Hierarchy of Needs
What does the Physiological portion of the Hierarchy of needs include?
Air, Water, Food, Shelter, Sleep, Clothing
Example: Food insecurity, sleep deprivation, untreated medical issues.
Engagement
Demonstrating empathy and unconditional positive regard
Explaining confidentiality and informed consent
Clarifying roles, boundaries, and expectations
Using cultural humility and awareness of power dynamics
Beginning strengths-based engagement
What is Mental Status Exam
Appearance – hygiene, dress, eye contact
Behavior – agitation, psychomotor slowing
Speech – rate, tone, volume
Mood – “How do you feel?”
Affect – congruent/incongruent, flat, labile
Thought Process – logical, tangential, circumstantial
Thought Content – SI/HI, delusions, obsessions
Perception – hallucinations
Cognition – orientation, memory, attention
Insight/Judgment – awareness, decision-making
Safety:
Physical, emotional, and psychological safety come first. People need to feel protected, respected, and free from harm in the environment and in their interactions.
What is the safety portion of the hierarchy of needs include?
Personal security, Employment, Financial security, Health and well-being, Safe environment, Protection from accidents or illness.
Example W/ client : Active DV, homelessness, child welfare involvement, immigration fear.
Assessment
Exploring biological, psychological, and social factors
Identifying environmental stressors (housing, employment, discrimination, etc.)
Assessing risk and safety
Identifying strengths and resilience
Considering systemic oppression and structural barriers
When do you use mental status exam
Intake
Crisis
Noticeable change in presentation
Concerns about safety or psychosis
Before psychiatric referral
Trustworthiness and transparency
Decisions, rules, and expectations are clear and consistent. Providers are honest about what will happen and why, which helps rebuild trust that trauma may have damaged.
What is the social portion of the Hierarchy of needs Include?
Friendship, Intimacy, Family, Trust, Acceptance, Being part of a group (community, team, religion, etc.)
Examples: Belonging, Social isolation, foster care, family conflict
Planning
Collaborative efforts
Identifying priority needs
Setting short- and long-term goals
Connecting goals to client strengths
Ensuring goals are realistic within environmental constraints
Discussing resources and services
What do you Assess for during safety and risk assessments?
Suicidal ideation
Homicidal ideation
Self-harm
Abuse/neglect
Psychosis impairing safety
Substance use + risk
Peer support
Connection with others who have lived experience of trauma is encouraged. Peer relationships help normalize reactions, reduce isolation, and promote healing.
What does the Esteem portion of the hierarchy of needs include.
Self-esteem, Confidence, Achievement, Recognition,Status, Respect from others
Examples: Shame, chronic failure narratives, low self-efficacy
Intervention
Counseling or therapeutic techniques
Case management and resource coordination
Advocacy (housing, legal, medical, educational systems)
Crisis intervention if needed
Skill-building and empowerment strategies
What is included Suicide Risk Assessment
Ideation – passive vs active
Plan – method, access, specificity
Intent – desire to act
Means – access to weapons/meds
History – past attempts
Protective factors – family, faith, goals
Current stressors
Collaboration and mutuality
Power differences are minimized. Care is done with people, not to them—clients, families, and staff are partners in decision-making.
What does the Self-Actualization portion of Hierarchy of needs include.
Personal growth,Creativity, Morality, Problem-solving, Pursuing passions, Fulfilling one's potential
Example of client issues in this area:Insight work, identity, long-term goals
Evaluation
Reviewing progress toward goals
Using measurable outcomes
Seeking client feedback
Revising plans as needed
Ensuring interventions remain culturally responsive
What are the risk levels and what do they include
Low – passive thoughts, no plan, strong protective factors
Moderate – ideation + some planning, limited intent
High – plan, intent, means, past attempts
Empowerment, voice, and choice
Cultural, historical, and gender responsiveness
Individuals are supported in making choices and having control over their care. Strengths and resilience are emphasized rather than deficits or pathology.
Care actively recognizes the impact of culture, identity, historical trauma, and systemic oppression. Services are respectful, inclusive, and responsive to diverse experiences.