Transcript Document
PS 499 Unit 8 Seminar Assessing Treatment Effectiveness Reminder Last day to submit late work for this course is Saturday, May 29, 2010. No assignments will be accepted or graded beyond that point. First, a review of common diagnoses……. Anxiety Disorders “What is an anxiety disorder?” What symptoms might a person with an anxiety disorder experience? Possible Symptoms Excessive and/or unreasonable worry Palpitations Sweating Shortness of breath Fear of losing control or going crazy Fear of dying Paresthesias Repetitive Behaviors that are hard to control Anxiety Disorders Related to Stress DSM-IV-TR Acute Stress Disorder & Post Traumatic Stress Disorder (PTSD). Both disorders involve exposure to traumatic event and subsequent anxiety symptoms: Event is re-experienced Sufferer avoids stimuli associated with event Increased arousal (difficulty sleeping, irritability, hypervigilance, exaggerated startle response. So, what is the difference? Duration of symptoms….. Acute Stress disorder occurs within one month of event, while PTSD requires at least one month of symptoms. Thus, PTSD cannot be diagnosed within one month of traumatic event, but should be considered if symptoms persist beyond one month. Specific Anxiety Disorders Agoraphobia (with and without panic disoder) Specific Phobia Social Phobia Obsessive Compulsive Disorder (OCD) Posttraumatic Stress Disorder (PTSD) Acute Stress Disorder Generalized Anxiety Disorder Depression Major Depressive Disorder DSM-IV-TR (2000) For at least 2 weeks, person has experienced either depressed mood and/or loss of interest or pleasure nearly every day. In addition, several of the following have been present: Changes in weight (5% within month) Sleep difficulties Psychomotor agitation/retardation nearly every day Fatigue or loss of energy nearly every day Feelings of worthlessness or excessive, in appropriate guilt nearly every day Difficulty concentrating nearly every day Recurrent thoughts of death Dysthymic Disorder Depressed mood for most of the day, for more days than not, for at least 2 years. Also, at least two of the following while depressed: Poor appetite Sleep difficulty Low energy, fatigue Low self-esteem Poor concentration Feelings of hopelessness (Note: this is not part of criteria for MDD) Bi-Polar Disorder Bi-Polar Disorder According to text, “An unstable emotional condition characterized by cycles of abnormal, persistent high mood (mania) and low mood (depression)” (p.515). Criteria for Manic Episode DSM-IV-TR (2000) “A distinct period of abnormally and persistently elevated, expansive, or irritable mood, lasting at least one week (or for any duration if hospitalization is necessary)” (p.362). Manic Symptoms Cont’d…. Also, at least 3 of the following (4 if mood is exclusively irritable): Inflated self-esteem or grandiosity Decreased need for sleep More talkative than usual Racing thoughts Easily distracted Increase in goal-directed activity or psychomotor agitation Excessive involvement in pleasurable activities that have high potential for painful consequences. How are all these disorders treated? Two Main Options Once treatment has begun, how do you evaluate client progress? Examples? Review of treatment goals and client’s progress toward each goal Client report (How do they feel about their progress?) Reports from family members Reports from workplace or other organization Attendance to sessions with clinician, as well as those outside the agency (i.e., AA, NA, OA). Assessments What is a transition plan? Way to prepare client for transition back into community, or functioning without regular case management services. Why are such plans needed? How does a transition plan differ from termination? Questions? That’s all for tonight. See you in the discussion board!