GEHART CHAPTER 12 - CLINICAL ASSESSMENT

Question 1

WHY DO A CLINICAL ASSESSMENT?

Answer 1

1. TO COORDINATE CARE WITH OTHER PROFESSIONALS/PROVIDERS.
2. TO DECIDE HOW TO KEEP CLIENTS AND THE PUBLIC SAFE.
3. DETERMINE NEED FOR REFERRALS AND ADDITIONAL SERVICES.
4. IDENTIFY POTENTIAL COURSES OF TREATMENT

Question 2

WHAT IS MY LENS THROUGH WHICH I SEE A CLIENT?

Answer 2

MY PERSONAL CULTURE, VALUES, HISTORY, BELIEFS, AND NORMS = MY WORLDVIEW.

Question 3

WHY BECOME AWARE OF MY LENS?

Answer 3

IN ORDER TO SEE MY CLIENT MORE CLEARLY AND WITH LESS BIAS.

Question 4

DIAGNOSIS AND GENDER

Answer 4

WOMEN CAN EASILY BE OVERPATHOLOGIZED.

MEN MAY BE UNDERDIAGNOSED IF THEY ARE HESITANT TO DISCUSS EMOTIONS.

Question 5

CULTURAL FORMULATION

Answer 5

ENCOURAGING CO TO STEP BACK TO LEARN HOW A CL PROBLEMS ARE VIEWED IN THE CONTEXT OF THEIR CULTURE. ALSO CONSIDER RELEVANT SOCIOPOLITICAL AND SOCIAL JUSTICE ISSUES

Question 6

SYSTEMIC PERSPECTIVE ON DIAGNOSIS

Answer 6

A DX DESCRIBES THE BEHAVIORS THAT A PERSON HAS ADOPTED TO MAINTAIN BALANCE IN CURRENT THEIR SYSTEM/RELATIONSHIPS.

Question 7

POSTMODERN PERSPECTIVE ON DIAGNOSIS

Answer 7

SKEPTICAL. CLIENTS MAY INTEGRATE DX INTO THEIR IDENTITY WHICH CAN CREATE A SELF FULFILLING PROPHECY.

Question 8

GENERAL FAMILY THERAPY APPROACH TO DIAGNOSIS

Answer 8

DX IS CONSIDERED TO BE JUST ONE VOICE IN A CONVERSATION. SOME CLIENTS WILL SEE DX AS HELPFUL IN TREATMENT, OTHERS HURTFUL. THE SYMPTOMS, FEELINGS, AND BEHAVIORS THAT QUALIFY A PERSON FOR A DX ARE SUBJECT TO CHANGE BASED ON THE CHANGES MADE IN THEIR RELATIONSHIPS/SYSTEMS

Question 9

RECOVERY MODEL

Answer 9

HELPING CLIENTS LEAD MEANINGFUL LIVES INSTEAD OF REDUCING THEIR SYMPTOMS OF A MH DX.
EMPHASIZES PSYCHOSOCIAL FUNCTIONING, DEEMPHASIZES DIAGNOSTIC LABELING

Question 10

MENTAL HEALTH RECOVERY-ORIENTED CARE

*SELF-DIRECTION

Answer 10

CL EXERCISE CHOICE OVER THEIR PATH TO RECOVERY/TREATMENT.

Question 11

MENTAL HEALTH RECOVERY-ORIENTED CARE

*INDIVIDUALIZED/PERSON-CENTERED

Answer 11

PATHS TO RECOVERY ARE BASED ON THE INDIVIDUAL’S UNIQUE STRENGTHS, RESILIENCIES, PREFERENCES, EXPERIENCES, AND CULTURAL BACKGROUND

Question 12

MENTAL HEALTH RECOVERY-ORIENTED CARE

*EMPOWERMENT

Answer 12

CL HAVE AUTHORITY TO CHOOSE FROM OPTIONS AND PARTICIPATE IN MAKING DECISIONS.

Question 13

MENTAL HEALTH RECOVERY-ORIENTED CARE

*HOLISTIC

Answer 13

ENCOMPASSING ALL ASPECTS OF LIFE: MIND, BODY, SPIRIT, COMMUNITY

Question 14

MENTAL HEALTH RECOVERY-ORIENTED CARE

*NONLINEAR

Answer 14

RECOVERY IS NOT A STEP BY STEP PROCESS BUT RATHER ONGOING PROCESS WITH GROWTH AND SETBACKS

Question 15

MENTAL HEALTH RECOVERY-ORIENTED CARE

*STRENGTHS BASED

Answer 15

FOCUSES ON VALUING AND BUILDING STRENGTHS, ABILITIES, AND RESILIENCE.

Question 16

MENTAL HEALTH RECOVERY-ORIENTED CARE

*PEER SUPPORT

Answer 16

CL ARE ENCOURAGED TO ENGAGE WITH OTHER CLIENTS IN PURSUING RECOVERY

Question 17

MENTAL HEALTH RECOVERY-ORIENTED CARE

*RESPECT

Answer 17

FOR RECOVERY TO OCCUR, CONSUMERS NEED TO EXPERIENCE RESPECT FROM PROFESSIONALS, COMMUNITY, AND OTHER SYSTEMS

Question 18

MENTAL HEALTH RECOVERY-ORIENTED CARE

*RESPONSIBILITY

Answer 18

CL ARE PERSONALLY RESPONSIBLE FOR THEIR RECOVERY AND SELF-CARE

Question 19

MENTAL HEALTH RECOVERY-ORIENTED CARE

*HOPE

Answer 19

RECOVERY REQUIRES A BELIEF IN THE SELF AND A WILLINGNESS TO PERSEVERE THROUGH CHALLENGES.

Question 20

PARITY AND NONPARITY DX

Answer 20

PARITY - TYPICALLY INCLUDE SEVERE MH DISORDERS AND MUST BE PRIMARY DX. INSURANCE COMPANIES MUST PAY FOR IT.

Question 21

ETIOLOGY

Answer 21

THE CAUSE OR ORIGIN OF A DISEASE

Question 22

INTERNALIZING DISORDERS

Answer 22

MOSTLY EMOTIONAL AND COGNITIVE SYMPTOMS THAT OCCUR WITHIN THE PERSON

Question 23

EXTERNALIZING DISORDERS

Answer 23

MORE BEHAVIORAL AND EXTERNAL SYMPTOMS

Question 24

ICD

Answer 24

INTERNATIONAL CLASSIFICATION OF DISEASES

Question 25

AXIS I

Answer 25

CLINICAL DISORDERS THAT ARE THE FOCUS OF TREATMENT, PRIMARY REASON FOR VISIT LISTED FIRST, INCLUDING DEVELOPMENTAL AND LEARNING DISORDERS

Question 26

AXIS II

Answer 26

UNDERLYING OR PERVASIVE CONDITIONS, INCLUDING PERSONALITY DISORDERS, DEFENSIVE MECHANISMS, AND MENTAL RETARDATION

Question 27

AXIS III

Answer 27

MEDICAL CONDITIONS AND DISORDERS

Question 28

AXIS IV

Answer 28

PSYCHOSOCIAL STRESSORS AND ENVIRONMENTAL CONDITIONS THAT MAY BE CONTRIBUTING TO A CONDITION AND/OR TREATMENT. E.G., ECONOMIC OR HOUSING PROBLEMS, PROBLEMS WITH PRIMARY SUPPORT SYSTEM (FAMILY, PARTNER, ETC.)

Question 29

AXIS V

Answer 29

GLOBAL ASSESSMENT OF FUNCTIONIN (GAF) - 70 AND ABOVE - SHOWS ADAPTIVE COPING AND GREATER MH - 60-69 - MILD SYMPTOMS (INSURANCE TYPICALLY REQUIRES 69 OR BELOW) - 50-59 - MODERATE SYMPTOMS - 40-49 - SEVERE SYSTEMS - 39 AND BELOW - SIGNIFICANT IMPAIRMENT THAT GENERALLY REQUIRES HOSPITALIZATION AND INTENSIVE TREATMENT.

Question 30

SUBTYPES

Answer 30

MUTUALLY EXCLUSIVE SUBGROUPS WITHIN THE DIAGNOSTIC CATEGORY

Question 31

SPECIFIER

Answer 31

USED TO NOTE INFORMATION ABOUT A CL'S CONDITION THAT MAY BE USEFUL FOR TX DECISIONS, WRITTEN AFTER THE NAME OF THE DIAGNOSIS ON THE DX LINE.

Question 32

DIMENSIONAL APPROACH

Answer 32

VARIATION OF INTENSITY ON A GIVEN SYMPTOM OR DIMENSION

Question 33

NOS

Answer 33

NOT OTHERWISE SPECIFIED - NO LONGER BEING USED

Question 34

NEC

Answer 34

NOT-ELSEWHERE-CLASSIFIED WHICH MAY BE AN "OTHER SPECIFIED DISORDER" OR "UNSPECIFIED DISORDER."

Question 35

OTHER SPECIFIED DISORDER

Answer 35

ALLOWS CO TO DOCUMENT THE SPECIFIC REASON A CL DOES NOT MEET THE CRITERIA FOR A SPECIFIC DX.

Question 36

UNSPECIFIED DISORDERS

Answer 36

USED WHEN A CL EXPERIENCES SIGNIFICANT CLINICAL DISTRESS BUT DOES NOT MEET THE CRITERIA FOR THE DISORDER. E.G., IN THE ER.

Question 37

WHODAS 2.0

Answer 37

WORLD HEALTH ORGANIZATION DISABILITY ASSESSMENT SCHEDULE 2.0 -USED TO ASSESS DISABILITY IN THE DOMAINS OF COMMUNICATION, GETTING AROUND, SELF-CARE, GETTING ALONG WITH PEOPLE, LIFE ACTIVITIES, AND PARTICIPATION IN SOCIETY.

Question 38

SYSTEMIC APPROACH TO THE MSE

Answer 38

USING THE SYSTEMIC PROBLEM ASSESSMENT INVOLVES TRACING INTERACTIONS FROM INITIAL HOMEOSTASIS TO ESCALATION OF SYMPTOMS (POSITIVE FEEDBACK LOOP) UNTIL THE SYSTEM RETURNS TO NORMAL OR HOMEOSTASIS.

Question 39

POSTMODERN APPROACH TO THE MSE

Answer 39

HONORING A CL'S DESCRIPTION AND PERCEPTION OF A PROBLEM | MAPPING THE INFLUENCE OF A PROBLEM

Question 40

CROSS-CUTTING SYMPTOM MEASURES

Answer 40

MEASURES THAT ALLOW CO TO QUICKLY IDENTIFY KEY SYMPTOMS THAT MAY OCCUR ACROSS VARIOUS DX. TWO TIER SYSTEM. LEVEL 1 - BROAD ASSESSMENT FOR IDENTIFYING POTENTIAL AREAS OF CONCERN LEVEL 2 - ASSESS IN GREATER DETAIL AREAS IDENTIFIED IN LEVEL 1.

Question 41

MAKING A DIAGNOSIS

Answer 41

RULE OUT SUBSTANCE USE RULE OUT MEDICATIONS AND MEDICAL CONDITIONS TRAUMA CO CONSIDERS ALL FORMS OF INFORMATION - CL REPORT, CO OBSERVATION, FAMILY DYNAMICS, GENDER AND CULTURAL FORCES, ETHICAL ISSUES, (LABELING) AND USE THEIR BEST JUDGEMENT.