Client Reflection

The patient asked this writer if this writer cannot talk to her mother and advocate for the patient to the clinic's TEAM about the urgency of getting her bottles. This writer was willing to talk to the patient mother and will try again, to advocate on the patient behalf to get her bottles. However, addressing the mental health portion, the patient stated she has to figure something out about the transportation barrier as no scheduled has been made with CHR due to her barrier. Please note, the patient is no longer seeing Dr. Kuru as the psychiatrist no longer works for CHR. The patient prescriber for her medication is her

to request that she meet with this writer to discuss her current counseling non-compliance status and how she is refusing to schedule an individual session. Counselor told her that she signed a notice of counseling non-compliance letter and if she failed to schedule an individual session by 1/22/16, she faces possible a discharge from the AMS program. Pt. agreed to schedule an individual session by stating, “I’m going to schedule something tomorrow. I’m sorry. I got a lot on my mind.”

The patient self-admits that she was not always compliant with her appointments due to changes to her work schedule since the month of December of 2016, but shared this information with her counselor. The patient is requesting to be reassigned to another counselor as she reports of not having a positive rapport with Cherron. Cherron was advised based on the patient complaint that it will be addressed with the Clinical Director based on her request to be

D-This writer met with the patient as he was placed on HOLD to address the status of the IOP. The patient provided this writer a paper that was provided to him with listing of IOP for him to explore. The paper shows scribbles of the patient taking down notes about his attempts of who he called. The patient reports Connecticut Addiction Recovery will call him back within 24-48 hours. The patient was able to schedule an appointment with New Direction for May 20th at 7pm; patient spoke with Dan. This writer commends the patient for all of his efforts; however, the patient needs to schedule something earlier than May 20th. This writer asked the patient about ICRC-Coventry House. According to the patient, he called the contact number and showed proof. The patient reports that ICRC gave him two different number and told him to do a walk-in at 8:30am. This writer shared with the patient about a recent conversation this writer had with ICRC. This writer told the patient

: Met with client before IOP group this date for ISP review, and to address overall treatment progress. Presented a good attitude and engaged well in the conversation. Reported no use of Methamphetamine or other substances, C/S date as 2/28/2018, although UA on 03/21/18 was positive for methamphetamine. Client reported he is excited that he is in treatment, stating “I never been to treatment before. I would like to learn about the addiction, but I am also affair of treatment because I am worried that I won’t make it.” Client reported main arears of concern is “staying clean and sober and complete treatment”. Stated “My ex-girlfriend is not supportive, and she drives me crazy. I work and pay the bills, but she never happy. She asked me to do this to do

The patient expressed about feeling that she is self-sabatoge her recovery for no apparent reason and currently thinking about going into an inpatient treatment- more so, a treatment that is spiritual. The patient shared that lately she's been feeling down and haven't been to going to church for the past two weeks. In addition, the patient shared about having homocidial thoughts with regards to her daughter's DCF case as she expressed frustration with the custody battle. This writer advises the patient about this writer's role as a mandated reporter and based on the patient comment of having homocidal thoughts, she recanted her statement and says," So, you are telling me that I cannot vent and express how I feel.....I am going to keep my mouth

Counselor met with Pt. for an individual session. Counselor and Pt. discussed her progress in treatment and description of her medication compliance. Pt. reported wanting a higher dosage of methadone to side effects (cold). Pt. mentioned that she would like to switch to Vivitrol medication because she is going to move with her mother house in Lewes, DE and she cant come to the clinic everyday. Pt. requested, discussed and completed an AMS Modality Switch form. Counselor encouraged Pt. to talk about her current triggers and possible solutions she can plan ahead of time. Pt. stated, "I have no triggers." Counselor elicited the client’s perceptions on her several positive urine analysis. Pt. indicated that she use crack cocaine when she is depressed.

Appointment Cancellation and No-Show Policy for All Patients. We ask that you give us at least 24 hours’ notice if you will be unable to keep an appointment you have scheduled. We may try to use that appointment for another individual seeking assistance from our clinic. If you provide us with less than 24 hours’ notice, we will designate the appointment as a “no-show.” Your provider may speak to you about your commitment to treatment if you have too many “no-shows.” If you do not reschedule at the time of cancellation, a staff member will contact you and offer a follow-up appointment.

D-Met with the patient to discuss her Aruba trips. This writer advised the patient that this writer is making contact with some staff members at the hospital, but was unable to speak to someone from the psychiatry department due to the hours as there is a 2 hour difference. The patient appeared to cheerful to learn that this writer is moving her host application forward. According to the patient, she apologized about her behavior yesterday and says, " Bobby was on me like why your counselor is not doing anything. My counselor did this and that.....it's frustrate me." This writer informed the patient that this clinic did not ignore her request whereas this writer was aware of it a month ago, but there was barriers to the patient dose as she

MR has unlimited access to group and individual counseling at New Beginnings. It was recommended MR visit a psychiatrist to be assessed for medication. MR does not believe he needs to be on medication, however resources were still given. MR would benefit from medication immensely. He would be able to think clearer and communicate better. It was also recommended MR attend Narcotics Anonymous (NA) meetings daily. After a group session at New Beginnings, all of the clients attended an NA meeting. MR stayed in at the NA meeting for two minutes and then went home. MR does not want to attend NA meetings because he believes he is getting enough help at New Beginnings. It would benefit MR to hear others stories about how drug use affected

Hill and Howard McQuirter, LCSW. They both shared the disposition that the patient should be discharged pending his agreeing to to follow up with outpatient services. Patient has agreed to follow up with outpatient services as recommended. His grandmother has been made aware of the plans concerning the patient. Patient contracted for safety, was given outpatient referral information, and completed a crisis plan. It should also be noted the patient has an up-coming appointment at DayMark 4/17/17 for groups and 5/1/17 to meet with his Psychiatrist. He has been given a list of shelter in the local area as

During the time of assessment the patient was sitting upright in her bed, her father at her bedside. The patient denies HI, SI, and symptoms of psychosis. The patient reports a history of depression. She expresses that a few days ago her and her boyfriend ended their one year relationship and he left the home due to the multiple domestic violence situations that have occurred in the home. The father of the patient provided a copy of the message sent of Facebook sent to the boyfriend, which expresses that the patient is hurt by the relationship ending and has suicidal thoughts with a plan to take a prescribe bottle of Valium to cope with the situation. Per documentation, patient's boyfriend throws knives at her, beat her and is verbally abusive. This was confirmed by the patient and her father. Per documentation the patient's parents picked her up a few days ago and she feels safe to go home. The patient reports joking about taking pills on Facebook. Per documentation the patient states, " If I wanted to kill myself,I'd just stay with him." Further the patient states, "If I go back to my boyfriend, he's going to beat me and I won't be able to take in much long." Per documentation the patient express crying episodes and feeling sadness, panic attacks for the past few day, and trouble

Patient no shows or non-attendance is one of the major problems faced by healthcare organizations. Patient no shows occurs when patients schedule an outpatient appointment, do not cancel appointment but do not appear for the care at the specified date, time and location (Stubbs, Geraci, Stephenson, Jones, & Sanders, 2012). The high prevalence of no-shows in primary care clinics acts as a barrier to continuity of care, results in loss of outpatient learning opportunities, and may result in more emergency room visits.

I place a call to AL 199019 to schedule a LCDC an appointment with her. She had some time to thinking about our conservation and is unwilling to go residential treatment for 90 days. The client said I am willing to continue my LCDC services for a few more weeks only. She reported having an appointment with Dr. Lemiar a psychiatrist on July 27, 2015 at 10:00am at Legacy Clinic. The client said (“I trust him with my life”). The LCDC will continue to move client through the stage of change.

9/21/17: When assessing client mood, due to him functioning in slow motion, he stated he was tired due to not sleeping well. At the beginning of the session he manifested difficulty with concentrating and staying focused for a long period of time but wanted to continue with the session. QMHP started the session by reviewing with client his goals and objectives. After which, QMHP pointed out to client the goals/objectives being addressed during this session. Due to client stating that he was depressed, QMHP asked him how he was coping with that. Client stated that he believes his medications is helping him to cope and indicated that he takes his medications as prescribed. When QMHP addressed his compliance and the effectiveness with client, he engaged in comparing his medications list to the medications to ensure he knows the name of all his medications. With verbal guidance and assistance, client looked at each label as he checked the name of the medications, the dosage, the expiration dates and how many refills are left. Since client choose not to use the pillbox to tack taking his medications, it difficult to know whether he’s missed a dose. Client engaged in updating his medications list to ensure he’s not taking any discontinued medications. When QMHP verbally reinforced client’s responsible compliance with his medications, he agreed to report and discuss any concerns with his doctor. Client did mention running out of his medication a few times due to not