Psychological assessment of burns by Suhasini Oliveira, National Burns Centre, Airoli

Mrs. Suhasini Oliveira

Clinical Psychologist

National Burns Centre

AiroliNational Burns Centre, www.burns-india.com, [email protected]

Sigmund Freud was a pioneer of psychology.

He is called as the Father of Psychoanalysis

The theories and work established psychoanalysis as a major school of thought in psychology

His work and writings contributed to our understanding of personality, clinical psychology, human development, and abnormal psychology

Freud’s work continues to influence psychology and many other disciplines to this day.

National Burns Centre, www.burns-india.com, [email protected]

"One feels inclined to say that the intention that man should be 'happy' is not included in the plan of 'Creation.'"

-Sigmund Freud

From Civilization and Its Discontents, (1930)


INTRODUCTIONBurns cause extreme distress in patients

because of devastating physical and psychological consequences.

Most of the burn patients are in the states of anxiety, depression and in emotions of irritability and frustration.

As a result these patients need to be assessed for psychological problems.


WHAT IS PSYCHOLOGICAL ASSESSMENT?

A psychological assessment is the attempt of a skilled professional, usually a psychologist, to use the techniques and tools of psychology to learn either general or specific facts about the patient, to predict their behavior and functioning in the future.


PURPOSE OF PSYCHOLOGICAL ASSESSMENTProvide more objective to measure personal characteristics.

Provide central information

Measure a large number of personality, cognitive or neuropsychological problems

Highlight potential obstacles in treatment and suggest alternatives.

Clarify the goals and focus of treatment.

Increase the patient's sense of independence and satisfaction.National Burns Centre, www.burns-india.com, [email protected]

KEY INGREDIENTS

Successful assessment requires knowledge of:

Psychological testsPsychopathology InterviewingStatisticsHypothesis testing


“ The most important single ingredient in the formula of success is knowing how to get along with people”

- Theodore Roosevelt.


HOW DO YOU DO?

Establishing RapportInterviewingObservationAdministering TestsDiagnosisTreatment Plan


TESTSThe tests which can be administered on burns are:Zung Self-Rating Depression Scale (Zung in 1965)Zung Self-Rating Anxiety Scale (Zung in 1971)Hospital Anxiety and Depression scale ( Zigmond and

Snaith in1983)Hamilton Rating Scale for Anxiety (Max Hamilton in

1959)Hamilton Rating Scale for Depression (Max Hamilton

in 1959)National Burns Centre, www.burns-india.com, [email protected]

Zung Self-Rating Anxiety ScaleInstruction

Patients will circle 1 of the 4 numbers in response to the questions. The healthcare provider, nurse, or medical staff assistant then scores the completed questionnaire and interprets the score using the information found in the box at right.

How to ScoreCheck that all statements have been answered. Add up the values for each response to get the score total.

Interpreting the ScoreA score total of 36 and over suggests the need for further medical assessment of Generalized Anxiety Disorder (GAD).


Zung Self-Rating Anxiety Scale


Contd…


Zung Self-Rating Depression ScaleInstruction

The patient reads each statement and selects a response which indicates how much the statement applied to him/her over the past week. There are no right or wrong answers.

How to score

Check that all statements have been answered. Add up the values for each response to get the score total.


Zung Self-Rating Depression Scale


Contd…


Normal Minimal to Mild

Moderate to Severe

Severe

Depression Less than 50

50-59 60-69 70 or More

Contd…

Interpreting the Score

•The maximum score of the Zung SDS is 80. •If the scores are over than 50 then the patient is suggested for further medication.



TREATMENT PLANCounselingBreathing ExercisesDistraction strategiesRelaxation Techniques• Meditate• Picture Yourself Relaxed• Breathe Deeply• Look Around You• Show Some Love• Try Self-Massage• Take a Time-Out• Try a Musical Detour


Contd…Positive attitudeImageryAcceptance of/resignation to the

situationVerbal psychotherapy: current

problems are discussed in light of past difficulties and options for coping with feelings and behavior

Cognitive Behavioral Therapy: focuses on symptoms and current goals. Helps the child identify faulty beliefs and learn new ways of thinking and behaving.


Contd…• Group therapy: issues are explored

within a group setting with individuals who share similar problems.

Family therapy: members of the family are helped to understand how their behaviors affect one another and instructions and strategies for making changes are provided.

Interpersonal psychotherapy: feelings and responses are explored within the context of different interpersonal or social relationships and situations.

Behavior ModificationNational Burns Centre, www.burns-india.com, [email protected]

CONCLUSIONincludes broad screening of the patient

allows the evaluator to compare the behaviour of the individual being tested to the responses of a norm group.

helps in diagnosis of differential and co-morbid conditions

to assess a particular area of functioning or disability

to help select type of treatment

to assess the outcome of the treatment


“If you talk to a man in a language he understands, that goes to his

head. If you talk to him in his language, that goes to his heart.”

- Nelson Mandela



Health & Medicine

Psychological assessment of burns by Suhasini Oliveira, National Burns Centre, Airoli