Chapter 16: Assessment Flashcards
(43 cards)
aims of a recovery-focused assessment include:
- to promote and validate the development or personal meaning
- to amplify strengths rather than deficits
- to foster personal responsibility rather than passive compliance
- to support the development of a positive identity rather than an illness identity
- to develop hopefulness rather than hopelessness
exploring the importance of personal meaning in the recovery process, the focus is on…
avoiding the imposition of meaning on individuals fulfilling the role of a mental patient
Baumeisters conceptual framework: four needs for meaning
purpose
value
efficacy
self-worth
purpose: definition and implication
present events draw meaning from their connection with future events.
listen for personal meaning and meaning-making approaches in accounts of past and current events
two types of purpose
- goals (an objective outcome: getting a job, a child)
- fulfillments (a subjective anticipated state of future fulfilment -> being in love, going to heaven)
wat zijn de implications van goals & fulfillments
goals = identify personal goals, provide goal-setting and goal-striving support, facilitate access to mainstream opportunities (employment, education, leisure, social)
fulfullment = encourage optimism and hopefullness
hoe kan je optimism and hopefullness supporten
- where would you like to be in 5 years?
- how can i support you to work towards that dream?
values =
lends a sense of goodness or positivity to life, can justify certain courses of action
values implication
support spiritual development by facilitating access to groups etc.
efficacy=
a belief one can make a difference
efficacy implication=
identify and amplify times of wellbeing, when person showed mastery and coped with unanticipated difficulties.
plan ahead
identify personal and social resources
support the development of crisis plans
self-worth=
reasons for believing one is a good, worthy person
self-worth implications
actively encourage the person to take on giving back roles (voluntary, writing, becoming a mentor). foster affiliation with high status groups
cultural competence =
a means to facilitate individualized approaches, fostering recovery
3 approaches to understanding experiences of psychosis:
- finding specific and concrete meanings
- understanding metaphoric or thematic associations
- understanding the purpose and significane of a persons elaboration of their psychosis
3 levels of understanding
- understanding the meaning of madness
- understanding the meaning in madness
- understanding the meaning through madness
Lazarus cognitive appraisal model defines coping as…
constantly changing cognitive and behavioural efforts to manage demands.
coping strategies: problem-focused, emotion-focused, meaning-focused.
coping responses are further classified into avoidance (deny or seek escape) versus approach strategies (actively confront)
clinical assessment should focus on 4 dimensions:
- deficiencies and undermining characteristics of the person
- strenghts and assets of the person
- lacks and destructive factors in the environment
- resource and opportunities in the environment
emotional avoidance: coping response, thoughts, feelings, behaviours, consequences/problems
- emotionally withdrawal from a too painful reality
- there is no problem
- drained, dead inside, wrung out, heavy, anxious, depressed
- drugs, alcohol, social isolation, day-dreaming, excessive sleep, giving up
- disengaged, amotivational, affective blunting, passivity, lacking insight
reframing: coping response, thoughts, feelings, behaviours
- try to make sense of a situation in a way that fits with current beliefs
- i can make sense of whats happened without changing myself
- suspicious, anxious, afraid, alone, uncertain, angry
- odd behaviour, increased religious activity
- paranoid, delusional, reasoning bias, lacking insight
active engagement: coping response, thoughts, feelings, behaviours
- try to change the world to fit with beliefs
- i can change the situation without changing myself
- engaged, angry
- challenging
- non compliant, manipulative
integration: coping response, thoughts, feelings, behaviours
- change beliefs, values, and goals to better fit reality
- this is how things are: what now?
- acceptance, combined happiness & sadness
- ventilation of feelings, use of social support
the tendency to emphasize deficits is reinforced by…
- the structured approach of clinicians, who often overlook individuals coping abilities and positive aspects.
- the lack of a shared language for dimensions beyond deficits contributes to this imbalance
- the expectation that indiviudals are to be treated: individual and problem centered focus.
- questions clinicians ask structure the dialogue: perpetuating a deficits focused discourse
Mental Health Assessment onderdelen
- current strengths and resources
- learning from the past
- personal goals
- past coping history
- inherited resources
- family environment
- developmental history
- valued social roles
- social support
- personal gifts (forensic history, drugs and alcohol)
- personal recovery (premorbid personality)
