Tolerance
An example of an antipsychotic drug is:
Zyprexa
Haldol
Thorazine
Risperdal
Fowler’s three core principles are:
A way to build a bridge for discussing client needs when planning for intervention.
The principles include:
- alliance building
- enhancing curiosity about the function of suicidal thoughts and urges
- enhancing experience and expression of intense emotions
The classification of drug used to treat various anxiety disorders is:
Antianxiety / Anxiolytic
The neurotransmitter that functions in the central nervous system with memory, learning, behavioral arousal, attention, mood, rapid eye movement AND an lead to muscle contraction in the peripheral nervous system is:
Acetylcholine
Medications that may be used to treat somatic symptom disorders include:
Antidepressants (TCAs, SSRIs, and SNRIs seem to be somewhat effective)
Name the term: Mental and biochemical response to a non-present drug intervention “as if” the drug were present
Placebo response
Medications that may be used to treat enuresis are:
Desmopressin (DDVAP)
Physically contain urine for a longer time
Imipramine / Tofranil (TCA)
For encopresis as well
The neurotransmitter which is more active in the peripheral nervous system and regulates fight or flight response is:
Epinephrine / Adrenaline
A break in how the mind handles information. Disconnecting from thoughts, feelings, memories, and surroundings. Can affect sense of identity and perception of time.
Dissociation
Key features of somatic symptom and related disorders include:
All share the “prominence of somatic symptoms associated with significant distress and impairment”
Usually diagnosed in primary care systems
Focus is on the presence of symptoms vs. lack of medical explanation
The classification of drug used to treat Major Depressive Disorder is:
Antidepressant
What is managed care?
Approach to delivering and financing health care that seeks to control costs, as well as ensure the quality and consistency of care provided to clients.
Common features of elimination disorders include:
Inappropriate elimination of urine or feces
Not due to a medical condition
Typically diagnosed during childhood and adolescence
Focus is on developmental age rather than biological age
Can be intentional or involuntary
Name the disorder: Recurrent episodes of binge eating, at least once a week for 3 months
Binge-Eating Disorder
Elements of the I in I CAN START. (Individual)
Counselor’s characteristics (personal and professional)
Transference & Countertransference
Experience and scope of practice
Elements of the R in I CAN START. (Research-based Interventions)
Grounded on theoretical framework and aims / objectives
Name the disorder: Restriction of energy intake relative to requirements, leading to significantly low body weight in the context of age, sex, development trajectory, and physical health
Anorexia Nervosa
The normative development of control over bladder and bowel movements is referred to as:
Normative toilet training
T/F: We are legally and ethically required to report child abuse
True
A disorder NOT listed under the category of Feeding and Eating Disorders is:
a) Pica
b) Rumination Disorder
c) Obesity
d) Anorexia Nervosa
c) Obesity
T/F: There is one specific etiology for suicidal ideation
False
Sasha reads the information packet for her new prescription of Zoloft (sertraline). Zoloft is classified as an antidepressant. What should Sasha expect to see under the medication’s indication?
a. “Many users of Zoloft might also like to try Cymbalta or any other of our fine products!”
b. “Zoloft is indicated to relieve symptoms related to depression and major depressive disorders”
c. “Zoloft should not be taken if the user drinks more than 5 alcoholic beverages daily”
d. “One side effect of Zoloft is indicated for dizziness and increased anxiety”
b. “Zoloft is indicated to relieve symptoms related to depression and major depressive disorders”
Terrance, a 44 year old African American man, mentions that he has had issues discussing his adolescent experiences with his father to his son. He notes that the stories have faded away from his memory “as if they were never really there”. He also notes that, when walking with his son around his childhood neighborhood, Terrance began to wander off away from the place where his old house once stood.
Terrance notes feeling upset every time his son asks him about his father, causing him to pull away from his child. He has no history of drug use and is “fit as a fiddle” according to his doctor.
What diagnosis might you offer Terrance?
a. F44.0 Dissociative Amnesia
b. None of the Above
c. F44.1 Dissociative Amnesia, with dissociative fugue
d. F20.81 Schizophreniform Disorder
c. F44.1 Dissociative Amnesia, with dissociative fugue
Potential issues with a “contract for safety” include:
a) The client may believe that the counselor is only concerned with protecting himself or herself from legal action
b) The contract may inadvertently silence clients; they may feel discouraged, embarrassed, or ashamed if they do experience suicidal ideation
c) The term “contract” implies a legally-binding agreement
d) The document may inadvertently lead counselors to believe they are legally protected against malpractice when no such protection exists
Elements of the A in I CAN START. (Assessment & Diagnosis)
Testing, data collection, intake form / interview
Mental Status Examination
Referral
Some therapeutic interventions for obsessive-compulsive disorders include:
ALL DISORDERS:
Cognitive Behavioral Therapy (CBT), including approaches such as Acceptance and Commitment Therapy (ACT), Exposure and Response Prevention (ERP), Mindfulness-Based Cognitive Therapy (MBCT)
OCD / Body Dysmorphic:
Group work:
Exploring the experiences with others facing similar symptoms
Body Dysmorphic:
Inference-Based Therapy:
Cognitive Based; Addresses faulty inferences of self to expose their overvaluation to the client
Trichotillomania / Excoriation:
BT: Habit-reversal training
Stimulus control
Trichotillomania:
DBT for emotion regulation
T/F: We are not legally required to report IPV unless the client is in imminent risk of harm
True
Some potential indicators of client suicidality are:
a) past suicide attempts
b) substance abuse
c) impulsivity
d) hopelessness
e) loss of control
f) aggressiveness
g) thoughts of suicide
h) presence of a mental health disorder
Treatment strategies for elimination disorders include:
Ruling out a medical issue
Behaviorist interventions (enuresis alarms)
Toilet education and training (encopresis)
Nutritional changes (encopresis)
Play therapy
Disorders included in the Elimination Disorders category include:
Enuresis
Encopresis
Other Specified Elimination Disorder
Unspecified Elimination Disorder
The study of how drugs affect receptor sites, send signals, and cause some neurochemical changes (in other words, how drugs affect the body) is:
Pharmacodynamics
Key risk characteristics for homicidal clients include:
Lack of empathy History of harming people or animals Destructive behaviors Marked disregard for social norms History of impulsivity
The preoccupation with one or more perceived defects or flaws in physical appearance that are not observable or appear slight to others is:
Body dysmorphic disorder
The five main phases once a drug enters the body are:
Administration: Introduction into the system
Absorption: Reception into the system
Distribution: Delivery through the system
Metabolism: Process through the system
Elimination: Removal from the system
T/F: In IPV, client safety is the first priority
True
The classification of drug used to treat ADHD is:
Psychostimulant
T/F: Couples counseling and trauma-based counseling are recommended in all IPV cases
False, if the client remains in an unsafe situation
An alternative to a no-suicide contract is…
A Commitment to Treatment Statement, which emphasizes what a client WILL do rather than what he or she WILL NOT do
Key features of feeding and eating disorders include:
“Persistent disturbance of eating or eating-related behavior that results in the altered consumption or absorption of food and that significantly impairs physical health or psychosocial functioning.” (APA, 2013, p.329)
A category of disorders requiring significant collaboration with medical professionals
An example of an antianxiety (anxiolytic) drug is:
Xanax Buspar Valium Ativan Librium Klonopin (also mood stabilizer)
T/F: Medication is recommended for Feeding Disorders
False
The letters in the mnemonic representing a client’s risk of suicide potential mean:
I = Ideation S = Substance Abuse P = Purposelessness A = Anxiety T = Trapped H = Hopelessness W = Withdrawal A = Anger R = Recklessness M = Mood Changes
T/F: In cases of imminent danger, it is NOT recommended to engage law enforcement or to warn potential persons at risk due to confidentiality
False
Culture effects…
How we view our clients, their behavior, and their diagnoses.
Recurrent skin picking, resulting in skin lesions
Excoriation
T/F: Pharmacokinetics deals with the movement of drugs within the body
True
A disorder often connected to beliefs around weight, body shape, and appearance
Eating Disorder
The neurotransmitter responsible for behavioral regulation, movement, learning, mood, and attention is:
Dopamine, which may have both excitatory and inhibitory effects in the brain
The simultaneous presentation of two disorders or conditions within a client is called:
Comorbidity
Deficit in memory–loss of memories, such as facts, information, and experiences–caused by brain damage, disease, trauma, or temporarily in the use of various sedatives and hypnotic drugs. Memory can be either wholly or partially lost due to the extent of damage. People with amnesia generally know who they are (although forgetting your identity is often seen in movie/television plots).
Amnesia
The classification of drug used to treat bipolar disorders is:
Mood Stabilizer
The function of neurotransmitters is:
To be the “messengers” that alert nerve and muscle cells to respond in specific ways
The neurotransmitter that stabilizes the brain by preventing overexcitation is:
GABA
Recurrent or persistent thoughts, urges or images that result in individual feeling driven to perform repetitive behaviors or mental acts is:
Obsessive-compulsive disorder
At least one hour a day
The neurotransmitter responsible for managing homeostasis in the brain, as well as mood regulation, control of appetite, sleep and arousal, and pain regulation is:
Serotonin
The disorders found in Feeding and Eating Disorders include:
Feeding:
- Pica
- Rumination Disorder
- Avoidant/Restrictive Food Intake Disorder
Eating:
- Anorexia Nervosa
- Bulimia Nervosa
- Binge-Eating Disorder
Other:
- Other Specified Feeding or Eating Disorder
- Unspecified Feeding or Eating Disorder
Elements in the T in I CAN START. (Treatment Approach)
Theoretical framework for intervention
Guides treatment plan based on diagnostic data
Name the disorder: Persistent eating of nonnutritive, nonfood substances over a period of at least 1 month.
Pica
Elements of the S in I CAN START. (Strengths)
Available assets client holds to support positive outcomes
Includes personal, family, school, and community strengths and resources
An example of an SNRI drug is:
Cymbalta
Effexor
Pristiq
Elements of the A in I CAN START. (Aims & Objectives)
SMART goals and evidence of change
The Level of Care Continuum contains:
4 levels: inpatient, residential, day/partial hospitalization, outpatient
An example of a stimulant drug is:
Adderall Ritalin Dexadrine Vyvanse Concerta Focalin
The category where “Acute Stress Disorder” is found is:
Trauma-Related Disorders
Some medications used to treat OCD are:
SSRIs: Celexa, Prozac, Luvox, Paxil, Zoloft
TCA: Anafranil (clomipramine)
Antipsychotics such as Orap, Haldol, Risperdal used with SSRIs
The part of I CAN START where intake, a mental status examination, etc. are conducted is:
A = Assessment and Diagnosis
T/F: Dissociative disorders are a subset of Psychotic disorders
False
Name the main neurotransmitters
First three are the “big 3”:
Norepinephrine Dopamine Serotonin Acetylcholine Epinephrine (adrenaline) GABA Glycine Glutamate
A disorder with the presence of one or more clinically significant psychological or behavioral factors that adversely affect a medical condition by increasing the risk for suffering, death, or disability.
Psychological Factors Affecting Other Medical Conditions
Disorders included in the Dissociative Disorders category include:
Dissociative Identity Disorder Dissociative Amnesia Depersonalization/Derealization Disorder Other Specified Dissociative Disorder Unspecified Dissociative Disorder
The categories of antidepressants include (five categories):
TCA – Tricyclic antidepressant (oldest, around for 60 years)
MAOI – Monoamine oxidase inhibitor
SSRI – Selective Serotonin reuptake inhibitor (around since late 1980s)
SNRI – Serotonin norepinephrine reuptake inhibitor (late 1990s)
Atypical
The mnemonic representing a client’s risk of suicide potential is:
IS PATH WARM
Which of the following is NOT a domain of the Cultural Formulation Interview?
a. Cultural Definition of the Problem
b. Cultural Factors Affecting Self-Coping and Past Help-Seeking
c. Cultural Factors Affecting Current Help-Seeking
d. Receptivity to Cultural Humility within Clinician
d. Receptivity to Cultural Humility within Clinician
HITS is:
An assessment used to detect IPV
Hurt
Insult
Threaten
Scream
Name that disorder: Difficulty digesting food; avoidance of specific types of food textures, colors and smells; eating at an abnormally slow pace, or having a general lack of appetite. The person does not have a distorted body image.
Avoidant/Restrictive Food Intake Disorder
The classification of drug used to treat insomnia is:
Sedative / sedative-hypnotic
The term that means a client experiences two diagnoses with much of the same need for principal diagnosis
Dual Diagnosis / Comorbidity
An example of an MAOI drug is:
Marplan
Nardil
Parnate
An example of a SSRI drug is:
Celexa Zoloft Prozac Lexapro Paxil Luvox
Some ways to document and structure steps and collaboration agreements for client care in suicidal clients include:
- Strengths-based approaches
- Contracts for Safety
- Commitment to Treatment statements
Terica, a licensed professional counselor, determines that her client, Drew, has demonstrated symptoms for F50.01 Anorexia Nervosa, Restricting type, Moderate, in Partial Remission. In her treatment plan, Terica acknowledges that she will work from an Interpersonal Psychotherapy framework to work towards the Aim of “promoting a 50% reduction of Drew’s anxiety towards gaining weight”. Which statement represents an appropriate intervention to address Terica’s aim?
a) Develop a list of social relationships and expectations that inspire anxiety around disordered eating and body image with Drew
b) Complete a mental status examination to assess Drew’s cognitive ability
c) Encourage Drew to return to school to further his opportunities to return to work
d) Discuss Drew’s medications with his Primary Care Physician
a) Develop a list of social relationships and expectations that inspire anxiety around disordered eating and body image with Drew
Detachment within the self, regarding one’s mind or body, or being a detached observer of oneself. Subjects feel they have changed and the world has become vague, dreamlike, less real, lacking in
significance or being outside reality while looking in.
Depersonalization
The disorders included within somatic symptom and related disorders are:
Somatic Symptom Disorder
Illness Anxiety Disorder
Conversion Disorder (Functional Neurological Symptom Disorder)
Psychological Factors Affecting Other Medical Conditions
Factitious Disorder (Including Factitious Disorder Imposed on Self, Factitious Disorder imposed on Another)
Other Specified Somatic Symptom and Related Disorder
Unspecified Somatic Symptom and Related Disorder
The study of how an organism affects a drug (from intake to elimination) is:
Pharmacokinetics
An example of a mood stabilizer drug is:
Depakote Abilify Lithium Klonopin Valproate
Common features of dissociative disorders include:
“…characterized by a disruption of and/or discontinuity in the normal integration of consciousness, identity, emotion, perception, body representation, motor control, and behavior.”
Typically found following trauma experiences and can result as a protection from pain
Client often loses connection to time and reality when experiencing a dissociative fugue.
Treatment strategies for Eating Disorders include:
CBT, Interpersonal psychotherapy (IPT), and Dialectical Behavior Therapy (DBT)
Psychopharmacology and medical interventions
Elements of the N in I CAN START. (Necessary Level of Care)
Level of Care Continuum: (from most restrictive and intense to least restrictive and intense)
Inpatient Hospitalization
Residential Treatment
Partial Hospitalization / Day Treatment
In-Home treatment programs
Community Treatment
Depends upon patient’s needs and resources available
