Professional Documents
Culture Documents
3 Patient has some awareness that his or her efforts are important in the
change process, but is fluctuating between this recognition and an
externalising stance
4 Patient generally accepts responsibility for the change process but may
lapse into externalising stance occasionally.
5 Patient recognises and endorses the role of his or her efforts will play in the
change process, for example: - you can point me in the right direction, but I
know I have to do the work myself.
4
Chronicity of Problems
0 Do not rate. Insufficient information
1 A nearly lifelong difficulty with at least one of the main complaints
2 Long-lasting difficulties with at least one of the main complaints for at least 5
years
3 Patient reports main problems or complaints lasting most of the past 2
years or during at least 2 episodes in the last 6 months
4 Patient reports that main complaints or problems have existed for more than
6 months but less than 2 years
5 A relatively recent (within past 6 months) onset of the main complaints
Security Operations
Security operations can be defined as psychological and/or behavioural
operations that function to reduce anxiety and raise self-esteem e.g.
avoidance of topic, preoccupation with fine details, selective inattention,
presenting self in exaggerated favourable lights and discussing
emotional issues in an intellectually distanced way.
0 Do not rate. Insufficient information
1 The patients security operations appear to be sufficiently disruptive to
constitute a substantial barrier to the therapeutic process
2 The patient displays security operations that are moderately disruptive, but
there do seem to be some points at which he or she is able to deal with
potentially anxiety-provoking issues openly and directly.
3 The patient displays mildly disruptive security operations. There appears to
be some openness to dealing with anxiety-provoking topics, but there is still
concern that some operations may ultimately interfere with therapy.
4 There is some evidence of disruptive security operations, but there is an
impression that these are not major obstacles to therapy.
5 There is no reason to believe that the patients security operations will
constitute an obstacle to therapy
Focality
The extent to which the patient is able to remain task-oriented and
focused during the session
0 Do not rate. Insufficient information
1 Patient is unable to focus on a specific situation being worked on during the
session
2 The patient is poor at focusing on a specific problem
3 The patient is able to focus on a specific problem without prompting by the
therapist, and stay on task
4 The patient shows very good ability to maintain a problem focus in the
absence of therapist prompting and feels comfortable working within such a
structure
5 The patient shows a very good ability to work within a problem focus and
uses this approach to explore fully a specific situation of importance
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