Home » Posts tagged 'Yvette’s Notes' (Page 3)
Tag Archives: Yvette’s Notes
Assessment (Part II)
Contributor: Yvette McBride Thomas
Assessment—the procedures and processes of collecting information and measures of human behavior outside of test data .
- Can be obtained “through a variety of formal and informal techniques including standardized tests, diagnostic interviews, projective personality measures, questionnaires, mental status examinations, checklists, behavioral observation, and reports by significant others (medical, educational, social, legal, etc.)”
- The concept of assessment emphasizes the humanness of counseling…a total picture of the person being evaluated.
- “The term assessment is being used increasingly to refer to the intensive study of an individual, leading to recommendations for action in solving a particular problem.”
- The goal of the assessment process is a comprehensive evaluation of individuals, usually in the present.
- Often it includes a formulation of a treatment plan that will result in positive and predictable outcomes.
- Ways to conduct assessments include:
- Structured clinical interviews
- DSM-IV-TR (2000)—Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, published by the American Psychiatric Association (APA)
- Mental Status Exam (MSE) is being “increasingly used by counselors in work settings requiring assessment, diagnosis, and treatment of mental disorders”
- Overall, assessment is crucial because it allows counselors not only to determine what a client’s problem is but to learn the client’s orientation to problem solving.
Resource: Gladding, S.T. (2011). Counseling: A comprehensive profession (7th ed.). Upper Saddle, NJ: Pearson-Merrill.
Answers to Some FAQs
Contributor: Yvette McBride Thomas
1. What happens if a patient has no progress for a long time?
Sometimes when a patient goes along time with no progress it can be one or a combination of several things: 1) The patient has become comfortable with the progress made up to that point and could possibly be afraid to move on; 2) sometimes patients sabotage their own progress because they are not use to having any success in their lives; 3) the relationship with the counselor may be the only positive relationship in their lives and they don’t want it to end. This list is not limited; it will be up to the counselor to help the client discover why they are not progressing further. This is where the stages of change will be very helpful and ASAM dimension 4. Treatment acceptance/resistance (Process of change). It is sometimes helpful to walk the client through each stage and help them discover where they are in their recovery and why they are stuck. Being stuck is a setup for relapse and if the client is unaware of their relapse triggers they may return to using and sometimes they will relapse to stay in treatment.
2. Will treatment be stopped?
Treatment usually will not be stopped until all avenues have been explored. Using the ASAM guidelines will help identify the possible challenges facing the client. They may not know what the challenge may be or if they do they do not know how to put it into words. If the client is really resistant to treatment and is not ready to make the necessary change or do the required work they will discontinue treatment on their own.
ASAM Dimension 4. Treatment acceptance/resistance/stages of changes:
a. Denial
b. Surrender and compliance
c. Process of recovery
d. Treatment issues
e. 12-step philosopy
f. Attitudes in recovery and addiction
g. Patient in need of information on treatment and program tools
3. Or would treatment be changed to something else?
The treatment goals can change based on the new information discovered. This may also be an opportunity to introduce the client to a new person via referral and explain to the client that based on the treatment changes it maybe beyond your scope of expertise (except when the client states that there has been some physical/sexual abuse) You can also suggest that the client attend a 12step support meeting for a specific area (i.e. ACOA or Coda)
ASAM Placement Criteria
Contributor: Yvette McBride Thomas
American Society of Addiction Medicine (ASAM) dimensional treatment plan categories.
The following are taken from the six dimensions of the ASAM patient placement criteria. The universal problem areas will be used to formulate treatment plans
Problem areas:
1. Acute alcohol and/or drug intoxication
2. Biomedical conditions and complications
3. Emotional/behavioral conditions
4. Treatment acceptance/resistance
5. Relapse potential
6. Recovery environment
Each of these problems is broad enough to encompass a variety of sub-categories
- Acute alcohol and/or drug intoxication
a. Disease concept
b. Post-acute withdrawal
c. Effects of alcohol and/or drugs
d. Eating disorders
e. Any other signature medical issues - Biomedical condition and complications
a. Client in need of information about std’s and hiv
b. Client is in need of nutrition information
c. High risk pregnancy
d. Any other significant medical issues - Emotional/behavioral conditions
a. Anti-social behavioral parents
b. Criminal behavior
c. Dual diagnosis
d. Co-dependency
e. Sexuality
f. Family conflicts/roles
g. Self-esteem
h. Spirituality
i. Communication/socialization skills
j. Parenting skills
k. Resentment/anger
l. Process of change
m. Obsessive/compulsive
n. Dysfunctional/relationships
o. Illiteracy
p. Feelings (gratitude, loss & grief, shame & guilt) - Treatment acceptance/resistance’s/stages of changes
a. Denial
b. Surrender and compliance
c. Process of recovery
d. Treatment issues
e. 12-step philosopy
f. Attitudes in recovery and addiction
g. Patient in need of information on treatment and program tools - Relapse potential
a. Relapse prevention plan
b. Understanding effects of people, places, and things on addiction and recovery
c. Signs and symptoms of relapse - Recovery environment
a. Self-help meetings
b. Aftercare plan
c. Halfway house/recovery home
d. Alcohol and/or drug free work place
e. Constructive use of leisure time
f. Budgeting
g. Occupational counseling
LCDC Exam Review 