Treatment Planning
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NBCC, NAADAC, CAADAC, and California Board of Behavioral Sciences approved Mental Health continuing education and addictions counselor training series. Narrated versions and CEUs available at http://www.allceus.com
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Treatment Planning
- 1. Treatment Planning Dr. Dawn-Elise Snipes, PhD, LMHC, CRC, NCC Copyright 2008-2012 AllCEUs.com, a subsidiary of CDS Ventures, LLC
- 2. Copyright 2008-2012 AllCEUs.com, a subsidiary of CDS Ventures, LLC What are Treatment Plans • Opportunities for us to teach clients ▫ Problem solving skills ▫ How to identify and use personal strengths • Dynamic documents that ▫ Address a client’s current functioning and needs. ▫ Evaluate the client’s progress in meeting specified goals and objectives ▫ Guide the course of treatment for identified problems or issues ▫ Enhance multidisciplinary team communication
- 3. Copyright 2008-2012 AllCEUs, a subsidiary of CDS Ventures, LLC What is treatment planning? • The process in which the counselor and client: ▫ Identify and rank problems needing resolution ▫ Establish agreed upon immediate and long-term goals ▫ Decide on the treatment methods ▫ Identify necessary resources
- 4. Copyright 2008-2012 AllCEUs, a subsidiary of CDS Ventures, LLC Treatment Plan Foundation • Biopsychosocial assessment ▫ Current stressors ▫ Coping skills ▫ Self-esteem ▫ Mental health ▫ Substance abuse ▫ Social network ▫ Physical health
- 5. Copyright 2008-2012 AllCEUs, a subsidiary of CDS Ventures, LLC Treatment Plan Development • The individualized treatment plan is: ▫ Structured ▫ Goal-oriented ▫ A schedule of services ▫ Developed jointly with the client ▫ A written document with treatment-related goals and measurable objectives • Interventions are grounded in the client’s learning style
- 6. Copyright 2008-2012 AllCEUs, a subsidiary of CDS Ventures, LLC Learning • 3 parts to the learning process: 1. Cognition How people acquire knowledge seeing, hearing or doing 2. Conceptualization How people process information abstract, specific, memory pathways 3. Affective People’s motivation, decision-making styles, values and emotional preferences how much does this information matter
- 7. Copyright 2008-2012 AllCEUs, a subsidiary of CDS Ventures, LLC Knowledge: Understanding Learning Styles • Active/Reflective ▫ When you process information • Auditory/hearing, visual/seeing, or kinesthetic/doing ▫ Methods for receiving information • Attitudinal or Emotional ▫ How you conceptualize information • Sensing vs. Intuitive ▫ What you pay attention to • Global vs. Specific ▫ Parts to whole or vice versa
- 8. Copyright 2008-2012 AllCEUs, a subsidiary of CDS Ventures, LLC Active/Reflective Learner Tips • Reflective learners ▫ think it through first ▫ prefer working alone • Active learners ▫ have difficulty sitting quietly through lectures ▫ like group work ▫ need discussion or problem-solving activities • Action without reflection can get you into trouble, while if you spend too much time reflecting you may never get anything done.
- 9. Copyright 2008-2012 AllCEUs, a subsidiary of CDS Ventures, LLC Auditory, Visual, Kinesthetic • Kinesthetic learners ▫ mentally or physically work with the material • Auditory learners ▫ need to hear the material • Visual learners ▫ need to see the material • In order to meet different learning needs, present material: ▫ visually (notes, graphs) ▫ verbally (talk about it) ▫ manipulatively (questions, group activities)
- 10. Copyright 2008-2012 AllCEUs, a subsidiary of CDS Ventures, LLC Attitudinal/Emotional • Thinkers vs. Feelers • Present compelling information in a way that appeals to people’s emotions ▫ Ex: Statistics on child abuse with pictures of kids
- 11. Copyright 2008-2012 AllCEUs, a subsidiary of CDS Ventures, LLC Sensing vs. Intuitive • Big picture vs. details • Find a balance • Present the big picture and the basics then let participants ask questions
- 12. Copyright 2008-2012 AllCEUs, a subsidiary of CDS Ventures, LLC Global vs. Sequential • Bottom Up or Top Down ▫ Think puzzles: Box or no box? ▫ Think DVDs: Read the back or no? • Present a general overview • Provide an outline/agenda for direction • Answer the question--- ▫ “Why do I care?”
- 13. Copyright 2008-2012 AllCEUs, a subsidiary of CDS Ventures, LLC Learning Style Summary • Create an emotionally and objectively meaningful and positive goal (Emotional, Attitudinal, Global) • Create steps to that goal (Sequential) • Write the sub-goals in a positive KSA format • For each sub-goal, provide written information, discuss it then apply it • Regularly address how each goal builds on the last
- 14. Copyright 2008-2012 AllCEUs, a subsidiary of CDS Ventures, LLC Where to now? • What we know ▫ Who they are ▫ Their issues ▫ Their learning style • What we still need to know ▫ What they are motivated to change
- 15. Copyright 2008-2012 AllCEUs, a subsidiary of CDS Ventures, LLC Steps of Treatment Plan Development • Step One: Problem Selection • Step Two: Goal Development • Step Three: Problem Definition • Step Four: Objectives • Step Five: Interventions
- 16. Copyright 2008-2012 AllCEUs, a subsidiary of CDS Ventures, LLC Problem Selection: Motivation • Changeable • Variable • Components ▫ Emotional ▫ Cognitive ▫ Social ▫ Physical ▫ Situational
- 17. Copyright 2008-2012 AllCEUs, a subsidiary of CDS Ventures, LLC Problem Selection: Meaningful • The reward must be worth the effort • Create mutually beneficial goals if needed • Help the client identify motivations and corresponding goals • Use the miracle question
- 18. Prioritizing Goals Copyright 2008-2012 AllCEUs, a subsidiary of CDS Ventures, LLC 5 Self-actualization 4 Self-esteem 3 Love & Belonging 2 Safety & Security 1 Biological/Physiological
- 19. Physical Needs Copyright 2008-2012 AllCEUs, a subsidiary of CDS Ventures, LLC •Substance Use •Physical Health Management •Medication Adherence Issues Biological/Physiological PHYSIOLOGICAL
- 20. Safety & Security Copyright 2008-2012 AllCEUs, a subsidiary of CDS Ventures, LLC •Mental health management •Functional impairments •Legal issues Safety & Security
- 21. Love & Belonging Needs Copyright 2008-2012 AllCEUs, a subsidiary of CDS Ventures, LLC Love & Belonging •Social & interpersonal skills •Need for affiliation •Family relationships
- 22. Self-Esteem Copyright 2008-2012 AllCEUs, a subsidiary of CDS Ventures, LLC Self-Esteem •Achievement and mastery •Independence/status •Prestige
- 23. Self-Actualization Copyright 2008-2012 AllCEUs, a subsidiary of CDS Ventures, LLC Self-Actualization • Seeking personal potential • Self-fulfillment • Personal growth
- 24. Copyright 2008-2012 AllCEUs, a subsidiary of CDS Ventures, LLC Writing the Plan • Individualized • Goals are: • Use positive language ▫ Meaningful to the • Address the reasons for patient not changing ▫ Observable ▫ Measurable ▫ Incremental ▫ Realistic ▫ Supported by sub-goals ▫ Use the KSA progression
- 25. Copyright 2008-2012 AllCEUs, a subsidiary of CDS Ventures, LLC Goal Development • What is the broad goal for resolution of the problem? • What is the absence of the problem?
- 26. Copyright 2008-2012 AllCEUs, a subsidiary of CDS Ventures, LLC Problem Definition • How is the problem evidenced in the client? • How is the problem affecting the client’s overall functioning? • What is the client’s perception of the problem? • What are the client’s strengths?
- 27. Copyright 2008-2012 AllCEUs, a subsidiary of CDS Ventures, LLC Objectives • Objectives are steps toward the goal • S.M.A.R.T ▫ Specific Rome was not built in a day Frequent reinforcement Logical sub-goals KSAs ▫ Measurable (duration, frequency, intensity) ▫ Attainable ▫ Realistic ▫ Time-limited
- 28. Copyright 2008-2012 AllCEUs, a subsidiary of CDS Ventures, LLC Pitfalls • Failing to consider why you currently do (or do not) engage in certain behaviors • Setting goals that are too big • Setting goals that are too hard • Setting too many goals • Setting goals without sufficient rewards • Setting goals that are too specific
- 29. Copyright 2008-2012 AllCEUs, a subsidiary of CDS Ventures, LLC Common Issues
- 30. Copyright 2008-2012 AllCEUs, a subsidiary of CDS Ventures, LLC Anxiety: Differential Diagnosis • General Medical ▫ Thyroid problems ▫ Hormone imbalance ▫ Medication (Methadone, decongestants, etc.) ▫ Diabetes ▫ Substance intoxication or withdrawal • Other ▫ Domestic violence ▫ Low self-esteem/external validation ▫ Diet—caffeine, low blood sugar
- 31. Copyright 2008-2012 AllCEUs, a subsidiary of CDS Ventures, LLC Anxiety • Statement ▫ “Sally will be calmer resulting in improved concentration/focus, increased energy, improved sleep and reduced headaches.” • Identify sub-goals (SMART) ▫ “What would it be like if you were not anxious anymore?” • Knowledge/Skills ▫ Educate Sally about anxiety causes, short and long term effects ▫ What skills does Sally have? ▫ What skills does sally need to learn? • Teach, discuss, role play, practice, report
- 32. Copyright 2008-2012 AllCEUs, a subsidiary of CDS Ventures, LLC Depression • General Medical ▫ Thyroid problems ▫ Hormone imbalance ▫ Medication (Opiates, antipsychotics etc.) ▫ Diabetes ▫ Substance intoxication or withdrawal • Other ▫ Domestic violence ▫ Low self-esteem/external validation ▫ Diet—insufficient carbohydrates
- 33. Copyright 2008-2012 AllCEUs, a subsidiary of CDS Ventures, LLC Depression cont… • Statement ▫ “Sally will be happier resulting in improved concentration/focus, increased energy, improved sleep and increased enjoyment of daily activities.” • Identify sub-goals ▫ “What would it be like if you were not depressed anymore?” • Knowledge/Skills ▫ Educate Sally about depression causes; short and long term effects ▫ What skills does Sally have? ▫ What skills does sally need to learn? • Teach, discuss, role play, practice, report
- 34. Copyright 2008-2012 AllCEUs, a subsidiary of CDS Ventures, LLC Substance Use • Statement ▫ “Sally will stay clean resulting in improved relationships, energy, health and happiness.” • Identify sub-goals ▫ “What would it be like if you did not feel the need to use anymore?” • Knowledge/Skills ▫ Educate Sally about addiction causes, short and long term effects ▫ What skills does Sally have? ▫ What skills does sally need to learn? • Teach, discuss, role play, practice, report
- 35. Copyright 2008-2012 AllCEUs, a subsidiary of CDS Ventures, LLC Psychosocial Issues • Statement ▫ “Sally will _________ resulting in _________.” • Identify sub-goals ▫ What would it be like if you (had this need met)? • Knowledge/Skills ▫ Educate Sally about the need and available resources ▫ What skills/resources does Sally have? ▫ What skills/resources does sally need? • Teach, discuss, role play, practice, report
- 36. Copyright 2008-2012 AllCEUs, a subsidiary of CDS Ventures, LLC Case A : Jan 27 year old, single Caucasian female 3 children under age 7 No childcare readily available Social companions using drugs/alcohol Unemployed No high school/GED 2 arrests for possession of meth & cannabis + 1 probation violation
- 37. Copyright 2008-2012 AllCEUs, a subsidiary of CDS Ventures, LLC Case B: Dan 36 year old, married African-American male 2 children 2 arrests and 1 conviction for DUI Arrest BAC .25 Employed Rates high severity - family problems
- 38. Copyright 2008-2012 AllCEUs, a subsidiary of CDS Ventures, LLC Problem Statement • “Alcohol Dependence” ▫ Not individualized ▫ Not a complete sentence ▫ Doesn’t provide enough information ▫ A diagnosis is not a complete problem statement ▫ Is a negative statement
- 39. Copyright 2008-2012 AllCEUs, a subsidiary of CDS Ventures, LLC Goal Statement • “Will refrain from all substance use now and in the future” ▫ Not specific for Jan or Dan ▫ Not helpful for treatment planning ▫ Cannot be accomplished by program discharge ▫ Still negative
- 40. Copyright 2008-2012 AllCEUs, a subsidiary of CDS Ventures, LLC Objective Statement • “Will participate in outpatient program” ▫ Again, not specific for Jan or Dan ▫ A level of care is not an objective
- 41. Copyright 2008-2012 AllCEUs, a subsidiary of CDS Ventures, LLC Changing Language: Problem Statements 1. Client has low self-esteem. 2. Client is in denial. 3. Client is alcohol dependent. 4. Client is promiscuous. 5. Client is resistant to treatment. 6. Client is on probation because he is a bad alcoholic.
- 42. Copyright 2008-2012 AllCEUs, a subsidiary of CDS Ventures, LLC Changing Language • Think about how you might change the language for 2 of the preceding problem statements. • Rewrite those statements using non-judgmental and jargon-free language.
- 43. Copyright 2008-2012 AllCEUs, a subsidiary of CDS Ventures, LLC Changing Language - Examples 1. Client has low self-esteem. ▫ Client averages 10 negative self-statements daily. 2. Client is in denial. ▫ Client reports two DWIs in past year but states that alcohol use is not a problem. 3. Client is alcohol dependent. ▫ Client experiences tolerance, withdrawal, loss of control and negative life consequences due to alcohol use.
- 44. Copyright 2008-2012 AllCEUs, a subsidiary of CDS Ventures, LLC Changing Language - Examples 4. Client is promiscuous. ▫ Client participates in unprotected sex four times a week. 5. Client is resistant to treatment. ▫ In past 12 months, client has dropped out of 3 treatment programs prior to completion. 6. Client is on probation because he is a bad alcoholic. ▫ Client has legal consequences because of alcohol- related behavior.
- 45. Copyright 2008-2012 AllCEUs, a subsidiary of CDS Ventures, LLC Summary • By working with your clients to develop goals, they will determine: ▫ How they learn the best ▫ How to identify appropriate sub-goals ▫ How to create an effective change plan
Editor's Notes
- The first step in developing a realistic wellness and treatment plan is for people to know their personal tendencies. What works for them? What adds extra dis-stress? What is the most efficient way to approach things based upon how they learn and their personality. A learning style is a name for relatively consistent pattern of behavior showing how people learn or adapt to their environment. People are often a combination of more than one learning style, but one style usually predominates. Learning style is the way people prefer to learn. It does not have anything to do with how intelligent they are or what skills they have. There is no such thing as a “good” learning style or a “bad” learning style per se, and it is important for people to be aware of how their brain learns best in order to optimize their learning experiences. Some environments cater more to one learning style than another. When this happens, people must know how to modify the situation to work best for them. Consider the last time you tried to learn a new computer program. Which method(s) work best for you: A) Reading the manual. B) Using the tutorial or just getting in and playing with it. C) Having someone tell you how to do it. Another common example is getting directions. Do you find your way easiest by: A) Reading a map or written directions. B) You have to drive it to know how to get there or C) Having someone give you directions verbally (such as at a gas station). People who select “A” or “C” usually have a pretty good ability to visualize things in their head once they get the information. Their primary difference is the way the information is input--through their eyes or ears. People who select “B” are strong kinesthetic learners and benefit from actually doing things. There are three parts to the learning process: 1) cognition: how people acquire knowledge (seeing, hearing or doing), 2) conceptualization: how people process information (abstract, specific, memory pathways), and 3) affective: people’s motivation, decision-making styles, values and emotional preferences (how much does this information matter). Learning styles can be conceptualized as auditory/hearing, visual/seeing, or kinesthetic/doing. . Circle the number of the statements you agree with: 1. I prefer to hear a book on tape read it myselfView the highlights in bulleted form When I put something together, Have someone read the directions to me as I do itI always read the directions firstLook at the pieces and put it together (directions are a backup) I prefer Hearing a lectureReadingReading a little bit and then applying it then reading some more Which do you like morePlaying strategy games like chessPlaying word games with a lot of reading like crossword puzzlesPlaying word games with a lot of talking like Outburst or Password I love to write letters or in a journalcall friends and talk about stuffgo out and do things…life is too short to talk about what has already happened When I talk, I like to say things like, I hear ya, that sounds good or that rings a bell.\"“I see what you mean” “I get the picture”“I understand.” “I can do that.” “That is possible.” I love Singing, actingWritingWorking with my hands and building or making things. 9. When I am trying to remember things I remember bestWhat someone has saidWhat I have highlighted in a book or readWhat I have heard or read about and actually done or applied myself. 10. When doing a group project I like toDo the final oral presentationDo the research and writingBrainstorm and put all of the pieces together 11. I am better atHearing voices or songs and identifying whether they are the sameLooking at objects on paper, and telling whether they are the same no matter which way they are turned. Taking solutions to problems or processes and figuring out whether they will produce the same end-result. 12. When I recall an experienceI mostly hear the sounds and talk to myself about it. I mostly see a picture of it in my mind. I mostly remember how I felt about it. 13. When learning how to run a new machine (VCR, Camera, car) I preferTo read the manualHave the sales person tell me how to do it, I’ll rememberHave someone show me 14. Do you prefer instruction and retain more information when the activities involve Auditory activities (listening to tapes, lectures, music)Visual materials (viewing pictures, maps or reading), , Tactual and kinesthetic activities such as note taking, and/or working on projects that involve making things (i.e., science projects, storybooks, diaries, model building, etc.) Review the 14 questions If you marked mostly As you are an auditory learner. If you marked mostly Bs you are a visual learner. If you marked mostly Cs you are a Kinesthetic learner. Most people are a combination of learning styles. If you marked two categories about evenly that is fine too. Although this is important for school-age people, learning is a life-long process and making it easier on yourself will reduce stress. It is also important to know how the significant others in your life learn, because when trying to communicate or make them understand something, you need to work within their preferred learning style. For example, my husbands is a visual reflective learner. I am an active kinesthetic/auditory learner. When I am trying to explain something or communicate my point of view, it is often helpful for him if I write it down so he can read it, reflect on it and then we can talk about it. Yet another application for this is helping your children learn. Successful, happy children that know how to study do not fuss as much about doing their homework or going to school and have increased self-esteem because they are “getting it.” Tips for active and Reflective learnersReflective learners prefer to think about it quietly first\"Let's think it through first\" Reflective learners, prefer working alone. Sitting through lectures without getting to do anything physical but take notes is hard for both learning types, but particularly hard for active learners. Active learners tend to like group work If you are an active learner in a class that allows little or no class time for discussion or problem-solving activities, study in a group in which the members take turns explaining different topics to each other. If you always act before reflecting you can jump into things prematurely and get into trouble, while if you spend too much time reflecting you may never get anything done. Tips for kinesthetic learnersActive kinesthetic learners tend to retain and understand information best by doing something active with it--discussing or applying it or explaining it to others. \"Let's try it out and see how it works\"Work with others to guess what you will be asked on the next test and figure out how you will answer. You will always retain information better if you find ways to do something with it. If you are a reflective learner in a class that allows little or no class time for thinking about new information, when you study don't simply read or memorize the material; stop periodically to review what you have read and to think of possible questions or applications. • Paraphrase and write-down important point as you read/talk/listen. (This is especially important if someone is trying to communicate something complicated)• Manipulate the material through teaching or doing it whenever possible• Use skits or acronyms to remember important ideas• Volunteer to make posters or overheads for group presentations (or a training manual if you are learning a job)• Manipulate the information by making multiple choice tests or applying it in different situations• Try to relate it to something you already know how to do Tips for auditory learners• Read your material out loud whenever possible• Tape record your notes and listen to them while you drive, work Out etc.• Try to partner with a visual learner if you need to borrow notes• Listen attentively to lectures• Try to block out extra auditory (verbal) interruptions.• If possible, tape record the class so you do not have to worry about taking notes• Discuss any material you are learning with a friendWorking in groups can be particularly effective: you gain understanding of material by hearing classmates' explanations and you learn even more when you do the explaining. Tips for visual learners:• When you read material, visualize it in your mind. Then, try to recite it from memory.• You may find you “hear” better if people write you letters or memos• Rewrite your notes in a format which is easy to visualize and learn such as: outlining, color coding, underlining...• Take mental “pictures” of things that must be rememberedUse flash cards to learn and test yourselfUse visual memory tricks where possible: acronyms, “a friend is a friend to the end” is a way to remember how to spell the word friendVisual learners remember best what they see--pictures, diagrams, flow charts, time lines, films, and demonstrations. Ask your instructor, consult reference books, and see if any videotapes or CD-ROM displays of the course material are available. Prepare a concept map by listing key points, enclosing them in boxes or circles, and drawing lines with arrows between concepts to show connections. Color-code your notes with a highlighter so that everything relating to one topic is the same color. Aside from the way you prefer to receive information, there are many other things that affect your learning. Think about the last time you had a training and the room was uncomfortable, or the class was at a bad time for you. Do you prefer silence, or background noise (television, others chatting), vocal music or instrumental music while concentrating or studying? Do you prefer soft, dim or bright light while concentrating. What level of temperature do you prefer while involved in studying and/or other learning activities? Do you like to have a fan on and a breeze? Do you prefer to study sitting at a traditional desk and chair, or do you like a more informal arrangement with different types of furniture, such as a couch, a recliner, or pillows and carpet on the floor? For any topic, you have to decide the extent to which you are interested in learning. Are you self-motivated (intrinsic) by a desire to learn constantly or externally motivated through interest in a topic or positive feedback and reinforcement from peers and/or superiors? Persistence relates to your attention span and ability to stay on task. Do you have a preference for working on one task until it is finished or do you prefer to work on a variety of tasks simultaneously? Can you get lost for hours in a task if it something you are interested in? Do you prefer to work independently without with little supervision, guidance or feedback, or do you prefer to have frequent feedback and guidance? Do you prefer being told exactly what the learning task is, how you should proceed, and what is expected of you, or do you prefer to be given an objective and then be left alone to decide which procedures or options you use to reach the objective? When working on an assignment, do you prefer to work alone or in a group? If you prefer working in a group, do you like large groups or pairs or does it matter? When working in a group do you prefer to be the group leader or just a member? Do you like to work together with a supervisor or subject expert or do you react negatively to having authoritative guidance? Do you like routines or patterns or do you prefer to work on what ever strikes your fancy at a given moment? Do you prefer to chew, eat, or drink something while studying, such as a soft drink or coffee? People’s energy levels vary at different times during the day. Do you prefer to work on a task that needs concentration in the early morning, late morning, early afternoon, late afternoon, or evening? Can you sit still for a long period of time as long as you are interested in what you are doing, or do you prefer to move constantly -- standing, walking, shaking your foot, tapping your pencil, changing body positions? People who have a preference for global learning are concerned with the whole meaning and the end results. They need to start with an overview of the big picture before they deal with details and facts. People who prefer an analytic style of learning prefer to learn one detail at a time in a meaningful sequence. Once they know all the parts, they put them together and comprehend the big picture. Which do you prefer?Sequential learners tend to gain understanding in linear steps, with each step following logically from the previous one. Global learners tend to learn in large jumps, absorbing material almost randomly without seeing connections, and then suddenly \"getting it.\" Sequential learners tend to follow logical stepwise paths in finding solutions; global learners may be able to solve complex problems quickly or put things together in novel ways once they have grasped the big picture, but they may have difficulty explaining how they did it. Many people who read this description may conclude incorrectly that they are global, since everyone has experienced bewilderment followed by a sudden flash of understanding. What makes you global or not is what happens before the light bulb goes on. Sequential learners may not fully understand the material but they can nevertheless do something with it (like solve the homework problems or pass the test) since the pieces they have absorbed are logically connected. Strongly global learners who lack good sequential thinking abilities, on the other hand, may have serious difficulties until they have the big picture. Even after they have it, they may be fuzzy about the details of the subject, while sequential learners may know a lot about specific aspects of a subject but may have trouble relating them to different aspects of the same subject or to different subjects. If you are a sequential learner and you have an instructor who jumps around from topic to topic or skips steps, you may have difficulty following and remembering. Ask the instructor to fill in the skipped steps, provide an outline of topics to be covered at the beginning of class or fill them in yourself by consulting references. When you are studying, take the time to outline the lecture material for yourself in logical order. In the long run doing so will save you time. You might also try to strengthen your global thinking skills by relating each new topic you study to things you already know. The more you can do so, the deeper your understanding of the topic is likely to be. If you are a global learner, just recognizing that you aren't slow or stupid but simply function differently from most of your classmates can help a great deal.4 However, there are some steps you can take that may help you get the big picture more quickly. Before you begin to study the first section of a chapter in a text, skim through the entire chapter to get an overview. Doing so may be time-consuming initially but it may save you from going over and over individual parts later. Instead of spending a short time on every subject every night, you might find it more productive to immerse yourself in individual subjects for large blocks. Try to relate the subject to things you already know, either by asking the instructor to help you see connections or by consulting references. Above all, don't lose faith in yourself; you will eventually understand the new material, and once you do your understanding of how it connects to other topics and disciplines may enable you to apply it in ways that most sequential thinkers would never dream of. Do you draw conclusions and make decisions quickly or are you methodical and think about the various alternatives and evaluate each before making a decision? Sensing learners tend to like learning facts, intuitive learners often prefer discovering possibilities and relationships. Which do you prefer? Sensors often like solving problems by well-established methods and dislike complications and surprises; intuitors like innovation and dislike repetition. Which is more like you? Sensors are more likely to resent being tested on material that has not been explicitly covered in class. Does this sound like you? Sensors tend to be patient with details and good at memorizing facts and doing hands-on (laboratory) work; intuitors may be better at grasping new concepts and are often more comfortable than sensors with abstractions and mathematical formulations. Which is more like you? Sensors don't like courses that have no apparent connection to the real world; intuitors don't like \"plug-and-chug\" courses that involve a lot of memorization and routine calculations. Which best describes you? Everybody is sensing sometimes and intuitive sometimes. Your preference for one or the other may be strong, moderate, or mild. If you are strong on intuition, you may miss important details or make careless mistakes in calculations or hands-on work; if you overemphasize sensing, you may rely too much on memorization and familiar methods and not concentrate enough on understanding and innovative thinking. Sensors remember and understand information best if they can see how it connects to the real world. If you are in a class where most of the material is abstract and theoretical, you may have difficulty. Ask your instructor for specific examples of concepts and procedures, and find out how the concepts apply in practice. If the teacher does not provide enough specifics, try to find some in your course text or other references or by brainstorming with friends or classmates. If you are an intuitor and you happen to be in a class that deals primarily with memorization and rote substitution in formulas, you may have trouble with boredom. Ask your instructor for interpretations or theories that link the facts, or try to find the connections yourself. You may also be prone to careless mistakes on test because you are impatient with details and don't like repetition (as in checking your completed solutions). Take time to read the entire question before you start answering and be sure to check your results