-
Ethics
- Countertransference (manage)
- Informed Conset (office policy, role of therapist, parameters of service, fee)
- Limits of Confidentiality
- Expectations (clarify unrealistic expectations, don't give advice)
- Boundaries (avoid problematic dual relationships)
- Scope of Competence
-
Crisis
- Mandates: Child/Dependent Adult/Elder
- Duty to warn
- Danger to others
- Spousal/Partner/Adult abuse
- Physical symptoms (eating d/o, STDs, glaucoma, hives, migraines, effects of abuse, grave disability)
- Alcohol/Drugs
- Anxiety
- Depression
- Suicide
-
Child Abuse
- Physical
- Unjustifiable punishment/mental suffering
- Unlawful corporal punishment
- Neglect
- Sexual
-
Dependent Adult/Elder Abuse
- Physical
- Abandonment
- Isolation
- Neglect (including self)
- Financial
- Abduction
-
Assessment
- Questions
- Releases
- Mental Status Exam
- Observations
- Testing
- History taking
- Strengths
-
Psychosocial Stressors
- Family (problems with primary support group)
- Social (phase of life, loss of friend, acculturation, isolation, discrimination)
- Occupational/Educational
- $ Economic
- Healthcare
- Housing
- Legal Problems
- Other (natural disasters, traumatic events [war], difficulty with non-family caregivers, etc.)
-
Management of Psychosocial Stressors
- Normalize
- Feelings (process)
- Strengths (elicit)
- Skills (teach)
- Collateral resources (utilize)
- Action plan (develop)
- Manageable parts
-
Human Diversity
- Socio-economic status
- Cultural background
- Age/Life Stage
- Gender/Sexual Orientation
- Spiritual Values/Religion
- Other (profession, disabilities [wheelchair, hearing or visual impairments], social affiliations [gangs, 12 steps, etc.], unique life experiences [rape, divorce, etc.]
-
Treatment/Early Stages
- Rapport
- Unit of Treatment
- Collaborative goals
- Symptom reduction
- Collateral resources
-
Treatment/Late Stages
- Goals (met or unmet)
- Loss of treatment, especially in psychodynamic
- Anticipate difficulties (review skills learned)
- Referrals
- Open door policy
-
Human Diversity
- Empathy
- Respect
- Rapport
- Curiosity
- Educate self
- Educated by client
- Personal bias
- Treatment Plan
-
Modify Treatment
- Client reaction
- Alliance (quality of)
- Value differences (are goals consistent with client values? Do you need to reassess?)
- Lifestyle (do interventions match life situation of client?)
- Timing (too early? too late?)
- Different interventions
-
Legal
- Mandates
- Duty to Warn/Danger to Others (5150 and EC Section 1024 allow break in confidentiality)
- Suicide (EC Section 1024 allows break in confidentiality)
- Scope of Practice
- $ Fees set before the start of therapy
- Confidentiality
- Consent to treat a minor
- Privilege
- Professional Therapy Never Includes Therapy
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