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Outreach Psychiatric Services

Psychiatric and Psychological Evaluations

Crisis Intervention

Stress Management

Depression and Anxiety Relief

Communication Training

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Psychiatric and Psychological Evaluations

A psychological evaluation is when a licensed professional checks with a series of assessments and questions whether you are experiencing a mental health problem. Patient’s are first walked through a mental status exam, where appearance, motor activity, insight, judgment, affect, memory, and behavior will be assessed, among other things. Safety issues whether, suicidal, homicidal, or self-injurious behaviors are assessed, and addressed. Then the patient’s presenting problem is discussed, the reason why they are there and seeking help. Then the patient’s background is discussed including past psychiatric history, family history of mental illness or addiction, any medical conditions, any medications, trauma history, substance use history, social history, educational/occupational history, strengths and limitations. Patient is then diagnosed by the professional if they meet certain criteria for a mental illness. Patient is usually scheduled for ongoing counseling and other services within Outreach Recovery.

For a psychiatric evaluation, psychotropic medication recommendations are made at the end of the session.

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Crisis Intervention

Crisis intervention is a broad term and could mean many things. Mainly it refers to when a counselor or mental health professional meets with an unstabilized patient one time with the sole focus on stabilizing them. This could be when a person could be completely psychologically normally functioning and have a balance in their lives but have a sudden loved one pass away, become bullied at school, become incarcerated or homeless, or experience living through a global pandemic. There are any number of ways that a normally functioning person would suddenly have issues adjusting to a ‘new’ normal.

There are many crisis intervention model all following certain stages, but all achieving similar results. Here is an example of Roberts’s Seven Stage Crisis Intervention Model

Stage 1: Assess lethality

Stage 2: Establish Rapport.

Stage 3: Identify problems

Stage 4: Deal with Feelings

Stage 5: Explore Alternatives

Stage 6: Develop an Action Plan

Stage 7: Follow-Up

Roberts, R. A. (2000). An overview of crisis theory and crisis intervention. For a psychiatric evaluation, psychotropic medication recommendations are made at the end of the session.

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Stress Management

Another large topic to be discussed, but the consensus among research these days seems to be around the benefits of mindfulness. Mindfulness is the opposite of mindlessness. Have you ever driven down the road and zoned out and been surprised that you can’t remember specifics about how you got home. That is mindless or careless. Biting your nails without thinking, or going to negative coping skills like drugs or alcohol can seem mindless. You don’t think before you do them.

Practicing mindfulness is a skill that can be worked on. There are many ways to start, one is by focusing on your breath or another simple activity. Focusing on your breath, the deep in and out breaths. Putting a hand on your stomach so your awareness is on your stomach as it goes in and out.

Breathing from your diaphragm, like babies breathe, and how adults breathe while asleep. It relaxes us, it also lets our body intake more oxygen which will destress us.

Focusing on your breathing will stop you from focusing on anything else. All the day to day stressors of normal life. And more specifically it can help patients who suffer from anxiety related disorders. Once you have mastered focusing on your breath, you can start to practice mindfulness in other areas of your life. Walking and doing tasks with intention, instead of the mindless malaise that life can sometimes turn into. Try walking from your car to the office door with intention of how your steps feel, is it cold on your skin, are there any noises you can hear.

Once you have practiced mindfulness in enough places, and yes you will need practice. This is a skill that is not easy to master; then when you feel those stressful thoughts or moments of the day coming, you can be better prepared. You can start to do mindfulness techniques while at work, while going to the grocery store, or while having arguments with loved ones; however your stress manifests itself.

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Depression and Anxiety Relief

Anxiety relief can and should be treated via medication and the use of breathing techniques and mindfulness stated in the section above.

With depression relief, and specifically reducing symptoms, medication is useful. One technique in counseling under the CBT model of counseling is using a thought record. As an assignment in counseling, a patient will be asked to complete a thought record. Which is to write down a situation that happened to them, their thought process about that situation, their emotions, and finally the behaviors that they did based on the situation. Patient’s will come in to the counselor and rework the entire situation, and come up with how it could have gone differently. Creating an alternative emotional and behavioral response to that exact scenario. The patient will do this often, and keep coming back with different scenarios, with the hope that they will instead implement the alternative immediate thoughts, emotions, and behaviors. It sounds like a lot of work because it is, with everything to relieve symptoms of depression and anxiety, we ask that the patient’s do a lot of the work with counselors as the support.

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Communication Training

Communication is about showing the other person that you are listening when they are speaking. This can be done by nonverbal communication, nodding and making good eye contact. This can also be done by your body language, putting away distractions, and asking questions. These skills are called active listening and can be taught.

Patients can also be taught if their communication style is passive, aggressive or assertive. We strive for assertiveness, without veering into aggressiveness. If a patient is inclined toward aggressive communication, these skills can be taught. A lot like the thought record earlier, going back and analyzing a situation with the help of a counselor and figuring out how to change from passive or aggressive to assertive communication style.

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Assertiveness Training

Assertiveness is based on balance, requiring one to be forthright about their wants and needs, while considering the rights, needs, and wants of others. Aggressive behavior is based on winning, doing what is in the best interest of yourself regardless of others’ rights, needs, feelings, or desires. There are many benefits of being assertive, often making great managers, negotiating successful win-win solutions; are better doers and problem solvers; and are often less anxious and stressed.

To become more assertive, you have to value yourself and your rights, understanding yourself and your beliefs and inherent values. Next is to voice your needs and wants with confidence. Acknowledge that you can’t control other people’s behavior. Expressing yourself in a positive way, and being open to criticism and compliments; as well as learning to say no. Assertive communication techniques are important as well. Using “I” statements, having empathy for others, being a broken record, and sticking to a script that you want. Mapping out what you will say and how you will react.

https://www.mindtools.com/pages/article/assertiveness.htm

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Problem solving/ Decision making Training

There are many different concepts for our to problem solve. One way to to break the problem down into smaller steps. This can be trained to a person through; similar to how a situation in someone’s life can be analyzed for antecedent, behaviors, and consequences.

Identifying the problem is not always that simple. Some people are generally wrong about what is the source of the problem. Attempts at fixing the wrong thing will not work. Defining the problem so that it can be the sole issue discussed. Forming a strategy will vary based on the situation and the individual’s unique preferences. Organizing the information into a who, what, why, when breakdown could be helpful for some people. Any way of understanding the information will better prepare the person to come up with an effective solution. Next is to allocate resources, determining how high priority it is, and not wanting to spend too much of your available time and resources coming up with a solution. Next is to monitor your progress, if you are not making good progress toward reaching your goal, then reevaluating your approach may help. Lastly, evaluate whether your solution worked.

https://www.verywellmind.com/what-is-problem-solving-2795485

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