Bipolar Disorder Assessment and Community Intervention Programs - Assignment Example

Bipolar Disorder Assessment and Community Intervention Programs Beck Depression Inventory There are quite a number of Beck Scales available in the contemporary world that aid in the assessment of bipolar disorder and other depressions. These scales include the Beck Anxiety Inventory (BAI), Beck Scale for Suicide Ideation (BSS), Clark-Beck Obsessive-Compulsive Inventory (BOCI), Beck Hopelessness Scale (BHS), and the Beck Youth Inventories of Emotional and Social Impairment (BYI) – 2nd edition (for children; adolescents, and 7-18 year olds) (Rosner, 2014). However, the Beck Depression Inventory (BDI) is perhaps the most widely used instrument in determining the extent/ presence of bipolar disorder (Rosner, 2014). In the market, as it is, there are three versions of the Beck Depression Inventory, which are basically improvements on previous versions (Parker & Ketter, 2010). The original version was first introduced for use in 1961 and is generally referred to as the BDI (Parker & Ketter, 2010). This was later in 1978 revised into the BDI-1A, which was also consequently modified into 1996’s BDI-II (Parker & Ketter, 2010). Presently, the BDI-II remains the most widely used version of the Beck Depression Inventory (Parker & Ketter, 2010). The BDI is a 21 question inventory of self report rating which evaluates the common symptoms and attitudes associated wit bipolar disorder (Rosner, 2014). The BDI is available in a number of different convenient forms such as computerized forms and card forms (Clinical Psychology, 2015). The forms require approximately 10 minutes to successfully complete (Beck Depression Inventory-II, 2015). However, the user requires a 5th to 6th grade level of reading competency in order that they may properly understand the questions and thus respond appropriately (Parker & Ketter, 2010). The multiple choice questionnaire, which is suited for persons who are 13 years of age and over, delves on items that determine presence/ absence of symptoms of bipolar disorder like irritability, hopelessness, feeling of being punished, guilt, fatigue, lack/ loss of interest in sex, loss of weight, and so on (Clinical Psychology, 2015). The assessment can be self administered or done verbally by a trained administrator. The user of the instrument has the responsibility of ensuring appropriate use of test, such as in administration, interpretation, application and scoring of the results (Clinical Psychology, 2015). Some test instances can be given and rated/ scaled by persons with lower levels of training as long as they remain under the supervision of a qualified user (Parker & Ketter, 2010). The use of the Beck Depression Inventory generally requires a qualification B level which requires a masters’ degree in the concerned field and some formal training on the ethical administration and interpretation of the results, or certification by/ full membership of a professional organization, or a license or degree to practice in health care or associated field (Rosner, 2014). The BDI is available in various world languages including English, Spanish, French, Korean, and so on, and is capable of monitoring change over time (Rosner, 2014). It has a specificity of 92% and sensitivity rated at 81% (Rosner, 2014). As for the results, scores of 0-13 indicate minimal depression, 14-19 indicate mild depression, 20-28 indicate moderate depression while scores ranging between 29 to 63 point towards depression that is severe (Clinical Psychology, 2015). According to Beck, Steer & Brown (2011), the reliability of the BDI is quite high and results in consistent outcomes under the same circumstances, and also shows consistency while measured against other bipolar disorder screening instruments like the Hamilton Depression Rating Scale (Rosner, 2014). The BDI further exhibits high one week test-retest reliabilities which show that the equipment is not unsuitably impacted on by mood shifts of subjects which can lead to erroneous conclusions (Baer, 2010). Validity, on the other hand, varies depending on factors such as the individual’s honesty in replies during the test (Baer, 2010). Certain environments of the individual such as those that may result in unease can cause a respondent to give inaccurate answers (Baer, 2010). Bipolar Disorder Community Resources in Vancouver, BC There are many resources in the form of support groups, in or out patient services, local programs, and so on, that are available to persons suffering from bipolar disorder and other depressions in the local communities of Vancouver. Most of these services are conveniently run and are easily accessible. An example is the H.R Mental Wellness Centre (HRMWC) which was founded by the El-Rayes Foundation to help people of the local community cope well with depression issues such as bipolar disorder, and so facilitate better management of their relationships and careers (H.R. Mental Wellness Centre, 2015). The group aims at restoring the individual to a healthy mental state in which they can ‘share their gifts with the world, enjoy life to the fullest and leave behind a legacy’ (H.R. Mental Wellness Centre, 2015). The HRMWC is structured to offer friendly, safe, supportive and non-judgmental surroundings for parents and their families/ friends, coupled with very fruitful, interactive, educative, fun and inspiring meetings (H.R. Mental Wellness Centre, 2015). The group has a social network of other persons who have successfully combated or are actively dealing with bipolar disorder and other depressions which aids one through the process of recovery. The group is led by Dr. Rayes who is a specialist in depression and who also facilitates the meetings and programs (H.R. Mental Wellness Centre, 2015). He is well experienced and has practiced in the field for over two decades now. Among other things, members are taught how best to understand self, manage themselves and their relations, address their feelings, develop new skills and make solid changes that aid recovery, receive emotional support, care, advise, communication and problem solving skills (H.R. Mental Wellness Centre, 2015). The family members and friends are also enlightened on the best ways in which they can help the patient’s recovery, and how, for instance, to behave towards them during episodes (H.R. Mental Wellness Centre, 2015). In general, services include healing from depression and anxiety, self-actualization, coaching for parents/ guardians/ friends/ relatives, coaching for couples, stress management seminars and 9 workshop sessions on weekends for healing from depression and anxiety (H.R. Mental Wellness Centre, 2015). A holistic approach to healing is embraced at the center which addresses the person’s body, spirit and mind through techniques like logotherapy, spirituality, mindfulness, and cognitive behavioral therapy (H.R. Mental Wellness Centre, 2015). Membership is absolutely free, with donations only a personal choice (H.R. Mental Wellness Centre, 2015). In addition, members who are unable to attend the group sessions in person can attend through online platforms from any region of the world (H.R. Mental Wellness Centre, 2015). The New Heights Church support groups equally come out as quite diverse and well structured. Groups in this program of community depression management are conveniently categorized so that there are men groups, women groups, mixed gender, children groups, groups for families and parenting, marriage groups and even single groups (New Heights Church Support Groups, 2015). Other group categories include life groups and activities and other small groups, where in the end, one has a choice on which group they would feel most comfortable in. support avenues for bipolar disorder in this initiative include services from the New Heights Clinic that is staffed with medical and trained professionals (which offer a medical perspective, diagnosis and drug prescriptions), support groups (in which members are taught on such crucial matters as self management and control (actualization), teaching for parents, guardians and friends, helping hands (where volunteers can help out with the management of the patients at home such as through visits, home repairs (plumbing, yard-work, and so on), hospital visits, meals, transport to and from appointments at the clinic, and general care and encouragement for the sick) and even opportunities for prayer requests (New Heights Church Support Groups, 2015). Moreover, there are special sessions and groups for students of various levels, that is, middle school, high school and college, which are facilitated and led by persons who have adequate experience of depression ailments such as bipolar disorder (New Heights Church Support Groups, 2015). This also offers better convenience and enhances freedom of participation thus elicit better results during sessions. The New Heights Church support groups’ schedules are published well in advance so members do not miss out on key events. On July 6th 2015, for example, there is the ‘Families in Recovery’ event where families will learn on how to best cope and behave at times of treatment and recovery (New Heights Church Support Groups, 2015). On July 7th 2015 there will be ‘Men’s Anger Management’ session which will teach on the causes of anger in men and practical ways of managing the same, for a better quality life, while on 15th September for instance, there will be programs for grief support and divorce recovery (New Heights Church Support Groups, 2015). Just like in the HRMWC, services of the New Heights Church support groups are free to attend, but voluntary financial support is equally welcome (New Heights Church Support Groups, 2015). Apart from this financial ease on families that the two groups offer for affected families, those around the sick are taught how to manage the sick in their midst (New Heights Church Support Groups, 2015). Aside from this, the groups are beneficial in offering useful recommendations concerning treatment facilities where people can obtain trusted and reliable medical assistance when dealing with bipolar disorder and other depression issues (New Heights Church Support Groups, 2015). With a great number of different hospitals, clinics, programs and support groups available for virtually all ages, genders and financial levels in Vancouver, there are indeed very few service gaps in the local community (New Heights Church Support Groups, 2015). Moreover, a significant these services are managed by qualified and experienced persons in matters depression (H.R. Mental Wellness Centre, 2015). However, in the context of support groups and programs, some absence of cooperation between these involved experts (in the groups and those in healthcare centers) especially those that deal with a single patient can be counter productive when talking medication recommendations and therapy regimens (H.R. Mental Wellness Centre, 2015). Cases of conflict are prone to occur because treatment of bipolar disorder can be accomplished through various means and drugs. In an ideal setting, there has to be some flow of information between these groups of experts involved with the patient (Baer, 2010). There is also apparent lack of support for the actual caregivers in most cases, with all the attention aimed at the patient (Baer, 2010). Follow up is also poor concerning the application of recommended behavior of caregivers and the patients themselves (Young, 2010). There is a major lack of population specific approaches in management of bipolar disorder in many support groups and programs within the community (Baer, 2010). Furthermore, most of the community resources are not specific to bipolar disorder but rather generalize on depression as a whole, regardless of what kind, level, factors involved or causes thereof (Baer, 2010). Very little information is available to members of the community concerning depression illnesses and how they may impact on life, intervention techniques and treatments available (Baer, 2010). There are certain social factors (health determinants) that commonly affect both inpatient and community follow up, especially in bipolar disorder cases (patients) in seeking treatment and consultations. One factor is the different education levels of various persons (Llesuy, 2012). Bipolar disorder in most cases is casually dismissed by patients and family members/ friends as imply the nature of the individual (especially when it has been noted in preceding generations, and so assumed as the habit inherited from parents) because of a lack of understanding of the ailment, while the person is actually sick (Llesuy, 2012). Another common factor is the discrimination and stigma associated with mental issues such as bipolar disorder (Llesuy, 2012). Therefore, a great number of patients shy away from getting medical help and communal support for recovery because they are afraid of being labeled mentally unstable (Mula, 2012). According to surveys, mental conditions such as bipolar disorder are therefore rarely diagnosed and managed properly in a significant number of cases (Baer, 2010). Conclusion The BDI is one of the most important inventions in the diagnosis of bipolar disorder and other similar depressions. It is very convenient and can be taken right from the comfort of homes, upon which results can be availed to professionals for further expert advise (Beck, Steer & Brown, 2011). However, in as much as the BDI is very efficient, convenient and boasts good sensitivities, reliability, and specificity, its use can only be truly useful when the respondent gives accurate answers (Beck, Steer & Brown, 2011). Therefore, the environment in which the individual is taking the test has to be free from any external pressures and influence that may prompt inaccurate replies (Beck, Steer & Brown, 2011). There are equally noted, several number of resources available in Vancouver in the shape of hospital services, support groups and related programs. However, perhaps more work is to be done in educating the locals about symptoms and signs of such mental illnesses so that they are not mistaken for habits and individual characters instead of the diseases that they are (so that the benefits of such resources as support groups are fully reaped) (Mula, 2012). In addition, less stigma and fear of being branded a lunatic will aid in these endeavors of managing and recovering from bipolar disorder in the shortest times possible (Mula, 2012). Example of Beck Depression Inventory Questionnaire (as obtained from http://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=2&ved=0CCgQFjAB&url=http://www.researchgate.net/publictopics.PublicPostFileLoader.html?id=5179a648cf57d78c20000009&key=e0b495179a6484f693&ei=lk6aVdTqBOTd7QanxIuoAg&u sg=AFQjCNFLFh) ‘Beck's Depression Inventory This depression inventory can be self-scored. The scoring scale is at the end of the questionnaire. 1. 0 I do not feel sad. 1 I feel sad 2 I am sad all the time and I can't snap out of it. 3 I am so sad and unhappy that I can't stand it. 2. 0 I am not particularly discouraged about the future. 1 I feel discouraged about the future. 2 I feel I have nothing to look forward to. 3 I feel the future is hopeless and that things cannot improve. 3. 0 I do not feel like a failure. 1 I feel I have failed more than the average person. 2 As I look back on my life, all I can see is a lot of failures. 3 I feel I am a complete failure as a person. 4. 0 I get as much satisfaction out of things as I used to. 1 I don't enjoy things the way I used to. 2 I don't get real satisfaction out of anything anymore. 3 I am dissatisfied or bored with everything. 5. 0 I don't feel particularly guilty 1 I feel guilty a good part of the time. 2 I feel quite guilty most of the time. 3 I feel guilty all of the time. 6. 0 I don't feel I am being punished. 1 I feel I may be punished. 2 I expect to be punished. 3 I feel I am being punished. 7. 0 I don't feel disappointed in myself. 1 I am disappointed in myself. 2 I am disgusted with myself. 3 I hate myself. 8. 0 I don't feel I am any worse than anybody else. 1 I am critical of myself for my weaknesses or mistakes. 2 I blame myself all the time for my faults. 3 I blame myself for everything bad that happens. 9. 0 I don't have any thoughts of killing myself. 1 I have thoughts of killing myself, but I would not carry them out. 2 I would like to kill myself. 3 I would kill myself if I had the chance. 10. 0 I don't cry any more than usual. 1 I cry more now than I used to. 2 I cry all the time now. 3 I used to be able to cry, but now I can't cry even though I want to. 11. 0 I am no more irritated by things than I ever was. 1 I am slightly more irritated now than usual. 2 I am quite annoyed or irritated a good deal of the time. 3 I feel irritated all the time. 12. 0 I have not lost interest in other people. 1 I am less interested in other people than I used to be. 2 I have lost most of my interest in other people. 3 I have lost all of my interest in other people. 13. 0 I make decisions about as well as I ever could. 1 I put off making decisions more than I used to. 2 I have greater difficulty in making decisions more than I used to. 3 I can't make decisions at all anymore. 14. 0 I don't feel that I look any worse than I used to. 1 I am worried that I am looking old or unattractive. 2 I feel there are permanent changes in my appearance that make me look unattractive 3 I believe that I look ugly. 15. 0 I can work about as well as before. 1 It takes an extra effort to get started at doing something. 2 I have to push myself very hard to do anything. 3 I can't do any work at all. 16. 0 I can sleep as well as usual. 1 I don't sleep as well as I used to. 2 I wake up 1-2 hours earlier than usual and find it hard to get back to sleep. 3 I wake up several hours earlier than I used to and cannot get back to sleep. 17. 0 I don't get more tired than usual. 1 I get tired more easily than I used to. 2 I get tired from doing almost anything. 3 I am too tired to do anything. 18. 0 My appetite is no worse than usual. 1 My appetite is not as good as it used to be. 2 My appetite is much worse now. 3 I have no appetite at all anymore. 19. 0 I haven't lost much weight, if any, lately. 1 I have lost more than five pounds. 2 I have lost more than ten pounds. 3 I have lost more than fifteen pounds. 20. 0 I am no more worried about my health than usual. 1 I am worried about physical problems like aches, pains, upset stomach, or constipation. 2 I am very worried about physical problems and it's hard to think of much else. 3 I am so worried about my physical problems that I cannot think of anything else. 21. 0 I have not noticed any recent change in my interest in sex. 1 I am less interested in sex than I used to be. 2 I have almost no interest in sex. 3 I have lost interest in sex completely. INTERPRETING THE BECK DEPRESSION INVENTORY Now that you have completed the questionnaire, add up the score for each of the twenty-one questions by counting the number to the right of each question you marked. The highest possible total for the whole test would be sixty-three. This would mean you circled number three on all twenty-one questions. Since the lowest possible score for each question is zero, the lowest possible score for the test would be zero. This would mean you circles zero on each question. You can evaluate your depression according to the Table below. Total Score Levels of Depression 1-10____________________These ups and downs are considered normal 11-16___________________ Mild mood disturbance 17-20___________________Borderline clinical depression 21-30___________________Moderate depression 31-40___________________Severe depression Over 40__________________Extreme depression A PERSISTENT SCORE OF 17 OR ABOVE INDICATES THAT YOU MAY NEED MEDICAL TREATMENT. IF YOU HAVE ANY CARDIAC CONCERNS, PLEASE CONTACT CARDIOVASCULAR INTERVENTIONS’ (Beck Depression Inventory, 2015) References Baer, L. (2010). Handbook of clinical rating scales and assessment in psychiatry and mental health. New York: Humana Press. Beck Depression Inventory-II (BDI-II). (n.d.). Retrieved July 2, 2015, from http://www.psychcongress.com/saundras-corner/scales-screenersdepression/beck- depression-inventory-ii-bdi-ii Beck Depression Inventory. (n.d.). Retrieved July 6, 2015, from http://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=2&ved=0CCgQFj AB&url=http://www.researchgate.net/publictopics.PublicPostFileLoader.html?id=5179a 648cf57d78c20000009&key=e0b495179a6484f693&ei=lk6aVdTqBOTd7QanxIuoAg&u sg=AFQjCNFLFh Beck, A., Steer, R., & Brown, G. (2011). Beck Depression Inventory–II. PsycTESTS Dataset. Clinical Psychology. (n.d.). Retrieved July 2, 2015, from http://www.pearsonclinical.com/psychology/products/100000159/beck-depression- inventoryii-bdi-ii.html Dozois, D. (2010). Beck Depression Inventory-II. The Corsini Encyclopedia of Psychology. H.R. Mental Wellness Centre | Vancouver | Dr. Hamdy El-Rayes. (n.d.). Retrieved July 5, 2015, from http://mentalwellnessbc.ca/ Llesuy, J. (2012). Depression and Migraine. Kanner/Depression in Neurologic Disorders: Diagnosis and Management Depression in Neurologic Disorders: Diagnosis and Management, 103-115. Mula, M. (2012). Basic Principles in the Management of Depression in Neurologic Disorders. Kanner/Depression in Neurologic Disorders: Diagnosis and Management Depression in Neurologic Disorders: Diagnosis and Management, 94-102. Parker, G., & Ketter, T. (2010). Management of Bipolar II Disorder. Clinical and Neurobiological Foundations Bipolar Disorder, 342-352. Rosner, R. (2014). Beck Depression Inventory (BDI). The Encyclopedia of Clinical Psychology, 1-6. Support Groups. (n.d.). Retrieved July 5, 2015, from http://newheights.org/support-groups Young, A. (2010). Practical management of bipolar disorder. Cambridge: Cambridge University Press. Read More