فرم‌ها برای درمانگر: منابع عملی برای حرفه‌ای‌های سلامت روان

Allan Hedberg has been in private practice as a psychologist for over 30 years. In this book, Dr. Hedberg has put together a one-stop source of every imaginable form for the early career therapist. The book is not geared exclusively to psychologists, but to all types of practitioners including psychologists, psychiatrists, social workers, marriage and family counselors, alcohol counselors, rehabilitation, recreational, occupational, physical, and speech therapists. The forms have been provided by experienced, seasoned professionals who have refined their content over the course of many years in practice. In addition to the forms themselves, practical guidelines on their use and helpful information on developing personalized forms is included. The book is written in a concise format and the forms are easy to duplicate or adapt for the busy professional. The website with electronic forms from this book can be found at: http://booksite.academicpress.com/hedberg/forms. * Forms are designed for early career therapists and obtained from experienced, seasoned therapists* Includes all types of forms including surveys, questionnaires, informal tests, informational ratings sheets, and "homework assignments" to be used between sessions* Information is geared toward all types of practitioners and forms are easily duplicated or adapted, saving professionals valuable time Cover Page ......Page 1 Front matter......Page 3 Copyright......Page 4 List of Icons......Page 5 List of forms by type......Page 6 Contributors......Page 19 About the editor......Page 21 Preface......Page 22 Acknowledgments......Page 23 Starting and Managing Your Clinical Practice......Page 24 Forms for Setting Up and Defining Your Practice......Page 25 Example professional resume (web version)......Page 26 Professional practice profile......Page 28 Vision implementation planner......Page 29 Strategic planning worksheet......Page 30 Professional will and instructions......Page 31 Codicil to personal or professional will Percentage of Adjusted Gross Estate......Page 34 Professional profile documents needed......Page 35 Business development and professional relationships......Page 36 Making a business plan......Page 37 Intentional strategic planning......Page 39 What are the components of a mission statement?......Page 40 Office set up and marketing needs......Page 41 Letter of introduction to the community......Page 42 The 14 Ps of marketing a practice, program or service......Page 43 Marketing by mail (1)......Page 44 Marketing by mail (2)......Page 45 General marketing guidelines......Page 46 Free use of the media......Page 47 Sample letter for a proposed community workshop......Page 48 Going green in the office......Page 49 Process Checklist......Page 50 Strategic planning vs. vision thinking......Page 51 A swot analysis of the practice......Page 52 Forms Related to Fees......Page 53 Structuring payment plans for patients who cannot afford standard fees......Page 54 Office financial policy......Page 55 Cancellation and missed appointments notice......Page 56 Notice of missed appointments......Page 57 Actions to take when patients miss appointments......Page 58 Payment agreement for past service rendered......Page 59 Past due letter requesting payment......Page 60 Doctor’s lien and authorization of payment......Page 61 office daily billing sheet......Page 62 Fee agreement for psychological expert witness services......Page 63 Fee schedule for clinical services ......Page 64 Fee schedule for medicAL/legal services......Page 66 insurance authorization log......Page 67 Insurance direct payment authorization......Page 68 HIPAA/Patient Privacy Forms......Page 69 HipAa office staff guidelines......Page 70 Hipaa complaint and resolution form......Page 71 Authorization for release or exchange of information......Page 73 Permission to allow information from a session to be used for research, teaching, lecturing, and/or publication purposes......Page 74 Patient records access form......Page 75 Request for no records to be kept......Page 76 Limits on patient confidentiality......Page 77 Guidelines for the release of psychological test data......Page 78 Medicare advance beneficiary notice......Page 79 General Informational Handouts for Patients......Page 81 Medication and Hospitalization......Page 82 Specialized Services......Page 83 The ways management might address these issues include the following......Page 84 Overview......Page 85 Disclosure of Risks and Benefits Regarding the Use of Psychotherapeutic Medications......Page 86 10 Steps to a healthier brain......Page 87 User guidelines......Page 88 Advice for patients seeking services on the internet......Page 89 Personal bill of rights......Page 90 Patient bill of rights......Page 91 Forms Related to Referral and Consulting Services......Page 92 Contract for Consulting Services: Brief Form......Page 93 Consulting Services Agreement with Other Professionals......Page 94 A Sample Contract......Page 95 Agreement for Psychological Expert Witness Services......Page 97 Confidential Referral......Page 98 Expert Witness Guidelines......Page 100 What to look for when reviewing a contract......Page 101 Approach to assessment......Page 102 Client’s Consent to Assessment......Page 103 Ethical Guidelines in Interdisciplinary Care......Page 104 Guidelines for Medication Referrals......Page 105 10 Networking tips......Page 106 Fitness for Duty and Workers’ Compensation Forms......Page 107 Notice of Unfitness for Duty......Page 108 Notice of Return to Duty......Page 109 Workers‘ Compensation Information Intake Form......Page 110 Workers’ Compensation Lien Cover Letter......Page 111 Forms Related to Patient Services......Page 112 We Value Your Trust ......Page 113 Confidentiality......Page 114 My training and approach to therapy......Page 115 Client Consent to Psychotherapy ......Page 116 Patient Confidential Information Form......Page 117 Confidential Alternate Communications Request......Page 118 Documenting All Services Rendered......Page 119 Behavioral Therapy Plan......Page 120 Needs Appraisal and Services Plan......Page 121 Review of Behavioral Medication by Physician......Page 122 Monitoring of Antecedent Events to Self-Defeating Behavior......Page 123 Components of a Patient‘s Chart: a Checklist......Page 124 Comments......Page 125 Patient Satisfaction Questionnaire......Page 126 Patient Satisfaction: Therapy’s Greatest Public Relations Approach......Page 127 How has it gone since the last session? ......Page 128 Jury Duty Excuse......Page 129 Forms Related to Therapist’s Professional Activities......Page 130 Continuing Education Log......Page 131 Weekly Travel Expense Sheet......Page 132 Expense Account......Page 133 Supervision Documentation Form......Page 134 Managing an Office Staff......Page 135 Program Staff Meeting Minutes......Page 136 For Use in a Multi-Staff Clinic......Page 137 Annual Survey of Office Staff......Page 138 Peer Evaluation of Employee......Page 139 Employee Self-Evaluation Form......Page 140 Employer Feedback to Employee from Annual Review......Page 141 A Notification System ......Page 142 Annual Employee Satisfaction Survey......Page 143 Unusual Incident Report Form......Page 144 Request for Time off......Page 145 Request for Early Dismissal or Overtime Authorization......Page 146 Employee Exit Interview......Page 147 Authorization to Release Employment Information......Page 149 Authorization for Letter of Reference......Page 150 Signs to notice and take seriously......Page 151 Professional Staff Meeting Agenda......Page 152 Emergency Action Needed: “Ina”......Page 153 What depressed employees need to know......Page 154 Leadership in Today’s World ......Page 155 Leadership in the Workplace......Page 156 A Check List and Plan for Improvement ......Page 157 Rules in crisis communication......Page 158 Dealing with “confrontational crisis”......Page 159 Termination of Treatment/Practice Forms......Page 160 Release from responsibility for discharge......Page 161 Letter to terminate services to a patient......Page 162 The practice profile ......Page 163 Psychotherapy Practice For Sale ......Page 165 Forms for Session Notes......Page 166 Session notes: version 1......Page 167 Session notes: version 2......Page 168 Session notes: version 3......Page 169 Session notes: version 4......Page 170 Relaxation training and biofeedback therapy session notes......Page 171 Group therapy notes......Page 172 Clinical Errors, Bad Habits, Ethical Complaints, and Law Suits......Page 173 12 Steps for reducing your risks in a malpractice suit ......Page 174 Four issues to be addressed in determining negligence in a civil law suit ......Page 175 Ways to respond to a complaint......Page 176 Guidelines for managing unintended errors and mistakes......Page 177 Bad habits to avoid as a therapist......Page 178 Medication consultation by psychologist ......Page 179 Expanding Your Practice......Page 180 Informed consent procedures for telemedicine......Page 181 Negotiating successfully......Page 182 Professional variables......Page 183 My plan to go forward......Page 184 Coaching Includes Your Choices of:......Page 185 Executive coaching to accelerate learning......Page 186 The general steps to be followed......Page 187 Intake Forms and Initial Assessment Tools for Evaluating Patients......Page 188 Organizing Your Charts and Evaluations......Page 189 Outline for a comprehensive clinical evaluation......Page 190 Discharge......Page 194 Disclosure forms......Page 195 Outline for a standard clinical evaluation and summary report......Page 196 General Assessments: Intake, Brief, Comprehensive, and More......Page 197 Getting to know you......Page 198 The intake process – issues to assess......Page 199 Legal intake form......Page 200 Intake assessment and proposed treatment plan......Page 201 Brief clinical assessment......Page 202 Brief Assessment and diagnostic Summary......Page 207 Brief diagnostic structured clinical interview......Page 208 Sentence completion-work......Page 209 Psychopathy checklist......Page 211 Critical events time line......Page 212 Assessments Related to Specific Tests and Scales......Page 213 Introduction......Page 214 Permeable boundaries......Page 215 Global assessment of relational functioning (garf) scale......Page 216 Gaf evaluation......Page 217 Social and occupational functioning assessment (sofa) scale......Page 218 Assessments Related to Risk, Competency, Health, and Neuropsychology......Page 219 Competency to stand trial status exam......Page 220 Assessing lifestyle and health......Page 221 Informal diagnostic exercises of aphasia......Page 223 What will the results tell me?......Page 224 Key benefits......Page 225 Forms, Exercises, and Information for Treating Specific Disorders......Page 226 Anxiety and Stress Relief with Relaxation Assessment and Exercises......Page 227 A Checklist ......Page 228 BALANCING YOUR PRIORITIES......Page 229 Identifying most critical issues......Page 231 Achieving your goals ... together......Page 232 Progressive relaxation......Page 233 Stress and anxiety management......Page 234 Stressful life events......Page 235 Well-being scale......Page 236 How well do you cope with life’s circumstances?......Page 237 Fear and its management......Page 238 Pain control statements......Page 239 Emotional fitness......Page 240 Calm Down and Live in Peace......Page 241 Stress is not a stocking stuffer......Page 242 Identifying traumatic stress......Page 243 What management can do to minimize employee stress......Page 244 Depression and Self-Esteem......Page 245 Depression myths......Page 246 Triple-column technique to understand and change my depression......Page 247 Bipolar: how to be self-defeating......Page 248 Bipolar disorder hypersexuality......Page 249 Feeling overwhelmed and desperate......Page 250 The happiness factor......Page 251 What are the symptoms of sad?......Page 252 Side effects......Page 253 Practicing spirituality......Page 254 A Personal Pursuit Exercise......Page 255 The self-esteem review......Page 256 10 Self-esteem boosters......Page 257 Insomnia and Sleep Therapy......Page 258 10 Tips for better sleep......Page 259 Helpful hints for easing into sleep......Page 261 How can i learn more to help me sleep?......Page 262 Sleep improvement program......Page 263 My sleep diary......Page 264 My sleep chart......Page 265 Sleeping improvement log......Page 266 Helping sleep through use of medication......Page 267 Importance of good sleep habits......Page 268 Addictive behavior......Page 269 Signs of alcoholism ......Page 270 Alcohol addiction questionnaire......Page 273 Alcohol involvement scale......Page 274 Other considerations......Page 275 How, how much......Page 276 Two questions on gambling......Page 277 Do i have a gambling problem?......Page 278 My gambling pattern in the past year ......Page 280 Are you Living with a Compulsive Gambler? ......Page 281 Caffeine consumption questionnaire......Page 282 Reasons to quit smoking......Page 283 Suicidal Behavior......Page 284 SUICIDE RECOVERY FOR FAMILY......Page 285 RISK FACTORS......Page 286 A Guideline for Detecting Dangerousness ......Page 287 No Harm Agreement......Page 288 Pain Management and Coping with Medical Disorders......Page 289 Seek immediate medical care if .........Page 290 Successful treatment......Page 291 Clinical interview......Page 292 Assessment and measuring pain......Page 293 Patient Pain Assessment......Page 294 Pain Identification Chart......Page 295 Charting Perceived Pain......Page 296 Physical Disorders Associated with Psychological Distress......Page 297 Patient Report of Illnesses and Medical Problems......Page 299 Treatment focus and objectives......Page 300 Dizziness Questionnaire......Page 302 Medications Being Taken by Patient......Page 304 Things to Do or Take to Manage GERD Symptoms......Page 305 WINNING OVER DEPRESSION:......Page 306 Anger and Violent Behavior......Page 307 How to handle angry people ......Page 308 Anger and how to deal with it......Page 309 Hostility discomfort scale......Page 310 Behavioral anger scale......Page 311 Anger inventory......Page 312 Behavioral hostility checklist......Page 313 My anger story... About Which I Am Not Proud......Page 314 My diagnostic anger map......Page 315 Five steps of anger control......Page 316 Dangerous propensities of a minor......Page 317 Risk for re-offending as a sex offender......Page 318 Skill Building Strategies and Tools for Personal Growth and Life Improvement......Page 320 Strategies and Tools for Personal Growth and Health Awareness......Page 321 My Developmental Experiences of Personal Growth and Development......Page 322 My Self-Analysis......Page 323 Considerations in Self-Image Building......Page 324 My Friendship Circle......Page 325 My Life’s Journey of Growth Experiences......Page 326 exercise......Page 327 Journal......Page 328 The Motivation Worksheet ......Page 329 My Daily Journal......Page 330 Test of Personal Meaning ......Page 331 exercise......Page 332 Happiness and Optimism Exercises......Page 333 Good Habits for Healthy Living......Page 334 Components of Brain Functioning......Page 335 Journal Writing......Page 336 Communication Tips and Exercises......Page 338 Communication tips from the tennis court......Page 339 What kind of listener am i?......Page 340 Communication exercises in the perception of feelings......Page 341 Model of communication patterns......Page 342 Obstructive styles of communication......Page 343 The listening skills ladder......Page 344 The stings and thorns of communication......Page 345 Nonverbal communication checklist......Page 346 Assertiveness inventory ......Page 348 Eating and Exercise Logs......Page 350 Personal Exercise Record......Page 351 Weekly Home Exercise Program......Page 352 Eating Behavior Schedule......Page 353 Helping Patients Live an Active Lifestyle......Page 354 Tips to Manage Weight Loss......Page 355 Cultural Diversity Appreciation Exercises......Page 356 Movies and Videos Focusing on Diverse Populations......Page 357 Q & A......Page 358 Procedure......Page 359 Questions for the therapist to consider and discuss......Page 361 Conflict Resolution and Problem Solving......Page 362 Walking Around the Edges of Conflict......Page 363 The Five Steps to Problem Solving......Page 364 Non-violent problem solving......Page 365 Violent problem solving......Page 366 Problem Solving Diagram......Page 367 The Problem Solving Worksheet......Page 368 A Therapy Work Sheet......Page 369 Thinking Distortions: Information and Patient Exercises......Page 371 How to stop it: an exercise to bring about change......Page 372 Thinking Distortions......Page 373 Behavioral Monitoring Logs......Page 374 behavior Monitoring Graph......Page 375 monitoring of Antecedent Diagnostic Events to Self-defeating Behavior......Page 376 A Look at my Self-defeating Behavior Pattern......Page 377 Charting of the daily progress at home and work......Page 378 behavioral Observations Chart for Daycare and Hospital patients......Page 379 Dealing with Crisis......Page 380 How Best to Respond to a Crisis ......Page 381 Crisis Intervention......Page 382 Along the path of a crisis......Page 384 Post-trauma Do’s......Page 385 Post-trauma Don’ts......Page 386 Trauma Response ......Page 387 Getting unstuck in recovery from trauma......Page 388 Dealing with Specific Types of Patient Problems and Issues......Page 389 Serving Children and Their Families......Page 390 The Family Needs Help to Change......Page 391 How long will therapy take?......Page 392 For family therapy, who will actually come to the sessions?......Page 393 Teaching Children How to Make Wise Choices......Page 394 Functional and Dysfunctional Families......Page 395 The Eight Vital Characteristics of a Functional Family......Page 396 The unhealthy process of raising children......Page 397 Check Your Family’s Vital Signs......Page 398 The Dysfunctional Family......Page 399 THE PLAN OF CARE......Page 400 Family Based Assessment......Page 401 An important word about “psychological testing”......Page 402 Family Life in the Home......Page 403 Child/Teen Brain System Checklist......Page 404 The Warning Signs ......Page 407 Learning Disabilities......Page 409 Children with Special Needs: Early Warning Signs......Page 410 Information I Need from You......Page 412 Multiple Intelligence......Page 413 Attention Deficit-Hyperactivity Disorder (ADD/ADHD)......Page 414 Problems for which to be alert and avoid......Page 415 Potential diagnostic confusion......Page 416 Key Benefits......Page 417 Possible Causes of Impulsivity and Hyperactivity......Page 418 ADHD Behavioral Review......Page 419 School Performance and Teacher Feedback......Page 420 Daily School Report ......Page 421 Weekly School Report ......Page 422 Weekly Schoolwork Review......Page 423 Teacher Feedback Form on Student Performance......Page 424 Student Rating Scale for Educational Planning......Page 425 Communication with Children......Page 426 10 Steps in Talking with Children......Page 427 A self-test on your communication with children today......Page 428 The Goodnight Formula for Children and Parents......Page 429 Agenda......Page 430 Family Locator and Connection Worksheet......Page 431 54 Ways to Say “Good for You”......Page 432 A Parent’s Pledge......Page 433 Basic Parental Behaviors to Use in Raising Boys......Page 434 The Making of Family Rules......Page 435 Exercises for Therapists to Get Children to Communicate......Page 436 Drawing a Face As a Rapport-Building Exercise......Page 437 Drawing a Dad Story for the Unforthcoming Child......Page 438 Drawing a Mom Story for the Unforthcoming Child......Page 439 Story Telling for the Unforthcoming Child......Page 440 Drug Use and Eating Disorders......Page 441 Parents and Teachers Combating Adolescent Drug Use......Page 442 Recommendations for Family Members of Anorexic Individuals......Page 443 Eating Disorder Evaluation: Bulimia......Page 444 Custody/Visitations......Page 446 The Visitation Conundrum ......Page 447 Parent to Parent Communication Form......Page 448 Child Custody and Visitation Preferences......Page 449 New Drivers......Page 451 The New Driver’s Learning Plan......Page 452 New Driver’s Contract......Page 453 Other Parenting Management Strategies......Page 454 Parent–Child Contingency Behavioral Contract......Page 455 Time Out as a Discipline Measure......Page 456 Parenting Events to Learn From......Page 457 26-Day Report Card on Bed Wetting......Page 458 Dealing with Geriatric Patients......Page 459 Assessment Scales and Checklists......Page 460 Geriatric depression scale (short form)......Page 462 The geriatric hypochondriasis scale......Page 463 Geriatric depression scale (long form)......Page 464 Adult brain system checklist......Page 465 Treatment focus and objectives......Page 468 Successful Aging......Page 470 Aging with resiliency and longevity......Page 471 The centenarian support system......Page 472 Tips for retiring seniors (boomers)......Page 473 My retirement portfolio......Page 474 The long pathway of aging......Page 475 The aging brain......Page 476 Guidelines for healthy and effective family visitation......Page 477 Dementia and Alzheimer’s Disease......Page 479 Part b: daily-activities and social-independence test......Page 480 The 10-numbers test of memory:......Page 481 Precautions for care providers......Page 482 A few measures of alzheimer’s and ways to chart its progression:......Page 483 A Step Beyond Dementia ......Page 484 A cognitive friendly unit for alzheimer’s patients......Page 486 Caregivers and Caregiving......Page 487 Advantages and benefits in serving older people......Page 488 Making the caretaking experience rewarding......Page 490 A word for the care providers......Page 492 What family, friends, and guardians can do to prevent abuse?......Page 493 Couples Therapy and Relationship Assessements and Exercises......Page 494 A “perfect” marriage wish list......Page 495 Marital happiness scale......Page 496 Request for marital behavior change......Page 497 Marital Satisfaction: Husband......Page 499 Seven components to loving......Page 500 “You” and “I” Messages......Page 501 20 Diagnostic factors that indicate relationship anger......Page 502 How To Love You?......Page 503 Marital pointers......Page 504 Marital problem area questionnaire......Page 505 Pre-marital questionnaire......Page 507 Dimensions of intimacy......Page 509 Navigating the confrontations of a discovered affair......Page 510 The final thought......Page 511 Marital action steps for the long run......Page 512 Interpersonal relationship distinctions......Page 513 What can i do?......Page 514 Summary......Page 515 How to predict A potentially violent relationship......Page 516 Why victims of domestic violence struggle with leaving......Page 518 Form Development and Usage for a Clinical Purpose......Page 519 Professional Issues in Clinical Practice......Page 520 C......Page 522 G......Page 523 O......Page 524 S......Page 525 W......Page 526

Allan Hedberg has been in private practice as a psychologist for over 30 years. In this book, Dr. Hedberg has put together a one-stop source of every imaginable form for the early career therapist. The book is not geared exclusively to psychologists, but to all types of practitioners including psychologists, psychiatrists, social workers, marriage and family counselors, alcohol counselors, rehabilitation, recreational, occupational, physical, and speech therapists. The forms have been provided by experienced, seasoned professionals who have refined their content over the course of many years in practice. In addition to the forms themselves, practical guidelines on their use and helpful information on developing personalized forms is included. The book is written in a concise format and the forms are easy to duplicate or adapt for the busy professional.

The website with electronic forms from this book can be found at: http://booksite.academicpress.com/hedberg/forms.

* Forms are designed for early career therapists and obtained from experienced, seasoned therapists

* Includes all types of forms, including surveys, questionnaires, informal tests, informational ratings sheets, and "homework assignments" to be used between sessions

* Information is geared toward all types of practitioners, and forms are easily duplicated or adapted, saving professionals valuable time Allan Hedberg has been in private practice as a psychologist for over 30 years. In Forms for the Therapist, Dr. Hedberg has put together a one-stop source of every imaginable form for the early career therapist. The book is not geared exclusively to psychologists, but to all types of practitioners including psychologists, psychiatrists, social workers, marriage and family counselors, alcohol counselors, rehabilitation, recreational, occupational, physical, and speech therapists. The forms have been provided by experienced, seasoned professionals who have refined their content over the course of many years in practice.In addition to the forms themselves, practical guidelines on their use and helpful information on developing personalized forms is included. The book is written in a concise format and the forms are easy to duplicate or adapt for the busy professional. Forms are designed for early career therapists and obtained from experienced, seasoned therapists Includes all types of forms, including surveys, questionnaires, informal tests, informational ratings sheets, and'homework assignments'to be used between sessions Information is geared toward all types of practitioners, and forms are easily duplicated or adapted, saving professionals valuable time