Treatment Settings

Question 1

Dual Diagnosis

Answer 1

clients w/ mental illness and a substance abuse diagnosis (usually require more frequent or longer hospitalizations than those with only a mental illness dx)

OR

client w/ mental illness development or developmental or intellectual disability dx

tend to have higher rates of nonadherence to tx and poorer long-term outcomes

recommended care = integrated care (rather than split or isolated care for the separate dx’s)

Question 2

Assertive Community Treatment (ACT)

Answer 2

provide many services that are necessary to stop the revolving door of repeated hospital admissions punctuated by unsuccessful attempts at community living

• skill training, support and teaching should be done int he community where it was needed rather than in the hospital
• problem-solving oriented, staff member attend to specific life issues no matter how mundane
• most services are provided directly rather through the referrals
• services are implemented in client’s home or communities (not offices)
• highest level of outpatient care

Question 3

Milieu

Answer 3

community setting w/ patients

Question 4

Inpatient Hospital Tx

Answer 4

short term:

• sometimes client will stay in ED, boarding, hoping that this period of time will allow the person to avoid admission and/or be able to benefit from less intensive services
• client have improved feelings of self-esteem and self-control
• clients who spend fewer days. in the hospital were just as likely to attend follow-up programs and more likely to be employed and have improved social functioning

long term:

• for those with severe and persistent mental illness who continue to require acute care services
• state hospitals

Question 5

Interdisciplinary Team Members

Answer 5

• pharmacist
• psychiatrist
• psychologist
• psychiatric nurse
• SW
• recreation therapist
• vocational rehab
• OT
• case manager

Question 6

Pharmacist

Answer 6

meds, management of SEs and interactions w/ nonpsychiatric meds

Question 7

Psychiatrist

Answer 7

physician certified in psychiatry, dx of mental disorders, rx of meds

Question 8

Psychologist

Answer 8

doctorate in clinical psychology and is prepared to practice therapy, conduct research, and interpret psychological tests. may participate in the design of therapy programs for groups of individuals

Question 9

Psychiatric Nurse

Answer 9

evaluates effectiveness of tx including meds. RN’s who get a masters in mental health may be certified as clinical specialists or licensed as advanced practitioners who can prescribe meds in many states

Question 10

Social Worker

Answer 10

may practice therapy and often have primary responsibility for working w/ families, community support, and referrals

Question 11

Recreation Therapist

Answer 11

helps client to achieve a balance of work and play in life and provides activities that promote constructive use of leisure or unstructured time

Question 12

Vocational Rehabilitation Specialist

Answer 12

determines clients interests and abilities and matches them w/ vocational choices

clients are assisted in job-seeking and job retention skills as well as in pursuit of further education if needed/desired

Question 13

Case Manager

Answer 13

nurses or social workers who follow the client from admission to discharge and serve as liaisons between client and community resources, home care, and third-party payers

Question 14

Recovery Model

Answer 14

recovery is possible!

patient-centered care

pt should have role in own tx

4 major dimensions support recovery:

• health: managing disease or symptoms and making informed, healthy choices that support emotional and physical health
• home: stability and safe place to live
• purpose: meaningful daily activities and having the independence, income, and resources to participate in society
• community: relationships and social connections that provide support, friendship, and love