2-Com: Plain Language toward Destigmatization

View all ForumsBack to Lesson

Home – NEW Forums Module 3 – Assessment of Early Psychosis Fall 2023 2-Com: Plain Language toward Destigmatization

Viewing 5 reply threads
  • Author
    • #10925

      Hi, I’m Holly, a counselor (MSW, RSW) with EPI. I have not used the 2-COM prior to this EPI course.

      The 2-Com tool reminds me of a tool Foundry Abbotsford uses when youth approach the front desk. Clients point with their finger which services they wish to access, rather than verbally stating aloud “I’m here for an STI check up”. I believe is aligned with trauma-informed practice. Some of the questions we ask clients are difficult to talk about. For example, I had a first session with a new client today. He is in his late 20’s, from Somalia, was in a refugee camp for 8 years in Jordan, and grew up with the belief that mental health challenges were a result of doing something bad. There is a lot of stigma around mental health and seeking support in his culture. I appreciate how the 2-COM uses plain language to identify what mental health and role functioning challenges may be at play. “Do you find it difficult to ‘get going’ or be energetic?” seems like a more approachable question for a client such as the one I identified above. I also appreciate that it allows clinicians to get a glimpse into someone’s inner life and challenges, while still allowing them the autonomy to choose what information they wish to share / elaborate / seek support around.

    • #10972

      Thanks for sharing holly, I really like the tool Foundry uses. I was discussing with a coworker the other day how we could make it easier for client to access harm reduction tools without verbally having to ask for them while in the waiting room, I am going to share this idea with them. This is a good way to maintain privacy and the safe container.

      I also found the plain language to be a good additions in the assessment tool as this type of language is accessible to most and is not as deeply rooted in the western medical field as most of the language we use is.

    • #11145

      I agree, I usually use the 2 com worksheet when I first meet with clients. I find it helpful to establish a baseline where clients are at, with the goal to be able to compare this at a later date and see if the challenges still persist for clients or things have improved. I also agree with the plain language it utilizes to discuss client’s personal experience with yes or no questions. Clients have been receptive thus far completing it, some clients can be a bit more guarded and reserved, so discussing the topics in a paced manner is often beneficial.

    • #11202

      I agree that the 2-Com tool is a tool that can be used to empower clients and assist in breaking down the power imbalance that exists between clients and practitioners. In addition to the above points of safeguarding privacy and being trauma informed, I can see the utility of this tool to promote autonomy and self-determination in a client’s care. By allowing the client to self ID which areas they are feeling the impacts of their symptoms or psychosocial stressors can better guide the interventions and interactions we have with folks. It is empowering for clients to preemptively be able to say what they do and do not want to talk about, provided we as clinicians are committed to respecting that. This will help build trust and rapport within the theraputic relationship and therefore allow us to provide better care and support.

    • #11203

      Hi Holly,
      I would definitely agree that this tool aligns well with trauma-informed practice. It provides so much choice and autonomy for clients in an easy to use and non-intimidating way. I very much appreciate the plain language but also the way in which they can identify an issue but table it for a later discussion. It allows them to let us know about an issue but also identify that it isn’t yet the right time to explore it. This practice develops a sense of respect.
      Lately, I’ve been working with a client who has many very pressing needs and she can be quite tangential. I have started working with her to create an agenda for our meetings and work together to stick to it, otherwise she brings a number of new issues to each session that take over our time and we end up missing items that we had hoped to cover. While I have not used the 2-Com tool yet, I can see how it could be helpful for clients like her, who may present with so many complex needs that preparing for and scheduling time for each topic ensures we can make the best use of our time. I intend to use this for her specifically as we work on addressing her basic needs, but she can perhaps complete this independently to identify any mental health issues that have changed/arisen.

    • #11217

      I am on an ACT team rather than an EPI team, and I have not used the 2 COM before. That being said, after looking at it I really like the list of things for clients to consider as going well or not, but the part that really speaks to me is the section that asks “do you want to talk about it.” As a caseworker it can be easy (for me at least) to forget that ask such intrusive questions so often. Giving clients the opportunity to tell us they don’t want to talk about something I think is so important, and I would argue helps give the client more autonomy in their own care. While we won’t be using this assessment tool on my team, I will definitely try to incorporate the option of not talking about a topic at the client’s discretion.

      • #11399

        Hi, I work on an ICMT team vs ACT, so I’ve not used 2-COM before either. I think we likely share some similar experiences with trying to use assessment tools like 2-COM. Even though 2-COM is more straightforward and plain-languaged than others, we often don’t get a chance to go through the list of questions during our brief engagements with clients (sometimes just 3-4 minutes before they shut the door on us). For our clients who use substances and experience homelessness/housing precarity, it’s difficulty to imagine getting more than 3-4 questions in sometimes. More over, folks who use stimulants in particular often seemed to be sensitized to common questions and phrasing alluding to or trying to assess postive symptoms of psychosis. While not de-stigmatized, the language of psychosis is definitely more prevalent now, and often taken out of their clinical context and meaning. I often finding myself focusing on asking clients (1) “what are your four immediate prioriities/goals” and (2) asking for subjective qualitative changes to their everyday between now and the previous engagement as the client’s basic needs are often not met.

Viewing 5 reply threads
  • You must be logged in to reply to this topic.