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what are the 7 steps to treatment planning
- Problem chronicity/complexity
- Problem solving phase
- Social support
- Subjective Distress
- Functional impairment
- coping style
What are the treatment steps for functional impairment?
- -high restrictiveness i.e. locked up for own safety
- Intensity, sicker people need higher intensity
- Medical vs psychotherapy
- -low restriction ie out patient
- low intensity e.g. a bit anxious
- No meds
- good pronosis
- not urgent
what are the treatment considerations for social support
- CBT VS rels prog
- duration of treatment
- psychosocial vs meds
- possible group intervention
- the quality and quantity of support available.
- High = shorter therapy duration, therapy gains faster and maintained esp. those related to relationship skills
- low - CBT more effective, meds and longer treatment more likely, group therapy might be good
what are the treatment considerations for Problem complexity/chronicity?
narrow symptom focus VS thematic unresolved issues
more likely to be identified by psychodynamic clinicans.
- High - free association
- 2 chair
- dream work
- carthartic discharge
- Low- behavioural intervention
- self monitoring
phobia vs self fulfilling prophecy e.g. poor selction of partner.
WHat arethe treatment considerations for coping style
behavioural vs insight oriented
- act out, blame others e.g. projection, extroversion, manipulation
DO better with behavioural e.g. social skills contracts, questioning beliefs
- intellectualise, deny, withdraw
do better with insight orientated e.g. blbliotherapy, dream interpreatation, interpretation, 2 chair.
what are the treatement considerations for resistance?
directive vs non directive
- High resiatnce
- anxious, oppositional conflict, non compliant
- use non directive approach e.g. support and reassurance, prescribe no change
- Low resitance submissive, open
- direct approach
what are the treatment considerations for subjective distress?
- high distress -visible autonomic agitation
- reduce using PMR exercise CBT for physical agitation
- mental agitation, meditation, reassurance
- low distress low energy, absence of
- role play, confrontation pratcie, interpretaion
treatment considerations in problem solving phase
stages of change