USW1 COUN 6336 Triage Assessment
\nDescribe in 250 words:<\/p>\n
The primary concern of Amy.
\nUsing the Triage Assessment Form (TAF) as a guide, identify Amy\u2019s overall symptom severity on a scale from 1-30.
\nIdentify what would be your next step to help Amy.
\nResources:<\/p>\n
James, R. K., & Gilliland, B. E. (2017). Crisis intervention strategies (8th ed.). Boston, MA: Cengage Learning.
\nChapter 2, \u201cCulturally Effective Helping in Crisis\u201d
\nChapter 3, \u201cThe Intervention and Assessment Models\u201d
\nChapter 7, \u201cPosttraumatic Stress Disorder\u201d Client Name: ____________________________________________ Time\/Date: __________________
\nCrisis Worker: _________________________ Contact Type: __________ Phone: _______ Office: _______
\nField
\nCrisis Event:
\nSexual assault Amy experienced during her high school senior class vacation. This event has caused her to experience flashbacks, anxiety, panic, and hypervigilance while on campus, particularly when walking alone in crowded areas._________________________________________________________
\n_______________________________________________________________________________________________
\n_______________________________________________________________________________________________
\nDisposition:
\nAmy’s current state and needs after experiencing sexual assault. Specifically, Amy is seeking counseling due to her anxiety symptoms and flashbacks, which are impacting her ability to attend school and form relationships. Her disposition requires interventions to address the trauma and help her cope with her symptoms.______________________________________________________________________
\n_______________________________________________________________________________________________
\n_______________________________________________________________________________________________<\/p>\n
Observations (Check as many that apply)
\n___ \toff medication*
\n__yes_ \tmedication not effective***
\n_sounds__ \thallucinating*** (___smells___
\nsights___sounds___touch)
\n___ \tbizarre behavior\/appearance
\n_yes__ \tpoor hygiene
\n___ \tabsurd, illogical speech***
\n__yes_ \tparanoid\/suspicious thoughts***
\n___ \tflashbacks, loss of reality contact
\n___ \tintoxicated\/drugged*
\n___ \tunder the influence of mood-altering
\nsubstance
\n___ other (explain)
\n___ \toppositional defiant to verbal suggestions
\n___ \tcoercion\/intimidation
\n___ \taggressive gestures*
\n___ \treckless behavior
\n___ \tself-injurious behavior
\n__yes_ \tphysically violent*
\n___ \tverbal threats to self or others
\n___ \tsuicidal\/homicidal
\nthinking\/verbalizing
\n__yes_ \tsuicidal\/homicidal
\ngestures\/behaviors*
\n__yes_ \tsuicidal\/homicidal plan clear*
\n___ \tuncooperative
\n___ \tflat affect
\n___ \timpulsivity
\n___ \thysterical
\n___ \tconfusion
\n___ unable to follow simple directions
\n___ unable to control emotions
\n___ cannot recall personal
\ninformation (phone,
\naddress)
\n___ situation perceived as
\nunreal (spectator)
\n___ nonresponsive***
\nNotes:
\n_____________________________________________________________________________________________________________________________
\n_____________________________________________________________________________________________________________________________
\n*** psychiatric evaluation recommended * hold for law enforcement officers or EMTs
\nFigure 3.2 Triage Assessment Form for Crisis Intervention.
\nSOURCE: Compiled from Triage Assessment Form (TAF), Triage Assessment System for Students in Learning Environments (TASSLE), Triage Assessment Checklist for Law Enforcement (TACKLE). Crisis Intervention & Preventions Solutions Inc.
\nPittsburgh, PA.
\nSEVERITY SCALES
\nCheck those that apply
\n1
\nNo
\nImpairment\t2\/3
\nMinimal
\nImpairment\t4\/5
\nLow
\nImpairment\t6\/7
\nModerate
\nImpairment\t8\/9
\nMarked
\nImpairment\t10
\nSevere
\nImpairment
\nA
\nF
\nF
\nE
\nC
\nT
\nI
\nV
\nE\t\uf06d\tStable mood, control of feelings.\t\uf06d\tAffect elevated but generally appropriate.\t\uf06d\tEvidence of negative feelings pronounced and increasingly inappropriate.\t\uf06d\tFeelings are primarily negative and are exaggerated or increasingly diminished.\t\uf06d\tFeelings are negative and highly volatile or may be nonexistent.\t\uf06d\tFeelings are extremely pronounced to being devoid of feeling.
\n\uf06d\tFeelings are appropriate.\t\uf06d\tBrief periods of slightly elevated negative mood.\t\uf06d\tDuration of feeling intensity longer than situation warrants.\t\uf06d\tEfforts to control emotions are not always successful.\t\uf06d\tExtremely limited control of emotions.\t\uf06d\tNo ability to control feelings regardless of potential danger to self or others.
\n\uf06d\tEmotions are under control.\t\uf06d\tEmotions are substantially under control.\t\uf06d\tEmotions are controlled but focused on crisis event.\t\uf06d\tEmotions not under control but remain focused on crisis.\t\uf06d\tEmotions start to generalize from crisis event to other people and situations.\t\uf06d\tEmotions of the crisis are generalized to other people and situations.
\n\uf06d\tResponses
\nto questions\/
\nrequests are calm and composed.\t\uf06d\tResponses to questions\/
\nrequests are emotional but composed.\t\uf06d\tResponses to questions\/
\nrequests vary from rapid and agitated to slow and subdued.\t\uf06d\tResponses to questions\/
\nrequests are emotionally volatile or beginning to shut down.\t\uf06d\tResponses to questions\/
\nrequests noncompliant due to interference of emotions.\t\uf06d\tCannot respond to questions\/
\nrequests because of interference of emotions.
\nB
\nE
\nHA
\nV
\nI
\nOR
\nS\t\uf06d\tBehaviors
\nare socially appropriate.\t\uf06d\tBehaviors are mostly effective; outbursts, if present, are inconsequential.\t\uf06d\tBehaviors are somewhat ineffective yet not dangerous.\t\uf06d\tBehaviors are maladaptive but not immediately destructive.\t\uf06d\tBehaviors are likely to intensify crisis situation.\t\uf06d\tBehaviors are totally ineffective and accelerate the crisis.
\n\uf06d\tDaily functioning is unimpeded.\t\uf06d\tCan perform tasks needed for daily functioning with minimal effort.\t\uf06d\tPerformance of tasks needed for daily living is minimally compromised.\t\uf06d\tPerformance of tasks needed for daily living is noticeably compromised.\t\uf06d\tAbility to perform tasks needed for daily functioning is seriously impaired.\t\uf06d\tUnable to perform even simple tasks needed for daily functioning.
\n\uf06d\tThreat or danger is nonexistent.\t\uf06d\tBehavior demonstrates frustration but is nonthreatening.\t\uf06d\tBehaviors are a minimal threat to self or others.\t\uf06d\tBehavior is a potential threat to self or others.\t\uf06d\tImpulsivity has the potential to be harmful to self or others.\t\uf06d\tBehaviors are highly destructive and could possibly cause injury\/death to self or others.<\/p>\n
\uf06d\tBehavior is stable and non-offensive.\t\uf06d\tBehaviors mostly stable and
\nnon-offensive.\t\uf06d\tBehavior is becoming unstable and offensive.\t\uf06d\tUpon request, behaviors can be controlled with effort.\t\uf06d\tBehaviors are very difficult to control, even with repeated requests.\t\uf06d\tBehavior is out of control and nonresponsive to requests.
\nC
\nOGN
\nI
\nT
\nV
\nE\t\uf06d\tDecisions are considerate of others.\t\uf06d\tDecisions may not be considerate of others.\t\uf06d\tDecisions are inconsiderate of others. \t\uf06d\tDecisions are offensive and antagonistic of others. \t\uf06d\tDecisions have the potential to be harmful to self or others.\t\uf06d\tDecisions are a clear and present danger to self and others.
\n\uf06d\tDecisions are logical and reasonable.\t\uf06d\tDecisions are becoming indecisive but only with respect to crisis.\t\uf06d\tDecisions are becoming illogical, unreasonable, and generalized beyond crisis.\t\uf06d\tDecisions about crisis are beginning to interfere with general functioning.\t\uf06d\tDecisions are illogical and have little basis in reality, and general functioning is compromised.\t\uf06d\tDecision making is frenetic or frozen and not based in reality and shuts down general functioning.
\n\uf06d\tPerception of crisis event substantially matches reality.\t\uf06d\tThinking is influenced by crisis but is under control.\t\uf06d\tThinking is focused on crisis but is not all consuming.\t\uf06d\tThoughts are limited to crisis situation and are becoming all consuming.\t\uf06d\tThoughts about crisis have become pervasive.\t\uf06d\tThoughts are chaotic and completely controlled by crisis.
\n\uf06d\tAble to carry on reasonable dialog and understand and acknowledge views of others.\t\uf06d\tAble to carry on reasonable dialog and understand and acknowledge views of others.\t\uf06d\tAbility to carry on reasonable dialog restricted and has problems understanding and acknowledging views of others.\t\uf06d\tResponses to questions and requests are restricted or inappropriate and denies understanding views of others.\t\uf06d\tIs defiant to requests and questions and\/or inappropriate with and antagonistic of others.\t\uf06d\tRequests and questions are believed as threats and responded to aggressively.
\n\uf06d\tProblem solving is intact.\t\uf06d\tProblem solving is minimally compromised.\t\uf06d\tProblem solving is limited.\t\uf06d\tProblem solving is blocked.\t\uf06d\tProblem solving ability is absent.\t\uf06d\tProblem solving is not observable with no ability to concentrate.<\/p>\n
CRISIS EVENT
\nIdentify and describe briefly the crisis situation: Amy is experiencing severe symptoms of depression, including loss of interest in her usual activities, feelings of hopelessness and helplessness, and suicidal ideation. She has also recently lost her job and is struggling financially, which has added to her distress. Amy is experiencing significant emotional distress and is at risk of self-harm, making this a critical situation that requires immediate attention and intervention<\/p>\n
AFFECTIVE DOMAIN
\nIdentify and describe briefly the affect that is present.
\n(If more than one affect is experienced, rate with #1 being primary, #2 secondary, #3 tertiary.)
\nANGER\/HOSTILITY: #1, evidence by her verbal and physical aggression towards her husband, as well as her use of profanity and threats towards him. Amy also expresses frustration and anger towards the police officers who arrive at the scene, which suggests that her anger is not limited to her husband<\/p>\n
ANXIETY\/FEAR: #1 Amy expresses worry about her financial situation, the potential loss of her job, and the impact it will have on her family. She is also anxious about the possibility of losing custody of her children if her mental health deteriorates further. This anxiety and fear contribute to her overall distress and sense of crisis.<\/p>\n
SADNESS\/MELANCHOLY: #3 little evidence<\/p>\n
FRUSTRATION: #1, Amy is feeling overwhelmed by her situation and is unable to cope with the stressors in her life. She is frustrated by her financial struggles, her lack of support from her partner, and her feelings of loneliness and isolation. This frustration is evident in her thoughts and behaviors, such as her feelings of hopelessness and her desire to give up. It is possible that her frustration is also contributing to her anxiety and anger\/hostility.<\/p>\n
BEHAVIORAL DOMAIN
\nIdentify and describe briefly which behavior is currently being used.
\n(If more than one behavior is utilized, rate with #1 being primary, #2 secondary, #3 tertiary.)
\nAPPROACH: #1 Demonstrated by Amy’s attempts to communicate with her boyfriend and to seek out help from a mental health professional. She is actively trying to address the crisis situation and is seeking solutions to her problems. This approach behavior is a positive sign that Amy is motivated to improve her situation and is taking steps to do so.<\/p>\n
AVOIDANCE:<\/p>\n
IMMOBILITY:<\/p>\n
COGNITIVE DOMAIN
\nIdentify if a transgression, threat, or loss has occurred in the following areas and describe briefly.
\n(If more than one cognitive response occurs, rate with #1 being primary, #2 secondary, #3 tertiary.)
\nPHYSICAL (food, water, safety, shelter, etc.): Amy’s cognitive response suggests that she perceives a loss in the physical domain, as she has been evicted from her apartment and is currently homeless. She may be experiencing feelings of insecurity, fear, and anxiety related to her physical safety, access to basic necessities like food and water, and lack of stable shelter.<\/p>\n
Transgression_____ Threat_____ Loss__#1____
\nPSYCHOLOGICAL (self-concept, sense of emotional well-being, ego integrity, self-identity, etc.): Amy may perceive a transgression in her psychological well-being due to the negative comments and criticism from her peers and the threat of being ostracized from her social group. This can lead to a negative impact on her self-concept and self-identity, causing her to question her value and worth.
\nThe criticism and negative comments from her peers can also be perceived as a threat to her emotional well-being, leading to feelings of insecurity, anxiety, and fear. This can further impact her self-identity and self-esteem, causing her to feel inadequate and unworthy.<\/p>\n
Transgression____#1_ Threat___#2___ Loss______
\nSOCIAL RELATIONSHIPS (positive interaction and support, family, friends, coworkers, church, clubs, etc.): Amy has recently moved to a new city and started a new job, which may have resulted in her feeling disconnected and lonely. She also mentioned feeling like she doesn’t have anyone to talk to about her feelings, which suggests a lack of social support. This loss of social connection and support may be contributing to her overall distress and affecting her mental well-being.<\/p>\n
Transgression______ Threat______ Loss__#1____
\nMORAL\/SPIRITUAL (personal integrity, values, belief system, spiritual reconciliation): Amy has lost her sense of purpose and meaning in life, which has caused her to question her belief system and values. This is evident when she says that she feels like she has “lost her way” and is struggling to find a reason to keep going. Her previous belief that she was making a difference in the world has been challenged, and she is having a crisis of faith as a result.<\/p>\n
TRIAGE ASSESSMENT (X = Initial Assessment\/O = Terminal Assessment)
\nAffective
\n_8__ Anger ___4 Fear __4_ Sadness
\n\u2022 \u2022
\n1\t2\t3\t4\t5\t6\t7\t8\t9\t10\tBehavioral
\n___8 Approach ___ Avoidance ___ Immobile
\n\u2022 \u2022
\n1\t2\t3\t4\t5\t6\t7\t8\t9\t10<\/p>\n
Cognitive
\n___ Transgression ___Threat ___Loss
\n\u2022 \u2022
\n1\t2\t3\t4\t5\t6\t7\t8\t9\t10
\n____7__ Physical ____7___ Psychological _____6__ Relationship ___6____ Moral\/Spiritual
\nInitial Total Score: _____31____ Terminal Total Score: _50________ (if used)<\/p>\n
Transgression______ Threat______ Loss______
\nDescribe the observations that led you to check the characteristics above:
\nAmy is primarily experiencing anger and using an approach behavior to cope. In terms of cognitive responses, she is primarily experiencing a sense of physical and psychological loss, with some impact on her relationships and moral\/spiritual well- being.____________________________________________________________________________
\n______________________________________________________________________________________
\nAmy is seeking counseling due to anxiety symptoms and flashbacks triggered by sexual assault she experienced during her senior high school class vacation. Her symptoms include anxiety, panic, hypervigilance, and flashbacks that occur when she is walking alone in crowded areas on campus. Using the Triage Assessment Form (TAF) as a guide, Amy’s overall symptom severity is marked impairment (8\/9). This implies that her symptoms are moderate, and she may have some difficulty carrying out her activities of daily living.<\/p>\n
The next step to help Amy is to provide interventions to address the trauma and help her cope with her symptoms. This can include referrals for therapy, medication management, or a combination of both. The therapist can use Cognitive Behavioral Therapy (CBT) to help Amy learn how to manage her anxiety and other symptoms. Additionally, therapists can use Eye Movement Desensitization and Reprocessing (EMDR) therapy to help Amy process the traumatic event and reduce her flashbacks and other PTSD symptoms.<\/p>\n
The therapist can also provide education about PTSD, its symptoms, and coping strategies, including relaxation techniques, mindfulness, and self-care. These strategies will help Amy manage her symptoms better and feel more in control of her life. As a crisis worker, it is essential to provide Amy with a safe and supportive environment that allows her to share her experiences and feelings without fear of judgment or ridicule.<\/p>\n
It is important to note that crisis intervention is not a one-time event, and recovery from trauma takes time. Therefore, it is essential to schedule follow-up appointments to monitor Amy’s progress and adjust the treatment plan as needed. Additionally, crisis workers can provide Amy with resources such as support groups, hotlines, and community-based organizations that can offer additional support and help her build a strong support system.<\/p>\n","protected":false},"excerpt":{"rendered":"
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