My top 10 burger joints in the USA

5 Rating factors from most to least important; Overall Burger quality (Taste/Presentation), location (Scenic/Destination), Customer service (Wait time/Manners), Decor/Theme,  Parking availability.

10. The Columns – Jersey Shore (Avon), NJ

9. Slaters 50/50 – Anheim, CA

8. Cliff House – San Francisco, CA

7. Hamburger Mary’s – Ybor City (Tampa), FL

6. Maple and Motor – Dallas, TX

5. Twisted Root – Deep Elum (Dallas), TX

4. B&B Joint – South Beach (Miami), FL

3. Great Lost Bear – Portland, ME

2. Crossroads – Dallas, TX

1. Bobcat Bite – Santa Fe, NM

*Honorable Mention- Danny’s Deli – Venice Beach, CA

Shooting suspect Jared Lee Loughner was ruled to be incompetent to stand for jury trial in his alleged Jan 8^th 2011 shooting of Senator Gabrielle Giffords in Arizona. Loughner, 22, had previously plead not guilty to 49 federal charges stemming from the shooting that also left 6 people killed and wounded 12 others. Judge Larry Burns has ordered Loughner to be sent to an inpatient treatment facility in Springfield, MO.

Wittiness at the hearing stated that Loughner had been responding to internal stimuli and making audible comments and mumblings. This begs the question about his ability to maintain his mental health and to recover from it which may allow him to be released in the future. He has a past history of dual diagnosis and is going to go under extensive evaluations to determine his relapse prevention plan.

The newsletter Youth Today, offered a review of a report issued by the Justice Department’s Pathway to Desistance study concerning connections between substance abuse and serious delinquent behavior. While all of the data of the study have not been released or analyzed, some conclusions have been drawn that indicate that some serious offenders also have drug abuse problems. This inconclusiveness lends itself to Joe Friday proselytizing, using spurious apologetics and anecdotal evidence to promote various agenda. Until the material has been thoroughly analyzed, it is in the best interests of all not to jump to unfounded conclusions.

The article in question did address treatment and recovery programs, and offered some vague inferences to their success rates. Given who is advertising on their site, this is not a surprise. After all, if advertisers do not see a return on their investment, they will pull their ads. One item that was conspicuously absent from the article was that the study showed that as the individuals who were part of the study grew older, they moved away from delinquent behavior and drug use. The authors of the study offered no reasons as to why this happened.

While substance abuse is a serious problem among adolescents and young adults, using a study that acknowledges in its opening statements that the research is incomplete, and more work needs to be done, does a great disservice to advances made in the treatment of addiction for this demographic. Better studies are not only available, but have had their conclusions validated by other studies and treatment success rates. Perhaps the more dangerous drug is the adrenalin rush that comes from misleading a reading public.

After Jared Laughner gun rampage on January 8^th, 2011 in Tucson, AZ which left Gabrielle Gifford critical wounded and 6 dead as well as a dozen more injured majority of democrats in congress started the process of wanting to tighten gun controls more specially limiting the number of rounds in a clip of a handgun to 10. Well I understand the true intent and path of their heart I think the more important proposal that should go on the floors at both house & senate is a bill for Mental Health prevention and treatment. Mr. Laughner was clearly mentally ill and because of lack of education from those around and the awareness of services could have prevented this tragedy. Now I am not blaming anyone in particular besides Mr. Laughner for his actions but the in actions especially from his family and those closest to him also in some way contributed to the outcome from the events of January 8^th, 2011. Limiting the number of bullets in a clip is absurd people would still have got hurt maybe even more we do not know.

I beg you congress to bring forth to the floor a bill with real purpose and a real solution for the root of Jared Lee Laughner’s core issues Mental Health – education, prevention services and access to quality treatment.

I want to end by sharing my deepest heart felt sorrow to the families and friends of the victims of this terrible tragedy.

I have started this year off by looking into getting a membership at an indoor gun range here in the Dallas area. My options came down originally to 3 places Bullet Trap Inc., Target Master, and DFW gun. Early on I eliminated DFW gun. Why? This was the first place I visited on my journey a few months ago and purchased a Glock 17 from them. I found out later it was overpriced even though they gave me a free range pass for a day I did not break even. The range itself was good central air, clean, helpful staff and decent size range. Location on the other hand for me was not the greatest. I live in East Dallas. Getting over towards Love Field can be a pain. That said I think the location of DFW gun is not good for anyone really looking to invest in an indoor range because it is in the middle of a lot of traffic problems.

 Here are the membership perks and fees for both Bullet Trap and Target Master directly from their website. Afterwards I will give my conclusion and decision.

Bullet Trap:

Memberships 
$110.00: Individual per year
$160.00: Family per year (parents and children under 21)
$60.00 Family Associate (per child over 21 carried on family membership)
$90.00: FF/Law Enforcement per year individual.
$110.00: FF/Law Enforcement per year family
$70.00: 10 visit punch card
$120.00: 20 visit punch card
*** NEW ***
$360.00: PLATINUM Individual per year
$320.00: PLATINUM Individual per year renewal
$460.00: PLATINUM Family per year
$410.00: PLATINUM Family per year renewal

***Regular Individual / Family membership renewals receive a 25% discount off current membership prices if renewed before expiration date***

Membership Advantages 
Over 58% off range fees
Up to 4% off new and used gun purchases
5% off accessory purchases
$1.00 off each box of range ammo
$4.00 off each rental gun  
$10.00 off New CHL Classes
$5.00 off Renewal CHL Classes
Frequent Shooter Cards
Punch cards available  
Reduced rates for guests  
Prior notice to all events / sales  
*** NEW ***
PLATINUM Membership = NO RANGE FEES!  

Range Fees – Members 
$7.99: Per lane 1 member 
$15.50: Per lane 2 member 
$21.00: Per lane 1 member / 1 guest 
$16.00: Guest on separate lane 
$30.00: 2 guests separate lane 
$7.00: Children 17 & under

Range Fees – Non Members 
$18.99: Per lane 1 person 
$35.00: Per lane 2 people 
$7.00: Children 17 & under

Test Fire Guns *
$10.00: Non-members per gun 
$6.00: Members per gun 
**3rd and subsequent test fire guns are only $5 each (mem or non)

Target Master:

On Membership pricing:

Target master is about 10$ cheaper than Bullet Trap. Also you can rent as many guns as you want from Target Master as long as you have out 1 at a time. This was told to me by someone who works there. Range fees about the same. Discounts about the same as well.

Advantage: Target Master

Gun Rentals:

It is an important in my decision making to have a place with a large variety of test fire guns. Even though Target Master has a better set up for pricing in this area I liked the large selection of guns at Bullet Trap. I believe they have one of the largest in the country. They also have a much user friendly set up for viewing the test fire guns over Target Master. Note: Both require that you buy their ammo when you rent a gun from them.

Advantage: Bullet Trap

The Range:

Is important in the sense of availability and also distances for shooting. I toured Target Masters and have shot on Bullet traps many times. I did like the central air in Target Masters over Bullet Trap and Target Masters Range had more lanes. Bullet Traps set up was a more professional and cleaner.

Advantage: Push

Facility:

This brings me to the facilities. Target master had a much larger parking lot. The floor itself was had more room than Bullet Traps so you don’t feel like you’re walking all over people. Bullet Traps was cleaner and didn’t feel like there were people smoking all over the place. Target Master had paper work all around and was in shambles. The display cases where Hodge podged. And the displays themselves made were not that great. They laid out based on caliber. Bullet Trap even though it had more of a crowed feeling was much cleaner and less chaotic.

Advantage: Bullet Trap

Staff:

I must say I found both staff’s very attentive and knowledgeable. It is good to note when I copied and pasted Target Masters Membership details from their site there were spelling errors that I left in the content so you the reader can see. At both places I was welcomed and didn’t feel like a burden. Target Master without hesitation let me look around. I would have like them to offer me a free range tryout as I told them I was shopping for a membership between them in Bullet Trap. I get in the grand scheme of things one membership doesn’t mean the entire world. Bullet Trap definitely had more staff. And they were also very knowledgeable. Bullet Trap has an employee named Mark who seemed to be the go to guy. Almost everyone that came in or called that day wanting to talk with him. I spent about an hour chatting with him through all this and he never got frustrated. Bullet Trap also didn’t have the information that I was shopping around for a membership unlike Target Master. There were only about 4 people at Target Master when I came in. This seemed like it could be frustrating because if they are staffed like that it may delay your ability to get on the range without a wait. At Bullet trap this does happen even with all the staff because they are so busy and have tight quarters. But the real difference maker here was Mark at Bullet Trap the consummate professional.

Advantage: Bullet Trap

Location:

This is a big deal for me. I want to be able to get in and out with ease. Recall I live in East Dallas and Target Master is in Garland only about 3 miles from me. Bullet Trap is in Plano but it is pretty simple to get there from my house mostly highway and a 2 lights. For others in the metroplex Plano can be difficult to because of traffic so can Target Master even though it is right off 635. This is really dependent on what time of the day you like to go to the range. Your pretty much in the same predicament for either range at 500p maybe a little less for Target Master because you get by just on 635 instead of 75 or George Bush..

Advantage (ME) : Target Master (rest of DFW) Push

Classes:

Being able to get lessons or a concealed gun license is important as well. Both offer classes. Bullet trap though offers many more and Mark teaches both the CHL and shooting lessons. So if you are looking for a flexible schedule Bullet Trap is the way to go. I do not know who teaches at Target Master but their schedule wasn’t that extensive. Prices were about the same for a CHL. Target Master did offer a 3 day class instead of a 1 whole day which I personally like better. Bullet trap offers a free range pass and a test fire gun if you do their class.

Advantage: Bullet Trap

My Decision

Overall I think Bullet Trap is a better range but for me what was the deciding factor is accessibility and price. Though 10 $ isn’t a lot of money. The distance is far greater this adds more gas money to the mix. If I purchase another gun I would lean more towards Bullet Trap. But for just a shooting range I am going to give Target Master a shot. And will update with any new developments.

Target Master

Client Identification Number-___________________

Mental Health & Substance Abuse

Biopsychosocial Spiritual Assessment

Assessment Date:

Client Name: DOB:

Intake/Screening Completed:

Clinical Assessment Information

History of Presenting Issues

Client’s perception of presenting need/problem: _____________________________________

__________________________________________________________________________________

__________________________________________________________________________________

What concerns, if any, does client have about getting help/treatment?

What does client most want help with?

Client’s strengths/weaknesses (emotional, psychological, psychiatric, etc.)

Client’s Assessment of Motivation/Readiness:

On a scale of 1-5 (1-low and 5-high) how motivated is client for treatment now?  1   2  3 4   5

What is motivating client for treatment now?  ______________________________________________

On a scale of 1-5 (1-low and 5-high) how ready is client for treatment now?  1   2   3   4   5

What motivates client to change? ________________________________________________________

What might client want to change about her/his current circumstances?

What makes client ready now? __________________________________________________________

What has motivated client to change in the past? ___________________________________________

Is there anyone close to client who is affecting decision to get help/treatment? ___Yes   ___No   __X_Unsure

If yes, who is that and how are they affecting client? ________________________________________________

__________________________________________________________________________________________

Family guardian perception of needs, problems, issues: (where appropriate):  ___________________

____________________________________________________________________________________

____________________________________________________________________________________

Client Identification Number-_____________________

Childhood/Family & Social History: Complete Genogram* (Attached to end of Assessment)

How does client describe self as a child? (check all that apply)  ___Happy       ___Sad   ___Angry   ___Scared

Other- ________________________________________________________________________________________

How would client describe home environment as a child?  ___Stable   ___Unstable   ___Not sure

Please describe – ________________________________________________________________________________

Current relationship with family/friends? __Good  __Fair __Bad Describe_________________________________________________________________________________________________________________________________________________________________________________

Marital status of client’s parents?   ___Parents never married   ___Parents still married  ___Parents separated   ___Divorced___Remarried   ___Other- _____________________________________________________________________________

Client’s age when parent divorces/separated/died?  ____  ( __ ) Not applicable

Is client’s mother still living?  _ __Yes   ___No  If “no”, age/how when she died?  _____________________________

Is client’s father still living?  __ _Yes   ___No  If “no”, age/how when he died?     _____________________________

Have client describe important/significant events in childhood or family history: ____________________________________________________________________________________________Values learned

._________________________________________________________________________________

Describe your personality characteristics/yourself -.___________________________________________________

______________________________________________________________________________________________

______________________________________________________________________________________________

Emotional/Psychiatric/Psychological Strengths/Needs:

Client rating of current emotional/mental health:  rGood rFair rPoor Other:_____________________________

Client rating of coping skills for handling stress:  rGood rFair rPoor Other:_____________________________

Client description of emotional strengths and weaknesses:  ___________________________________________

___________________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

COGNITIVE SCREEN:

Does client appear to have any suspected cognitive deficits? __Yes  __No  __Unsure  (If ‘No’, skip section)

Please score 1 point for correct answer and 0 points for incorrect answer.

1. What is the name of this place?  ____                                 4.  How old are you?                     ____

2. Where is it located (address)?     ____                                 5.  What month were you born?                ____

3. What is today’s date?                  ____                                 6.  What year were you born?           ____

Score- ____

Needs a further cognitive evaluation/referral?  __Yes  __No

Concentration: Have client do serial 7’s X 5-(e.g.,7, 14, 21,etc…)                Spell “world” backwards- ‘dlrow’

Results- __________________________________________________________________

Memory: How is your memory?

Long Term – ___Good  ___Fair  ___Poor  Describe-_______________________________

Short Term-  ___Good  ___Fair  ___Poor  Describe-_______________________________

Could/is client (be) under the influence of any substance during this exam?  ___Yes    ___No   ___Unknown

Needs further evaluation/referral?  __Yes  __No

Client Identification Number-_____________________

Mental Health History ( _N_ )No past or present Mental Health or Behavioral problems/concerns(Skip)

Has client ever experienced (diagnosed or undiagnosed) any of the following conditions? (please mark all that apply)

___ADHD                              ___Learning Disabled             ___PTSD

___Depression                                    ___Anxiety                             ___”E.D.”

___Schizophrenia                    ___Conduct Disorder             ___Oppositional

___Attachment Disorder        ___Bipolar Disorder               ___Other-_______________________________

Diagnoses client has received (what/when):  ____________________________________________________________

Does client have a history of any of the following behaviors? (mark all that apply)

___Gambling               ___Compulsive eating             ___Compulsive sex

___Risk taking             ___Stealing/kleptomania          ___Compulsive spending

___Pyromania             ___Explosive behavior                        ___Other-_________________________________________

Has client had any behavioral or disciplinary problems–home, school, in community?  ___Yes  ___No  ___Unsure?

Please describe-__________________________________________________________________________________

Have these problems been related to mental health or alcohol/drug use?  ___Yes  ___No  ___Unsure?

Please describe-__________________________________________________________________________________

Harm to Self/Others

Current suicidal ideation/intent/plans? ___Yes   ___No —> Describe:_______________________________________

Any past suicidal ideation/attempts?  ___Yes   ___No —> Describe:________________________________________

Current homicidal ideation/intent/plans? ___Yes   ___No —> Describe:_____________________________________

Any past homicidal ideation/attempts?  ___Yes   ___No —> Describe:______________________________________

Mental Health Treatment ( _N_ )No past or present Mental Health or Behavioral problems/concerns(Skip)

Has client ever been in counseling for any emotional/behavioral issue? ___Yes   ___No

If Yes, when, where and for what? __________________________________________________________________

____________________________________________________________________________________________________________________________________________________________________________________________

Is client currently on prescribed medication for psychiatric/mental health reasons? ___Yes   ___No

If Yes, what medication(s)/dosage? __________________________________________________________________

______________________________________________________________________________________________

Has client been prescribed medication for psychiatric reasons in the past? ___Yes  ___No

If Yes, what medication(s)/dosage?  _________________________________________________________________

______________________________________________________________________________________________

What has the client found helpful in the counseling/treatment he/she has received?  (   )Not applicable

______________________________________________________________________________________________

______________________________________________________________________________________________

______________________________________________________________________________________________

Rate Client’s Response to Past Mental Health Treatment:                               #/score – ______

(1) Fully Responsive: No past Tx or past Tx successful; continued successful gains/progress w/o ongoing Tx.

(2) Significant Response: Past Tx successful, needed repeat Tx, ability to retain progress w/structure; complies w/Tx

(3) Moderate Response: Intense repeated Tx needed, min. motivation, loss of progress w/o structure, limited compliance

(4) Poor Response: Limited success even w/repeated intense Tx, unable to maintain gains even w/high structure

(5) Negligible Response: Tx response minimal in any setting, symptoms continue w/no improvement despite Tx efforts

Needs further evaluation/referral?  __Yes  __No

Client Identification Number-_____________________

BIOMEDICAL CONDITIONS

Current health?  ___Good   ___Fair   ___Poor  Please explain-______________________________________

Current/Past Medical/Dental Conditions:  _____________________________________________________________

_______________________________________________________________________________________________

_______________________________________________________________________________________________

Current/Past Medications/Supplements(what/dose/who Rx’ed):  _____________________________________________

________________________________________________________________________________________________

Allergies?  ___No  ___Yes  If ‘yes’, to what?  ___________________________________________________________

Name of client’s doctor(s): _____________________________

Name of dentist(s):____________________________

Last physical/Dr.’s visit?  ____________________________

Dentist?  ____________________________________

Any specific dental needs?  ___Yes  __ _No  ___Unknown  Describe:  ________________________________________

Do you have any hearing or vision difficulties?  ___Yes  __ _No  ___Unknown  Describe:  ________________________

Did client get immunizations as a child?     ___Yes  ___No  ___Unknown  Describe:  ________________________

Has client had any serious medical conditions/injuries?  ___Yes  _ __No  ___Unknown  Describe: __________________

_______________________________________________________________________________________________

Has client had any past hospitalizations (medical)  ? ___Yes  __ _No  ___Unknown  Describe: _____________________

________________________________________________________________________________________________

Nutrition/Eating

Client’s current height:_’ ”_______   Client’s current weight:_____Weight +/-? __Yes  __No Enough to eat? __Yes __No

Has client ever experienced any of the following? (mark all that apply)   ___Anorexia   ___Bulimia   ___Food Compulsion

Other nutritional issues/allergies-______________________________________________________________________

Does this client need a referral for further nutritional/eating assessment? ___Yes   ___No Refer to-________________

Pain Assessment __N_Not Applicable (skip to next section)

Do you have problems with pain?  ___Yes   ___No   ___Unsure

Where is the pain located?______________________________ Present for how long?___________________________

Describe any treatment received for the pain:____________________________________________________________

Needs further evaluation/referral?  __Yes  __No

Sexuality Assessment ___N/A   ___Client prefers not to discuss (skip to next section)

What is your sexual orientation?  ___hetero-sexual  ___bisexual   ___homosexual

Are you sexually active now? ___Yes   ___No                 Are you a virgin?  ___Yes   ___No   ___Unsure

Do you normally just have one partner or several? Please describe- ___________________________________________

Do you practice birth control? ___Yes   ___No   Do you practice “safe sex”?  ___Yes   ___No

Do you have any sexual difficulties, past or present?  ___Yes   ___No If ‘Yes’, please describe_____________________________________________________________________________________________________________________

HIV / STD Status Assessment ___N/A ___Client prefers not to discuss (skip to next section)

Have you ever been tested for HIV? ___Yes  ___No     Results:_______________________________________________

If you are HIV+, do you get treatment?  ___Yes  ___No  If ‘Yes’, where?  ______________________________________

Have you ever had any STDs (other than HIV)? ___Yes   ___No   ___Prefers not to discuss

Needs further evaluation/referral?  __Yes  __No

Nicotine/Caffeine:

Do you smoke cigarettes or use tobacco?  __Yes  __No  If ‘Yes”, how much/long

_____________________________

Did you ever try to quit? Results? _______________ If you do smoke, do you want to quit? __Yes  __No  __Unsure

Do you drink coffee/soda?  __Yes  __No  If ‘Yes’, how much?__________________________________________

Client Identification Number-___________________

Substance Use/Abuse/Dependence ( ___ )  No current/past Substance Use/Abuse – SKIP AHEAD to next section

Does client feel substance use is a problem?  __Yes  __No  __Unsure  Describe-_________________________

At what age did client begin drinking and/or using drugs? _______Years

What has client used in the past 30 days, if anything? (what, frequency, amount, route, how long)

________________________________________________________________________________________

Client’s Drug(s)/Substance(s) of Choice -_____________________________________________________

What else has client used in the past?

Has client ever used IV Drugs?   ___Yes   ___No  If ‘Yes’, what and how long?  __________________________

Has client ever used Methadone? ___Yes  ___No  If ‘Yes’, how long and results?  _________________________

Has the client ever experienced withdrawal? ___Yes   ___No  If ‘Yes’, what, when and how long ____________

Has the client ever had medical intervention for withdrawal/detox? ___Yes    ___No  If ‘Yes’, please describe-

__________________________________________________________________________________________

Has client ever been hospitalized or in residential treatment for substance abuse?   ___Yes    ___No

If ‘Yes’, please describe- ______________________________________________________________________

Has client ever been in individual, group or family counseling for substance abuse? ___Yes   ___No

If ‘Yes”, please describe- ______________________________________________________________________

If ‘Yes’, what has been helpful to client in past substance abuse treatment? _______________________________

___________________________________________________________________________________________

Has client had any medical problems related to substance use? ___Yes  ___No  ___Unsure  __Not applicable

Please describe- _____________________________________________________________________________

Have you ever gotten an OUI?     ___Yes    ___No    If ‘Yes’, please describe- ____________________________

What is the longest sobriety achieved? ____________________________________________________________

How does client feel about 12-Step Programs? _ _____________________________________________________

Has s/he ever been to a self-help meeting?  ___Yes  ___No  If ‘Yes’, what was it like?

Date of last meeting attended:_________________  Does client have a sponsor?  ___Yes    ___No

What does using do for you? ____________________________________________________________________

What kinds of triggers have led client to relapse or start using again? (check all that apply)-

___Stress         ___Family issues         ___Relationship issues            ___Peers/Friends         Other- __Unsure about problem________

___________________________________________________________________________________________

Is there any history of drug / alcohol abuse problems in client’s family? ___Yes   ___No   ___Not sure  If ‘Yes’,

Please describe – ____________________________________________________________________________

Does client’s feel that family history affects his/her mental health or substance use?  ___Yes  ___No   ___Not sure

Please describe – ______________________________________________________________________

____________________________________________________________________________________

Does client think his/her family should be involved in treatment? ___Yes   ___No   ___Not sure  If so, why?  __Not at this time_______

Does this client need a more in-depth Substance Abuse Evaluation? ___Yes   ___No  ___Unsure  Please describe-

___________________________________________________________________________________________

Does this client need a Substance Abuse Consultation with the Medical Director? ___Yes   ___No

Physicians Medical Orders/Notes: (  )Not applicable

___________________________________________________________________________________________

___________________________________________________________________________________________

Client Identification Number-___________________

Rate Client’s Response to Past Substance Abuse Treatment:  Score- ____

(1) Fully Responsive: No past Tx or past Tx successful; continued successful recovery w/o ongoing Tx.

(2) Significant Response: Past Tx successful, needed repeat Tx, ability to retain recovery w/structure, complies w/Tx

(3) Moderate Response: Intense repeated Tx needed, min. motivation, loss of sobriety w/o structure, limited compliance

(4) Poor Response: Limited success even w/repeated intense Tx, unable to maintain sobriety even w/high structure

(5) Negligible Response: Tx response minimal in any setting, use continues w/no improvement despite Tx efforts

Developmental History

Where and when was client born?  __________________________________________________________________

As far as client knows, was birth “normal”?  ___Yes  ___No  ___Unsure   Please describe if complications-_________

As far as client knows, has development been “normal”?  ___Yes  ___No   If No, please list any problems/delays: ____

Who has raised client? __ _______________________________________________________

Housing/Finances/Sources of Support:

Client’s current housing:   ___Street/Outdoor   ___Emergency Shelter   ___Residential Program   ___Jail/Youth Center

___Private Housing (Apartment/House)   ___Other – ____________________________________________________

Client’s rating of current housing situation?   ___Good   ___Fair   ___Poor   ___Other-_________________________

Client’s description of family’s financial status?   ___Above average   ___Average   ___Below average   Other- ______

Do your family/friends help to support you financially and otherwise?  ___Yes   ___No  Describe-_______________

Client’s rating of personal financial situation?      ___Above average   ___Average   ___Below average   Other- ______

How do you manage/handle money?   ___Well   ___Fair   ___Poorly  Please describe:  _________________________

Does client have a lot of debt?   ___Yes   ___No   If ‘Yes’, please describe- __________________________________

Who to you turn to for support?  _________________Why?  _ ________________________________________

Do you have much of a support system/network?  ___Yes   ___No  Explain-__________________________________

Physical/Environmental Barriers: ___N/A (skip to next section)

Are any of the following potential barriers between you and services/treatment?

___Transportation     ___Financial     ___Child Care     ___Emotional Health     ___Physical Health

___Language             ___School        __Not Motivated/Ready                           ___Not Voluntary

___Other- _____________________________________________________________________________________

History of Abuse/Family Violence Assessment: ___N/A  ___Client refuses (skip to next section)

Are you experiencing abuse at the present time?  ___Emotional   ___Physical   ___Sexual   ___Other – _______________

Who is perpetrating the abuse?  _____________________________   ( ___ )Declines to divulge

Have you experienced past/present abuse from a parent/caregiver?  ___Yes   ___No   Describe- _____________________

Have you experienced past/present abuse from a boy/girl-friend?    ___Yes   ___No   Describe-  _____________________

Have you experienced past/present abuse from someone else?         ___Yes   ___No   Describe-  _____________________

Have you ever witnessed family/domestic violence?  ___Yes   ___No  Please describe-  ____________________________

Have you ever abused anyone?  ___Yes   ___No   Please describe- ____________________________________________

_________________________________________________________________________________________________

Needs further evaluation/referral?  __Yes  __No

Review Client History of Abuse/Family Violence

The mandatory reporting of abuse laws in the State of Maine require that witnessed, alleged or suspected abuse,

neglect or exploitation be reported immediately.

Telephone numbers are:  Child Protective Services:  1-800-452-1999

Adult Protective Services:  1-800-624-8404

Client Identification Number-___________________

Education-

Highest-grade completed/current grade?  _____        Any likes/dislikes about school?  ____________________

Ever told you may have a learning disability?  ___Yes   ___No   If ‘Yes’, what?  ________________________

Ever receive special services at school?  ___Yes   ___No  If ‘Yes’, what?  _____________________________

Any difficulties reading/writing?  ___Yes   ___No  Describe-  _______________________________________

Educational goals – ________________________________________________________________________

Ever go to school under the influence?  ___Yes   ___No

Describe_________________________________

Employment-             ___N/A (skip to next section)

Are you currently employed/working?  ___Yes   ___No   Describe- __________________________________

Where do you work? ___________________

What do you do?    ___________________________________

How long have you worked or not worked? _______________Describe- _____________________________

Have you ever been fired?  ___Yes   ___No  Describe- ____________________________________________

Additional work experience- _________________________________________________________________

Career goal(s)- ____________________________________________________________________________

Legal-             ___N/A (skip to next section)

Are you, or have you ever been, on probation? ___Yes   ___No     If so, why? __________________________________

Probation Officer (name/number)-_______________________  Any current legal charges?  ___Yes   ___No

Please Describe- ____________________________   Have you ever been in jail/prison/youth-center? ___Yes   ___No Explain-___________________________________ Is treatment a condition of probation?  ___Yes   ___No

What is you opinion of authority/cops/law?  _____________________________________________________________

Engaged in illegal activity past/present?  ___Yes   ___No  Please describe- _____________________________________

Daily Living/Leisure/Recreation and Peer Relations:

Which of the following can client do on her/his own?  (check all that apply):

___Cook     ___Shop for food     ___Do laundry     ___Manage money     ___Contact help     ___Other- _____

Client has enough to eat?  ___Always     ___Most of the time     ___Sometimes     ___Rarely

Hobbies/Recreational Activities-  (check all that apply):

___Reading     __Eating out     ___Dating     ___Listening to music     ___Dancing     ___Cooking

___Socializing ___Movies         ___Playing     ___Shopping                  ___Trips          ___Exercising

___Spending time with family/friends     ___Other- ________________________________________________

What does client like to do in their spare time?   _________________________________________________

Does client drive a car and have a license?   ___Yes   ___No   Transportation?  _________________________

Client’s self-rating with peer group?   ___Good     ___Fair     ___Poor  Describe- _______________________

Tends to hang out with-  ___Same age     ___Older     ___Younger     ___Other- ________________________

Religion/Spirituality-

Client’s religious affiliation/background-   ___Catholic   ___Jewish   ___Protestant   ___Muslim   ___Buddhist

Other- _Atheist_______________.

Current spiritual practices-  ___Prayer   ___Meditation   ___Attending services   ___Other- ______________

___Charity work   ___12 Step work   ___None  Describe- ________________________________________

Culture/Ethnicity/Race

Client description of racial/ethnic/cultural background- __________________________________________________

Any specific ethnic/cultural practices that client follows- _________________________________________________

Primary language of client’s/family- ____________________

Does anything about ethnic or cultural background either help or hinder client in dealing with mental health or substance abuse issues?  __________________________________________________________________________________

Client Identification Number-___________________

Appearance: rClean  rDisheveled  rSoiled  rOdiferous rInappropriate

Mood: rEuthymic/”Good”rAnxious  rAngry  rAfraid   r Depressed rAshamed  rOther-_____________

Affect: rAppropriate  rInappropriate  rFlat  rLabile  rDepressed  rAnxious  rIrritable  rGrandiose

rOther-_____________________________________________________________________________

Thought Process: rClear/coherent  rBlocking  rConcrete  rLoose Associations  rTangential  rRacing thoughts rCircumstantial  rDissociation    rOther-_________________________________________________

Thought Content: rRelevant  rObsessional     rParanoid  rGrandiose  rDelusional  rSomatic

Perception: rNo distortions  rHallucinations  rAuditory  rVisual  rTactile  rOther-______________________

Memory: rIntact (long+short)  rlong term faded  rShort term faded  rLapses  rOther-___________________

Homicidal: rNo history/presence r+past ideations/intent/plan(s)  rPresent I/I/P   rOther-___________________

Suicidal: rNo history/presence r+past ideations/intent/plan(s)  rPresent I/I/P   rOther-___________________

SOCIAL BEHAVIOR ASSESSMENT (mark all that apply)

rAppropriate body language  rAppropriate self-disclosure  rCan maintain relationships  rAssertiveness

rEnjoys company of others  rAttentive listener  rPleasant speech  rPresents ideas in an articulate manner

rAppropriately groomed/clothed  rOther-___________________________________________________________

Motivation/Readiness:

Clinician’s assessment of client’s motivation/readiness -  ___High   ___Medium   ___Low

Please describe – Client is contemplating drinking problem or possible substance abuse problem_______________________________________________________________________

Are there any potential needs for Crisis Intervention Services?  ___Yes   ___No  If ‘Yes’, please describe-

______________________________________________________________________________________

______________________________________________________________________________________

CLINICAL SUMMATION/RECOMMENDATIONS

Who is client and why is s/he here_____________________________________________________________________________________________

_________________________________________________________________________________________________

_________________________________________________________________________________________________

Client Identification Number-___________________

DIAGNOSTIC IMPRESSIONS (DSM-IV-R)

AXIS I             Mental Health:                       ________________________            Code- _______________

________________________                       _______________

Substance Abuse:        ________________________               _______________

________________________               _______________

AXIS II           Personality Disorder  ________________________            Code- _______________

________________________                _______________

AXIS III          Medical Problems       ________________________                        _______________

________________________

AXIS IV          Psychosocial Issues     Code-309.9 Unspecified______________

rProblems with primary support group rRelationship Problems

rProblems related to social environment

rEducational problems rOccupational problems

rHousing problems rEconomic problems

rProblems with access to health care

rProblems with legal system

rOther psychosocial and environmental problems

AXIS V          GLOF/GAF r0-20 r20-30 r30-40 r40-50 r50-60 r60-70 r70-80 r80+

Does this client have Co-Occurring Disorders? ___Yes    ___No    _X__Need further assessment

Problems Identified – 1) _____________,  2) ______________, 3) __________________

4) ______________________,  5) _____________________, 6) __________________

What are the *Primary treatment plan goals/problems and their objectives agreed upon and identified for treatment:

*1) Goal # 1 __________________________________ Objective -__________________________________

*2) Goal # 2 –_________________________________  Objective -_________________________________

*3) Goal # 3 – __________________________________ Objective – __________________________________

*4) Goal # 4 – __________________________________ Objective – __________________________________

*5) Other -     _______________________________ Objective-_______________________________

*- These same goals/objectives are to be placed on the initial treatment plan and within the clinical notes

Potential Barriers to Treatment:       ___None     ___Transportation      ___Financial     ___Childcare

___Work    ___Physical Health     ___Emotional Health

__Not motivated/ready     ___Other responsibilities   ___Non-voluntary

Clinically Recommended Treatment Interventions

___Hospitalization (med/psych)*   ___ Hospitalization (detox)*   ___Residential (long term)(FHR)   ___Res. Rehab (short)*

___ Halfway/Transitional(22 Park)___ Partial Day Program*      ___ Intensive Outpatient Program*  ___ Medical Services*

___ Nursing Assessment*              ___ MD Psychiatric Eval.*     ___ Med. Evaluation*                     ___ Psych. Testing*

___ Educational Services*             ___ Vocational Services*        ___ Social Services*                  ___12-Step*

___ Case Management (csp/tcm)   ___ Substance Abuse Tx         ___Mental Health Tx.                      ___Adult Individual

___Child Individual                        ___Couples Therapy               ___Family Therapy                           ___Group Therapy

___Group/Psycho-Educational       ___ Outreach/Aftercare Services   ___Other- __________________________________

*Clinician needs to help facilitate this outside referral for and with client.

Program where services will be rendered:

_X__The Whale’s Heart

___The Garage

Client Identification Number-_____________________

REFERRAL PLANNING

Clinician: Review entire assessment form for indicated outside referrals and list each below

Type of Referral Needed:                  Date Made:                 Provider/Date of Appointment:

DISCHARGE PLANNING

*Preliminary Discharge Plan: How will you know client is ready for discharge, why, and what criteria met?

When client has either been medical cleared and feels they have no problem or when client gets apporiate help for possible S/A S/D

_____________________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

PLAN AND APPOINTMENTS

Client has completed this comprehensive assessment with counselor and has voluntarily agreed to engage in the  following

service(s) with assigned start/appointment times for the duration recommended:

Service Purpose                        Start/Appt. Time                 Suggested Duration

______________________________     ______________                          ___________________________     _____________

Counselor’s Signature                          Date                                              Client’s Signature                     Date

__________________________     ____________              ________________________    ___________

Supervisor’s Signature                  Date                                    Witness (if necessary) Date

Every time the earth circles the sun we get one year older – and with each chronological year the market place in the treatment industry changes several, if not dozens, of times. New technology, new strategies, new tools, and numerous other innovative strategies help us capture leads which help people get into treatment. I took this all into consideration when I was asked me to write an article about marketing and its relation to the people we try to help. In my experience, I know we are working with three categories of people: those wanting to provide help (treatment providers), and those needing the help (potential client), and then there is those actually getting the help (potential client turned action-oriented client). But where and how do we find these motivated individuals?

When I first started in the drug and alcohol treatment industry, I quickly realized that this industry was very different in many ways from your traditional business culture. I believe this difference plays a major role in saving the clients from us, the treatment professionals. In business there is always a sense of competition (capitalism). The general public may feel that based on the length of stay or therapeutic techniques that all treatment centers are the same – that they provide the same, help the same and are going for the same. When I spent some time traveling to various treatment centers, I realized this was an illusion in our field. While it may appear that all treatment centers are cookie cutters of each other, the reality is something much different. Most drug and alcohol treatment providers I have visited are very unique and have a particular niche that makes them specifically suited for certain types of clients.

When I got down to the unique differences in various treatment centers, I saw that the milieu was managed differently, the staff had a specific philosophy, the techniques were more geared towards one modality then another, the clients they treated came from one culture vs. another, and the list of unique differences could continue. I realized that it is a major mistake to make the assumption that all 30-day treatment centers are all in competition for the same type of client, or that all 90-day treatment centers are in competition for the same client. This couldn’t be further from the truth. A heterosexual married woman with four small children at home needs something very different than a 22-year-old bi-sexual male college student.

As a treatment provider, I believe marketing your program based only on a cookie-cutter length of stay is a major disservice to yourself, your company and your potential client.  It is much more effective to carve out your identity when you present your program to others – Who are you? What makes you unique? What makes your counselors unique? What makes your philosophy unique? How is your facility unique? What type of client do you work best with?  It is important to pitch the things that make your treatment center stand out in a business that is swamped with similar lengths-of-stay. I had a teacher once tell me that in recovery he has never seen anything that didn’t at least work for somebody and he has never seen anything that worked for everybody.  Carving out your identity, which is simply known as branding, will help you find those whom you can best serve and help them find you.  So stand proud of what makes the treatment provider you represent uniquely qualified to help people.  And if you don’t know what makes your facility unique and special, please find out!!   In my experience, the best way to find out what is really happening at your treatment program is to ask those clients that are actually getting the help – after all, isn’t that what this is all about?