| back 1 - developed my Engle
- posits that health and illness
result from the interplay between biological, psychological, and
social factors
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front 2 Biopsychosocial-spiritual model | back 2 - model oftentimes used by counselors
- expands on the
biopsychosocial model developed by Engle
- includes the idea
that one must also consider the ways in which individual find
meaning in their lives
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front 3 Indicators of biopsychosocial stress | back 3 - cognitive= difficulty concentrating, poor memory,
anxiousness
- emotional=tearfulness, agitation, irritability,
loneliness, depression, unstable moods, detachment
- physical= weight loss/gain, swelling or aches, GI problems,
insomnia, heart palpitations, chest pain, breakouts, fatigue,
frequent minor illnesses
- behaviors= change in appetite,
withdrawal from preferred activities, nail biting, pacing, tics,
hyperactivity, increased aggression
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front 4 Components of the biopsychosocial assessment | back 4 - Identification= demographic info
- Chief
complaint=client's version of what the problem is
- social/environmental issues=evaluates development and physical
settings: friends, family, peers, work, housing, financial
status
- history= multi stage process of obtaining family hx,
developmental hx, medical hx, substance use, mental health hx
- MSE= concise, complete eval of client's current mental
functioning level regarding cognitive and behavioral aspects
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| back 5 - process in which counselor gathers info to make a diagnosis
based on DSM5TR
- can be structured or unstructured, includes
hx, development, etc
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| back 6 - the system of knowledge, concepts, rules, and practices that
are learned and passed on throughout generations
- dynamic
- oftentimes, one experiences cultures that
intersect at once= leads to a unique individual identity
- must be considered by counselors as culture interacts with
client experiences
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| back 7 - race=category of identity based on physical traits and
biological characteristics
- ethnicity= specifies an
individual's community or group (Can be self assigned or attributed
by others)
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front 8 DSM 5 Cultural Formulation Interview | back 8 - CFI
- designed to evaluate client perspective in order
to to gain a comprehensive understanding of the individual's
specific experience
- 16 questions across 4 domains,
generally asked in an initial interview
- cultural definition
of the problem
- cultural perceptions of cause, context,
support
- cultural factors affecting self coping
- past help seeking
- provides emphasis on
the way mental illness is perceived thru cultural lens
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| back 9 prevailing circumstances, symptoms, difficulties that the client
believes is a problem requiring therapy |
front 10 factors that may influence the initial interview | back 10 - counselor's personal characteristics
- client may adjust
responses to questions based on how they perceive the counselor's
characteristics
- counselor's demographics may influence how
much clients want to share
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front 11 Components of the initial interview | back 11 - establish rapport
- start where the client is
- exploratory interviewing=delve into the topics that seemed
particularly troubling to client as they discuss the presenting
problem
- questioning= use open, closed, clarification
questions to get deeper insight into problem
- observation
- note taking of subjective and objective
data
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| back 12 - normal= those that are common to the majority of the
population, as related to emotional functioning, social
interactions, mental capacity
- abnormal= maladaptive,
dysfunctional, or disruptive bxs. Can be an exaggeration of a normal
bx or be the absence of a typical response
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| back 13 - Deviant Bx=withdrawal from society's concept of appropriate
bx
- Dysfunction= interferes with daily living
- Distress= does the dysfunction cause distress?
- Danger=
danger to self and/or others
- Duration= length of
symptoms
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front 14 DSM 5 differences (Compared to DSM IV) | back 14 - exclusion of Asperger syndrome
- loss of subtype
variations of schizophrenia
- renaming of gender identity dx
to gender dysphoria
- PTSD criteria include application to
combat vets and first responders
- omission of bereavement
exclusion for depressive dx
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| back 15 - about 7% of US population has at least 1 episode of MDD
annually
- 3x more frequent in ages 18-29 than other age
ranges
- 1.5-3x more likely in women than males
- 64% of
cases occur with severe impairment
- length of mdd is a
factor in recovery
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| back 16 - premenstrual dysphoric dx
- when pregnant, women with
pmdd tend to notice symptoms disappears; after pregnancy these
symptoms can be exacerbated
- SI very common
- tends
to follow a predictable, cyclical pattern
- higher rate of
postpartum depression is expected (but research shows that women
with pmdd did not have higher occurrence of it than control
groups)
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| back 17 - autism spectrum dx and reactive attachment dx share many
symptoms but are different
- children with RAD must
experience the component of severe social neglect (while children
with ASD are less likely to have a hx like this)
- ASD
presents individuals with difficulty in having intentional
communication (while RAD still allows children to have social
communication levels representative of their intellect)
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| back 18 - disinhibited social engagement dx and ADHD
- a lot of
children who have DSED are misdiagnosed as ADHD bc the impulsivity
they may present when interacting with stranger
- it is
possible for the two to occur concurrently
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front 19 dissociative dx and trauma | back 19 - oftentimes, dissociative dx form as a result of trauma
- many of the symptoms of dissociation are determined by trauma
(e.g. embarrassed or confused by symptoms or even a desire to
conceal them from people)
- because of this, dissociative dx
are placed right next to the trauma dx section in the dsm
- many trauma dx include dissociative symptoms
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front 20 sexual dysfunction subtypes | back 20 - describes the onset of the sexual dysfunction= determines the
course of treatment
- lifelong subtype= present since first
sexual experiences
- acquired subtype= developed after a
period of normal sexual functioning
- generalized
subtype= not limited to certain types of stimulation,
situations, or partners
- situational subtype= present
only during certain situations
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front 21 neurodevelopmental vs neurocognitive dx | back 21 - neurocognitive refers to issues with cognitive functioning that
have been acquired rather than developed as a child
- neurocognitive dx represent impairment in functioning that has
increased throughout time and thus the reasoning for the abnormality
can be determined
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front 22 what determined the severity of a neurocognitive dx? | back 22 - severity of the impairment to cognitive functioning
- in
major neurocognitive dx, there is severe decline in 1+ areas of
cognitive functioning (language, or memory, or social
cognition)
- in mild neurocognitive dx, the individual can
largely still meet responsibilities of daily living (generally able
to function on their own)
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front 23 What distinguishes Cluster A, Cluster B, and Cluster C? | back 23 - A= odd and eccentric
- paranoid PD, schizoid PD,
schizotypal PC
- B= dramatic and erratic
- antisocial PD, borderline PF, histrionic PD, narcissistic
PD
- C= fearful and anxious
- avoidant
PD, dependent PD, obsessive compulsive PD
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| back 24 - mental status exam
- tool used when evaluating a client
and is part of the collection of info used to diagnose
- purpose: determine how the client is functioning mentally and
emotionally at that specific moment in time, whether its during the
initial interview or any session in the therapy process
- mostly done by observation (appearance, attitude, behaviors, and
motor functioning)
- good MSE eval should cover things such
as emotional state, their thoughts, cognitive functioning, and
general impression of the client
- cognitive portion of MSE
cannot rely only on observation- must assess for orientation,
memory, concentration, intelligence
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| back 25 - AKA dual disorders or dual diagnoses
- more prevalent in
client who have substance use dx or presently use substances
- a substance use dx often co-occurs with a mood or anxiety
dx
- should be addressed simultaneously-- and thus may required
a multidisciplinary team approach
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front 26 Signs that a co-occuring dx is present: | back 26 - mental health symptoms worsening while undergoing
treatment
- persistent substance use problems with
treatment
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| back 27 - assessed by examining a number of self-sufficient factors, like
the presence of a formally diagnoses developmental disability,
physical disability, or mental dx
- includes client's ability
to communicate needs, IQ, ability to complete self care tasks, risk
of voluntary or involuntary harm to self or others
- Levels
of care include
- outpatient services
- inpatient
services
- assisted living ina facility
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front 28 Areas to address when reviewing the problem history with client | back 28 - onset= when the problem started (may provide info re
triggers)
- progression= determining the frequency of the
problem (intermitted, acute or chronic, if there is a pattern,
etc)
- severity= how severe does the client think it is? how is
it impacting the client
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| back 29 - persons other than the client who can provide info to the
client's level of functioning
- requires an ROI (unless its a
forensic interview and there's implied consent)
- can provide
a level of objectivity when discussing the client's situation
- can be helpful when a client's info can't be trusted or is
skewed for some reason (e.g. substance use severe cognitive
impairment, mental illness or disorder)
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| back 30 - allows client to define the problem specifically and determined
factors affecting emotional wellbeing
- Antecedents= what was
going on before the problem? this could be environmental or could be
individuals in the client's life
- Behaviors= problematic
interactions/ reactions based on the antecedents.
- Consequences= cognitive (internal) and environmental (external)
interactions with the behavior. What happened as a result of the
behavior. Certain values or beliefs may be linked to the behavior
and attempting to maintain or decrease the behavior
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front 31 evaluating an individual's level of mental health functioning | back 31 - normal does not equal good and abnormal does not equal bad
- use person centered language to help de-stigmatize
- normal vs abnormal bx is culturally dependent
- use the 4
D's of abnormality to assess for mental health functioning
- deviance
- dysfunction
- distress
- danger
- duration is sometimes considered the 5th
d
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front 32 Screening clients for appropriate services | back 32 - it is important to use various tools (questionnaires,
checklists, rating scales, standardized tests) to make sure client
are getting the services they need
- standardized testing=
formal process that produces a score can be interpreted using
guidelines
- personality tests= MMPI
- projective
tests include TAT and Rorschach
- objective tests
include 16 personality factors questionnaire and Edwards
Personal preference schedule
- aptitude
test= SAT
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| back 33 - test
- more formal means to quantify info, guide tx, and
develop goals
- assessment
- more
informal. Includes surveys, interviews, observations
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front 34 List the major types of tests | back 34 - achievement
- aptitude
- intelligence
- occupational
- personality
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| back 35 - measure knowledge of a specific subject
- primarily used
in education
- GED and California Achievement Test are
examples that measure learning
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| back 36 - measure the capacity for learning and can be used as part of a
job application
- measure abstract or conceptual reasoning,
verbal reasoning, and or numerical reasoning
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| back 37 - measure mental capability and potential
- example:
Wechsler Adult Intelligences Scale and Wechsler Intelligences Scale
for Children
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| back 38 - assesses skills, values, or interests as they relate to
vocational and occupational choices
- includes the ONet
Interest profiler, the Career Assessment Inventory
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| back 39 - can be objective ( rating-scale based) or projective
(self-reporting based) and help counselor and client understand
personality traits and underlying beliefs and behaviors
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front 40 Beck Depression Inventory II | back 40 - BDI II
- inventory used to measure presence and severity
of symptoms in individuals 13+
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front 41 Bricklin Perceptual Scales | back 41 - BPS
- inventory designed for children 6+
- examines the perception the child has of each parent of
caregiver and is often used in custody cases
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| back 42 - there are 4 total: clinical multiaxial inventory 3, adolescent
clinical inventory, adolescent personality inventory, and behavioral
health inventory
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front 43 Minnesota Multiphasic Personality Inventory | back 43 - MMPI=II
- 567 item inventory
- one of the most
widely administered projective personality tests
- used to
determine indicators of psychopathology in adults 18+
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front 44 Myers Briggs Type Indicator | back 44 - inventory widely used to help people 14+ what personality trait
influence their perception of the world and decision making
process
- preference is ID'd within 4 types:
- extraverted or introverted
- sensing or
intuitive
- thinking or feeling
- judging or
perceiving
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front 45 Quality of life inventory | back 45 determined the perception of personal happiness and satisfaction in
individual 17 + |
front 46 thematic apperception test | back 46 - TAT
- projective test
- narrative and visual test
that required the individual to create a story and allows the
counselor insight into the individual's underlying emotional states,
desires, behavioral motives, and needs
- 5+
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| back 47 - visual test that records an individual's perception and
description of various inkblots
- used to determine
underlying personality or thought disorders 5+
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| back 48 observing the ABCs of a client in real time. The counselor would be
observing the client as they interact with the real world or testing
environment and noting the ABCs |
front 49 Observation of client communication | back 49 - Alertness
- primary indicator of client's level of
consciousness. alert and orient x1, x2, or x3 (person, place,
time)
- can also be described with adjectives like
lethargic, apathetic, confused
- Speech
Patterns
- how articulate (mumbling, cursing, sentence
syntax), tone, fluctuations
- Nonverbal Cues
- eye contact, facial expression, mannerisms (fidgeting,
etc)
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| back 50 - clients are asked to complete an assessment form prior to the
first session
- includes identifying info about household,
gender, age, brief description of the problem in the client's own
words
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| back 51 - diagram that depicts the client's family systems in order to
understand significant life events that may indicate familial
patterns
- can provide insight into perceived relationships
btwn client and fam
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| back 52 - reviews all systems the client is involved with
- client
can construct map of social relationships in their life (work,
church, organizations, etc
- client then uses different lines
to define the relationship btwn self these social systems (solid=
strong; dotted= fractured)
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front 53 cross cutting symptom easures | back 53 - DSM5 created
- adult and child version (adult will
complete their own; a parent may complete the child's; an
adolescents will complete the child version for themselves)
- first level= self report questions in 13 domains, rated on scale
0-4. A high enough score on this may indicate that the second level
of questioning may be needed
- second level= another level of
questioning in these domains. helps counselor identify areas of need
to help create clinical formulation
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| back 54 - world health org. disability assessment schedule 2
- assessment conducted by clinicians to analyze disability in
people 18+
- 2 versions:
- simple= client rates
difficulty on scale 1-5. summed across all 13 domains and
determined the degree of impairment in functioning
- complex= uses item0response theory based scoring, which
weighs individual items within each domain. This is done with a
computer and results in a score 0-100, where 0= no disability
and 100=full disability
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front 55 examples of self injurious bx | back 55 - cutting
- strangling self
- hitting head on
something
- ignoring medical advice
- excessive
substance use
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| back 56 middle aged adults present highest suicide risk over other age groups |
| back 57 males are more likely to commit suicide than females |
| back 58 high suicide risk, especially those healthy entrenched in social
media groups as a means of support and socialization |
front 59 types of evaluation tools | back 59 - this is to evaluate the counseling process and outcomes
- goal attainment scaling= Id problems are reframed as goals
to be address. goals are given weights or rating of importance
and addressed in that order
- target problem scaling=
help when the ID problems are hard to quantify. client IDs
severity of each target problem and rates the changes in the
problems as treatment progresses
- task achievement
scaling= tasks related to the established goal are given rating
when completed to assess progress toward goal
- surveys=
used to rate and evaluate the client's feelings about services
and may measure satisfaction
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| back 60 - first pioneered by Carl Rogers and his person-centered,
humanistic approach to counseling, Carkhuff developed a 5 point
scale to measure the counselor's levels of empathy, genuineness,
concreteness, and respect
- therapist is contradictory in
statements and nonverbal cues; exhibits defensiveness
- therapist is superficially professional but lacks
genuineness
- therapist does not express defensiveness;
there is implied but no overt professionalism
- therapist is genuine and nondefensive
- therapist is
open/ honest, accurately and genuinely reflects ideas and
reactions to client
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