Assessment Concepts

Impact of trauma and violence

• traumatization results in neurological distress that does not go away/ takes away from baseline and cannot be returned.

• Indicators of traumatic stress include SUD, poor interpersonal relationships, depression, anxiety, agoraphobia, negative self-image, etc.

Family dynamics and their effects

• family dynamics has a significant influence on how they see themselves, wellbeing, and interpersonal relationships.

healthy functioning characteristics:

• each member as an individual

• Routines and structure

• Connection to extended family or community

• Realistic expectations

• Quality time without conflict

• Taking care of individual needs not just family needs

Impact of poverty

• family income appears to be more related to children’s success/achievements rather than emotional development

• Research thus far suggests that interventions during early childhood is the most important in reducing poverty impacts

Dynamics of interpersonal relationships and relationship development

• family- client views/ behaviors are heavily influenced by family systems approach. Equifinality is the ability of the family to accomplish the same goals through different routes. Negative feedback loops maintain stability and positive feedback loops promote change.

• Couple-

• Groups-

Components of biopsychosocial assessment

1. Bio- physical/medical hx

2. Psycho- current psychiatric conditions/ tx in the past

3. Social- client systems that contribute to strengths, weaknesses, or resources

Mental status exam

A necessary part of every assessment no matter the presenting problem.

1. Appearance

2. Orientation

3. Speech pattern

4. Affect/mood

5. Impulsivity/ potential for harm

6. Judgment/insight

7. Thought process

8. Intellectual function/memory

Biopsychosocial factors related to mental health

1. Bio- genes contribute to the development of psychiatric disorders

2. Psycho- personality includes a wide variety of psychological responses to cope with different situations

3. Social- influence dramatically ie socioeconomic status, gender, life events, culture

Co-occurring disorders

1. Each must be independent and not symptomolgy resulting from other disorder.

2. Disorders and conditions may not be equivalent in severity or timeline

Defense mechanisms

1. Acting out- actions rather than feelings

2. Compensation- making up in other areas rather than deficiencies

3. Conversion- disturbance of body function, usually sensory

4. Denial- inability to acknowledge significance of feelings

5. Devaluation- attributes exaggerated negative qualities to self or others

6. Displacement- directing an impulsive towards something else in a less threatening situation

7. Identification- pattern themselves after sig other

8. Identification with aggressor- becoming more powerful to counteract negative feelings

9. Incorporation- figuratively ingesting representation of person

10. Intellectualization- focusing on facts and logic to avoid negative feelings

11. Rationalization- giving believable explanation

12. Repression- expressed clinically by amnesia

13. Splitting- all good or all bad

14. Sublimation- turning maladaptive behaviors into something more socially acceptable (anger issues turning to sports)

15. Undoing- using words or actions to reverse unacceptable thoughts or feelings

Racial, ethnic, and cultural development through the lifespan

• adolescent model based on stages- 1. Unexamined identity 2. Identity search 3. Identity achievement

• Classic model based on statuses: 1. Preencounter 2. Encounter 3. Immersion-Emersion 4. Internalization and Commitment