Cambios de la CIE-11 en los trastornos por consumo de sustancias y comportami...Guillermo Rivera
Los Trastornos por consumo de sustancias y comportamientos adictivos constituyen una agrupación cuyas definiciones han sufrido modificaciones en la mas reciente versión de la CIE-11 de la OMS
Cambios de la CIE-11 en los trastornos por consumo de sustancias y comportami...Guillermo Rivera
Los Trastornos por consumo de sustancias y comportamientos adictivos constituyen una agrupación cuyas definiciones han sufrido modificaciones en la mas reciente versión de la CIE-11 de la OMS
American psychologist Henry Murray developed a theory of personality that was organized in terms of motives, and needs. Murray described a need as a potentiality or readiness to respond in a certain way under certain given circumstances.
Theories of personality based upon needs and motives suggest that our personalities are a reflection of behaviors controlled by needs.
Define what constitutes a “personality disorder”.
Explore the Five Factor Model (FFM) of personality.
Review the three (3) major personality “clusters”.
Look at the ten (10) individual personality disorders.
The Psychology and Neurology of Substance Related DisordersRaymond Zakhari
New York City Chapter Men In Nursing Conference 2016 an overview (includes specific information regarding marijuana, stimulants, hallucinogens, depressants)
According to the Diagnostic and Statistical Manual (DSM-IV), a personality disorder is an "enduring pattern of inner experience and behavior that deviates markedly from the expectation of the individual's culture, is pervasive and inflexible, has an onset in adolescence or early adulthood, is stable over time, and leads to distress or impairment."
Because these disorders are chronic and pervasive, they can lead to serious impairments in daily life and functioning.
Different Disorders have been discussed.
American psychologist Henry Murray developed a theory of personality that was organized in terms of motives, and needs. Murray described a need as a potentiality or readiness to respond in a certain way under certain given circumstances.
Theories of personality based upon needs and motives suggest that our personalities are a reflection of behaviors controlled by needs.
Define what constitutes a “personality disorder”.
Explore the Five Factor Model (FFM) of personality.
Review the three (3) major personality “clusters”.
Look at the ten (10) individual personality disorders.
The Psychology and Neurology of Substance Related DisordersRaymond Zakhari
New York City Chapter Men In Nursing Conference 2016 an overview (includes specific information regarding marijuana, stimulants, hallucinogens, depressants)
According to the Diagnostic and Statistical Manual (DSM-IV), a personality disorder is an "enduring pattern of inner experience and behavior that deviates markedly from the expectation of the individual's culture, is pervasive and inflexible, has an onset in adolescence or early adulthood, is stable over time, and leads to distress or impairment."
Because these disorders are chronic and pervasive, they can lead to serious impairments in daily life and functioning.
Different Disorders have been discussed.
Asociación entre achicamiento de hospitales psiquiátricos con aumento de pobl...Guillermo Rivera
Nuestro estudio revela que la reducción de la cantidad de camas en los hospitales para los pacientes psiquiátricos estaría asociada con un aumento de las poblaciones carcelarias.
En seis países de Sudamérica, los autores observaron que la cantidad de detenidos creció desde 1990 a medida que disminuyó la cantidad de camas disponibles de los hospitales psiquiátricos.
Los supercentenarios. Las claves de la longevidad.Guillermo Rivera
La probabilidad de convertirse en supercentenario es de alrededor de una en siete millones. Para ello hace falta tener mas de 110 años. En la mayoría de los casos, se trata de personas con parientes cercanos longevos. La genética pesa, en este contexto, más que otros factores, como la dieta, el ejercicio o el estilo de vida. Lo que aprendamos de ellos permitirá diseñar drogas que ayuden a enlentecer el proceso de envejecimiento.
The Assessment, Management, and Treatment of Suicidal PatientsJohn Gavazzi
This PowerPoint is a companion to The Ethics and Psychology Podcast #25: The Assessment, Management, and Treatment of Suicidal Patients. Dr. John Gavazzi speaks with Dr. Sam Knapp about assessing, managing and treating the suicidal patient. Please read the disclaimer and the note on competence in dealing with suicidal patients. The podcast or video meets the requirements for Pennsylvania Act 74 requirements for all mental health professionals in Pennsylvania.
Question 2 Help1. Not all media is created equally, so critical .docxmakdul
Question 2 Help
1. Not all media is created equally, so critical thinking is needed to digest what is presented.
2. In general, media depictions are inaccurate. This may be due to many factors—including but not limited to the following: (a) the media in the U.S.A. falls within the entertainment industry—not education or a government regulated agency, (b) shock value/sensationalism, (c) exaggerating taboo qualities, (d) stereotypes and biases within individuals who work for media corporations, (e) public preferences, and/or (f) the limited time and information sometimes available to the person in charge of the media presentation.
3. Negative representations lead to negative attitudes toward people with behavioral pathology.
4. The media both shapes public opinion and caters to public preferences. If there were no consumers for the product, there would be no sponsors and no media portrayals as they now exist. The students in this class are a part of the public and you make choices as consumers—like do other members of the public—which can encourage or discourage current practices in the media.
5. The type of media venue can greatly impact the degree and direction of the distortions or misinformation (e.g., news, dramas, comedies, biographical movies, social media, internet stories, magazines, documentaries, educational programming such as PBS).
6. Those who are educated would prefer that the focus of the media be redirected away from negative effects of psychopathology. Ideally, the media would use their resources to explore human consequences for psychopathology.
Question 3 Help
In favor of gender dysphoria being in the DSM-5. Differing thoughts on whether insurance should cover sex reassignment surgery (SRS) and hormone replacement—and whether insurance should cover reversals in the case of regret.
We were reminded that the key feature of inclusion in the DSM-5 as a psychiatric diagnosis was the presence of impairment in psychosocial functioning. Thus, looking at this criteria, if a person identified as being Transgender but is not experiencing any clinically significant distress or impairment in social, school, or other important areas of functioning, this individual would not be diagnosed with Gender Dysphoria according to the DSM-5. That being the case, the question then becomes is Gender Dysphoria the best diagnosis for such individuals or can they receive the treatment needed if this diagnosis is removed and what other diagnosis(es) in the DSM-5 would be appropriate for Transgender individuals who do show clinically significant distress or impairment in social, school, or other important areas of functioning if Gender Dysphoria is removed from the DSM?
The controversy extended to the ICD-10, and the instructor introduced another DSM-5 diagnosis for the class’ consideration that could apply to Transgender individuals who are experiencing distress that warrants intervention—not due to being Transgendered but due to homophobic discrimin ...
Before moving through diagnostic decision making, a social worke.docxtaitcandie
Before moving through diagnostic decision making, a social worker needs to conduct an interview that builds on a biopsychosocial assessment. New parts are added that clarify the timing, nature, and sequence of symptoms in the diagnostic interview. The Mental Status Exam (MSE) is a part of that process.
The MSE is designed to systematically help diagnosticians recognize patterns or syndromes of a person’s cognitive functioning. It includes very particular, direct observations about affect and other signs of which the client might not be directly aware.
When the diagnostic interview is complete, the diagnostician has far more detail about the fluctuations and history of symptoms the patient self-reports, along with the direct observations of the MSE. This combination greatly improves the chances of accurate diagnosis. Conducting the MSE and other special diagnostic elements in a structured but client-sensitive manner supports that goal. In this Assignment, you take on the role of a social worker conducting an MSE.
To prepare:
Watch the video describing an MSE. Then watch the Sommers-Flanagan (2014) “Mental Status Exam” video clip. Make sure to take notes on the nine domains of the interview.
Review the Morrison (2014) reading on the elements of a diagnostic interview.
Review the 9 Areas to evaluate for a Mental Status Exam and example diagnostic summary write-up provided in this Week’s resources.
Review the case example of a diagnostic summary write-up provided in this Week’s resources.
Write up a Diagnostic Summary including the Mental Status Exam for Carl based upon his interview with Dr. Sommers-Flanagan.
By Day 7
Submit
a 2- to 3-page case presentation paper in which you complete both parts outlined below:
Part I: Diagnostic Summary and MSE
Provide a diagnostic summary of the client, Carl. Within this summary include:
Identifying Data/Client demographics
Chief complaint/Presenting Problem
Present illness
Past psychiatric illness
Substance use history
Past medical history
Family history
Mental Status Exam (Be professional and concise for all nine areas)
Appearance
Behavior or psychomotor activity
Attitudes toward the interviewer or examiner
Affect and mood
Speech and thought
Perceptual disturbances
Orientation and consciousness
Memory and intelligence
Reliability, judgment, and insight
Part II: Analysis of MSE
After completing Part I of the Assignment, provide an analysis and demonstrate critical thought (supported by references) in your response to the following:
Identify any areas in your MSE that require follow-up data collection.
Explain how using the cross-cutting measure would add to the information gathered.
Do Carl’s answers add to your ability to diagnose him in any specific way? Why or why not?
Would you discuss a possible diagnosis with Carl at time point in time? Why?
Support Part II with citations/references. The DSM 5 and case study
do not
need to be cited. Utilize the o.
PART1-Due ThursdayRespond to the following in a minimum of.docxJUST36
PART1-
D
ue Thursday
Respond to the following in a minimum of 175 words:
Review this week’s course materials and learning activities, and reflect on your learning so far this week. Respond to one or more of the following prompts in one to two paragraphs:
Provide citation and reference to the material(s) you discuss. Describe what you found interesting regarding this topic, and why.
Describe how you will apply that learning in your daily life, including your work life.
Describe what may be unclear to you, and what you would like to learn.
PART2-
University of Phoenix Material
Case Study Two Worksheet
Respond to the following questions in 1,250 to 1,500 words.
1. Why is this an ethical dilemma? Which APA Ethical Principles help frame the nature of the dilemma?
2. How might Irina’s age and parents’ involvement in the referral affect how Dr. Matthews can resolve the dilemma? How might the state law on treatment of minors and HIPAA rule on access of guardians to a minor’s health care record influence Dr. Matthews’ decision?
3. How are APA Ethical Standards 2.01a b, and c; 2.04; 3.04; 3.06; 4.01; 4.02; and 10.10a relevant to this case? Which other standards might apply?
4. What are Dr. Matthews’ ethical alternatives for resolving this dilemma? Which alternative best reflects the Ethics Code aspirational principle and enforceable standard, as well as legal standards and Dr. Matthews’ obligations to stakeholders?
5. What steps should Dr. Matthews take to ethically implement her decision and monitor its effects?
PART3-
Write
a 300-word or more paper in which you examine the legal aspects of record keeping and providing expert testimony. As part of your examination, address the following items:
Evaluate the legal issues associated with assessment, testing, and diagnosis documentation in professional psychology
Fisher, C. B. (2013).
Decoding the ethics code: A practical guide for psychologists
. Thousand Oaks, CA: Sage.
REFERENCE FOR PART 1
Psychologists aspire to promote accuracy, honesty, and truthfulness in the science, teaching, and practice of psychology and do not engage in subterfuge or intentional misrepresentation of fact (Principle C: Integrity). Standard 5.01a of the APA Ethics Code (APA, 2010b) prohibits false, deceptive, or fraudulent public statements regarding work activities or the activities of persons or organizations with which psychologists are affiliated.
The terms
avoidance
and
knowingly
exclude as violations statements that psychologists would reasonably be expected to believe are true but that they may later learn are false.
☑ A psychologist in a group practice distributed brochures with a listing of the group members’ credentials, only to discover that one member had submitted false credentials. She ceased distribution and ordered a corrected brochure.
☑ A research psychologist gave a public lecture, a series of media interviews, and congressional testimony during which he publicly .
Adv. biopharm. APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMSAkankshaAshtankar
MIP 201T & MPH 202T
ADVANCED BIOPHARMACEUTICS & PHARMACOKINETICS : UNIT 5
APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMS By - AKANKSHA ASHTANKAR
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
The Gram stain is a fundamental technique in microbiology used to classify bacteria based on their cell wall structure. It provides a quick and simple method to distinguish between Gram-positive and Gram-negative bacteria, which have different susceptibilities to antibiotics
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Clinical psychologists: Along with the growth of PhD programs has been the development of programs that are called “professional schools” of psychology some of which offer a PhD and some of which offer a newer degree, the doctor of psychology (PsyD). Some psychologists are trained within the field of counseling psychology , where the emphasis is on normal adjustment and development, rather than on the psychological disorders. Clinical psychologists are trained in conducting psychological testing , a broad range of measurement techniques, all of which involve having people provide scorable information about their psychological functioning. Psychiatrists: Medical doctors (MDs) with advanced training in treating people with psychological disorders.
In making a diagnosis, mental health professionals use the standard terms and definitions contained in the Diagnostic and Statistical Manual of Mental Disorders (DSM) . A syndrome is a collection of symptoms that form a definable pattern.
The authors of the DSM-IV had to ensure that the diagnoses would meet the criteria of reliability , meaning that a given diagnosis will be consistently applied to anyone showing a particular set of symptoms. Teams of researchers throughout the United States have continued to investigate the validity of the classification system, meaning that the diagnoses represent real and distinct clinical phenomenon. In all of these efforts, experts have had to keep in mind the base rate of a disorder, the frequency with which it occurs in the general population. The lower the base rate of a disorder, the more difficult it is to establish the reliability of the diagnosis because there are so few cases to compare. Social Context: Does DSM-IV unfairly label people? Some behavior that seems disordered may be appropriate at least understandable when one considers the context in which it occurs.
The first edition of the American Psychiatric Association’s DSM was the first official psychiatric manual to describe psychological disorders and was a major step forward in the search for a standard set of diagnostic criteria. However, criteria were vague, had poor reliability, and were based on faulty assumptions about origins of disorders. The second edition, DSM-II , based its classification of mental disorders on the system contained in the International Classification of Diseases (ICD) . DSM-III provided precise criteria and definitions for each disorder, enabling clinicians to be more quantitative and objective. To specify criteria further, DSM-III-R was published as an interim manual until a more complete overhaul.
The DSM-IV relied on comprehensive reviews, thorough analyses of research data, and field trials to test reliability and validity further. A “text revision,” the DSM-IV-TR , included editorial revisions to the DSM-IV. Many professionals simply refer to it as the DSM-IV.
A syndrome is a collection of symptoms that forms a definable pattern. Mental disorder: A clinically significant behavioral or psychological syndrome or pattern that occurs in an individual and that is associated with present distress (e.g., a painful symptom) or disability (i.e., impairment in one or more important areas of functioning) or with a significant increased risk of suffering death, pain, disability, or an important loss of freedom. In addition, this syndrome or pattern must not be merely an acceptable and culturally sanctioned response to a particular event, for example, the death of a loved one.
One of the most prominent assumptions of the DSM-IV is that this classification system is based on a medical model orientation, in which disorders, whether physical or psychological, are viewed as diseases. Atheoretical orientation: The DSM-IV simply classifies and describes a set of symptoms for each disorder without regard for explaining their cause, without theoretical orientation. Categorical approach: Implicit in the medical model is the assumption that diseases fit into distinct categories. Multiaxial system: Each axis is a class of information regarding an aspect of an individual’s functioning.
The major clinical disorders and adjustment disorders are on Axis I. Axis II disorders (personality disorders and mental retardation) represent enduring characteristics of an individual’s personality or abilities. Personality disorders: Personality traits that are inflexible and maladaptive and that cause either subjective distress or considerable impairment in a person’s ability to carry out the tasks of daily living. On Axis III , the diagnostician notes the individual’s medical conditions, which may or may not be connected to the person’s psychological condition. On Axis IV , the clinician documents events or pressures that may affect the diagnosis, treatment, or outcome of a client’s psychological disorder. Axis V is used to document the clinician’s overall judgment of a client’s psychological, social, and occupational functioning. The rating of the client’s functioning during the preceding year provides the clinician with important information about the client’s prognosis , or likelihood of recovering from the disorder.
When clinicians use multiple diagnoses, they typically consider one of the diagnoses to be the principal diagnosis , the disorder that is considered to be the primary reason the individual is seeking professional help. In certain cultures, psychological disorders may be expressed as particular patterns of behavior, perhaps reflecting predominant cultural themes that date back for centuries, known as culture-bound syndromes . For example, “ghost sickness” is a preoccupation with death and the deceased that is reported by members of American Indian tribes.
When clinicians use multiple diagnoses (e.g., alcoholism and depression in the same person), they typically consider one of the diagnoses to be the principle diagnosis , the primary reason the individual is seeking professional help.
The first phase of treatment planning is to establish treatment goals, objectives the clinician hopes to accomplish in working with the client. These goals range from the immediate to the long term. First, the clinician deals with the crisis at hand, then handles problems in the near future, and finally addresses issues that require extensive work well into the future. However, in other cases, there may be a cyclical unfolding of stages.
Treatment sites include psychiatric hospitals, outpatient treatment settings, halfway houses and day treatment centers, and other treatment sites such as the school or workplace, that provide mental health services. The more serious the client’s disturbance, the more controlled the environment that is needed and the more intense the services. Hospitalization is also recommended for clients who have disorders that require medical interventions and intensive forms of psychotherapeutic interventions. Because hospitalization is such a radical and expensive intervention, most clients receive outpatient treatment in which they are treated in a private professional office or clinic. Community mental health centers (CMHCs) are outpatient clinics that provide psychological services on a sliding fee scale for individuals who live within a certain geographic area. Halfway houses are designed for clients who have been discharged from psychiatric facilities but who are not yet ready for independent living. Day treatment programs are designed for formerly hospitalized clients as well as clients who do not need hospitalization but do need a structured program during the day, similar to that provided by a hospital. Psychological treatment is also provided in settings not traditionally associated with the provision of mental health services such as the schools and workplace.
The modality , or form in which psychotherapy is offered, is another crucial component of the treatment plan. In individual psychotherapy , the therapist works with the client on a one-to-one basis. In family therapy ; several or all of the family members are involved in the treatment. Group therapy provides a modality in which troubled people can openly share their problems with others, receive feedback, develop trust, and improve interpersonal skills. Milieu therapy , is based on the premise that the milieu, or environment, is a major component of the treatment; a new setting, in which a team of professionals works with the client to improve his or her mental health, is considered to be better than the client’s home and work environments. Whatever modality of treatment a clinician recommends, it must be based on the choice of the most appropriate theoretical perspective or the most appropriate aspects of several different perspectives.
In other words, clinicians should base treatments on state-of-the-art research findings which they adapt to the particular features of each client.
In optimal situations, psychotherapy is a joint enterprise in which the client plays an active role. It is largely up to the client to describe and identify the nature of his or her disorder, to describe personal reactions as the treatment progresses, and to initiate and follow through on whatever changes are going to be made. Some obstacles that clinicians face in their efforts to help clients include curious and frustrating realities. The most frustrating involve the client who is unwilling to change.
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