Wolverine is a comic-book character who has violent disposition but sets the standard of a comic hero. The character possesses razor sharp claws with the ability to heal any injuries rapidly and has a skeleton reinforced with indestructible metal. The first appearance of this character was made in The Incredible Hulk (1974). However Wolverine (1982), the aspect of the character was further explored, a much-lauded miniseries drafted by Frank Miller and Claremont (Lopes, 2009). The analogy series Marvel Comic Presents that debuted in 1988 furthered the character when it featured a Wolverine serialized story in almost every issue. The well known of all these "Weapon X" showed in 1991 illustrated the experiments that Wolverine's skeleton was covered with adamantium. Throughout the 90s and early 21st century, details about Wolverines past were unveiled ad it became increasingly apparent that the character was older than it was considered to be. It was uncovered that he managed to fight alongside Captain America and others but he that was not the case because he seems much older than that. The full back-story of the character was finally reflected in Origin (2001) miniseries.
Wolverine was born James Howlett to a well-off family in Canada-Alberta. With an entirely withdrawn mother and a busy dad, James largely cared for by Rose -a red haired girl and a hired playmate. After the grounds groundskeeper of the family killed his dad, claws that seemed bone protruded from the hands of young James for the very first time and he fatally used them in stabbing the groundskeeper a man later identified as the real father of James. These chains of events ultimately brought about the suicide of her mother. Rose adopted James as his own son and took him to a mining colony to live there and renamed him, Logan. In relation to this character, a comprehensive assessment serves as the basis for identifying a diagnosis and developing a case conceptualization and treatment targets. Three approaches to such an assessment are diagnostic, theory-based, and pattern based (Barling et al., 1992). An assessment is likely to be more complete or comprehensive if it includes at least two approaches.
Comprehensive Assessment Process
Structured Interview Protocol
Orientation and Consciousness
The client can view the orientation question as offensive. He can feel belittled by having to answer these simple questions. When cognitively impaired the client will act indignant, perhaps from embarrassment or for covering his disorientation (Hjermstad et al., 2011). It will help when the client is informed that orientation questions are routine. The first step will be mental status examination where my client will provide details about himself, the ongoing situation, place and time. The orientation will begin with simple questions. The following questions will be used in combination with more chatty questions and statements to assess the orientation.
What is your full name? Where are you from?
Where do you currently live?
Are you employed? (If so) What do you do for a living?
Are you married? (If so) What is your spouses name?
Do you have any children?
There has been a lot happening these past few days; I Wonder if you can describe for me where you are?
What city are we in?
Whats the name of the building were in right now?
Whats todays date? (In case my client will claim not to remember, I will ask for an estimate: estimates can assist in knowing his levels of disorientation)
Are you aware of todays week?
What month is it?
How long have you been here?
Do you know why we are here?
Whats your best guess as to what we will be doing next?
Consciousness As an examiner I will observe the client's response and behavior during the interview and select a descriptor of consciousness this often elevates form alert to comatose. Even though consciousness and orientation are related, they are not the same. These include: Alert, Confused, Unconscious, Stuporous, Clouded, and Comatose
Reliability, Judgment, and Insight
Reliability will depend on with the client's trustworthiness and credibility.
The client's judgment will be revealed through exploration of activates and vocal choices. The client will participate in providing details of his life- threatening activities or choices.
What does the saying mean: People who live in glass houses shouldnt throw stones?
Whats your most memorable experience with Oirgin (2001) miniseries?
Informal Assessment Tools or Methods
Informal assessment often involves less structure and questions are asked that the interviewer believes relevant at that time. Flanagan (2002) states that the formal interview has advantages over the informal interview as the tools are structured interview plans mean that people are assessed in more or less the same way. Information about the client will be found in two ways: 1) he will provide them or 2) it will be retrieved from family members through an interview. The assessment techniques recommended by Flanagan include; direct observation, questionnaires, and rating scales. Tools such as observations, interviews, interest inventories, preference questionnaires and self-assessment may be employed in the process of consultation on the ongoing diagnostic assessment. Other informal examinations and structural diagrams are present. Conducive to the less structured environment, informal assessment is highly subjective in interpretation (Melone, 1990). They provide the assessor with the opportunity to collect more comprehensive information.
The CBT-based assessment can also be used as a valuable strategy as well. This type of theoretically based assessment will focus on the questions such as "What particular thoughts reminds you of your father? What feeling did you have when u learned that your mother had committed suicide?" Such theory based information is essential for developing a CTB-base conceptualization. The questions lead to clients specific emotional and behavior problems. The main aim of employing CTB-base assessment is to inquire more eliciting story of recurrent maladaptive interpersonal patterns that reflect dysfunctional mental working model (Ellis & Langhorne, 2005). The CBT based assessment is a systematic approach that is solution focused and primarily provides a solution for therapy. The question it often presented in prose format such as "What have you tried? How did you do that? Exactly what did you say? Did it work?"
Figure 1: Assessment Consideration Approaches for the Client
Approach Focal Consideration
Dynamic Re-enactment of past present; unconscious conflicts and defense mechanism; Clinical maladaptive patterns
Cognitive behavioural Automatic thoughts: distorted beliefs; core maladaptive schemas; maladaptive behaviors and faulty learning
Integrative Personality dynamics and systematic dynamic, family constellation and other indicators
Standardized Assessment Tools
Questionnaires and rating scales
Questionnaires and rating scales are designed to provide specific information on some aspect of a client's functioning. Questionnaires can be completed by the client or as part of the interview process. Other questionnaires require only a yes or a no answer to gain a score on particular aspects of functioning (McDowell, 2006). With rating scales, the client is asked to rate the severity of the problem or their performance, or to indicate the extent to which they agree or disagree with a statement. Rating scales can assess patterns of behavior and measure belief, attitudes and values. Rating scales end with several scores. The score reflects the extent to which some emotions are felt; some behaviors are performed, and some thoughts are experienced (Fillenbaum & Smyer, 1981). Appropriate assessment targets and simple observation methods are important for the client to remain engaged in the process of self-monitoring. Barker advises that creative personalized ways of self-monitoring are important in ensuring that the person engages in this process.
Essentially, the assessment process involves gathering and then interpreting the provided information. Alternative assessments improve client capabilities and leave room for self-development. Interviews are particularly effective because of they are semi structure. In a semis structure interview, the client is asked exploratory questions on various topics. Other questions arise out of the answers they provide. The interview is orderly without being regimented and provides latitude to follow paths without losing the flow of the interview. Using other tools such as observations, interesting inventories, preference questionnaires and self-assessment in the process of consultation on the ongoing diagnostic assessment, assists in engaging the client during the proves of assessment.
Lopes, P. (2009). Demanding respect: The evolution of the American comic book. Temple University Press.
Barling, J., Fullagar, C., & Kelloway, E. K. (1992). The union and its members: A psychological approach. Oxford University Press.
Flanagan, D. P. (Ed.). (2002). The achievement test desk reference (ATDR): Comprehensive assessment and learning disabilities. Allyn & Bacon.
Ellis, G., & Langhorne, P. (2005). Comprehensive geriatric assessment for older hospital patients. British medical bulletin, 71(1), 45-59.
Melone, N. P. (1990). A theoretical assessment of the user-satisfaction construct in information systems research. Management science, 36(1), 76-91.
McDowell, I. (2006). Measuring health: a guide to rating scales and questionnaires. Oxford university press.
Fillenbaum, G. G., & Smyer, M. A. (1981). The development, validity, and reliability of the OARS multidimensional functional assessment questionnaire. Journal of gerontology, 36(4), 428-434.
Hjermstad, M. J., Fayers, P. M., Haugen, D. F., Caraceni, A., Hanks, G. W., Loge, J. H., ... & European Palliative Care Research Collaborative (EPCRC. (2011). Studies comparing Numerical Rating Scales, Verbal Rating Scales, and Visual Analogue Scales for assessment of pain intensity in adults: a systematic literature review. Journal of pain and symptom management,41(6), 1073-1093.
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