Using the Triage Assessment Form

 

After reading the case examples in the Myer and Conte (2006) article, you have a better understanding of how to use one type of assessment tool. A Microsoft Word copy of the Triage Assessment Form (TAF) is included in the assignment Resources. The most current version of this form is also shown in your James and Gilliland (2013) text, pages 63–65. Use the form to analyze Jordan, described below. You can save the form as you have completed it as a MS Word document or as a PDF document, and attach the form to your written paper as an appendix.

 

Rate the client in each of the three domains (Affective, Behavioral, and Cognitive) using the Severity Scale included with each domain on the Triage Assessment Form (TAF) and total the scores. Describe, in detail, the rationale for your ratings, including your judgment about how intense and directive the treatment should be based upon the total score. In your discussion of the rationale, summarize diagnostic skills and techniques that can be used to screen for addiction, aggression, and danger to self and others, as you note these risks in your client. Similarly, a possible co-occurring mental disorder (such as substance abuse) may become apparent during a crisis, disaster, or other trauma-causing event that ties in with your assessment during the client’s crisis. Note this as well in your rationale.

 

Project Objectives

 

To successfully complete this project, you will be expected to:

 

·         Summarize diagnostic skills and techniques used to screen for addiction, aggression, and danger to self and others, as well as co-occurring mental disorders during a crisis, disaster, or other trauma-causing events.

 

·         Evaluate key elements of the crisis, disaster, or trauma-causing event including the nature of the crisis and associated risks, including client and counselor safety.

 

·         Discuss developmental and cultural considerations in crisis assessment and intervention.

 

·         Exhibit proficiency in effective, credible academic writing, and critical thinking skills.

 

Note: A template for your APA formatted paper is included in the assignment Resources. Please use the template to present the assignment criteria in an organized way. The headings guide you to the criteria, and the details that are included describe what is necessary to complete the assignment to a Distinguished degree.

 

Case

 

 

 

Jordan

 

Jordan arrives at counseling saying that her husband, Jake, left the house earlier that day in an agitated mood and with his rifle, and tearfully discloses concerns about her safety and his. She states that her friend, who has been worried about her for some time, insisted that she see a counselor. Jordan says she was surprised at Jake’s abrupt departure because she was unaware of any plans he had to go hunting, and if he was not going hunting, why he would take his gun out. She recalls that she and Jake had fought the previous night over his drinking. Jordan reports that she asked Jake to stop drinking so much, and in response, he threatened her and slammed a few doors. She recalls that Jake said he liked being a little drunk and pushed her back against the kitchen counter at one point. When Jake went back into a spare bedroom to sleep that night, Jordan found numerous beer bottles in the den and a large empty whiskey bottle in front of his truck. Jordan states that it was not unusual for Jake to put his rifle in his truck when he planned to go hunting, but when he had done so today, he had still been quite angry about her accusation that he was drinking too much. After he left, Jordan reports that she began shaking. She felt fear for her own safety, so she called her friend who insisted that she speak to a counselor. While Jordan was on her way to counseling, her husband called her. He seemed calm, asked about her day, and said nothing about the previous night or his abrupt departure. Jordan states that this switch in mood from extreme aggression to a pleasant tone “seems weird.” Jordan asks for help in dealing with her husband’s odd behaviors. She fears for her own safety and the safety of her husband, but is unwilling to call the police. As she speaks, she is agitated and continually looks over at the doorway, as though expecting it to burst open.

 

Project Requirements

 

·         Content: Prepare a comprehensive paper that includes all elements described.

 

·         Components: The paper must include a title page, abstract, and reference list.

 

·         Written communication: Develop accurate written communication and thoughts that convey the overall goals of the project and do not detract from the overall message.

 

·         APA formatting: Resources and citations must be formatted according to APA (6th Edition) style and formatting.

 

·         Number of pages: The body of the paper should fall within 3–5 pages of text, plus 3 pages of the Triage Assessment Form, excluding title page and reference list.

 

·         Number of resources: Minimum of 4 current resources, published within the last 12 years, and you may include your text as one.

 

·         Font and font size: Times New Roman, 12-point.

 

Submit the completed paper and form to the assignment area.

Using the Triage Assessment Form

Learner First Name MI. Last Name

Instructor Name

Abstract

There is no indent on an abstract. An abstract is a paragraph that summarizes the most important parts of the entire paper. It briefly allows your reader to quickly obtain an overview of your writing. It is an accurate reflection of the purpose and content of the text written in clear and concise language within the limit of 150 to 250 words.

Using the Triage Assessment Form

Include the title of your paper centered at the top of the page, not bolded; it is not considered a heading. *This first section is your paper’s introduction. Note that it does not have a heading; its position at the beginning of the body of the paper implies that it is the introduction. In the body of your paper, indent the first line of each paragraph. As always, use double spaced, 12-point Times New Roman font, and 1.0 margins all around the page layout. Throughout the paper, please support your work by citing at least four current resources (including your textbook). For the purposes of this assignment, simply replace this text with a brief paragraph in your own words introducing the topic and informing the reader of the organization of the paper.

Triage Assessment of the Client

Complete the Triage Assessment Form for the selected case, including all three domains and the total score. In this section of the paper, summarize the results and provide a logical and articulate rationale for each of the domain ratings with specific descriptions of each, by relating the specifics of the case to the ratings you determine. There is detail about using the TAF in Chapter 3 of your text, as well as the assigned Myer and Conte article. Use appropriate terminology, such as the psychobiological assessment found in Chapter 3 of your text, and language found in the TAF Severity Scales, to guide the course of treatment based upon your total score.

Diagnostic Skills and Techniques

Elaborate on diagnostic skills and techniques that can be used to screen for addiction, aggression, and danger to self and others, as well as co-occurring mental disorders during a crisis, such as the Hybrid Model and the ABC’s of Assessing Crisis Intervention found in Chapter 3 of your text. Discuss what counseling skills you use in a triage assessment of this client.

Developmental and Cultural Considerations in Crisis Assessment and Intervention

In this section of the paper, describe how you would differentiate between the characteristics of crisis states versus developmentally appropriate reactions to life obstacles. Describe crisis assessment and interventions considerations and strategies when working with diverse populations. Consider any cultural, diversity, or even gender issues that may be involved in assessment or intervention with your chosen scenario. Give examples of what you would include in your assessment and intervention.

References

Cite your textbook and at least three scholastic articles in your paper. The reference below provides an example citation for an article.

Author, A. A., Author, B. B., & Author, C. C. (year). Title of article. Title of Periodical, volume# (issue#), xx–xx.

Triage Assessment Form: Crisis Intervention

© by R. A. Myer, R. C. Williams, A. J. Ottens, & A. E. Schmidt

Crisis Event

Identify and describe briefly the crisis situation:

______________________________________________________________________________________________________________________________________________________________________________________________________________________________

Affective Domain

Identify and describe briefly the affect that is present. (If more than one affect is experienced, rate with number 1 being primary, number 2 secondary, number 3 tertiary.)

Anger/Hostility ____________________________________________________________________________________________________________________________________________________

Anxiety/Fear ____________________________________________________________________________________________________________________________________________________

Sadness/Melancholy ____________________________________________________________________________________________________________________________________________________

Affective Severity Scale

Highlight the number that most closely corresponds with client’s reaction to crisis.

1	2 3	4 5	6 7	8 9	10
No Impairment	Minimal Impairment	Low Impairment	Moderate Impairment	Marked Impairment	Severe Impairment
Stable mood with normal variation of affect appropriate to daily functioning.	Affect appropriate to situation. Brief periods during which negative mood is experienced slightly more intensely than situation warrants. Emotions are substantially under client control.	Affect appropriate to situation but increasingly longer periods during which negative mood is experienced slightly more intensely than situation warrants. Client perceives emotions as being substantially under control.	Affect may be incongruent with situation. Extended periods of intense negative moods. Mood is experienced noticeably more intensely than situation warrants. Liability of affect may be present. Effort required to control emotions.	Negative affect experienced at markedly higher level than situation warrants. Affects may be obviously incongruent with situation. Mood swings, if occurring, are pronounced. Onset of negative moods are perceived by client as not being under volitional control.	Decompensation or depersonalization evident.

Behavioral Domain

Identify and describe briefly which behavior is currently being used. (If more than one behavior is used, rate with number 1 being primary, number 2 secondary, number 3 tertiary.)

Approach ____________________________________________________________________________________________________________________________________________________

Avoidance ____________________________________________________________________________________________________________________________________________________

Immobility ____________________________________________________________________________________________________________________________________________________

Behavioral Severity Scale

Highlight the number that most closely corresponds with client’s reaction to crisis.

1	2 3	4 5	6 7	8 9	10
No Impairment	Minimal Impairment	Low Impairment	Moderate Impairment	Marked Impairment	Severe Impairment
Coping behavior appropriate to crisis event. Client performs those tasks necessary for daily functioning.	Occasional use of ineffective coping behaviors. Client performs those tasks necessary for daily functioning, but does so with noticeable effort.	Occasional use of ineffective coping behaviors. Client neglects some tasks necessary for daily functioning.	Client displays coping behaviors that may be ineffective and maladaptive. Ability to perform tasks necessary for daily functioning is noticeably compromised.	Client displays coping behaviors that are likely to exacerbate crisis situation. Ability to perform tasks necessary for daily functioning is markedly absent.	Behavior is erratic, unpredictable. Client’s behaviors are harmful to self and/or others.

Cognitive Domain

Identify whether a transgression, threat, or loss has occurred in the following areas and describe briefly. (If more than one cognitive response occurs, rate with number 1 being primary, number 2 secondary, number 3 tertiary.)

PHYSICAL (food, water, safety, shelter, et cetera):

Transgression _____ Threat _____ Loss _____

____________________________________________________________________________________________________________________________________________________

PSYCHOLOGICAL (self-concept, emotional well-being, identity):

Transgression _____ Threat _____ Loss _____

____________________________________________________________________________________________________________________________________________________

SOCIAL RELATIONSHIPS (family, friends, coworkers, et cetera):

Transgression _____ Threat _____ Loss _____

____________________________________________________________________________________________________________________________________________________

MORAL/SPIRITUAL (personal integrity, values, beliefs):

Transgression _____ Threat _____ Loss _____

____________________________________________________________________________________________________________________________________________________

Cognitive Severity Scale

Highlight the number that most closely corresponds with client’s reaction to crisis.

1	2 3	4 5	6 7	8 9	10
No Impairment	Minimal Impairment	Low Impairment	Moderate Impairment	Marked Impairment	Severe Impairment
Concentration intact. Client displays normal problem-solving and decision-making abilities. Client’s perception and interpretation of crisis event match reality of situation.	Client’s thoughts may drift to crisis event but focus of thoughts is under volitional control. Problem-solving and decision-making abilities minimally affected. Client’s perception and interpretation of crisis event substantially match reality of situation.	Occasional disturbance of concentration. Client perceives diminished control over thoughts of crisis event. Client experiences recurrent difficulties with problem-solving and decision-making abilities. Client’s perception and interpretation of crisis event may differ in some respects from reality of situation.	Frequent disturbance of concentration. Intrusive thoughts of crisis event with limited control. Problem-solving and decision-making abilities adversely affected by obsessiveness, self-doubt, confusion. Client’s perception and interpretation of crisis event may differ noticeably from reality of situation.	Client plagued by intrusiveness of thoughts regarding crisis event. The appropriateness of client’s problem-solving and decision-making abilities likely adversely affected by obsessiveness, self-doubt, confusion. Client’s perception and interpretation of crisis event may differ substantially from reality of situation.	Gross inability to concentrate on anything except crisis event. Client so afflicted by obsessiveness, self-doubt, and confusion that problem-solving and decision-making abilities have “shut down.” Client’s perception and interpretation of crisis event may differ so substantially from reality of situation as to constitute threat to client’s welfare.

Domain Severity Scale Summary

Affective _____ Cognitive _____ Behavioral _____ = Total _____