Week 11: Treatment Planning Flashcards
What are splitters?
Clinicians which tend to focus on “specific” techniques in terms of treatment planning
What are lumpers?
Clinicians who tend to focus on common, non-specific factors that facilitate change in terms of treatment planning
e.g. Rogers - genuineness, empathy, unconditional positive regard.
What is the 1st general approach to treatment planning?
Focus on the therapy
Treatment planning approaches were once related to particular therapeutic approaches.
This relates to the client-centred approach which Carl Rogers referred to as including:
Genuineness
Unconditional positive regard
Accurate empathy
Involves nonspecific qualities, basic case management and enhancing client relationship
What is the 2nd general approach to treatment planning?
Concentrate on the presenting issue, specific diagnosis or symptoms of the client.
Relies on accurate diagnosis, is very similar to medical procedures.
Also referred as ‘differential therapeutics’
Where has ‘differential therapeutics’ been successful?
In anxiety related conditions
Less suitable for treating types of depression.
What is the 3rd general approach to treatment planning?
Focus on client characteristics, so look for traits which are likely to influence engagement and success in treatment and change process.
How many characteristics have been investigated in terms of client characteristics and treatment planning?
Over 200 have been suggested, and 100 have been researched.
Through addressing these traits, treatment effectiveness has improved.
What are the 6 different categories of potential recommendations?
Treatment
Placement
Further evaluation
Changes to the client’s environment
Education and self-help
Other recommendations
What are the two considerations to focus on when making recommendations following assessments?
What is the most appropriate, evidence based approach for the client’s presenting issue.
How to communicate the recommendations so the client can understand them and take action.
What are the 4 overarching factors which drive decision-making around interventions for a client?
Case formulation
Understanding the problem
The context of the problem
Specific client characteristics which may affect treament
What are the social determinants of health?
The non-medical factors which influence health outcomes.
Can impact health equity in positive and negative ways.
Place of birth, home environment, work environment, external forces and systems that the person interacts with.
Social determinants of health account for ____% of health outcomes.
30-55%
Low educated subgroups report _____% more often “poor health” than tertiary educated
100%
Effective case management requires what?
Practitioners to survey general case issues, focus on salient features and make recommendations based on this.
What should recommendations include?
How restrictive the treatment should be, severity of the problems and whether patient is a danger to self or others.
What are options of possible local resources within a client’s community?
Inpatients, outpatient clinic, medical facility, suicide prevention centre, AA
What resources could be included in order to enhance treatment?
Self help resources (books, links)
What other decisions are required regarding treatment options?
The frequency and duration of treatments
In terms of a client’s environment, what should a practitioner be recommending?
Ways to optimize the client’s environment.
e.g. encourage the client to use available social support or find adequate support structures
Or remove them from certain environments in order to avoid possible relapse
How should recommendations be tailored for clients?
Deliberately based on the client’s characteristics and circumstances.
Many therapists often provide the same or similar interventions for all of their clients.
Why do therapists provide similar interventions for all of their clients?
Typically because it aligns with the school of therapy they therapist is most familiar with.
Why are there issues around providing the same intervention for all clients?
Because different clients will respond in varied ways to interventions
What did a study show about clients that were suspicious and poorly motivated?
They did poorly with therapists who were empathetic, and accepting.
Indicates that not all treatments and therapeutic style are best for all clients.
When is relationship quality likely to deteriorate in terms of a therapeutic relationship?
When the therapist uses highly directive techniques with a defensive client.
What is the do-do bird verdict?
There are minimal differences between various therapies
Everyone wins and all deserve a prize
What is the most impactful in terms of therapeutic outcomes.
Similarity between client/therapist
Acknowledging client preferences in terms of therapist
Acknowledging the clients preference.
When does dissimilarity between client and therapist appear to support therapeutic outcomes?
When there the therapist and client have different attachment and dependency needs
What factors should one consider when deciding if a client should receive inpatient care?
Psychological, physical and social problems of the client
Actual and potential of the problem behaviour
Impact on the community of problem behaviour
When is recommending further evaluation appropriate?
When the assessor believes there is more information to be gathered about client and their problem that fall outside area of expertise.
e.g. medical testing
