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Psychological Injury

 

 

The assessment, diagnosis and treatment of a psychological injury is generally less clear-cut than with a physical injury.  Unlike physical injuries that can be observed - e.g. lacerations,  or easily picked up through investigative procedures such as x rays or CT scans, psychological injuries are inferred.  Physical disorders nearly always have clearly demonstrable physical causes and associated physiological (or anatomical) changes as a result of the illness or injury processes.  The vast majority of psychological disorders however do not have identifiable pathogens or a demonstrable organic basis.

 

Psychological Injuries or psychological health problems can occur for a range of reasons.

 

Some of the most common include:

  • Child hood trauma and experiences  - e.g. physical, sexual or emotional abuse
  • Grief and loss  - death of someone close, loss of a relationship, the loss of physical or psychological functioning and quality of life as a result of injury or sickness
  • Problems in a personal or family relationships
  • Workplace problems ranging from conflict with a co-worker, harassment, excessive workloads, lack of instruction and/or support in how to do a job
  • Trauma – e.g. being involved in a traumatic event such as armed hold up, witnessing a fatal accident, being victim to assault or rape
  • Overuse or interaction of substances – prescribed or otherwise
  • Constitutional factors - Certain types of mental illness tend to run in families.

 

Frequently the manifestation of a psychological health problem or, (in the case of Workers compensation assessment) a psychological injury is the interaction of a number of factors with varying degrees of attribution to the manifesting psychological problem.  It is the task of the psychologist or psychiatrist assessor  therefore to assess, categorise, attribute causality and propose a plan of treatment.

 

There are many effective models in use for assessing and assisting people who are experiencing psychological difficulties however the one that stand s out and is used most regularly is The Diagnostic and Statistical Manual of Mental Disorders 5 – DSM-V.  This system of classification of Psychological health difficulties although not linked into any particular health care model does have an affinity with the Medical Model whose underlying assumption is that an organic basis underlies most disorders.  The group of professionals who are most trained in use of this system of classification are psychiatrists (whose background training is in general medicine) however a number of other professionals such as psychologists, frequently have skills in utilising this system of classification (see advantages and disadvantages of DSM-V system of classification).

 

Irrespective of what system of classification is used, the process of assessing, categorising and attributing causality in psychological health problems relies on different assessment methods and tools to those used when diagnosing a physical disorder.   Information may be obtained in the following ways:

  • Through evaluating the problems and “symptoms” reported by the clients e.g. changes in emotional, cognitive, energy levels
  • Observation of client behaviours – e.g. disturbances in their thinking, emotional responses, or behaviours
  • Evaluation of information reported about client from a third party
  • Use of psychological tests that screen for psychological difficulties and in some cases challenge the genuineness of symptom reporting,
  • Use of medical diagnostic tests such as CT scans, MRI scans EEG’s drug screen to identify organic factors contributing to a mental disorder– e.g. a tumour, and drug induced mental illness.

 

A sound assessment will be one that:

  1. Is from a professional who has experience and training with psychological problems.
  2. Utilises at least 2 of the above methods in information collection and evaluation
  3. Is neutral in context and not bias one way towards or against a particular person or party involved in the assessment process
  4. Evaluates all possible factors of attribution in a injured workers problem and explains reasons for conclusions
  5. Proposes strategies of assistance that identify clearly defined goals that are realistic, achievable, within time frames and are likely to have the approval of the various parties involved.

Psychological Injury Topics

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