Crisis, trauma week 3
When providing a clinical assessment for clients, several colleagues may work with the same client and come up with varying perceptions of how the client is functioning. It is essential to work collaboratively with colleagues to provide the best client care. You need to be able to provide a respectful rationale to defend your assessment as well as be open to varying perspectives to come to a consensus on the best way to move forward with the client based on this assessment process.
For this Discussion, you will examine a case study of in the Learning Resources and begin to assess the client care needs for this client.
To Prepare:
Review the week’s Learning Resources.
Review the case study of Amy.
Post:
1. The primary concern of Amy.
2. Using the Triage Assessment Form (TAF) as a guide, identify Amy’s overall symptom severity on a scale from 1-30.
3. Identify what would be your next step to help Amy.
Requirements: 2 pages (600 words). USE APA and 2 CREDIBLE sources.
NB: Use the case study of Army 1 to do the assessment (Triage Assessment Form). After using the TAF, which will help you assess the army from the case study, do the POST (3 questions). The Form that must be used and the case study attached.
Client Name: ____________________________________________ Time/Date: __________________
Crisis Worker: _________________________ Contact Type: __________ Phone: _______ Office: _______
Field
Crisis Event:
___________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
Disposition:
__________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
Observations (Check as many that apply)
___ off medication*
___ medication not effective***
___ hallucinating*** (___smells___
sights___sounds___touch)
___ bizarre behavior/appearance
___ poor hygiene
___ absurd, illogical speech***
___ paranoid/suspicious thoughts***
___ flashbacks, loss of reality contact
___ intoxicated/drugged*
___ under the influence of mood-altering
substance
___ other (explain)
___ oppositional defiant to verbal suggestions
___ coercion/intimidation
___ aggressive gestures*
___ reckless behavior
___ self-injurious behavior
___ physically violent*
___ verbal threats to self or others
___ suicidal/homicidal
thinking/verbalizing
___ suicidal/homicidal
gestures/behaviors*
___ suicidal/homicidal plan clear*
___ uncooperative
___ flat affect
___ impulsivity
___ hysterical
___ confusion
___ unable to follow simple directions
___ unable to control emotions
___ cannot recall personal
information (phone,
address)
___ situation perceived as
unreal (spectator)
___ nonresponsive***
Notes:
_____________________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________________
*** psychiatric Assessment recommended * hold for law enforcement officers or EMTs
Figure 3.2 Triage Assessment Form for Crisis Intervention.
SOURCE: Compiled from Triage Assessment Form (TAF), Triage Assessment System for Students in Learning Environments (TASSLE), Triage Assessment Checklist for Law Enforcement (TACKLE). Crisis Intervention & Preventions Solutions Inc.
Pittsburgh, PA.
SEVERITY SCALES
Check those that apply
1
No
Impairment 2/3
Minimal
Impairment 4/5
Low
Impairment 6/7
Moderate
Impairment 8/9
Marked
Impairment 10
Severe
Impairment
A
F
F
E
C
T
I
V
E Stable mood, control of feelings. Affect elevated but generally appropriate. Evidence of negative feelings pronounced and increasingly inappropriate. Feelings are primarily negative and are exaggerated or increasingly diminished. Feelings are negative and highly volatile or may be nonexistent. Feelings are extremely pronounced to being devoid of feeling.
Feelings are appropriate. Brief periods of slightly elevated negative mood. Duration of feeling intensity longer than situation warrants. Efforts to control emotions are not always successful. Extremely limited control of emotions. No ability to control feelings regardless of potential danger to self or others.
Emotions are under control. Emotions are substantially under control. Emotions are controlled but focused on crisis event. Emotions not under control but remain focused on crisis. Emotions start to generalize from crisis event to other people and situations. Emotions of the crisis are generalized to other people and situations.
Responses
to questions/
requests are calm and composed. Responses to questions/
requests are emotional but composed. Responses to questions/
requests vary from rapid and agitated to slow and subdued. Responses to questions/
requests are emotionally volatile or beginning to shut down. Responses to questions/
requests noncompliant due to interference of emotions. Cannot respond to questions/
requests because of interference of emotions.
B
E
HA
V
I
OR
S Behaviors
are socially appropriate. Behaviors are mostly effective; outbursts, if present, are inconsequential. Behaviors are somewhat ineffective yet not dangerous. Behaviors are maladaptive but not immediately destructive. Behaviors are likely to intensify crisis situation. Behaviors are totally ineffective and accelerate the crisis.
Daily functioning is unimpeded. Can perform tasks needed for daily functioning with minimal effort. Performance of tasks needed for daily living is minimally compromised. Performance of tasks needed for daily living is noticeably compromised. Ability to perform tasks needed for daily functioning is seriously impaired. Unable to perform even simple tasks needed for daily functioning.
Threat or danger is nonexistent. Behavior demonstrates frustration but is nonthreatening. Behaviors are a minimal threat to self or others. Behavior is a potential threat to self or others. Impulsivity has the potential to be harmful to self or others. Behaviors are highly destructive and could possibly cause injury/death to self or others.
Behavior is stable and non-offensive. Behaviors mostly stable and
non-offensive. Behavior is becoming unstable and offensive. Upon request, behaviors can be controlled with effort. Behaviors are very difficult to control, even with repeated requests. Behavior is out of control and nonresponsive to requests.
C
OGN
I
T
V
E Decisions are considerate of others. Decisions may not be considerate of others. Decisions are inconsiderate of others. Decisions are offensive and antagonistic of others. Decisions have the potential to be harmful to self or others. Decisions are a clear and present danger to self and others.
Decisions are logical and reasonable. Decisions are becoming indecisive but only with respect to crisis. Decisions are becoming illogical, unreasonable, and generalized beyond crisis. Decisions about crisis are beginning to interfere with general functioning. Decisions are illogical and have little basis in reality, and general functioning is compromised. Decision making is frenetic or frozen and not based in reality and shuts down general functioning.
Perception of crisis event substantially matches reality. Thinking is influenced by crisis but is under control. Thinking is focused on crisis but is not all consuming. Thoughts are limited to crisis situation and are becoming all consuming. Thoughts about crisis have become pervasive. Thoughts are chaotic and completely controlled by crisis.
Able to carry on reasonable dialog and understand and acknowledge views of others. Able to carry on reasonable dialog and understand and acknowledge views of others. Ability to carry on reasonable dialog restricted and has problems understanding and acknowledging views of others. Responses to questions and requests are restricted or inappropriate and denies understanding views of others. Is defiant to requests and questions and/or inappropriate with and antagonistic of others. Requests and questions are believed as threats and responded to aggressively.
Problem solving is intact. Problem solving is minimally compromised. Problem solving is limited. Problem solving is blocked. Problem solving ability is absent. Problem solving is not observable with no ability to concentrate.
CRISIS EVENT
Identify and describe briefly the crisis situation:
AFFECTIVE DOMAIN
Identify and describe briefly the affect that is present.
(If more than one affect is experienced, rate with #1 being primary, #2 secondary, #3 tertiary.)
ANGER/HOSTILITY:
ANXIETY/FEAR:
SADNESS/MELANCHOLY:
FRUSTRATION:
BEHAVIORAL DOMAIN
Identify and describe briefly which behavior is currently being used.
(If more than one behavior is utilized, rate with #1 being primary, #2 secondary, #3 tertiary.)
APPROACH:
AVOIDANCE:
IMMOBILITY:
COGNITIVE DOMAIN
Identify if a transgression, threat, or loss has occurred in the following areas and describe briefly.
(If more than one cognitive response occurs, rate with #1 being primary, #2 secondary, #3 tertiary.)
PHYSICAL (food, water, safety, shelter, etc.):
Transgression_____ Threat_____ Loss______
PSYCHOLOGICAL (self-concept, sense of emotional well-being, ego integrity, self-identity, etc.):
Transgression_____ Threat______ Loss______
SOCIAL RELATIONSHIPS (positive interaction and support, family, friends, coworkers, church, clubs, etc.):
Transgression______ Threat______ Loss______
MORAL/SPIRITUAL (personal integrity, values, belief system, spiritual reconciliation):
TRIAGE ASSESSMENT (X = Initial Assessment/O = Terminal Assessment)
Affective
___ Anger ___ Fear ___ Sadness
• •
1 2 3 4 5 6 7 8 9 10 Behavioral
___ Approach ___ Avoidance ___ Immobile
• •
1 2 3 4 5 6 7 8 9 10
Cognitive
___ Transgression ___Threat ___Loss
• •
1 2 3 4 5 6 7 8 9 10
______ Physical _______ Psychological _______ Relationship _______ Moral/Spiritual
Initial Total Score: _________ Terminal Total Score: _________ (if used)
Transgression______ Threat______ Loss______
Describe the observations that led you to check the characteristics above:
______________________________________________________________________________________
______________________________________________________________________________________
