Set III Flashcards
What effect does the lack of self-awareness by a journeyman have on a patient
It can limit the journeyman’s ability to be accepting of a patient.
Define empathy.
Acknowledging how a patient feels without actually feeling the same way.
When establishing a therapeutic alliance initially, how will the patient view the interviewer?
The patient will view the interviewer as the authority figure.
Why is it important for the patient to view the interviewer as an ally instead of a person who is in a position of authority? Give two reasons.
If the interviewer remains in a position of authority, the patient will become increasingly dependent upon the interviewer and expect the interviewer to solve the patient’s problems for him or her and the patient may continue to avoid taking responsibility for his or her life. Secondly, this will help the patient to understand that we are working as a team, in unison, and for a common goal. It will also help the patient understand that he or she must take an active role in the process of improving his or her situation or emotional health.
What interviewing skills are considered critical?
Being self-aware, capable of conveying acceptance, being observant, and possessing empathy are critical characteristics.
What is verbal following?
Responding verbally to what is being said without changing the subject.
What words are considered most effective when using open-ended questions?
Who, what, where, when, or how.
What words are often associated with close-ended questions?
Is, are, do, or did.
What are the benefits of using reflection in an interview?
hint: 3 things
It focuses attention on current feelings, encourages the patient to talk, and provides feedback to the patient on how the interviewer sees the situation affecting the patient emotionally.
What is the benefit of self-disclosure to a patient in an interview?
It communicates to the patient that you have a clear understanding of what he or she is going through because, perhaps, you have been through something similar. Self-disclosure also validates your empathy.
How do some patients mask their status as a self-referral?
In the fact that his or her spouse or supervisor is highly recommending he or she seeks assistance.
What information can be gained by reviewing the patient’s Outpatient Record?
Psychiatric treatment, chronic medical conditions, or injuries that may be related to the patient’s visit. Medications. Recent or current medication usage can contribute to or mask the patient’s presenting complaint.
When should you avoid soliciting information from a self-referred patient’s family?
If the patient is self-referred, cooperative, cognizant, and a good historian.
What are some instances when a self-referred patient’s commander or first sergeant can be contacted without the consent of the patient?
Suicidal and homicidal ideation, threats or gestures; threats to national security, or inability to perform PRP responsibilities.
What are some examples of patients who report to the clinic as non-voluntary referrals?
CDEs, an allegation of family maltreatment and any substance abuse incident will generally initiate a mandatory referral.
Why might family members be uncooperative as a resource of the non-voluntary referral?
Despite sometimes being victims of abuse themselves for fear of reprisal by the alleged offender, fear of getting the referred member in trouble, or fear of losing their livelihood if the sponsor is prosecuted or removed from the military.
Many of our relationships are formed or centered on which individuals?
Parents, siblings, peers, and coworkers.
What is the benefit of knowing your patient’s educational level?
Allows you to better communicate and suggest treatment options for the patient.
In which area of the substance use history would you ask about how often the patient is/was using a substance?
Frequency.
What is the benefit of taking what a patient reveals regarding his or her use history and paring it with progression?
It will give you an idea of increased tolerance and or a progression to a more powerful substance.
What is the primary purpose of conducting a MSE?
hint: gathering objective data which may be helpful in these 4 things.
Gather objective data which may be helpful in determining etiology, diagnosis, treatment, and prognosis.
What subtle behavioral changes in a patient’s response may indicate that you have touched on an area of importance to the patient?
Such things as a change in voice pitch, change in eye contact, tears, heavy sighs, overt swallowing or other physical responses, and hesitancy to answer particular questions, may all be indicators that you have touched on an area of importance to the patient.
What does using statements in a matter-of-fact manner accomplish when documenting the MSE?
It eliminates embellishment and personal emotions that are often inserted into an observation.
Define the term mood as it pertains to a patient’s emotions.
A patient’s internal emotional tone.
Define the term affect as it pertains to a patient’s emotions.
The observable external expression of the patient’s internal emotional tone.
What does an inappropriate mood often signify?
Often a sign of emotional illness or more serious psychological problem.
What are the primary types of affect?
Appropriate, inappropriate, flat, blunted, labile.
Define the term cognitive.
Mental awareness or fully informed.
“Can you tell me where you attended school?” would be an example of testing what kind of memory?
Remote memory.
If a patient cannot accomplish a serial 7 or 3 task, what might this indicate?
A learning deficit, or organic brain disease.
Describe the term thought process as it applies to a patient.
The patient’s ability to interpret and mentally organize the flow of conversation or events occurring around him or her.
What are good measures of insight?
A patient’s degree of understanding and capacity to understand what is causing his or her distress or illness.
What is one of the best indicators of a patient’s judgment?
Past decisions he or she has made in dealing with situations and problems of everyday life.
What are the most common types of perceptual disturbance?
Hallucinations and illusions.
What is generally true of a patient who has a specific suicide plan?
The more specific the plan the higher the risk for suicide.
Define motivational interviewing.
MI is a patient-centered, directive method for enhancing intrinsic motivation to change by exploring and resolving ambivalence.
In the autonomy component of MI, what position does this method call on the clinician to take with regard to a client’s decision to change his or her current behavior?
Respect the patient’s right for self-determination, regardless of whether or not the clinician agrees with the decisions of the patient.
What four principles guide the application of motivational interviewing?
hint: the symbols
Express empathy, develop discrepancy, roll with resistance, and support self-efficacy.
Explain the term self-efficacy as it pertains to motivational interviewing?
Refers to a patient’s belief in his or her ability to resolve problems and make positive changes.
What establishes the criteria used to determine appropriate DETOXIFICATION SERVICES?
Acute intoxication and/or withdrawal potential.
In addition to the questions ascertaining the appropriate detoxification services, what else should the counselor continually assess?
Safety of the patient.
Which dimension forms the basis for treatment recommendations?
All six dimensions.
During which dimension does the counselor assess factors within the patient’s environment that could impact his or her ability to be successful?
Dimension 6, Recovery environment.
