PART 3: What information is needed for  GP/ CAMHS assessment? 

評估會面時,相關團隊會根據下例框架提出問題,家長或當時人若能據此作出準備,並向團隊提供相關 資料,有助於取得適切的服務。

  1. 當前家長或學童關注/問題 
  1. 最近有沒有發生什麼事情讓您的孩子/您此時尋求幫助?
  1. 存在問題的持續時間
  1. 問題的嚴重性(超出個別兒童/青少年的正常發展和當前情況)

A. 有什麼風險嗎?

  • 自殘行為(頻率增加、方法、有傷害意圖、缺乏應對策略、缺乏抗逆力)(Self-harm behaviour (increasing frequency, unsafe methods, intent to harm, few coping strategies, lack of resilience))
  • 傷害他人 (Harm to others)
  • 自殺意念; 結束生命的意圖,有自殺計劃,很少或缺乏保護因素,有執行計劃的方式,曾有自殺經驗 (Suicide ideation; intent to end life, plan in place, little or no protective factors, means to carry out plan, previous attempts)
  • 濫用藥物 (Misuse of substances impacting on safety and functioning of the child / young person)
  • 從事危險/有害的性活動 (Engaging with risky/harmful sexual activities)
  • 有害使用對情緒/心理健康產生負面影響的社交媒體 (Harmful use of social media which is negatively impacting on emotional/mental health)

B. 有任何健康問題嗎?

  • 食慾增加或減少 (Increased or reduced appetite)
  • 睡眠模式的改變 (Concerning changes in sleep pattern)
  • 體重變化 (Concerning changes in weight)
  • 飲食習慣 (Concerning eating habits)
  • 過度運動 (Excessive exercise)
  • Increased physical symptoms which may be psychosomatic (headaches, stomach aches etc with no other explanation)
  • 長期健康狀況出現惡化(沒有其他解釋)(Worsening of diagnosed chronic health conditions (with no other explanation))
  • 急性身體疾病 (Onset of acute physical illness)
  • Co-morbidities e.g  autism spectrum disorder/attention deficit hyperactivity disorder/tics/tourettes/intellectual disability

C. 有什麼負面想法嗎?

  • 扭曲的思維模式 (Distorted thought patterns)
  • 強迫思想/不受控制的重覆思想 (Acting on intrusive thoughts)
  • 壓力的累積 (Increasing level of distress from intrusive thoughts)
  • 負面想法 (Unhelpful thoughts which impact on the ability to function)
  • 「回閃」事發現場的經過 (Flashbacks)

D. 有任何情緒問題嗎?

  • 易怒 (Irritability)
  • 侵略性 (Aggression)
  • 退縮 (Withdrawn)
  • 隔離 (Isolating)
  • 狂躁 (Manic)
  • 情緒低落 (Feeling low)
  • 哭泣 (Tearful)
  • 過度敏感 (Over-sensitive)
  • 難以控制情緒 (Difficulty in controlling emotions)

E. 對兒童/青少年的家庭、教育和社交生活的影響

對家庭生活的影響

  • 從家庭成員自我抽離 (Withdrawing from family members)
  • 需要比以前更多地與家人聯繫 (Needing to have more contact with family members than before)
  • 爭執/衝突增加 (Increased arguments / conflict)
  • 缺乏合適的管教和支持 (Concerns regarding parenting ability / lack of parent support / comfort)
  • 過度尋求兒童/青少年的安慰 (Excessive reassurance seeking from child/young person)
  • 家庭活動的變化 (Change in family activities)
  • 家庭互動的變化 (Change in family set up/dynamics)
  • 失去或喪親 (Loss or bereavement)失去或喪親 (Loss or bereavement) 
  • 家庭成員的身心健康情況 (Mental and physical health of family members which may impact on the young person)

對教育和學習的影響

  • 出席率下降 (Attendance dropping)
  • 長期缺勤/逃學 (Persistent absences / truanting)
  • 成績改變 (Attainment changing)
  • 動機改變/缺乏參與 (Change in motivation / lack of engagement)
  • 專注力下降 (Change of concentration level)
  • 行為模式改變(退縮/挑戰等) (Behaviour pattern changing (withdrawal / challenging etc))

對社交關係的影響

  • 朋友圈的變化 (Changes in friendship groups)
  • 欺凌行為或欺凌對象 (Bullying behaviour or Subject of bullying)
  • 友誼質量的變化,例如他們還在和朋友交流嗎? (Change in quality of friendships such as are they still communicating with friends?)
  • 失去或喪親 (Loss or bereavement)失去或喪親 (Loss or bereavement)
  • 結交損友 (Engaging with inappropriate relationships)

對生活效能的影響

  • 失去對事物、活動的興趣 (Decreased enjoyment of previously enjoyed activities and/or interests)
  • 退出活動 (Withdrawal from activities)
  • 缺乏參與 (Lack of engagement)
  • 自我照顧技能的改變(改變他們的著裝/展示方式 (Change in self-care skills (change in how they dress/present themselves))
  • 冒犯行為/持續的反社會行為 (Offending behaviour/persistent anti-social behaviour)
  • 過於熟悉/過於友好 (Over-familiar/over-friendly)

社會心理和家庭問題,包括家庭成員或親屬系統中的重要人物 

  • 大型家庭活動 (Big family events)
  • 疾病 (Illnesses) 

過往支援的成效 / 問題改善程度? 

  • 學校心理健康服務 (School health service involvement)
  • 校內支援 (Student support within school)
  • 家庭服務 (Family service intervention)
  • 私人輔導 (Private/voluntary counselling)
  • 學校輔導 (School counselling)
  • 家庭暴力/保護服務 (Domestic abuse services)
  • 喪親服務 (Bereavement services)
  • 相關志願機構 (Relevant voluntary agencies) 
  • 自助網站 (self-help websites)

第四部份: 轉介流程及CAMHS處理流程

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