wk 1 power point p2

8/17/2019 wk 1 power point p2

1/56

Interviewing &Assessment

SOCW 601


2/56

Psychosocial

• You all know the general urose an! structure o$ut here we will%

eview general asects

'ighlight the slight changes that are ma!e "or aassessment


3/56

Assessment (general)

• *Assessment involves gathering an! analy+ing in"ora$out the client# the story to !ate# an! the conte,tularger system in-uences a.ecting the client an! the

• Assessment is an on-going process as we continumore in"ormation an! learn more a$out the erson#worl! an! their li"e we continue to "ormulate# a!at

rene our treatment lan• Continue to gather in"ormation an! "ormulate worki

concetuali+ation# hyothesis# e,lanation# continueorgani+e an! un!erstan! in"ormation an! rovi!e a!irection o" where to go# what to !o


4/56


• Attemting to un!erstan! $ehavior ai!es assesi!enti"ying what is resent

• Assessment gui!es conceptualization# our worun!erstan!ing an! e,lanation o" what "actors a!ynamics are resent an! how they are relate! t

another an! how they interact• Concetuali+ation gui!es an! in"orms intervent

what we !o# how we reson!


5/56


•Assessment2what !etails you o$tain# how much in"ormation you get !etaile! an! thorough) an! how in"ormation is interrete! is imacte!

3heoretical orientation o" the worker

3ye o" assessment e,4 5ocational assessment2vs42mental health asses

Agency e,ectation (most have esta$lishe! assessment "ormats# in"orseci"y)

Practicality (e,4 time constraints# etc4)

3he erson2what they !eci!e to share# how much# how accurate the in

• 3here is no er"ect assessment# In some way it will $e incomlete# O"tin"ormation is limite! to time# urose

• Assessment is based on and is only as good as the amount andof the information we have to that point


6/56

Initial Assessment

•*Clinicians are o"ten aske! to !o "ormal# reasona$ly structure! assessmin!ivi!uals "or the urose o" !iagnosis# treatment lanning# or resear!etermine eligi$ility "or seciali+e! services such as !isa$ility assistanayments# resi!ential lacements# or inatient treatment/

• O"ten !one when the erson rst resents "or services4 In"ormation is a$out a num$er o" areas o" li"e# history an! "unctioning to ascertain wchallenges# strengths an! resources are an! to !etermine !irection o"

• Sometimes calle!%

Initial assessmentevaluation

7iagnostic assessmentevaluation

Intake assessmentevaluation

A!mission assessmentevaluation

Psychosocial assessmentevaluation


7/56

Initial Assessment

• Although the "orm"ormat an! the tye an! amount o" in"orme,ecte!emhasi+e! will vary "rom agency to agency# the grocess an! structure o" assessment is the same

• We learn generally to !o assessment an! then we can a!at secic "ormat an! re8uirements o" the agency

• Some laces still have a *narrative/ assessment "ormat wherclinician is summari+ing an! conveying the !etails in a *narra

• Some assessments are not narratives an! look more like *chean! *ll in the $lanks/

• Some o" these will inclu!e some sace "or narrative

• With the increase! use o" electronic me!ical recor!s (9:;s) more o" a ush to re2oulate! choices# $o,es# !ro !own m


8/56

Initial Assessment

• I!enti"ying In"ormation

• Presenting Problem/Concern; History of Presenting Illness

• Past Psychiatric History

• :e!ical history

• Alcohol an! 7rug 'istory

•


9/56

Initial Assessment

• We will "ocus the most on%Presenting Pro$lemConcern 'istory o" Presenting Illness

Past Psychiatric 'istory

7iagnosis 7iagnostic Imressions (well# not really2this is =usyou list your !iagnoses (co!e an! name in or!er o" attentiosignicance)

:ental Status 9,am

• >ut rst let;s $rie-y review the others

• We nee! to $ecome thorough# !etaile! oriente! history takeis Imortant to remem$er that all in"ormation we get is fun


10/56

9cologicalSystems :o!el


11/56

I!enti"ying In"ormation

• >rie" !etails o"%7escritive !emograhic in"ormation2the erson

name# age# gen!er# raceethnicity# marital an!emloyment status

#rief statement o" reason "or resentationre"erthey are coming (sometimes this is searate! o.own $rie" section calle! Chief Complaint)

e"erral source (i" alica$le) or *sel"2re"erral/


12/56

:e!ical 'istory

Any current or ast health ro$lems?Current an! ast treatment% Are they receiving treatment a

where an! "rom whom?

7o they have a !octor? I" so who? 'ow many an! what tye(Primary care hysician# car!iologist# etc4)

Current me!ications (names# !oses etc4)# any known !rug a

Pro$lems with treatment# receiving treatment or accessing c

If the history is negative then report that %

3here;s always something to reort

3he a$sence o" something is still something


13/56

Alcohol an! 7rug 'istory

• I" this is their resenting ro$lem then this in"ormation will $e a$eginning o" the assessment

• egar!less the !etails are the same# $ut we will review these la

• I" this is not the resenting ro$lem remem$er there still mightrelevant !ata here4

If the history is negative then report that %

3here;s always something to reort 3he a$sence o" something is still something

*Client !enies!oes not reort any currentast use an!or issuesu$stance usea!!iction or relate! !i@culties/

*Patient !enies any currentast treatment or involvement with


14/56


15/56


16/56


17/56

9mloyment5ocationalWork his

• Sometimes this section is not its own section an! is art o" the history

Are they currently working?

I" so "ull or art2time? Where an! what tye o" work?

Are they satise! with work?

Any ro$lemscon-icts at work or concerns over work er"orma

relationshis with coworkers or management?I" unemloye! how long an! wherewhat tye o" work !i! they !

Past work history an! vocational training

I" !isa$le! are they receiving !isa$ility $enets or are they in tho" alyingaealing?


18/56

Strengths an! esources

• A!mitte!ly this section o"ten !oes not aear on many assessments astan! alone section ($ut shoul!)

• B to us to i!enti"y an! inclu!e in"ormation on strengths throughout thassessment

What !o they !o well?

What !o they see as their ositive traitsstrengths?

What are the goo! things a$out them?

esources2who is in their li"e that canis heling them (eoleagencie

'ow have they !ealt with ro$lems $e"ore?

What in their li"e can hel them with this?

What have they accomlishe!?

What have they overcome in the ast?


19/56

SummaryImressions

• 3his is where you summari+e an! $ring in"ormattogether

• Con!enses# integrates# an! analy+es in"ormationthe assessment

• Sometimes aske! to give a rognosis (likelihoo!

imrovement or lack thereo")•


20/56

Organi+ation Within Categories

• In a!!ition to organi+ing in"ormation in these gecategories# we also want to organi+e the in"ormawithin the categories so that in"ormation that is is e,resse!!escri$e! together

• 9,4 Social history has in"ormation on "amily#relationshis# e!ucation2organi+e in"ormation wio" these together# not =um$le!

• Organi+e aca!emic in"ormation with aca!emicin"ormation# vocational in"ormation with vocatioin"ormation# *like in"o with like in"o/


21/56

3reatment Plan

• ame an! "ormat varies "rom agency to agency

• O"ten a "ormal rocess an! !ocument whose !eveloment aerio!ic review is re8uire! an! monitore! $y agencies an! (e,4 :e!icai!) O"ten inclu!es seci"yingi!enti"ying the ro$or issue

• O"ten inclu!es seci"yingi!enti"ying an overall# $roa! or ge

•Inclu!es more secic treatment goals• ist o" resourcesservices that will $e utili+e!# tye an! "re8services# or lanne! re"errals

• % treatment plan is a living $ocument in that it changtimes an$ actively gui$es intervention/services


22/56

Presenting Pro$lem or Concern

• 3his section is where you rovi!e an overview# a !escritiocurrent ro$lems

• 'ere you list an! $escribe symtoms they are reorting

In a!!ition to listing symtom also imortant to rovi!e# !e,amle(s) o" how that looks "or them

9,4 Markedly diminished interest or pleasure in all, or almo

activities most of the day, nearly every day

Client reorts loss o" interest an! leasure in most all activ!escri$es no longer getting as much =oy "rom his woo!worhas cease! going to his clu$ meetings# is no longer in conthis "amily an! "rien!s as he once was# an! he isolates at h


23/56

Presenting Pro$lem or Concern

• 'istory o" these !i@culties% when !i! they start (onset)? 'ow lothey $een occurring (!uration)? 'ave the symtoms change! ogotten worse? >etter? 7eveloment o" new or !i.erent symto(course)? 'ave there $een any erio!s o" remissionescalation

• 'ow is it a.ecting or !isruting their li"e an! "unctioning?

• What relate! or other ro$lems is the ro$lem causing?

• Again imortant to rovi!e !etails "rom the client;s secic e,

that illustrate an! suort• We can;t ossi$ly memori+e every symtom "or every con!itio

imortant to know as much as we can $ecause that hels us towhat 8uestions to ask to suort the !iagnosis (secic symto"rames# etc4)


24/56

Past Psychiatric 'istory

• Sometimes this is inclu!e! in the Presenting Pro$lem sectio

• Currentast sychiatric !i@culties!iagnoses

• Past treatment eiso!es%

When# where# with whom# "or how long

What kin! o" treatment (IPOP# me!s# etc4)

Outcome o" care an! their e!perience2how was treatment 7i! they n! it hel"ul? What was it like working with their rovi!er?

• I" alica$le list currentast sychiatric me!ications trie! ae.ectsresonse (hele!? ot? Any si!e e.ects?)# ossi$ly !who rescri$e! it to them


25/56


• I" this is their resenting ro$lem# why they are coming an! the servic

rovi!e then this will $e the rst main sectionCurrentast su$stance use

3ye o" !rug(s) they use(!) an! ossi$ly !rug o" choice

When rst use!# when last use!# how long erson has use!# how o"ten("re8uency) an! how much use! (amount) an! once they use "or how ltime might they use (!uration)

Any revious e.orts to 8uit or re!uce use an! i" so how success"ul# hothey cease or change use?

• Any ro$lems cause! $y use now or in the ast (legal# nancial# relatiooccuational# recreational)

• Currentast treatment# i" so name o" rovi!er(s)# tye o" care (outatresi!entialIP# !eto,)


26/56


• Can assess "or gam$ling

• Currentast involvement in recovery

Currentast 1D2ste articiation?

Sonsor# home grou?

Past success# ro$lems with recovery?

• Suort system or lack thereo"

7o the eole in their li"e also useencourage use?

7o their "amily an! "rien!s think they have a ro$lem?

7o they have "amily an!or "rien!s who are suorting an!encouraging change e.orts an! heling out?


27/56

Sources o" Assessment In"orma

• We receive an! synthesi+e several sources o" in"ormation4 'ow much weight

each is $ase! on our own assessment an! !iscernmentClinical interview2this will always $e our rimary source o" in"ormation4 Still# w

weigh in"ormation we get "rom the interview against ancillary in"ormation

O$servation2can $e $oth "ormal an! in"ormal

3esting2results o" sychological testing# la$imaging results

eview o" recor!s2"rom revious rovi!ers

Can $oth $e very valua$le an! not valua$le

ot everyone !oes a goo! or thorough =o$ !iagnosing

• Colla$orative in"ormation ("rom "amily# "rien!s)

Can $oth $e very valua$le an! not valua$le

Sometimes corro$orates# sometimes con-icts with client;s account# have to arelia$ility o" source an! whether or not they might have a hi!!en agen!a


28/56

:ental Status 9,am (:S9)

• 3he :S9 is our o$servation# !escrition an! assessment o" how the

aears an! interacts with us in the interviewSome arts we will simly !escri$e what we o$serve

Sometimes we will ask secic 8uestions (e,4 Asking a$out moo!# t

Sometimes might ask secic sets o" 8uestions (9,4 :emory)

• Certain characteristics o" resentation or changes an! !istur$ancesstatus can $e suggestive o" certain !iagnoses or sychiatric crisis

• Also imrovements in :S9 can sometimes $e o$serve! i" eole ar$etter

• Starts the minute we lay eyes on them

• :any laces now use check$o,es# $ut still nee! to know what areas

• 'as several categories# si, main comonents with several su$com


29/56

:S9

Aearance# Attitu!e# an! >ehavior:oo! an! A.ect

3hought Process

3hought Content

CognitionInsight# =u!gment an! Intellect


30/56

Aearance# Attitu!e an! >eha

Appearance

7o they aear their state! age or aear younger or ol!er?

Clothing% tye o" clothing# aroriateness o" clothing to season acon!ition (clean# !irty# worn# etc4)

'ygiene an! grooming% 7o they aear clean an! well kemt? Bn7irty# malo!orous? 7ishevele!?

E>e sensitive to ersonal an! cultural re"erences# economic realitPosture% sit uright? Slume!? igi! or tense?

Attitude

7escri$e their overall attitu!e towar!s the interview an! interv


31/56


Behavior

'ow they act !uring the interview# level o" motor activity

Agitate!? estless? Settle!? Slowe!retar!e! movement?

7o they seem to $e !islaying any a$normal movements (gestures# tremors# stereotye! $ehaviors)

Gait# coor!ination

Psychomotor retar$ation2slowe! movements# reactions

Psychomotor agitation2e,cessive activity associate! wito" tension acing# !geting# ina$ility to sit still# wringing otugging on clothes


32/56


9ye contact% !o they maintain eye contact# look !own# or lo

Glaring# ,e!?

Seech% rate an! volume

Pressure$ speech2rai!# !rive seech where it seems !i@the erson not to kee talking continue! seech !esite ereally talking to anyone or not really in resonse to interview

to interrutClanging2when wor!s are chosen "or their soun! as oose

meaning

&or$ sala$ 2an aarently ran!om an! illogical mi,ture o" soun!s


33/56

:oo! an! A.ect

• Moo$ 2an emotional attitu!e reorte! $y the in!ivi!ual how they

are "eeling• %'ect 2range an! intensity o" how the erson conveys or e,resse

emotions

(lat a'ect 2a$sence or near a$sence o" any sign o" a.ective e,r

#lunte$ a'ect 2signicant re!uction in the intensity o" emotional

)estricte$ a'ect 2mil! re!uction in range an! intensity o" emotio

e,ression*abile a'ect 2e,ression o" emotion shi"ts 8uickly# intensely

Inappropriate a'ect 2incongruence# !iscor!ance $etween what t!escri$ing an! e,ressing


34/56

3hought Process

• 3hought rocess2'ow they are thinking

• *3hought rocess aeare! logical# se8uential# relevant# oran! sontaneous/

• 7erailment can inclu!e%

+angential thin,ing2when one line o" thought goes o. to(or many others)# o"ten with e,cessive or irrelevant !etails

erson never returns to or comletes original thought thin!eraile!

Circumstantial thin,ing2when one line o" thought goes oanother (or many others)# o"ten with e,cessive or irrelevan$ut the erson eventually comes $ack to the original oint


35/56

3hought Process

(light of i$eas2a nearly continuous -ow o" accelerate! thin

abrupt changes "rom toic to toic that are usually $ase! ounderstandable associations# !istracting stimuli# or lays

*ooseness of associations2rai! leas "rom one line o" thoanother without clear connection between the topics oerson $eing aware o" the rai! shi"ts

)esponse latency 2signicant ga $etween 8uestion an! re+hought bloc,ing2when a erson;s train o" thought a$rut

une,ecte!ly stos

%utistic thin,ing2a reoccuation with one;s own rivate inworl! an! i!eas# o"ten illogical# makes sense only to the ers


36/56

3hought Content

• 3hought content2What they are thinking# or reorting a$out th

thinkingHallucinations2a ercetion2like e,erience with the clarity a

o" a true ercetion $ut without the e,ternal stimulation o" thesensory organ the erson may or may not recogni+e that thee,erience is not groun!e! in reality# can $e%

Au!itory (o"ten voices# sometimes other soun!s)

5isual (seeing eole or -ashes o" light# geometric shaes)

Ol"actory2smell (usually unleasant)

Gustatory2taste (unleasant# metallic)

3actile2touch# such as insects $eing un!er the skin


37/56

3hought Content

"elusions2a "alse $elie" $ase! on incorrect in"ea$out e,ternal reality that is rmly hel! !esite almost everyone else $elieves an! !esite whatconstitutes incontroverti$le an! o$vious roo" oevi!ence to the contrary

7elusions can $e unsystemati+e! or systematizemeaning that that are unite! $y a common themreresent a comlete an! relatively well2organi+network o" $elie"s

7elusions can $e mood-congruent or moo!2inco


38/56

3hought Content

• 3yes o" !elusions can inclu!e%

>i+arre2involves henomenon that the erson;s culturregar! as hysically imossi$le atently a$sur! or we

Healousy2!elusion that susects a rival or one;s se,ualis un"aith"ul

9rotomanic2!elusion that another erson# usually o" hstatus# is in love with the in!ivi!ual

Gran!iose2!elusion o" in-ate! sense o" worth# imortaower# knowle!ge# a$ility# i!entity# or secial relations!eity or "amous erson


39/56

3hought Content

>eing controlle!2!elusion where the erson $elieves their "eelings

imulses# actions are un!er the control o" some e,ternal "orce rath$eing un!er their control

O" re"erence2!elusion in which events# o$=ects or other ersons in imme!iate environment are seen as having a articular an! unususignicance4 3hese !elusions are usually o" a negative or e=orativ$ut also can $e gran!iose in content

9,4 A re! car arke! across the street means that I will $e re! "roI$ea of reference2overvalue! i!ea where the erson is virtually#

totally# convince! that o$=ects# eole or events in their imme!iatenvironment have ersonal signicance to them (when it;s a !elusis no !ou$t)


40/56

3hought Content

Persecutory2!elusion where the central theme is that

someone (ossi$ly someone close to them) is $eing aharasse!# cheate!# ersecute! or consire! against

3hought $roa!casting2!elusion that one;s thoughts a$roa!caste! out lou! so that they can $e erceive! $

3hought insertion2!elusion that certain thoughts are one;s own# $ut rather are inserte! into one;s min!

Somatic2!elusion whose main content ertains to theaearance or "unctioning o" one;s $o!y


41/56

3hought Content

ihilistic2!elusions involving themes o" none,istence

9,4 >elie" one is !ea! or !oesn;t e,ist *Ain;t no heart in there Hohn# mare gone/

Sin or guilt2!elusion where erson $elieves they have committe! a teactsin an! !one something un"orgivea$le4 Person $ecomes e,cessivinaroriately reoccuie!4 :ay "ocus on acts "rom chil!hoo! or evethe erson thinks they are resonsi$le "or a !isaster (e,4


42/56

3hought Content

Paranoia2i!ea that someone(s) will or wants to harm erson# char

$y sense o" ersecution# susiciousness# =ealousy# resentment4 Casomeone $eing guar!e!# =ealous# sullen# rigi!# humorless an! hyeto in=ustice allege!ly $eing !one to them ECan e,ist without $eing $ut can also $e !elusionalF

Magical thin,ing2erson is convince! that their wor!s# thoughts or actions will ro!uce or revent a secic outcome that !ees acause an! e.ect ECan e,ist without $eing !elusional# $ut can also !elusionalF

bsession2recurrent an! ersistent thoughts# urges# or images the,erience! as unwante! an! intrusive 4 O"ten erson tries to ignosuress or neutrali+e them with some other thought or action# o"treetitive an! ritualistic (Compulsion)


43/56

3hought Content

• "issociation23he slitting o. o" clusters o" mencontent "rom conscious awareness sense o" sean! !istance "rom e,erience# can inclu!e $eingto recall or remem$er

• "epersonalization2the "eeling o" $eing !etachan! as i" one is an outsi!e o$server o"# one;s me

rocesses# $o!y or actions ("eeling as i" in a !reaercetual alterations# num$ing an! sense o" un

• "erealization2the e,erience o" "eeling !etachan! as i" one is an outsi!e o$server o"# one;ssurroun!ings (other in!ivi!uals or o$=ects are

e,erience! as unreal !reamlike "oggy li"eless


44/56

Suici!ality'omici!ality

• I$eation2resence o" thoughts# images# imulses

Plan2!egree to which they have !eveloe! a way or !eci!e! to

Access to means2!o they have access to the items# ways theuse

• Intent 2!egree to which they inten! to act on i!eation an! lan

• Also imortant to assess%

um$er an! nature o" ast attemts# means use!# result (me!treatment# hositali+ation# etc4)

A$ility to i!enti"y reasons "or not acting# willingness to contract

• I!eation# secicity o" lan# an! intent very an! increase in inteseverity


45/56


'igh (e!)2clear i!eation# clear lan# access to means# e,resse! intent# lessa$ility to i!enti"y reasons "or not en!ing li"e# less willing (or unwilling) tocontract "or sa"ety an! !evelo a sa"ety lan

5ery secic i!eation# lan# intent

:e!ium (Yellow)2thoughts a$out en!ing one;s li"e are now more secic#intense# "re8uent# $ut no lan# or there may $e an i!entie! lan or the ersonmight have several ways they have consi!ere! $ut not !eci!e!# may haveaccess to means or may not# no intent to act on these thoughts# can stillrea!ily i!enti"y reasons "or not en!ing li"e# more willing to contract "or sa"etyan! !evelo a sa"ety lan

:ore secic i!eation# lan# intent

ow (Green)2vague# occasional# assing# -eeting transient thoughts (o"ten o"shorter intensity an! !uration) o" wishing one were !ea!# $elieving they an!others woul! $e $etter o.# thoughts o" en!ing li"e that are not secic# noi!entie! lan# a$le to i!enti"y reasons "or not en!ing their li"e

5ague or a$sence o" i!eation# lan# intent


46/56


• 3here are several risk "actors more risk "actors someone has# higher the risk

S2se, o" ersonA2age

D2!eression# hellessness# hoelessness

P2revious attemts

E2ethanol an! other !rug a$use

R2rational thinking loss (hallucinations# !elusions)

S2social suorts lacking

O2organi+e! lan

2no sousesignicant other

S2sickness (hysical illnessain)

Wall o" esistance to Suici!e


47/56

Wall o" esistance to Suici!e

Counselor or therapist Duty to others Others?

Good Health Medication Compliance Fear

Job Security

Or Job Skills

Responsibility orchildren

Support oSi!niicant other"s#

Diicult $ccess to means $ sense o HO%& %ositi'e Sel(este

%et"s# Reli!ious%rohibition

Calm&n'ironment

$$ or )$ Spons

*est Friend"s# Saety $!reement +reatment $'ailab

((SO*R,&+-((

Protective (actors


48/56

eacting to Suici!e

• emain calm an! o$=ective as $est you can try not re

critical=u!gmental# !ismissivein!i.erent or anicke! • >e suortive

• I!enti"y strengths (esecially their seeking hel an! a!it)# suorts an! resources

• I!enti"y the imme!iate ro$lem

• 7ecrease isolation• 9,lore ast coing mechanisms

• Avoi! clichs

• 9,amine a menu o" otential otions


49/56


• Imortant to know your agency;s roce!ure an!

"or risk assessment an! reson!ing to suici!alityhomici!ality

• 9,ecte! review# suervision (suervisor# hysicetc4)

• "ocument what you !i!# who you talke! to# stetook# how you reson!e!

i i


50/56

Cognition

• Orientation an! memoryconcentration

• Orientation2usually re"er to orientation *JK/ or *all sheres/• Orientation to%

3ime2are they aware o" what !ay it is# !ate# time o" !ay# month# seyear?

Place2!o they know where they are# country# state# town# location?

Person2!o they know who they are (ractically# not e,istentially)

Purose2!o they know what is haening# conte,t "or interview?

• With some o" these it will $e very aarent that there are not !ecthese areas# so you !on;t always have to ask# $ut with some con!resentations there can $e !istur$ances an! worker may more "orassess these areas

C i i


51/56

Cognition

• :emory an! concentration

• Imme!iate memory# short2term memory an! long2term• When more "ormally assesse! imme!iate memory is o"ten assesse! $

three unrelate! wor!s or three !igits an! asking the erson to reeatto you

• When more "ormally assesse! short2term memory is o"ten assesse! $the erson to recall the three items a"ter a erio! o" three to ve min

• When more "ormally assesse! long2term memory is o"ten assesse! $

the erson a$out events "rom the ast !ays# weeks# years o" their li"ea$out general in"ormation covering toics that are commonly known

9,4# resi!ent(s)# num$er o" states# nota$le events

'ave to take into account erson;s intelligence# e!ucation an!e,eriencesre"erences

C iti


52/56

Cognition

• Calculation# a$straction# attention an! concentration

• When a$ility to calculate is more "ormally assesse! o"teis aske! to comlete

Serial L;s or serial three;s where starting with 100 (or anstarting oint) the erson is aske! to su$tract $y seven $ack to 0# you note how "ar they get o" how many mista

ma!e# usually only asking them to !o a$out M or so su$t:ight $e aske! to !o simle calculations like making ch

• :ight ask the erson to sell a wor! $ackwar!s or to list(animals# wor!s that start with *7/# etc4)

C iti


53/56

Cognition

• A$straction is the erson;s a$ility to think a$stractly# meta

sym$olically4 When more "ormally assesse! erson might $to e,laininterret hrases# such as rover$s%

7on;t cry over silt milk eole who live in glass houses shthrow stones

What are the similarities an! !i.erences $etween a car an!

• Concentration is o"ten generally assesse! $y how well theythe interview an! stay on task# their attention to what is $e!iscusse!# reson!ing to 8uestions aske! $ut sometimesconcentration might $e more "ormally assesse! $y sycholtesting

C iti


54/56

Cognition

• 3he !egree to which you "ormally or in"ormally a

Cognition(orientation# memory# a$straction# calcattention) will !een! uon the nature o" the issare a!!ressing# the re8uirements o" your agencytye o" evaluation you are !oing

9,4 Some !isa$ility an! lacement evaluations (

nursing homes) may re8uire or e,ect "or "ormaassessment

• 3here are "ormal ways o" assessing# such as the :ental Status 9,am (::S9)

I i ht H ! t ! I t ll t


55/56

Insight# Hu!gment# an! Intellect

• Insight2to what caacity !o they seem to $e aware o" an! un!ers

nature o" their !i@culties# the cause2e.ect relationshi or correlanature o" !ynamics# their awareness an! un!erstan!ing o" their cas well as nee! "or an!or tye o" services receive!

• Hu!gment2$e care"ul on =u!ging =u!gment4 Phrase tentatively (e,4*seems/)# re-ects sense o" their choices or riorities an! whetherthose create !amage or harm "or their "unctioning an! well2$eing

• Intellect2o"ten general estimation is ma!e $ase! o. wor! choice#

communicate# rovi!e in"ormation# etc4Person aears to $e o" average# $elow average# a$ove average

Can $e more "ormally assesse! through sychological testing

Imortant to note a$ility to rea! an!or write or !ecits

i !


56/56

emin!ers

• Hust like !iagnoses these terms give us a common voca$ulary "or commother rovi!ers so imortant to learn

• Someone always has a mental status4 3heir mental status may $e incre!an! "unctional# $ut it is still a mental status4

• With more severe con!itions# however# there can $e very !rastic !isrutareas across the mental status4 :any items are interrelate! an! inter!ean! certain !isrutions are more characteristic o" some con!itions than the mental status "or in!ivi!uals with schi+ohrenia will look !i.erent thwith an an,iety !isor!er# $ut in!ivi!uals with schi+ohrenia share many

!isrutions as !o in!ivi!uals with an,iety !isor!ers)• Signicant !isrutions in mental status are relate! to imairments in "un

an! risk o" !anger# $ut also can $e signs o" imrovement

• :any laces now have this as a checklist or !ro2!own screens to choosoulate! terms# $ut still imortant to know which terms an! !escritioalica$le "or your client

wk 1 power point p2

Documents

Transcript of wk 1 power point p2