BMFT 602: Internship I
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Transcript of BMFT 602: Internship I
BMFT 602: Internship IFebruary 2, 2010
Today’s Agenda
•Setting up the client file (8:10-8:20)•Informal & formal assessment (8:20-9:05)•Break (9:05-9:20)•Ethical & legal issues (9:20-10:50)
Setting up the Client File
Setting up the Client File
Assessment Definitions
General Assessment Plan
General Psychosocial Assessment
Significance of Spiritual Assessment
Definitions
Spiritual Assessment Options
Assessment Decision TreeAssessment Decision TreeHodge (2005)Hodge (2005)
Brief AssessmentBrief Assessment
Brief assessment sufficient or is a comprehensive assessment warranted?Brief assessment sufficient or is a comprehensive assessment warranted?
SufficientSufficient
AssessmentAssessmentCompleteComplete
WarrantedWarranted
Are generational/historical factors important?Are generational/historical factors important?
YesYes
Are generational factors the primary focus or are Are generational factors the primary focus or are current relationships also of interest?current relationships also of interest?
GenerationalGenerational
Spiritual GenogramSpiritual Genogram
Generational & PresentGenerational & Present
Spiritual EcogramSpiritual Ecogram
NoNo
Are current relationships the primary focus or is life Are current relationships the primary focus or is life history also relevant?history also relevant?
Current RelationshipsCurrent Relationships
Spiritual EcomapSpiritual Ecomap
Life HistoryLife History
DiagrammaticDiagrammatic
Spiritual LifemapSpiritual Lifemap
VerbalVerbal
Spiritual HistorySpiritual History
Other Topics of Assessment
Advantages of Formal Assessment Tools
MFI Assessment Protocol
Instruments Used
Other Instruments Available in MFI
Other Topics of Assessment• Couples – relationship
history & sexual functioning
• Family dynamics▫ Family roles▫ Family emotional
expression▫ Family individuation▫ Family power
distribution▫ Family communication▫ Family subsystems
• Readiness for therapy• Family rules• Family myths• Family rituals• Disengagement• Parentification• Stress• Work-related factors• PTSD
Advantages of Formal Assessment Tools•Help to objectify & organize treatment
effort while establishing an atmosphere of purposeful direction to replace family chaos
•Provide family members an opportunity to systematically understand what other members’ concerns are
• Individuals are provided with the opportunity to self-disclose through paper & pencil rather than their usual method, which has failed
MFI Assessment Protocol
•Other assessments available for use▫MMPI▫Connors▫MAST
•Supervision – must formally discuss 16PF & MMPI results with supervisor
Break
Ethical & Legal Issues
Suicide• Misperceptions
▫ Discussing thoughts of suicide will cause an attempt▫ Discounting the seriousness of suicide threats▫ Believing that a therapist cannot intervene effectively
• Demographics (National Institutes of Mental Health)▫ 3rd leading cause of death for young people 15-24▫ 4 times as many males as females ages 15-19▫ More than 6 times as many males as females ages 20-24▫ Per 100,000:
1.3 Children ages 10-14 8.2 Adolescents ages 15-19 12.5 Young adults ages 20-24
▫ Highest rates among American Indian and Alaska Natives, Non-Hispanic Whites
▫ Lowest rates among Hispanics, Non-Hispanic Black, Asian and Pacific Islanders
Suicide• Factors to assess
▫ Detail or specificity in the plan▫ Lethality and reversibility▫ Intentionality▫ Proximity▫ What is preventing the person from committing suicide?▫ Family members – Do they prevent or increase the
possibility of suicide?
Suicide
•Characteristics of families w/ suicide potential▫Inability to accept necessary changes▫Role & interpersonal conflicts▫Disturbed family structure▫One-sided intrafamilial relationships▫Affective difficulties▫Communication disturbances▫Intolerance for crisis
Suicide
•If a child or teenager is threatening suicide…▫Develop a safety plan with the
parent/guardian that includes… Contacts for crisis situation Agreement to remove weapons/harmful
substances from the home Daily parental assessment of suicidal ideation
Suicide• MFI Policy
▫ No Harm Agreement▫ Contact with resource persons – may get a release to talk
with those people▫ Assess the need for psychiatric care or hospitalization▫ Call your supervisor asap after the session▫ Extreme situations – call 911▫ Assess suicidal ideation every session with your client
until the threat is no longer present – best way is to use scaling question
▫ Take copious notes
Other Ethical/Legal Issues
•Sexual attraction to clients•Feeling bored/stuck with clients•Running into clients outside of therapy•Whether or not to accept phone calls at
home•Touching clients•Reporting sexual or physical abuse
General Rule
Talk to your supervisor or a trusted colleague as soon as possible!!