assessment of addiction and mental health issues
TRANSCRIPT
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Assessment of Addiction and Mental Health Issues Identifying the Problem
Presented by: Dr. Dawn-Elise Snipes Executive Director, AllCEUsPodcast Host: Counselor Toolbox & Happiness isn’t Brain Surgery Author: Journey to Recovery (2015) & Happiness Isn’t Brain Surgery (2017)
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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
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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
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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.
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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
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Assessment Provides Awareness of SNAP Strengths
◦ Resources◦ Skills◦ Mitigating Factors and exceptions
Needs◦ Biological◦ Safety◦ Love and Belonging
Attitudes◦ About recovery◦ Cultural
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Awareness of SNAP Preferences
Learning style Treatment approach Quality of Life
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5 Principles of Motivational Interviewing Generate a Gap Roll with Resistance Avoid Arguing Can Do Express Empathy
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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)
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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
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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
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Mental Health Depression/Hopelessness/Apathy Anxiety/Worry Difficulty Concentrating Irritability Agitation Fatigue Changes in sleep duration or quality Changes in eating
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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
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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)
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Resolution/Goal What does happiness look like for you?
What will be different?EmotionallyMentallyPhysicallySocially (self-esteem, relationships and recreation)Environmentally
What will be the same?
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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
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Evaluate potential causes of the symptoms Physical
Sleep Nutrition Pain/Illness Sunlight Exercise Addiction
Alcohol Anxiety Depression Tremors
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Evaluate potential causes of the symptoms Physical
AddictionAmphetamines, cocaine and other stimulants can trigger
Anxiety, panic Depression (withdrawal) Tremors
Marijuana can trigger Anxiety Apathy/Lack of motivation Impaired concentration Paranoid delusions/hallucinations
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Evaluate potential causes of the symptoms
Physical Addiction
Opiates Depression Decreased pain tolerance Disruption of circadian rhythms
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Evaluate potential causes of the symptoms
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.
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Evaluate potential causes of the symptoms Social
Your immediate family Social supports Stressors Self-Esteem
Environmental Active/Interruptions vs. Calm/Peaceful Supportive of sleep? Supportive of relaxation?
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Evaluate potential causes of the symptoms
Emotions Anger Anxiety Depression Happiness
Thought triggers for each emotion
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Symptom AssessmentBehaviors Thoughts Environments
Make the symptom worse
Make the symptom better
Impact of Symptom
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Symptom Assessment: LennyBehaviors 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
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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…EmotionallyMentallyPhysically
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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
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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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