Presenter Information

Transcription

1 Strength Based Documentation Presented by: Kihra A Kohler MS & Whitney Sigall MSW Presenter Information Kihra A. Kohler MS Masters in Psychology Leading Hoarding Disorder Specialist CHS Active Member of the Allegheny County Hoarding Taskforce Interviewed as a subject matter specialist by Pittsburgh Post Gazette, Catholic World Health Magazine, and WPXI News Whitney Sigall MSW Masters in Social Work Hoarding Disorder Specialist CHS Therapeutic Supp0rt Specialist - CHS Active Member of the Allegheny County Hoarding Taskforce Conference on Hoarding 1

2 Objectives Build program documentation that helps to ensure success Analyze gathered information to help drive client centered goals Learn to identify key words, phrases, and behaviors captured in the referral, assessment, reassessment, and service plan that may indicate that a client is not ready for a lifestyle change Referral Designed to determine client s perception and accountability Used to help determine ready willing and able Must be filled out by the client Must be a self referral All questions are directed to the client and not a third party (Therapist) Conference on Hoarding 2

3 Referral Levels of threat Prioritizing based on threat Problems Present Allows us to determine hoard severity prior to being allowed in the home Significant Life Stressors Data collection Mental Health Treatment Strongly Suggested Assessment The Assessment is just used as a guide for us, our assessments are completed conversationally to increase comfort for the client. Our conversations focus on past and present events to determine how they relate to collections/items Readiness to Change Buried in Treasures Cleanliness/ dirt physical Change Cognitive Activities of Daily Living Physical ability to complete work Physical disability accommodations Contact review and signing Conference on Hoarding 3

4 Reassessment Home Safety and Sanitation Check List Reasonable back slide Unreasonable back slide Reassessed every 90 days Provide a chance to discuss any areas of the contract they may not be met Client input on assessment scores Score discussion Back Slide Reasonable Flat surfaces Triggering experience Prioritization Shopping/Acquisition Unreasonable Rotting foods Biohazards Child safety and reportables Cancellations/Lack of sessions Conference on Hoarding 4

5 Initial Service Plan Focused on four major categories, Prioritization, Organization, Coping with Stress, and Cleaning Ability to celebrate little successes to achieve an overall goal Client driven goal setting Develop goals based on client skill level to help increase positive reinforcement Implement exposures to develop coping skills Progress Note Anxiety Level before, during, after Was it easy/difficult focus on the easy Discuss the difficult but celebrate the successes Today s Goal Talk with the client to determine what we should accomplish during the session How did it go? Focus on the things the client did well Celebrate every success no matter how small it may seem New Homework Work with the client to determine what they feel like they can successfully complete between visits Conference on Hoarding 5

6 Progress Note Activity Details Location of session Items that were handled We cleaned out a drawer in the kitchen today that was filled with Candles, Paperclips, Christmas Ornaments, and socks The process steps of organization Any emotions the client discuss during the session How the session went focusing equally on the easy and difficult so that we can gear the next session more towards the client s strengths Therapeutic interventions Key Words and Behaviors Referral My family thinks I should I don t have too much stuff it just needs organized Blaming others or situations for hoard Assessment Clutching onto multiple items Unprompted defensiveness Time focus (past, present. Future) Reassessment No change in sanitation No change in safety Service Plan Not competing the activities Extending space rather than reclaiming Progress Note Failure to complete homework regularly Chronic cancellations Failure to schedule appointments Using time to churn items Conference on Hoarding 6

7 Typical Hard Conversations Child safety Home sanitation Finances Eating habits Exercising Self-care Time management Prioritization Organizing sex related items Suicide Fire safety Legal repercussions Landlord/Property Management Eviction Hospitalization Removal from home Removal from program Interpersonal issues related to hoarding Exposure response Questions Please feel free to ask any questions you may have at this time. Or feel free to contact us: Kihra A Kohler Kkohler@chscorp.org Whitney Sigall Wsigall@chscorp.org Conference on Hoarding 7