Mental state exam for youth workers: Mood and Affect.

Posted on May 2, 2013May 26, 2020 by Aaron Garth

So far in this series we have been developing an understanding of the core components of a mental state exam. So far we have discussed how a young persons appearance, behaviour, speech and language can provide indicators as to their mental state. Today we discuss how a young persons mood and affect can provide insight into their current mental health status.

Mood

Mood is described using a young person’s own words. Happy, sad, angry, elated, anxious or apathetic. Many young people may be unable to describe their subjective mood state. Throughout my career I have seen a marked decrease in emotional intelligence in our society. It may take some work to flesh out how a young person feels. There are a number of resources to help young people to articulate their emotions, my personal favourites are mood dudes and the stones. In essence Mood is how young people see themselves in their own opinion.

Emotional intelligence in a squeeze ball

The key to remember about mood is that it is subjective. The young person is the master of their own emotional state. Only they truly know what is going on inside.

Affect

Affect is noted by us when we observe the apparent emotion conveyed by the person’s nonverbal behaviour. Affect may be described as appropriate or inappropriate behaviour to the current situation, and as congruent or incongruent with their thought content. For example, a young person who shows a neutral affect when describing a very distressing experience such as family violence would be described as showing incongruent affect, which might suggest PTSD. The intensity of the young persons affect may be conveyed as normal, blunted, exaggerated, flat, heightened or overly dramatic.

A flat or blunted affect can be associated with schizophrenia, depression or post-traumatic stress disorder. Heightened affect might suggest mania, excitement or anxiety and an overly dramatic or exaggerated affect might suggest certain personality disorders. A young person may show a full range of affect, or a wide range of emotional expression during your assessment. They may move from heightened to blunted or they may only show a single affect.

The key to remember about affect is that it is objective. It is what you observe about a young person. The key here is to be clear about what you are observing and why you believe it means what you believe. For example, “Aaron appeared sad. He spoke slowly, kept eye contact on the ground and cried“.

Stay tuned next week as we discuss part five: Thought process and content.

Aaron Garth

Aaron Garth is the Executive Director of Ultimate Youth Worker. Aaron has worked as a youth worker in a number of settings including local church, street drug and alcohol outreach, family services, residential care, local government and youth homelessness since 2003. Aaron is a regular speaker at camps, retreats, & youth work training events and is a dedicated to seeing a more professional youth sector in Australia. Aaron is a graduate of RMIT University and an alumnus of their youth work program. He lives in Melbourne with his wife Jennifer & their daughters Hope, Zoe, Esther, Niamh and son Ezra.

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Mental State Exam for youth workers: Behaviour.

Posted on April 5, 2013May 26, 2020 by Aaron Garth

“Oh Behave!” Austin Powers knew all to well that we toe a fine line as humans when it comes to ‘normal’ human behaviour. When we are doing a mental state exam we are observing the fine line between what our clinical brothers and sisters would call ‘normal’ and ‘abnormal’. Behaviour is an interesting phenomenon for youth workers to observe. It requires us to use our powers of observation and our own self reflection (apparently youth workers can be a little abnormal!) to determine whether a person is doing alright. We need to observe whether the young person is acting in a similar way to how they act most of the time or differently. Whether they are acting similar to their peers or completely different. Behaviour requires us to have an understanding of normal behaviour and abnormal behaviour.

Normal day or abnormal behaviour?

Movements

Tremors, shakes, tics, involuntary movements may indicate a neurological disorder, or they could be the side effects of antipsychotic medication, schizophrenia or drug abuse. If your young person is showing these types of movements it may be normal for them or it might be abnormal. It may be something serious like a neurological disorder or it may just be the effects of the drugs they have used. Your ability to observe this behaviour and refer them out to more specialised support will be key.

This also goes if they are hyperactive, rocking, gesturing wildly, fidgeting or unable to sit still. This may mean they are delirious or manic, or it might just mean they are excited or full of beans. Only your keen observation of their movements and your deep relationship will tell you if something is out of the ordinary or ‘abnormal’.

Level of activity and arousal

A persons level of activity and arousal may also provide insight into their mental state. Are they hyperactive (high action) or lethargic (low action)? An increase in arousal and movement (hyperactivity) which might reflect mania or delirium. An inability to sit still might represent akathisia, a side effect of antipsychotic medication. Similarly a decrease in arousal and movement (akinesia or stupor) might indicate depression or a medical condition such as dementia or delirium.

Of course if you are over aroused and hyperactive you may just be having a birthday, bar mitzvah or a wedding. You may be on a camp and really excited. If your young people are lethargic it may just be the last day of camp, the end of a boring group session or a distressing break-up with a cherished boyfriend. Your keen understanding of your young people will help you to know whether or not it was the red cordial or sad movie that is making your young person behave differently or whether it is something else more insidious.

Eye contact

The eyes are the window to the soul they say, and never more so was this true than whilst doing a mental state exam. Does your young person make good eye contact with the floor? Can they look you in the eye? What happens when they are telling you porky pies??? A persons eye contact can say a lot about their mental state. It can tell you if they are lying. It can tell you if they are psychopathic. It can tell you if they are nervous, sad or depressed. Eye contact is one of the most important behavioural signposts for us as youth workers.

There are of course some caveats to this. If your young persons culture frowns on eye contact for example the aboriginal population in Australia. A young person will not make too much eye contact with an adult out of respect. A young person with eye issues such as having a lazy eye may not seem to be making good eye contact, but it may just be your view.

There is a danger

Behaviour is difficult to observe objectively. Not Impossible, but difficult. Most of us observe others behaviour subjectively. We watch through the lens of what we find appropriate. In some cases this is not an issue. We see someone hit their child with a lump of wood, or a person overdosing or a young person in a relationship with a 40 year old and our observation is that this is abnormal. For the most part this is right. When we start to look at others behaviour we must think about what they are thinking when they do this. Most of us do not behave inappropriately on purpose… too often anyway. There is also a number of theories from a number of very noted behavioural theorists that can help us determine whether a person is normal or abnormal.

Aside from the clear observable issues like shakes, poor eye contact or hyperactivity some peoples behaviour can just be different to us. One of the best way we know of to observe and relate to a person on a behavioural level is DISC. Disc is a quadrant based behavioural analysis tool which can help you to determine if another person is nuts or just in a different quadrant than you. Since doing some training in DISC and using this to view peoples behaviour I have found that my mental state exams (as well as my general observations) have become more clear.

PS. If you observe something that seems out of the ordinary, try to explain what it is. For example, ‘John seemed depressed’, will not get you much help from a clinician. However, if you say, ‘John seemed depressed as he was making poor eye contact, was mumbling and wouldn’t finish sentences’, then you are more likely to elicit a response from clinicians.

We hope this helps. See you next week for part three, Speech.

Aaron Garth

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Observe the C in DISC for youth worker’s

Posted on November 15, 2012May 26, 2020 by Aaron Garth

Over the last five weeks we have looked into the best tool we know of to help people build relationships with people the DISC behavioural profile. So far we have looked at three of the quadrents DOMINANCE, INFLUENCE and STEADINESS. This week in our ‘Thursday Think Tank’ we continue with the final quadrant in the profile and an overview of the CONSCIENTIOUSNESS behavioural style. People with this style are usually reserved and task focused.

Mr and Mrs facts and figures. People with high CONSCIENTIOUSNESS in the group are the epitome of dot your I’s and cross your T’s. They are slow to speak but when they do it is meticulous and ordered. They focus on task and process. They respect people who are precise and accurate. They often have a sterile work space. They are time conscious but not restrained by it. They are hard to read when it comes to body language and above all else want to be right! If these guys were a slogan they would be HTC: quietly briliant.

A person with a high level of CONSCIENTIOUSNESS in their profile is a rule follower. If there isn’t a rule they want one created. These people are usually polite and diplomatic. They will often communicate in writing over face-to-face. They do not focus on big picture but get down in the weeds, the detail. No abstracts or opinions here, They only discuss the facts. A high C can often get stuck in the old ways of doing things and systems of old and would rarely act without a precedent.

A high level of CONSCIENTIOUSNESS can lead to giving in to avoid conflict. They can be slow to act and do not see the forrest for the trees. They see the problems and can be critical of others. To make a decision these guys need every piece of information and every avenue of thought to be addressed… even then if there is any risk they may not act. They are thorough and persistent. They are matter-of-fact which can come accross as abrasive.

Here are our top seven tips for working with people with CONSCIENTIOUSNESS behavioural traits:

Give clear expectations and deadlines: If you want a decision tell them that. Be clear about the time frame too. Don’t extend your timeline be clear that a decision needs to be made and when you want it done by.

Show dependability: Let them know that you depend on their work and that they can depend on you to support them.

Show loyalty: Back them whereevr you can. These guys don’t like conflict so will not argue with you if you go against them, they will just withdraw. If you can, Show them you are on their side.

Be tactful and reserved: Even if you are going to go with another idea be supportive of them. They are not party animals so tone it down and focus on their knowledge and expertise.

Honour precedents: If something has worked in the past and they bring it to your attention try to run with their idea. If there is a rule in place, even if it is unwritten, be aware and open to following it.

Be precise and focused: this is similar to number one, however is more about how to do it. Do not leave any ambiguity. Be clear consice and if necesary say it twice. Set SMART goals and require them to report on their actions. Send your request in an email… they’ll love it.

Value high standards: These guys expect perfection and then attempt to deliver it. When they want to have it perfect but you have a short timeframe express your thanks for their standards but explain the need for brevity. Hold it in high regard. Praise them for their effort. Let them know you still expect the highest possible quality within the timeframe.

Some well known high CONSCIENTIOUSNESS behaviour holders you may know and have seen.

Colin Powell

Mr. Spock

Bill Gates

Kevin Rudd

Fred Hollows

James May

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Aaron Garth

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Observe the S in DISC for youth worker’s

Posted on November 8, 2012May 26, 2020 by Aaron Garth

Over the past few weeks we have been looking at the DISC behavioural profile and its use for youth worker’s in developing relationships and networks. So far we have discussed the EXTRAVERTS of the group and we continue on with the PEOPLE focused groups today. This week in our Thursday Think Tank we continue with the third quadrant in the profile and an overview of the STEADINESS behavioural style.

STEADINESS is the nurturer of the bunch. The motherly figure. The thrive on small talk. They are the first people to ask you how you are going. They prefer to ask rather than tell. They love to listen rather than talking. They are the slow steady deliverers. Those that have a STEADINESS profile are often reserved and speak with a lower volume. These people will use first names and speak with a warmth that is genuine. STEADINESS behaviours tend to prefer speaking one-on-one rather than to a group. They speak calmly and methodically and are often seen as the steady ship when all around is chaos because they proceed carefully. These people often have photo’s all over their desk, are embarassed when praised but are the first to celebrate others and seem to be everyones friend. On the negative side they are often resistant to change, have difficulty prioritising tasks and sticking to deadlines. They struggle with systems and struggle with presentations and believing that their part in the grand scheme really is worthwhile. If these guys were a slogan they would be Optus: We hear you.

A person with a high level of STEADINESS in their profile speak rarely. They want to check on how a decision will affect others and are slow to impliment tasks particularlly if there is not a precedent. These folk are all about the story…all 18 volumes of it. They want to be part of the team and let everyone have a say. The saying you have two ears and one mouth so listen more than you speak was written by a high S. When they do speak though it is at a hundred miles an hour…they have a lot of ground to cover and not much time to do it.

It is hard to get a rise out of a high S. They epitomise the ostrich sticking their head in the sand. They shy away from any conflict as it goes against everything they stand for…Status quo and friends for all. They will rarely fight back, but if they do it is usually over the notions of justice and fairness. When they do fight back it is usually a quick explosion of how unfair an idea is and that as a person you are unfair because of your decision. It is also over as quick as they can make it happen as they want to get back to the way things were. Remember they are people persons.

Here are our top five tips for working with people with STEADINESS behavioural traits:

Be logical and systematic: These guys struggle with priorities and systems but they need to have a plan of action, otherwise they would spend all day around the watercooler or at a cafe chatting about your life. set clear boundaries and timelines for task completion.
Provide a secure environment: They do not like change! Make their environment as predictable as you can. Do not ask them to change thier password, move desks, do a rush presentation or lead a project that needs a quick resolution. Make them feel safe.
Tell them about change early: If there needs to be a change, pre-wire them early. Give them a heads up. Provide time for them to become comfortable with the idea of change. Walk them through it step by step and address their concerns.
Show how they’re important: If they do something great. Minimise your appreciation in public and be as sincere as possible in private. They struggle to feel their work is important so explain how they have made a difference.
Teach them shortcuts: If you let them run the show it will take two days to make a cup of coffee! The conversations will take up all their time. They want consensus and a clear picture of everything that needs to be done. The key thought here is do not make the perfect the enemy of the good.

Some well known high STEADINESS behaviour holders you may know and have seen.

Michelle Obama

Ghandi

Pope John Paul

Grant Hackett (Australian Swimmer)

Mother Teresa

Aaron Garth

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Observe the I in DISC for youth worker’s

Posted on November 1, 2012May 26, 2020 by Aaron Garth

Last Thursday we began a looking at the individual quadrants within the DISC behavioural profiling system with “Observe the D in DISC for youth worker’s“. We are half way through our overview series and hope that you have been able torecognise some DOMINANCE behavioural styles in those around you. In this blog we continue the series with an overview of the INFLUENCE behavioural style.

One of the most exciting behavioural style to be around (and it is my secondary behavioural style) is that of INFLUENCE. The social butterfly or life of the party, people with thisbehavioural type often have large networks and seem to draw people to themselves. They are talkative, they over communicate, are born performers, are style setters, in teams they are the idea generators and they are very quick-witted. They are the most enthusiastic and active people you will ever meet and develop relationships quickly. They are fast starters and begin project with gusto. All of these positive adjectives are often linked to a person who is exhibiting a INFLUENCEbehavioural trait. On the other hand you have probably seen their negative behaviours as well. They work off intuition without reason. They can be highly emotional. They are sporadic and scattered. They start fast but rarely finish. They have too many projects on the go. If they were a slogan they would be Nokia: Connecting People.

A person with a high level of INFLUENCE in their behaviour speaks in a way that about 75% of us struggle to keep up with. They sell ideas with an inspiring style. They talk a lot at the 50,000 foot view but struggle to get down in the grass. They avoid bringing up difficult subjects but give good constructive feedback. They enjoy interaction and focus on the feelings of their subject intently. They get enthusiastically involved in discussions and often talk too much. They may not assess what is being said and can loseconcentration and get sidetracked easily. They speak in stories and anecdotes often from personal experience. They are prone to exaggeration and when excited they speak really fast and approachyou closely using lots of facial expression.

Most of us struggle to get a word in edgeways with a High I and we are confronted at the speed and tangential thinking present in their conversation… but we do enjoy their conversation. They do respect a smile, a pat on the back and seven conversations at once. So how do we work with these people when their excitement is off the charts and you are not really sure which conversation you are having with them?

Here are our top six tips for working with people with INFLUENCE behaviour traits:

Approach them informally. These guys and girls hate feeling constrained. A meeting in an office with suits and ties and a policy document may just make them explode. A brief chat on the way to lunch or even a confab at their desk is the best way to get them on side. Do not start with facts and stats or a policy document it will make them throw a toddler tantrum.
Be relaxed and sociable. Even if you need to pull them into line be chilled out. These guys take their reputation seriously and if you are not sociable they will take it as a sign that you hate them.
Let them tell you how they feel and how awesome they are. Yes the sun doth shine from their backside and you would do well to acknowledge this with a hearty nod of the head. They are the centre of attention and you are a tool for propping up their ego. Whilst they care about people it is hard to notice them through their haze of awesomeness.
Keep the conversation light. Remember, they are up there in the clouds in the land of big dreams. It is a place where balloons pop very easily. You want to be a fluffy cloud and sharp grass. Details are the enemy. There is no pressure here. It should be like a trip to Tahiti.
Provide written details to focus their attention. As those with INFLUENCE behaviours can be flighty and forgetful write things down and get them to take notes. It also helps when they begin to go on a tangent if their KPI’s are written down as you can steer them back on course.
Use humour. Everything has a funny side… even paperwork!!! Try to lighten the mood by making a joke or finding a humourous take on the situation. If all else fails steal a Robin Williams skit. It will diffuse any tension and let them see you have a pulse.

Here are just a few people you might have seen on a TV that have INFLUENCE in their behavioural style.

Bill Clinton

Oprah Winfrey

Richard Branson

Dolly Parton

Robin Williams

Shane Warne (Cricketer)

Hamish Blake (Australian TV and Radio Personality)

Han Solo

Ellen DeGeneres

Leave us a comment below or post a comment on facebook and twitter.

Aaron Garth

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Observe the D in DISC for youth worker’s

Posted on October 25, 2012May 26, 2020 by Aaron Garth

Last Thursday we began a Series looking at the DISC behavioural profiling system and discussed how DISC can help us to develop a behavioural lens to inform how we work with young people, our colleagues and other networks. Using the lens of DISC will help you understand peoples strengths and weaknesses, how to speak to them in a way that they will understand and warm to. This week we continue the series with an overview of the DOMINANCE behavioural style.

We are going to start with DOMINANCE as it is probably the easiest behaviour to spot (and it is my dominant behavioural style). You know the type. The jerk, the sore loser, Mrs self-centred, the poor listener, the steam roller, the irritated one or perhaps even Mr opinionated. All of these negative adjectives are often linked to a person who is exhibiting a DOMINANCEbehavioural trait. On the other hand you have probably seen their positive behaviours as well. They are the determined people, the strong willed, they get results when others struggle, they are fast thinker and even faster talkers, they take risks and get rewards. THEY GET THINGS DONE. If they were a slogan they would be Nike: just do it.

A person with a high level of DOMINANCE in their behaviour will often speak in a way that about three quarters of the population struggle with. They tell rather than ask. They talk more than they listen. They may be seen as pushy or even rude. They don’t beat around the bush and seek quick communication. They speak with an authoritative tone of control to assert their POWER over the situation. They are direct and forceful in their communication and impatient with pleasantries and meaningless pomp. They are focused on task and expect results. They are willing to get into trouble if it means getting thing things done in a timely fashion. People who have a dominance streak can rely on gut feelings over data and to many they are seen as mavericks.

Many people are scared of a confrontation with a high D. But that is the best way to deal with one. High D’s are blunt and demanding, they lack sensitivity, empathy and care even less about social interaction… They respect people who show the same qualities. So how do we work with these people when they seem so entrenched???

Here are our top seven tips for working with people with DOMINANCE behaviour traits:

Communicate briefly and as to the point as you can. If you are writing an email and its more than four sentences kill it or cut it down. If you call them and it lasts much more than a minute they will start to wrap it up. If you are chatting with them… Ha Ha I made a funny. They would never chat.

Respect their need for independence. Do not impose upon them unnecessarily. Use your role power sparingly if you have it and if you don’t have any then only stand up against them when it is absolutely required.

Be clear about rules and expectations. Whether in a team meeting or a group be clear about what is and is not allowed. Be unmistakable about the outcomes expected and how to achieve them.

Let them take the lead. They usually have innate leadership ability so where possible let them have it. They will probably try to take it anyway.

Show your competence. High D’s respect clarity and results. If you stuff around and then do not achieve you are painting a sign on your back. Do your tasks, lead the group whatever you do; do it to the best of your ability.

Stick to the topic. One thought at a time and if possible no sub points. Do not go off on tangents and for the love of God do not do a Grandpa Simpson.

Show independence. Stand up for what you believe and do not be afraid to express your opinion. Be more forceful. You will think you are arguing. They will think that they are finally having a worthy conversation.

Here are just a few people you might have seen on a tv that have DOMINANCE in their behavioural style.

Donald Trump

Hillary Clinton

General Patton

Margaret Thatcher

Kerry Packer (Australian Businessman)

Russell Crowe (Actor)

Leave us a comment below or post a comment on facebook and twitter.

Aaron Garth

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Behavioural observation is the key to best practice youth work.

Posted on October 18, 2012May 26, 2020 by Aaron Garth

A few weeks ago we stated that we would look at how to develop a behavioural lensto inform how you work with young people and colleagues. A lens that will help you understand peoples strengths and weaknesses, how to speak to them in a way that will help you develop your relationship with them and ultimately strengthen your work with everyone you come across. This week we show you the framework.

A while ago I interviewed for a managementposition. One of my interviewers was someone that if I got the role I would supervise. In the interview I was able to answer the questions and got along well with two of the three interviewers. The third interviewer was a blank slate. I couldn’t read him at all. The worst part was that he was going to be my direct. I was freaking out and needed a way to break through their blank persona.

A few years earlier I was managing a youth drug andalcohol rehab. I had a young person come to us straight from jail with a personality bigger than Ben Hur. Everyone thought he was great, the life of the party. He was a lot of fun to work with, but he was also really frustrating. He never followed through on anything!!!

These are just two people and a snapshot of their behaviour, but I am sure you can all imagine people like this that you have come across. Before I was shown this simple but most important framework people showing these behaviours were extremely difficult for me to understand or work with. Afterwards, with a little work, I have become a better judge of character and supportive youth worker.

DISC

DISC is a quadrant behavioral model based on the work of Dr. William Moulton Marston (1893–1947) to examine the behavior of individuals in their environment or within a specific situation (otherwise known as environment). It therefore focuses on the styles and preferences of such behaviour. For most, these types are seen in shades of grey rather than black or white, and within that, there is an interplay of behaviors, otherwise known as blends. The determination of such blends starts with the primary (or stronger) type, followed by the secondary (or lesser) type, although all contribute more than just purely the strength of that “signal”. Having understood the differences between these blends makes it possible to integrate individual team members with less troubleshooting. In a typical team, there are varying degrees of compatibility, not just toward tasks but interpersonal relationships as well. However, when they are identified, energy can be spent on refining the results.

The four behavioural types are Dominance, Influence, Steadiness and Conscientiousness.

Those with Dominance and Influence behavioural types are more ASSERTIVE.

Those with Steadiness and Conscientiousness behavioural types are more RESERVED.

Those with Influence and Steadiness behavioural types are more PEOPLE focused.

Those with Dominance and Conscientiousness behavioural types are more TASK focused.

This graphic illustrates this more effectively.

Over the coming ‘Thursday Think Tanks’ we will delve more into these behavioural types and how they can help you to develop your emotional intelligence and practical wisdom.

In the meantime Stay Frosty!!!

Aaron Garth

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