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PS 499 Unit 8 Seminar
Assessing Treatment Effectiveness
Reminder
Last day to submit late work for this course is
Saturday, May 29, 2010. No assignments will be
accepted or graded beyond that point.
First, a review of common
diagnoses…….
Anxiety Disorders
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“What is an anxiety disorder?”
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What symptoms might a person with an anxiety
disorder experience?
Possible Symptoms
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Excessive and/or unreasonable worry
Palpitations
Sweating
Shortness of breath
Fear of losing control or going crazy
Fear of dying
Paresthesias
Repetitive Behaviors that are hard to control
Anxiety Disorders Related to Stress
DSM-IV-TR
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Acute Stress Disorder & Post Traumatic Stress
Disorder (PTSD).
Both disorders involve exposure to traumatic
event and subsequent anxiety symptoms:
Event is re-experienced
 Sufferer avoids stimuli associated with event
 Increased arousal (difficulty sleeping, irritability,
hypervigilance, exaggerated startle response.
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So, what is the difference?
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Duration of symptoms…..
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Acute Stress disorder occurs within one month
of event, while PTSD requires at least one
month of symptoms. Thus, PTSD cannot be
diagnosed within one month of traumatic event,
but should be considered if symptoms persist
beyond one month.
Specific Anxiety Disorders
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Agoraphobia (with and without panic disoder)
Specific Phobia
Social Phobia
Obsessive Compulsive Disorder (OCD)
Posttraumatic Stress Disorder (PTSD)
Acute Stress Disorder
Generalized Anxiety Disorder
Depression
Major Depressive Disorder
DSM-IV-TR (2000)
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For at least 2 weeks, person has experienced either
depressed mood and/or loss of interest or pleasure
nearly every day. In addition, several of the following
have been present:
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Changes in weight (5% within month)
Sleep difficulties
Psychomotor agitation/retardation nearly every day
Fatigue or loss of energy nearly every day
Feelings of worthlessness or excessive, in appropriate guilt
nearly every day
Difficulty concentrating nearly every day
Recurrent thoughts of death
Dysthymic Disorder
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Depressed mood for most of the day, for more
days than not, for at least 2 years.
Also, at least two of the following while
depressed:
Poor appetite
 Sleep difficulty
 Low energy, fatigue
 Low self-esteem
 Poor concentration
 Feelings of hopelessness (Note: this is not part of criteria for
MDD)
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Bi-Polar Disorder
Bi-Polar Disorder
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According to text, “An unstable emotional
condition characterized by cycles of abnormal,
persistent high mood (mania) and low mood
(depression)” (p.515).
Criteria for Manic Episode
DSM-IV-TR (2000)
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“A distinct period of abnormally and persistently
elevated, expansive, or irritable mood, lasting at
least one week (or for any duration if
hospitalization is necessary)” (p.362).
Manic Symptoms Cont’d….
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Also, at least 3 of the following (4 if mood is
exclusively irritable):
Inflated self-esteem or grandiosity
 Decreased need for sleep
 More talkative than usual
 Racing thoughts
 Easily distracted
 Increase in goal-directed activity or psychomotor
agitation
 Excessive involvement in pleasurable activities that
have high potential for painful consequences.
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How are all these disorders treated?
Two Main Options
Once treatment has begun, how
do you evaluate client progress?
Examples?
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Review of treatment goals and client’s progress
toward each goal
Client report (How do they feel about their
progress?)
Reports from family members
Reports from workplace or other organization
Attendance to sessions with clinician, as well as
those outside the agency (i.e., AA, NA, OA).
Assessments
What is a transition plan?
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Way to prepare client for transition back into
community, or functioning without regular case
management services.
Why are such plans needed?
How does a transition plan differ
from termination?
Questions?
That’s all for tonight. See you in
the discussion board!