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6 Cards in this Set
- Front
- Back
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Functional Impairment
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problems interfere with social, occupational, interpersonal realms; level of severity
MMSE: range 0-30 measures cognitive imparmt and indicates level of severity (none, mild, moderate, severe) rough measure |
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FI Treatment planning
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severe/high levels: inpatient setting, partial hospitalization when stablized
low levels: outpatient setting longer duration for those with serious diagnosis, poor premorbid functioning, 25-50 y/o, low level of social support short duration: acute disorder, external stress is primary cause, good premorbid level of functioning high levels: pharmalogical and also have other severe diagnoses (anxiety, depression) low levels: psychosocial acute FI, symptoms focus severe Fi: can be insight-focus for longer duration or symptom focus for shorter duration No treatment for negative response, no response or spontaneous imporvement acute: structure, directive, active interventions |
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Problem Complexity
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underlying patterns; presence of several problem domains/diagnoses (co morbidity), pervasive patterns of problem behavior, personality disorder
no well-defined instrument to assess, but MCMI can give indication if elevations in personality scales. TAT can indicate how client relates to others, copes with interpersonal conflict |
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Problem Complexity planning
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primarily psychosocial modality
if high problem complexity: more intense treatment, longer duration, to address long standing personality problems if low problem complexity: low intensity and less frequent high p/c: individual, group, family therapy to explore patterns of responses and patterns in relationships low p/c: individual high p/c: insight/awareness-focus orientations to resolve underlying conflicts low p/c: skill building and symptom-focus to treat specific symptoms outpatient setting high: 2 chair, dream work, projective test of free association, cathartic discharge, interpreting transference and resistance low: behavior contracting, social skills training, graded exposure, reinforcement of target beh, cbt techniques |
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Resistance
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defense against what client percieves as others attempting to exert sense of control; need to control, hostility, impulsivity, direct avoidance, difficulty taking feedback, lack of empathy
MMPI could indicate resistance with high elevations of L and K validity scales (client has lied) |
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Resistance treatment planning
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duration depends on if high or low resistance
psychosocial modality; individual format high resistance; insight and awareness-focus low resistance: symptom and skill focus outpatient setting high resistance; nondirective, supportive, self directed techniques. Self monitoring, therapist reflection, support and reassurance Low: more directive, structured approaches. Behavior contracting, contingency management, graded exposure, direct hypnotic suggestion, cognitive restructuring, directed imagery |
