Definitions of 5P's
Define Presenting Concerns
a presenting concern is the concern that prompts a client to seek treatment.
What is a Case Formulation?
The biopsychosocial model is an interdisciplinary way of understanding a client/patient beyond a diagnosis or label, to being able to understand them from a holistic view.
It allows you to treat and support the person, rather than just simply a diagnosis.
It is about "What's going on with this person?" as opposed to "What's wrong with this person?“
How did a person get to where they are? and how can this person best be supported?
What are some open ended questions you may ask a client to get to understand their 'presenting concern?'
What are the client’s concerns?
What brings them to the session?
What items would fall under 'stabilization needs' in our case formulations?
- physical health
- psych needs
- risk!
- withdrawal management needs
Where can you find substance use and gambling worksheets on the OneDrive?
Explore this!
Define Protective Factors
This includes the client's own areas of competency, skill, talents, interest and supportive elements.
What are the subtitles of case formulations at FourCAST?
-General Info
- Stabilization Needs
- Psychosocial History
- Mental Health
- Substance Use and Gambling
Please provide some examples of precipitating factors
Recent breakup in a relationship triggers the patient’s current depression
Recent use of marijuana triggers the patient’s psychosis
Recent start of school year triggers anxiety
Where do we put the GAIN SS results in our case formulations?
- Depends!
- Some sections would fall under Mental Health, some would fall under Substance Use.
What score on a MMS would prompt you to send a referral to Mental Health Services?
A few answers:
- 10 +
- 5-9 (with a clinical need)
- If the client endorsed question regarding suicidality
- If the client endorsed question around trauma
Define Perpetuating Factors
These are any condition in the client, family, community or larger system that exacerbate rather than solve the problem.
Think- Chronic!
Why do we use Case Formulations at FourCAST?
Case conceptualization is fundamental during the assessment phase that supports treatment planning
Case formulation organizes the client's presenting symptoms ,facilitates an understanding of the difficulties ,and enables the development have a comprehensive care management plan for ongoing work.
Your Case Formulation will guide treatment planning decisions that are theoretically grounded and culturally appropriate.
Please provide some examples of protective factors
Healthy relationships, connection with work, school
Healthy coping strategies
Insight
What information should be found within the substance use section of the case formulation?
- History of Use
- Pattern, Frequency,
- Onset age, what was happening around then?
- When did it become a concern? What was happening around that time?
- periods of abstinence
- stage of change
- coping skills
- triggers
Where would a mental health diagnosis fall within the 5P's?
Depends (I know, its a trick question)
- It depends on the symptoms the client is experiencing. Are they experiencing something, acutely, chronically, or was it apart of their set up from childhood, is it all of them,etc.?
Define Predisposing Factors
are areas of vulnerability that increase the risk for the presenting concern.
Think- generally childhood, early years, how did the individual develop?
What is their set up?
What information should be embedded within each section of your case formulation?
The 5P's of course!
Please provide some examples of perpetuating factors
- Chronic stresses
- Chronic Illness
- Chronic unsafe housing
-Lack of insight
What sort of information should be found within the 'Psychosocial History' in Case Formulations?
- Family History
- Education
- Employment
- Spiritual / Cultural Beliefs
- Major Life Roles
What should you always do after completing a case formulation and treatment plan?
- Discuss it with your client
- Update risks in EMHware
Define a Precipitating Factor
these are events or circumstances that immediately precede the presenting concern.
Think: Triggers
'What acute event happened and how did it affect them?'
What information should we use to inform our case formulations?
- Intakes
- Cognitive Impairment Screeners
- GAIN SS
- MMS
- Safe T
- GAIN MI ONT
- Community Partner Records
Please provide some examples of predisposing factors:
Family and genetic history of vulnerability to psychosis
Adverse childhood experiences and early trauma
Poverty, systemic racism, oppression and colonialism
What information should be included in the Mental Health section of the case formulation?
- mental health medications
- coping skills
- history of therapy (what has helped?)
When should you complete a SAFE T assessment?
Bonus Point: Where do you find the assessment?
Whenever suicidal risk is mentioned by a client. (GAIN SS, MMS, GAIN MI ONT, In conversation, at point of intake, etc)
EMHware!