Assessment of Addiction and Mental Health Issues

Assessment of Addiction and
Mental Health Issues
Identifying the Problem
Unlimited CEUs $59 Certificate Training Programs $149 Live Webinars $5 https://allceus.com
Presented by: Dr. Dawn-Elise Snipes Executive Director, AllCEUs
Podcast Host: Counselor Toolbox & Happiness isn’t Brain Surgery
Author: Journey to Recovery (2015) & Happiness Isn’t Brain Surgery (2017)

Objectives
 Define screening and assessment
 Define the purpose of assessment
 Explore the steps in the assessment
 Recognize the stage of change a client is in with
regards to mental health and substance abuse and
utilize this towards creating a treatment plan.
 Learn about the first steps in moving toward
happiness

Why Is This Important
 47% of US Adults suffers from maladaptive signs of
an addictive disorder over a 12-month period
 Co-Occurring Disorders are the EXPECTATION not
the Exception
 Statistics indicate that the majority of people
seen in mental health treatment struggle with
addictive behaviors.
 Refer for treatment or treat yourself

Screening and Assessment
 Screening is a very quick process which can be
done by
 Physicians
 Coaches
 Specialists/Techs
 Counselors
 Screening simply determines if there may be a
need for further evaluation.

Purpose of Assessment
 To identify symptoms
 Explore the course of the symptoms
 Identify exacerbating and mitigating factors
 Determine the impact of symptoms
 Identify change goals
 Develop an action plan based on identified goals

Assessment Provides Awareness of SNAP
 Strengths
◦ Resources
◦ Skills
◦ Mitigating Factors and exceptions
 Needs
◦ Biological
◦ Safety
◦ Love and Belonging
 Attitudes
◦ About recovery
◦ Cultural

Awareness of SNAP
 Preferences
 Learning style
 Treatment approach
 Quality of Life

5 Principles of Motivational Interviewing
 Generate a Gap
 Roll with Resistance
 Avoid Arguing
 Can Do
 Express Empathy

Stages of Readiness for Change
 Most people have multiple issues
 Readiness for change can be different for each
issue---even each symptom of each issue
 Stages
 Precontemplation
 Contemplation
 Preparation/Determination
 Action
 Maintenance (needs attention when addressing new
issues)

Addiction (vs. Recreational Use)
 Tolerance need more to get the same rush, high or
feeling.
 Withdrawal: Anxiety, irritability, shakes, sweats, nausea,
depression when unable to access the addiction
 Negative consequences: Continued to use even though
there have been negative consequences.
 Neglected or postponed activities because of your use?
 Significant time or energy spent obtaining, using,
concealing, planning, or recovering from your use.
 Unsuccessful attempts to cut down or control your use

Chemical and Behavioral
 Addictive behaviors causes a “flood” of neurochemicals
 This flood contributes to an imbalance
 Like a “hangover” occasional use does not necessarily
alter brain functioning
 Repeated use causes the brain to shut down certain
pathways so it is not constantly being flooded (tolerance)
 Many other issues such as pre-existing anxiety or
depression can indicate a pre-existing neurochemical
imbalance which is being self-medicated
 Requires additional stimulation to produce the same relief
because many fewer “doors” are open

Mental Health
 Depression/Hopelessness/Apathy
 Anxiety/Worry
 Difficulty Concentrating
 Irritability
 Agitation
 Fatigue
 Changes in sleep duration or quality
 Changes in eating

First Steps
 Identify the Problem
 Identify the Solution
 Learn about what causes the problem in general
 Learn about what causes the problem for you
 Learn about possible solutions
 Identify solutions that will work for you
 Develop a plan to start implementing those
solutions

Presenting Problem
 Presenting problem
 What are your symptoms (as evidenced by)
 How long has each been going on
 What makes it worse
 What makes it better
 What are the consequences of each symptom (as
evidenced by)

Resolution/Goal
 What does happiness look like for you?
 What will be different?
Emotionally
Mentally
Physically
Socially (self-esteem, relationships and recreation)
Environmentally
 What will be the same?

Transactional Model
 The way you feel emotionally or physically
impacts:
 How you interact with others
 Your stress response
 Your attitude and ability to concentrate
 Your environment
 Each one of those things also impacts how you
feel

Evaluate potential causes of the symptoms
 Physical
 Sleep
 Nutrition
 Pain/Illness
 Sunlight
 Exercise
 Addiction
 Alcohol
 Anxiety
 Depression
 Tremors

 Physical
 Addiction
 Amphetamines, cocaine and other stimulants can trigger
 Anxiety, panic
 Depression (withdrawal)
 Tremors
 Marijuana can trigger
 Anxiety
 Apathy/Lack of motivation
 Impaired concentration
 Paranoid delusions/hallucinations

 Physical
 Addiction
Opiates
 Depression
 Decreased pain tolerance
 Disruption of circadian rhythms

 Age
 Many physiological changes take place as a result of
age. Taking this into account can assist in determining
some of the possible causes of symptoms
 Younger people have fewer experiences against which
to judge current experiences
 The culture and environment changes for people of
different ages.

 Social
 Your immediate family
 Social supports
 Stressors
 Self-Esteem
 Environmental
 Active/Interruptions vs. Calm/Peaceful
 Supportive of sleep?
 Supportive of relaxation?

 Emotions
 Anger
 Anxiety
 Depression
 Happiness
 Thought triggers for each emotion

Symptom Assessment
Behaviors Thoughts Environments
Make the
symptom worse
Make the
symptom better
Impact of
Symptom

Symptom Assessment: Lenny
Behaviors Thoughts Environments
Make the
symptom
worse
• Working out really hard
for several days
• Not getting enough sleep
• Too much caffeine
• I am having another
cardiac episode
• I can’t breathe
• I have to make this
stop
• I am overwhelmed
• Chaotic
environments
• Negative people
Make the
symptom
better
• Working out moderately
each day
• Getting sufficient sleep
• No caffeine
• Doing something each day
I enjoy to have a sense of
accomplishment
• Petting Mojo
• Positive self-talk
• Focus on what I need
to do better to
eliminate the
symptoms
• Focusing on the things I
can change and letting
go of what I cannot
• Aromatherapy
• Clean/organized
environments
• Calm
Impact of
symptom
• Afraid to workout
• Lethargic
• Increase a sense of
helplessness
• Become “stressed”
• Withdraw from
other people

Next Step
 Work on becoming mindful of your symptom
triggers
 Do a mindfulness scan prior to each meal to identify
how you feel and what you need…
Emotionally
Mentally
Physically

Summary
 The Assessment is really the beginning point
 It helps clients get a clearer idea of what may be causing
their symptoms or making them worse.
 Proper nutrition, adequate quality sleep and pain
management are all necessary for happiness and recovery
 At this stage clients are starting to envision what
happiness looks like for them.
 Help them identify their strengths and what things are
good uses of their energy

Summary
 Identify which presenting symptoms the client is most
willing to work on a develop a treatment plan from
there
 From the perspective of the transactional model,
improving any area will likely improve the person’s
overall happiness
 The symptom assessment chart can help identify
current strengths and possible contributors to the
symptom.

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Assessment of Addiction and Mental Health Issues

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