University of South Florida Interview on Mental Illness Discussion

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University of South Florida

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I'm working on a humanities writing question and need an explanation and answer to help me learn.

* After reviewing the chapter and presentation, practice completing a functional assessment. Ask a friend, relative, co-worker, or classmate to role play with you. Explain that this is a practice and fictitious assignment. The purpose of this activity is for you to become familiar with this type of assessment and the process of completing it. Review each of the 12 questions on p. 37-38 and record your interviewee's responses.

Did you focus on your "client's"/interviewee's strengths as well as his/her needs?

Were you comfortable with this type of interview?

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HUS 1450 – Chapter 3 Assessment and Differential Diagnosis of Dual Disorders Watkins, T.R,, Lewellyn, A., Barrett, M.C. (2001) Mental Illness • Mental illnesses are medical conditions that disrupt a person’s thinking, feeling, mood, ability to relate to others, and daily functioning. Just as diabetes is a disorder of the pancreas, mental illnesses are medical conditions that often result in a diminished capacity for coping with the ordinary demands of life. • Serious mental illnesses include major depression, schizophrenia, bipolar disorder, obsessive compulsive disorder (OCD), panic disorder, post traumatic stress disorder (PTSD), and borderline personality disorder. Nancy Teten, LCSW, CAPl Facts About Mental Illness • Mental illnesses can affect persons of any age, race, religion, or income. Mental illnesses are not the result of personal weakness, lack of character, or poor upbringing. • Mental illnesses are treatable. • Most people diagnosed with a serious mental illness can experience relief from their symptoms by actively participating in an individual treatment plan. • The good news about mental illness is that recovery is possible. Nancy Teten, LCSW, CAPl More Facts About Mental Illness • Mental illnesses are biologically based brain disorders. • They cannot be overcome through "will power" and are not related to a person's "character" or intelligence. • Even though mental disorders are widespread in the population, the main burden of illness is concentrated in a much smaller proportion about 6 percent, or 1 in 17 Americans — who suffer from a serious mental illness. • It is estimated that mental illness affects 1 in 5 families in America. • The World Health Organization has reported that four of the 10 leading causes of disability in the US and other developed countries are mental disorders. • By 2020, Major Depressive Disorders will be the leading cause of disability in the world for women and children. Nancy Teten, LCSW, CAPl Mental Health Issues & Prognosis • Mental illnesses usually strike individuals in the prime of their lives, often during adolescence and young adulthood. • All ages are susceptible, but the young and the old are especially vulnerable. • Without treatment the consequences of mental illness for the individual and society are staggering: unnecessary disability, unemployment, substance abuse, homelessness, inappropriate incarceration, suicide and wasted lives. • The economic cost of untreated mental illness is more than 100 billion dollars each year in the United States. • The best treatments for serious mental illnesses today are highly effective; between 70 and 90 percent of individuals have significant reduction of symptoms and improved quality of life with a combination of pharmacological and psychosocial treatments and supports. Nancy Teten, LCSW, CAPl Treating Mental Illness • With appropriate effective medication and a wide range of services tailored to their needs, most people who live with serious mental illnesses can significantly reduce the impact of their illness and find a satisfying measure of achievement and independence. • A key concept is to develop expertise in developing strategies to manage the illness process. • Early identification and treatment is of vital importance. • By ensuring access to the treatment and recovery supports that are proven effective, recovery is accelerated and the further harm related to the course of illness is minimized. Nancy Teten, LCSW, CAPl Ryglewicz and Pepper (1992) Variety of Dual Disorders • Persons with a primary mental illness with episodic psychoses without the use of substances • Persons with psychiatric disorders other than brain disorders such as severely impaired personality disorders clients who become psychotic only when using substances • Persons with primary substance abuse or dependence and personality immaturity and dysfunction • Persons with primary substance abuse or dependence who have problem symptoms after withdrawal Nancy Teten, LCSW, CAPl Complex Management Techniques Four dimensions of Rehab & Relapse prevention strategies: 1. 2. 3. 4. Differential diagnosis as a critical element of meaningful assessment A biopsychosocial grid for assisting in accurate diagnosis A rehabilitation assessment focusing on client strengths as well as needs Assessment of readiness for change as an important strategy for relapse prevention Nancy Teten, LCSW, CAPl Using the DSM – IV Multi – Axial Diagnosis • Each disorder included in the DSM – IV manual is accompanied by a set of diagnostic criteria and text containing information about the disorder, such as associated features, prevalence, familial patterns, age-, culture- and gender-specific features, and differential diagnosis. • Diagnostic criteria have been included in the DSM because their provision has been shown to increase diagnostic agreement. • It is important to understand that the appropriate use of the diagnostic criteria requires clinical training and that they cannot be simply applied in a cookbook fashion. • No information about treatment or presumed etiology is included. Nancy Teten, LCSW, CAPl Differential Diagnosis • Axis I – psychotic disorders, mood disorders, and anxiety disorders co – occurring with substance – related disorders • Axis II – personality disorders seen in combo with Axis I substance disorders • Axis III – medical conditions that mimic or precipitate mental disorders on Axis I or II • Axis IV – psychosocial and environmental problems co – occurring with substance – related disorders such as cocaine dependence with incarceration and unemployment and ETOH dependence with problems such as jot loss, pending divorce, and living alone • Axis IV – GAF score Nancy Teten, LCSW, CAPl TX for Psychotic Disorders • Varies by disorder • Usually involves psychopharmacology (drugs to control symptoms), and psychotherapy (talk therapy). • Hospitalization is an option for serious cases where a person might be dangerous to himself or others. Nancy Teten, LCSW, CAPl Major Considerations • Know the type and the amount of drug (s) consumed by the individual • Know the substance – specific withdrawal symptoms of the drug (s) used • Know the medical history of the individual • Know the psychosocial history of the individual • Consult with multidisciplinary tx team Nancy Teten, LCSW, CAPl Psychotic Disorders • Psychotic disorders are severe mental disorders that cause abnormal thinking and perceptions. • People with psychoses lose touch with reality. • Two of the main symptoms are delusions and hallucinations. • Delusions are false beliefs, such as thinking that someone is plotting against you or that the TV is sending you secret messages. • Hallucinations are false perceptions, such as hearing, seeing or feeling something that is not there. Nancy Teten, LCSW, CAPl Mood Disorders • Mood is the way a person feels inside, the experience of emotion, sustained and predominant internal emotional experience. • A mood disorder is characterized by a disturbance in this internal experience. • Two of the most common mood disorders are depression and bipolar disorder. • Researchers believe most serious mental illnesses are caused by complex imbalances in the brain's chemical activity. • Mood disorders are one form of serious mental illness. Nancy Teten, LCSW, CAPl Mood Disorder Types Bipolar Disorder I Bipolar Disorder II Bipolar Disorder NOS Cyclothymic Disorder Depressive Disorder NOS Dysthymic Disorder Mood Disorder Due to a General Medical Condition Mood Disorder NOS Substance – Induced Mood Disorder Nancy Teten, LCSW, CAPl Anxiety Disorders • Anxiety is a group of disorders characterized by a number of both mental and physical symptoms, with no apparent explanation. • Apprehension, fear of losing control, fear of going "crazy", fear of pending death or impending danger, and general uneasiness are among the most common mental symptoms. • Common physical symptoms include dizziness, lightheadedness, chest or abdominal pain, nausea, increased heart rate, and diarrhea. • Because there are so many physical symptoms, anxiety disorders may not be recognized and the symptoms only treated as physical disorders. • Doctors and researchers believe that with both psychotherapy and medication over 80% of persons with anxiety disorders can be helped. • Anxiety can also be one of the common symptoms of psychiatric disorders. Nancy Teten, LCSW, CAPl Substance Related Disorders • Disorders related to taking of a substance, legal or not. • A substance can be anything that is ingested in order to produce a high, alter one's senses, or otherwise affect functioning. • The most common substance thought of in this category is alcohol although other drugs, such as cocaine, crack, marijuana, heroin, ecstasy, and special K, are also included. • Probably the most abused substances, caffeine and nicotine, are also included although rarely thought of in this manner by the layman. Nancy Teten, LCSW, CAPl Substance Abuse • A pattern of substance use leading to significant impairment in functioning. • One of the following must be present within a 12 month period: (1) recurrent use resulting in a failure to fulfill major obligations at work, school, or home (2) recurrent use in situations which are physically hazardous (e.g., driving while intoxicated) (3) legal problems resulting from recurrent use (4) continued use despite significant social or interpersonal problems caused by the substance use. • The symptoms do not meet the criteria for substance dependence as abuse is a part of this disorder. Nancy Teten, LCSW, CAPl Substance Dependence • Substance use history which includes the following: (1) substance abuse (2) continuation of use despite related problems (3) increase in tolerance (more of the drug is needed to achieve the same effect) (4) substance – specific withdrawal symptoms Nancy Teten, LCSW, CAPl Personality Disorders • When personality traits are considered maladaptive, rigid, and inflexible across many different settings and situations • Will see these in early development, in late adolescence, and early adulthood • Will cause significant impairment in occupational, social, and personal situations • Will deviate from the prescribed culture norm • Cannot be due to another mental disorder, substance abuse, or medical condition Nancy Teten, LCSW, CAPl Types of Personality Disorders • Cluster A – Odd, eccentric ❖ Paranoid Personality Disorder ❖ Schizoid Personality Disorder ❖ Schizotypal Personality Disorder • Cluster B – Erratic ❖ ❖ ❖ ❖ Antisocial Personality Disorder Borderline Personality Disorder Histrionic Personality disorder Narcissistic Personality Disorder • Cluster C – Anxious, Fearful ❖ Avoidant Personality Disorder ❖ Dependent Personality Disorder ❖ Obsessive – Compulsive Personality Disorder Nancy Teten, LCSW, CAPl Biopsychosocial Assessment • See Gorski’s (1994) biopsychosocial grid on page 36 – Table 3.1 • Gorski developed this grid to help delineate chemical dependency, mental disorders, and personality disorders based on physical symptoms, psychological symptoms, and social symptoms • Useful tool to prevent underdiagnosis, misdiagnosis, and overdiagnosis Nancy Teten, LCSW, CAPl Summary of Assessment Tools • A holistic assessment is essential for dually diagnosed clients with a complex of overlapping biopsychosocial issues. ➢Client self – evaluation ➢Laboratory Tests ➢Hx of past/recent sexual trauma ➢Cultural issues related to race/ethnicity ➢Functional assessment Nancy Teten, LCSW, CAPl Variables Critical to Comprehensive Assessment • • • • • • Differential Diagnosis Medical Screening Functional Assessment Motivation or Readiness to Change Transtheoretical Approach to Assessment Emphasis on Quality of Life Across Biopsychosocial Domains Nancy Teten, LCSW, CAPl
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Interview on Mental Illness
Student’s Name
Institutional Affiliation




Interview on Mental Illness
Basis of the Assignment
This assignment is fabricated, and it is based on knowing what people’s perspective is
regarding mental illness. In this interview, a friend will enlighten us on their view.
Mental Illness and Age Group
Mental illness affects people in all age g...

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UC Berkeley

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