OPTIMAL OUTCOME OF TREATMENT
The client attains an agreed upon level of functioning and learns skills to prevent or manage future episodes of illness. These skills can include increased awareness of mood disorder symptoms, continuation of preventative medication, and changes in thinking about oneself, the world, and one's future which facilitate health.
ASSESSMENT GUIDELINES (See Assessment Guidelines for Adults)
1. Clients with mood disorders should be assessed at intake for danger to self (and others when appropriate.) Crisis intervention should be provided as needed. Appropriate quantification achieved through instruments such as the Beck Depression Inventory (BDI) or Hamilton Depression Scale may be helpful to evaluate the severity of mood disruption and suicidality.
2. SPMI clients who are affected by a mood disorder should be screened and referred, as appropriate, for case management, psychosocial rehabilitation and/or support services.
3. Clients with mood disorders should be referred to a medical provider, as indicated, for evaluation for general medical conditions which may contribute to the mood disorder.
TREATMENT GUIDELINES (See Treatment Guidelines for Adults)
Psychotherapy, education, and medication are the foundations for effective treatment of mood disorders.
1. Therapists providing psychotherapy with mood disordered clients should use cognitive, interpersonal, or other effective treatment methods and focus on collaborative goals. An individualized treatment plan should be developed with the client and progress should be continuously evaluated. Treatment should be time-effective and focused.
2. Client education about his/her illness and treatment options is an essential part of treatment. Clients should be provided information about their illness and have opportunities to discuss this information. Family members and significant others should be included in this process whenever appropriate and possible.
3. Medication is a proven treatment for adult mood disorders. A medication evaluation should be recommended to all clients with recurrent depression, Bipolar Disorder, and clients with symptoms of:
4. Clients with a positive response to medication should be advised to continue medication for an appropriate length of time given the age of onset, severity of symptoms, and number of episodes. Medical staff have the primary responsibility to periodically review medication with the client. Therapists should review medication use with the client and refer concerns to the medical staff as indicated.
5. When a client misses a scheduled appointment, outreach should be initiated as clinically determined.
6. An assigned staff person should assume primary responsibility for the coordination of treatment between care providers. All providers should work collaboratively in the treatment. Each provider assumes responsibility for appropriate documentation for the services they provide, e.g., Psychotherapy, Club House Services, Medication Management, etc.
THESE GUIDELINES HAVE BEEN
DEVELOPED BY:
THE UTAH PREFERRED PRACTICE CONSENSUS PANEL
UNDER THE AUSPICES OF THE UTAH
DIVISION OF MENTAL HEALTH
APPROVED APRIL 19, 1996