SHARES is a clinically useful mnemonic for ensuring that the various needs of chronically disabled mentally ill patients are being addressed. (!3) Symptoms: How is the patient's illness responding to the specific treatment provided?

Housing: Are the patient's housing needs adequately met? Does he or she have adequate supervision in the home? Is he or she in danger of eviction?

Activities of Daily Living: Are the person's needs for assistance in everyday living being met? Can he or she obtain an adequate diet, take care of laundry, shopping and personal safety?

Recreation: Does the person have opportunities for relaxation and amusement?

Employment: Is the person participating in pre-vocational or vocational training, or is he or she engaged in sheltered employment, or working in the open labour market?

Significant others: Does the person need help in fostering a network of social supports, including family and friends?

If the problem-oriented record approach and the individualized treatment plan are not used wisely, they may simply lead to a series of lists with little coherent logic, in which all needs or problems are given equal weight in the development of a treatment plan. To avoid this, the diagnostic evaluation of the patient should include a formulation, which comprises a summing-up of the salient facts of the case and of the aetiologically important factors ( Chapter.1.:.i10.1). The treatment plan then emerges from the formulation and reflects its logic in prioritizing the needs of the patient.

Breaking Bulimia

Breaking Bulimia

We have all been there: turning to the refrigerator if feeling lonely or bored or indulging in seconds or thirds if strained. But if you suffer from bulimia, the from time to time urge to overeat is more like an obsession.

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