DSM of Britney Spears

Britney Spears DSM
axis I- 296.23 Major Depressive Disorder with Chronic specifier(characterized by one or more episodes at least two weeks of depressed mood) [some symptoms she showed: depressed mood most of the day, significant weight gain or loss, low energy], 296.80 Bipolar Disoreder NOS ( need more information for this but she has some of the symptoms, such as displaying shifting of expressions of emotions, drawing attention to self)
axis II- deferred
axis III- deferred
axis IV- divorce with husband, media constantly watching her(pictures of her wearing no underwear, driving with kid on her lap)
axis V- 40 ( impairment in reality testing or communication, greatly influenced by others, impairment in communication or judgement

round robin

I felt that the assignment was helpful with the group I was in because luckily, I have them in my Thursday night class so it was kind of nice if I was confused on something, they most likely were too so we kind of would figure it out together. Then we all split the questions up and worked on them separately but then after worked on them together and read everyone’s feedback.
I felt that the questions I was doing on confrontation were a little harder than the other questions on “I” statements. It probably has a lot to do with how I am as a person because I am not a fan of any confrontation whatsoever and avoid it, but deal with it when necessary. However, I think I do a good job on expressing how I feel about certain situations and things that are going on in my life so that may be why it was so hard for me to answer the questions. I know I’ve said this before, but I don’t feel comfortable in giving, but I am learning on how to be more helpful with it so the person that I am giving it to can benefit from what I am saying. Also though, I didn’t see that many blogs up yet for me to rate.
I would rate my answers probably just good. I am not going to say they were the best because I don’t like grading myself either, but I also had a difficult time with them although I spent some time on them, but I will admit, I was a little confused on the chapter, there was a lot of information so the exercise helped. I certainly felt like I understood it a little better. There’s always room to improve with me and that’s something I am trying to do with my feedback, I do want to improve and try to be helpful to my peers so I am going to try to thoroughly read their work and try to give them ideas to make it a little better, just because, like I said there’s always room for work with everyoneJ. I guess, I just don’t want to seem like I am criticizing their work, even though they probably wouldn’t feel that way. It’s hard to grade someone else’s work because I am just a student too like them and that’s why I have a hard time with it because I just want to tell them the good things they did in the paper.
This assignment was good to know and understand for us when dealing with clients. You need to never seem like you are talking down to them or judging them, you can’t make a client feel belittled by your words and that’s very important. Also, its good to know how to deal with confrontational situations and environments. That part will really come in handy for me inside of work and just with life. You need to handle the situations calmly and respectful.

my interview with Jessica =]

I did my interview on Jessica Henderson on Thursday, September 30, 2010 at 8:00 pm. She is actually my Behavior Assessment instructor along with working third shift at a community-based residential facility for adults with mental illness. The facility is called Almost Home Again in Gilman, Wisconsin which used to be Crossroads. It’s pretty much a big house with support staff.

Here are some of the questions I had asked Jessica Henderson:

WHERE DO YOU WORK?

WHAT IS YOUR ROLE AT YOUR CAREER?

WHY DID YOU GO INTO HUMAN SERVICES?

WHAT DO YOU LIKE ABOUT YOUR JOB?

WHAT DO YOU DISLIKE ABOUT YOUR JOB?

WHATS A ‘TYPICAL’ DAY WHEN YOUR WORKING?

WHAT ARE SOME ISSUES YOU FACE WITH AT WORK?

HOW DO YOU HANDLE RUDE AND CRABBY CLIENTS?

WHAT DO YOU ENJOY DOING WITH YOUR CLIENTS?

DESCRIBE THE FACILITY YOU WORK AT.

WHAT ARE SOME OF THE ACTIVITIES THE CLIENTS DO DURING THE DAY?

HOW MANY CLIENTS DO YOU HAVE?

WOULD YOU CHANGE ANYTHING ABOUT THE FACILITY?

HOW MUCH IS THE AVERAGE SALARY YOU MAKE THERE?

WERE YOU SURPRISED AT THE NUMBER? DID YOU THINK IT WOULD BE HIGHER? DID YOU THINK IT WOULD BE LOWER?

WHAT IS YOUR DEGREE?

HOW LONG HAVE YOU WORKED THERE?

WHATS A HECTIC DAY?

WHAT KIND OF PAPER WORK DO YOU FILL OUT?

WHAT KIND OF CLIENTS DO YOU HAVE?

WHAT WAS THE CRAZIEST DAY YOU EVER HAD?

At Almost Home Again, the staff makes it feel like home to clients as much as possible, but the clients still have rules and regulations to abide by. The staff there really emphasizes the fact that they want the clients to feel very comfortable like they pretty much are at home. It’s not a locked facility due to medical emergencies. For instance, if there were to be a fire, the clients couldn’t just run outside. But they let the clients have some freedom and go outside and walk around so they shouldn’t ever feel trapped.

]Jessica’s role at Almost Home Again is to work with clients as they work to increase their daily living skills and gain independence, to educate her clients on their mental illness – symptoms, importance of medications and routine, signs they are relapsing, reaching out when they feel they are de-compensating – to seek out outside resources that are helpful to the client and make referrals for aftercare once they leave the facility to live independently. She will meet with clients as needed, usually daily, to discuss any issues or concerns they are having and work one on one on the above materials. She also facilitates groups that focus on healthier living, living with a mental illness, and coping.

A big duty she has is paperwork! Paperwork, paperwork, paperwork! Documenting all contacts with outside supports, tracking medications and changing medication sheets when new prescriptions come in, making sure that medication procedures follow state codes, facilitate groups, take my clients to their psychiatric appointments (she’ll sit in on those and participate as needed, taking notes so that they can all incorporate that information into their treatment plan), she will write monthly reports that serve as updates to the client’s county social worker as well as devise their individual service plan within 21 days of admit and update it every 6 months or as needed.

When I asked her if she liked her job, let’s just say she loves it! “No two days are ever the same”, she said, “there is nothing more gratifying that watching a client work through their issues, learn about their illness, and really see they are getting it. Watching a client leave the facility to live independently and knowing that they now have a better chance at living successfully because of the knowledge I have is amazing!” Jessica also said to me, “Small victories are great, like when a client begins to open up because we’ve worked hard at building rapport and all our staff have shown them that they won’t be judged within our facility. We have had some pretty tough clients, one guy told us, ‘I’m not going to follow your program, I’m not going to fall for your tricks to make me like any of you’ and so on, he came to love us all and leaving was very hard for him. He didn’t have strong ties with his family, to him we became his family. Cracking those shells is amazing, especially when at first glance it seems like it will be impossible.”

In high school all the aptitude tests said Jessica would be great working with people! Once she got serious about going back to school she didn’t know what she wanted to do, other than a people centered job. NTC was her closest option and the HS program was the best fit. It wasn’t until she got going that she realized how broad the field was and the array of jobs available to her. Working in this field allows her to have the contact with a wide array of people without having to spend her quality time going out for social interaction, ”I don’t like to let people get too close to me, so this works well for me. “ She got her Associate’s in Human Services from NTC in 2006, then in 2009, she got her Bachelor’s in Human Services/ Management from University of Phoenix.

Some issues she faces at work are things like clients in crisis, clients being manipulative, clients refusing to follow their program and having to confront them on why. A lot of times they will refuse groups and chores and such and then expect to have a privilege like a weekend home visit. When I turn them down and explain why, it tends to set them off a bit. That’s when she will give them time and then later, they talk about how their actions led to that consequence. They have clients who palm meds so they are always on high alert at med times.

She gets paid a low salary due to the owner shutting down other facilities when Jessica took the position. She was happy to get the pay increase she did and the title and experience. The average pay, for the other caseworkers, seems to be between $13-15 per hour (non-profit agency). For a non-profit, it’s about right. “I think we all strive to always make more money and find ways to justify why we should get paid more, with that, I’ll say I should definitely get paid more!”

Something she enjoys with clients is outings. “ I love getting out of the facility and having fun out in the community. On appointment days we will stop off to shop or have lunch, but we also do group outings with all the clients. We will load up multiple vehicles and going to garage sales in the summer, stopping for a picnic lunch. It’s great to get out and unwind. “

She has about 5 clients on her own caseload. They take in any client with primary diagnosis of a mental illness such as bipolar disorder, schizophrenia, personality disorders. They might be voluntary, on a court commitment, or NGI (not guilty by reason of mental disease or defect). Their clients have to be able to take care of their own ADL’s and able to exit the facility in a timely manner, as mandated by the state codes. All clients are referred to us by county social workers.

She wouldn’t change anything about the facility she works at. She loves the people she works with and she is never afraid to speak her mind for ideas for change and improvements at the facility. “I think the facility is great and suits its purpose very well.”

Dealing with crabby and rude clients? She stays calm and nonjudgmental. She really will try to fully listen to them and empathize with what they are saying. If they are too upset, she may ask them to leave and take some time to calm down. Then she’ll come back to the situation.

What the paperwork consist of is things like this: each phone call gets a joint staffing report, they will fill out incident reports when needed, and each day a daily shift log on each client stating what they did that day and their overall affect. Each month she will write a monthly report on each client that is sent to their social worker. She also has other forms for tracking/documenting medications, group attendance, and other smaller tasks.

The craziest day she’s ever had is she had a client, a man in his 60’s that was having some health problems. She quoted “His doctor had attributed his dizzy spells to anxiety attacks. One weekend he had fallen and hurt his foot, which we found out was broken, though he had adamantly refused medical care. I was getting him ready to take him to the doctor’s office for his foot and I went into his room and he started having a seizure. I called for my co-worker and told him to call 911. I followed the ambulance to the hospital and spent much of my day there. Once I got back I had to make a gazillion phone calls to notify everyone that had to know. While doing that, I had other clients trying to demand time with me as well. Any of our staff have to always be ready to deal with emergencies like that.”

So I learned so much from just interviewing her and having her as an instructor, I think I would love her job! It sure seems interesting none the less! She has worked here for over four years, four years when it was called Crossroads and now that it’s called Almost Home Again, six months. She is a great instructor and obviously a hard worker. She was very helpful and gave me a lot of information, I really appreciated this and loved doing the interview on her!

Four Resources-Communication and Culture

http://www.ntc.edu:2081/ehost/pdfviewer/pdfviewer?vid=6&hid=4&sid=4256d558-9cbe-4f17-84a2-e2395282de0f%40sessionmgr13

USEFUL/ACCURATE- This website seemed both useful and accurate to me, it talks about the cognition theory points with language and culture in today's society. All the information in this article I had found on the ntc library had been cited and so they had sources down. At the bottom of the article is all their references they used for it.
COMPLETE- Yes, there was a conclusion of the whole article. I felt it was ended appropriately and didn't drag on or anything. It was nice because there were little figure and graph like things that was nice to look and understand it.
WHAT I LEARNED- Like I said, some of the little graphs really helped me understand the article better and then to learn the cognition theory with language and culture was what this article was about so it was pretty interesting.

http://encyclopedia.jrank.org/articles/pages/6491/Culture-and-Communication.html

USEFUL/ACCURATE- This website seemed like it was all pretty accurate. It talks about the relationship of culture and communication and even more things like characteristics and glimpses of culture. I would certainly use this as a resource if I were writing a paper about culture and communication.
COMPLETE- There was a lot of good information on this website and I found this one to be the most useful one out of all for me.
WHAT I LEARNED- I never thought of how all the different groups and all the other social units that have culture, it was interesting. Also, to think of all the different ways of communicating not just with words, but non-verbal ways too; they talked about that in the website too.


http://jmm.aaa.net.au/articles/85.htm

USEFUL/ACCURATE- Seemed useful and accurate, talks about all the different cultures in a lot of countries. There was a bibliography on the bottom of the page where all the information came from.
COMPLETE- Yes, seemed kind of complete, it ends with a short conclusion talking about what a culture "shock" is, with the Western countries.
WHAT I LEARNED- I learned all the different cultures in the countries, it was very interesting and thought this had a lot of useful information on it.


http://www.ntc.edu:2081/ehost/pdfviewer/pdfviewer?vid=15&hid=4&sid=6117e2b1-ae52-43c1-9864-3587c1c1ac88%40sessionmgr4

USEFUL/ACCURATE- This seemed like it was very accurate by siting the sources and authors. It was a different type of looking at communication and culture with students from different ethnicity and working together. There are sources and acknowledgements on the bottom of the article.
COMPLETE- Yes, found this to be pretty interesting and very complete.
WHAT I LEARNED- I found this to be interesting because I have had to work in groups before, I like working in groups and this article talks about the study of group learning and with different ethnicity backgrounds.

I felt in this assignment, looking at all these different resources and viewing them that there is so many different ways we communicate and putting that with all the different cultures in the world is very interesting. I like how the one website I had looked up that talked about all the different culture groups and even just groups within ourselves like organizations, relationships and stuff like that, because we all have different rules and customs. It also was very interesting to see how much culture changes over time, it changes as society changes. The relationship between culture and communcation, like the article stated, is so complex! I mean, without communication it is pretty impossible to pass along cultural characteristics like it said. There are so many levels of communicating through people. And like the last website I had posted, working together- More people, the better. If you are working with people of different cultures and different outlooks and ideas that its going to have a positive outcome.

ethics article

This is an article about the code of ethics for nurse educators. Interesting article that talks about the codes that ethics for educators to keep it relivant and updated. Things change alot over the years and this article talks about how the educators need to stay updating. Because like I said, alot of things have changed such as technology. The Code of Ethics for nursing educators was originally published in 1983, and since then we have come along way. There are so many different practices being done now. In the article they state that they now have different medicines, different researches that are being done now, cloning, etc. Code of Ethics change after decades and they are so important to follow. Codes of Ethics protect the client and helps the worker. They are a way of doing your job and doing it right. Codes of Ethics are around for a reason and they can change throughout the years like this article is about. I'm not in the nursing field but actually, a lot of fields codes need to be revised and are after a few years because society changes and so we need to change things too. Health care has changed since the 80's too and that's another thing they need to look at. They are doing so many different studies and, like I said before, a lot has changed so this is a good article and good idea to revise the codes. Very interesting, hope you like it.

http://www.ntc.edu:2081/ehost/detail?vid=5&hid=3&sid=71482772-1cd0-43ad-9d9f-33db75f1c6e0%40sessionmgr11&bdata=JnNpdGU9ZWhvc3QtbGI2ZQ%3d#db=aph&AN=47660206#db=aph&AN=47660206

creating the codes of ethics

Agency: shelter for the mental health recovery for women.

Goal: to guide them in a healthy direction to a better life and give them the tools they need to live a safe life that makes her feel comfortable the way she is and who she is. we show them there are no reason to feel ashamed to ask for help.

Codes of Ethics Policy
FOR MANAGERS,EMPLOYEES:
Number 1 thing is to protect our clients and all the information they tell us confedential.
We also need to support them and show them trust, integrety and professionalism towards our clients.
Always keep a professional relationship with other colleages andclients.
Always be honest and ethical, treat all clients the same, no matter what race, color or gender.
Respect other colleages.
Respect clients and be dedicated to them.
Avoid any conflicts with clients or other colleages.
Always be accurate with information that you evaluated with a client.
Never judge a client or make them feel like you are looking down on them for something he/she may have done.

interventions on number 1

designing three levels of intervention number 1
Maria is paralyzed from the waist down following an accident three years ago in a swimming pool. She is hoping to complete her degree in accounting, but she is complaining of depression and an inability to focus on school. When you see her, she looks anxious and tired. Her affect is flat, and she tells you nothing interests her. At the local college, she has had trouble finding appropriate parking and misses many days of class when the weather is bad because of the parking situation. One of the professors she must work with rather closely has made remarks about the difficulty of "other people getting around that wheelchair." She believes her boyfriend, who was there the night the accident happened, has remained with her simply out of pity. When they fight about other things, she throws this up to him, although he vehemently denies it and tells Maria this is a hurtful accusation.

micro level- Micro is where I need to be looking at Maria's personality and motivation. It is obvious she doesnt have alot of motivation. Maybe talk to her about going to a support group. There are many different social groups out there and we could find one that would be right for her, maybe a disabled support group so she could talk to others that have some difficult times in their lives too because of being in a wheelchair. Maybe some motivational speakers would brighten her up a little more.

meso level-Meso level is focusing on certain things that are really bothering her. So I should set up a meeting for her to talk with her issues with the parking lot and arrange something for her so she can attend her classes and not miss any. It is important for everyone to have a good education and if she finishes school, I think thats something that would make her feel better about herself. Also, after class or before class, she could sit down and have a face-to-face meeting with her teacher and talk to him about how she is offended by some of the things he sayss and does and hopefully that will fix the problem. And the issue with her boyfriend, she could bring him for a session with me sometime, and then they can figure out what's bothing each of them and figure out the problem.

macro level- This is where we need to be focusing on the big picture. Yes, Maria is having a hard time dealing with the wheelchair and society. She has had many changes in her life and it is very hard to cope with them all. So I, as a social worker, need to find ways to help stregthen her as a person. We need to find thigs that will help the client as well as the environment around her. If she does have depression, I should maybe set her a doctor's appointment so she can get the medication needed to treat it. Also, maybe set up regular appointments with a counselor or just someone that she can talk to.