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| Identify Assessment Tools related to symptom identification and diagnosis | Structured Clinical Interview for DSM(SCID)- uses specific interview techniques to make psychiatric diagnosis from the DSM more dependable; Brief Psychiatric Rating Scale, (BPRS)- a rating scale that evaluates 18 items related to symptom severity used by a practioner after interviewing a client; Symptom Checklist-90-R- a 90 item assessment tool completed by the client to determine the severity and impact of psychiatric symptoms; Positive and Negative Syndrome Scale (PANSS, SAPS, SANS)- helps identify certain sets or patterns of symptoms that correlate with specific disorders. |
| Empowerment in psychiatric rehabilitation and the elements of this principle | The active and meaningful participation in decisions affecting their lives. Gives a sense of control and power over ones life that is often missing for people suffering from mental illness. Empowerment is recognized as situational as clients may have more power in some parts of life than other. Control can be exercised with the authority to make final decisions or might be shared with others; Empowerment is not given instead a person must take it on for themselves. Support can be given to ensure that individuals are facilitated in taking on power of their lives. |
| Assessment tools related to HEALTH | MOS 36 Item Short Form Survey-(SF 36) evaluates social, behavioral, physical, and emotional aspects of health in people with chronic conditions through an interview or client self report; Sickness Impact Profile(SIP)-assesses illness related dysfunction in behavior terms b considering psychosocial and physical categories as well as measures of independent living; Quality of well Being(QWB)- a broad tool that can evaluate the effect of a specific system or program on the overall health situation of an individual or group; International Classification of Functioning or disability(ICD)- created by the world health organization to consider disability of an individual by evaluating in the categories of functioning, behavior and involvement in society. |
| Goal | A broad statement of a desired state one hopes to achieve, this should be the foundation of the rehabilitation plan |
| Objective | considered a subordinate part of a goal and is usually more specific in nature with outcomes that can be measured and may be more short term; a goal might be divided into a number of specific objectives |
| Interventions | actions, services, strategies or products designed to help individuals overcome the effects of mental disability |
| Strength | an identified ability, skill or personal characteristic that an individual possesses which can be used advantageously in recovery from psychiatric rehabilitation |
| Deficit | an identified personal characteristic lacking skill or inability that inhibits recovery from psychiatric rehabilitation |
| Tools evaluating Global Functioning | Behavior and Symptom Identification Scale(BASIS 32) 32 item tool completed by the client which asks for a rating of difficulty in a number of areas including relationships, daily living, functioning in desired roles, specific behaviors level of depression or anxiety and episodes of psychosis; Global Assessment of Functioning Scale(GAF)- is a single item rating on a scale of 0-100 based on a practioners behavioral observations of client functioning in areas of work, social interaction or involvement and mental state; Role Functioning Scale(RFS)- a short tool that focuses on single measures for four areas of independent living, occupational productivity, close social relationships and expanded social interaction by measuring on a seven point scale base on observations; Life Skills Profile(LSP)- schizophrenia specific 39 item tool completed by someone very familiar with the client to assess level of disability or functioning in areas of caring for oneself maintaining clam, social integration, communication skills, and personal responsibility; Disability Rating Form - measures level of disability on a five point scale that correlates with the Social Security Administrations definition for disability. |
| Describe side effects associated with PSYCHOTROPHIC drugs | Irregularities with hormones, appetite changes, weight gain; muscular stiffness; poor motor coordination, especially noticeable in gait; altered blood pressure; seizures; tardive dyskinesia; Parkinsonian symptoms; vision blurring; dry mouth. |
| Beliefs about Recovery in mental illness | 1. Recovery sometimes happens without any professional help because people are the most important ingredient in their own recovery; 2. A major factor is often the people an individual perceives as supporting and expressing confidence; 3. Recovery has nothing to do with a persons beliefs about the causes of illness; 4. Recovery is not a cure and symptomatic episodes in terms of length and reoccurrence; 5. recovery is not a prescribed set of steps and does not follow a pattern; 6. Recovery from the effects of the disease such a loss of self esteem and family estrangement is sometimes the hardest part; 7. Recovery from psychiatric disorders should not be cause to negate the reality and seriousness of the illness. |
| Readiness Assessment | a tool to assist individuals in determining if they are ready to take part in rehabilitation |
| Readiness Development | a variety of activities practioners can provide individuals to increase readiness by expanding individuals understanding about the rehabilitation process and demonstrating how rehabilitation can improve quality of life. |
| Functional assessment | a tool that assist the Spyri practioner and his client figure out what skills are needed to achieve the clients' goals and which of these needed skills the client possesses |
| Resource Assessment | a tool used in psychiatric rehabilitation to determine what support systems and other resources the client needs to achieve his goals and which of these are currently available. |
| Direct skills teaching | an intervention utilized to develop lacking situational skills through activity based instruction learning the skills in the target environment |
| skills programming | an intervention utilized to help individuals take advantage of a skill they already possess by getting around obstacles to application in the target environment |
| Resource Coordination | an intervention intended to support individuals by helping them identify and access resources and support systems that are available such as government programs, transportation systems, self help programs etc. |
| resource modification | an intervention intended to support individuals by altering an available resource to better meet an individual's needs,. |
| Three overall Goals of PsyR | 1. Helping clients reach Recovery-requires understanding that recovery is a unique experience for each person and the mental health profesional is the guide; 2. Help clients be as much a part of the mainstream community as possible. This includes some level of independent living as well as involvement and acceptance within that community.; 3. Help clients experience life at the highest quality achievable. Issues related to this goal include basic needs such as food shelter and clothing but also apply to all things important to quality of life such as relationships, sex, jobs, leisure activities, support network and sense of community. |
| Three descriptors commonly used to define or explain mental illness | Aim is to prevent labeling people in a derogatory, discriminatory or demeaning way…1. diagnosis which gives a specific identity to the illness. The person would be described as having schizophrenia not as being a schizophrenic. 2. Level of Disability- This is usually in form of commonly understood as a number of mild, moderate and severe.; 3. Duration- this indicates the length of time the person has suffered from the illness such as ongoing, persistent, prolonged etc. |
| Psychiatric Rehabilitation Readiness | describes an individual's interest in and motivation to participate in psychiatric rehabilitation services. |
| Factors assessing PsyR readiness | 1. Interest level of individual and level of unhappiness in present situation.; 2. Level of commitment the individual has to change specifically the ideas that change has to happen and can happen change can be positive and support is available to assist this change.; 3. The depth of understanding client has about circumstances in which they need to be successful.; 4. The understanding and knowledge that an individual has about himself, strengths, values beliefs etc.; 5. The level of trust that an individual has in the PsyR professional who will be providing services. |
| Process of involving the client in PsyR rehabilitation Diagnostic Interview | 1. Orienting to make sure the client understand what will take place in the interview including purpose what part each participant will play and what is expected of each.; 2. Solicitation of Information - gather needed facts, feelings and opinions the interviewer must use techniques that facilitate open communication such as open ended questions.; 3. Showing understanding through feedback, responses and restatements showing that the interviewer has good understanding of the client's point of view. |
| Values Assessments | Process in which a practioners gets the client to identify the things that s/he values in daily life . The practioners works to make connections between client statements about values and objective daily goals. Practioners can do numbering of priority of importance to a list or can provide group in which provide fictional or real dilemmas for consideration and have clients come to conclusion on how to handle the dilemma tying it to values. |
| Actions of PsyR practioner during stages of diagnosing and planning | Diagnosing- 1. determining if a client is prepared to participate in rehab.; 2. Assist client in reaching preparedness.; 3. Establishing goals for rehab by building a relationship with the client, helping the client determine interests and needs, assist client in considering environments in which he wishes to function.; 4. Analyzing client's level of functioning by identifying needed skills and their various applications and determining the client's current skills and proficiency level.; 5. Identify resources needed for client to reach goals and determine what resources are available, how they can help, and what is needed for the client to access those resources. PLANNING_ establish a plan to build needed skills as well as to locate and access needed resources through determining most important needs, clarifying goals, and picking appropriate interventions with the client's help. |
| Possible Outcomes of a readiness assessment including different options that PsyR practioner can help the client consider | ready to start rehabilitation- work together on the next step of goal setting; Not really prepared to begin but wishes to proceed with starting- practioner should help client understand that rehab may take more commitment and time to complete.; Lacking readiness- client has options including working with practioner on improving preparedness before entering to increase chances of success, delaying rehab while focusing on treatment and symptom management, avoid rehab services choosing self help groups or avoid all services. |
| Advance Psychiatric Directives | Advance directive is written with instructions as to client's preferences for treatment and care under certain medical circumstances. For psychiatric care personal preferences and wishes might be addressed in which legal and medical guardian are appointed in times of incompetence, including treatment such as medication, restraints, ect, family involvement, acceptable visitors, involvement in experimental drugs. Not yet standardized and accepted by courts. |
| Function of IAPSRS outcome toolkit | Tool kit is an assessment tool designed to bring consistency and simplicity to the evaluation of programs serving individuals with mental illness. It is intended to measure the outcome of client goals and the effectiveness of interventions or programs. It does this by creating a database based on specified client outcomes. Outcomes are divided into seven domains that coincide with goals of psyR. (employment, education, housing, hospitalization, financial, legal matters) collects demographic data and measures client perception in the areas of quality of life, personal empowerment, accomplishment of goals and overall satisfaction with the program |
| Areas of data gathered when measuring outcomes of rehabilitation goals | usually on a number scale using short answer input and use precoded responses for common choices. 1. Demographic information; 2. DSM diagnosis.; 3. Housing situation past present and future.; 4. Hospitalization history.; 5. Employment history including wages hours and support.; 6. Educational history including vocational training.; 7.Govertnemtn benefits.; 8. Legal issues.; 9. Member satisfaction with program |
| Conditions that SAMHSA uses to define an individual with mental illness | At least one of the following conditions or events should be present- 1. individual has discussed, strategized about or actually tried to commit suicide during the last year.; 2. The client has no meaningful or fruitful role within the community such as a job, volunteering or attending school.; 3. The individual has faced serous obstacles to his role with in the community such as difficulty maintaining employment obtaining housing or accessing transportation. 4. the individual lacks any significant interaction or relationships with others or is isolated within the community. |
| Describe outcome measures that a psychiatric rehab practioner might consider | Residential status, recidivism rates, level of independence, length of employment, type of employment, educational status, overall health, functioning in roles, pursuit of leisure activities, social interactions and relationships. |
| Areas to assess in client satisfaction survey | Luekart scale 1-4 I am satisfied with my life; if a job was available, I could work successfully; I have a good relationship with my family; I am satisfied with my present living situation. |
