Pitfalls for Multidisciplinary Teams

Please read assignment carefully I have attached the things you need for the assignment. There are many reasons why an individual human services professional or a helping team might hesitate to follow the five steps of the multidisciplinary approach and go straight to solving the problem. The passion to help can generate energy and enthusiasm to reach the final outcome thus making it easy to be carried away, even to lose focus. When the multidisciplinary process is followed, the team is providing effective and meaningful solutions leading to a much more powerful form of helping. When the multidisciplinary approach is not followed, hasty outcomes and solutions can be misdirected or ineffective as the problem is never truly addressed. Helping professionals and helping teams need to be aware of the pitfalls that may interfere with this effectiveness. Some of the most common pitfalls include: Moving too quickly.Assuming that everyone thinks the way you do.Fearing (and therefore avoiding) potential conflicts.Wanting to be right.Failing to understand and identify the true problem. Based on the readings in this course so far, and what you observed in the Riverbend City: Multidisciplinary Approach Demonstration Mission, focus on approaches and behaviors that you think have the greatest chance to prevent you or a team from being sidetracked. For your initial post in this discussion, analyze and explain your thoughts about the pitfalls that are present when working to apply all five steps of the multidisciplinary approach. In your post include the following: What do you feel is the most important pitfall to recognize and why? What impact does this pitfall have on the process?Based on your understanding of yourself, where do you see your biggest challenge? How will you go about addressing this challenge?Describe an example you have observed of a pitfall in action. What was the outcome and what impact did this pitfall have?


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Expository Text
A multidisciplinary approach is crucial to providing ethical leadership in a variety of situations. In this
mission, human services professionals work with medical and mental health professionals as well as the
legal system to meet the needs of a young woman who is in critical need of help.
Stacy Nixon is the governor’s daughter and has just been admitted to Riverbend City Medical Center for
injuries sustained when she crashed her motor scooter. As you move through the mission, you will see
HS leaders engaging in the four main skills needed for effective multidisciplinary practice. These are the
abilities to:
Lead collaborative sessions.
Analyze, synthesize, and integrate information into clear, concise messages.
Communicate effectively.
Instructional Text
As you watch this mission, consider how the characters are demonstrating the skills and how you could
model those skills yourself in a different context.
When you have completed the mission, you will be able to revisit any location in any order.
Characters in this Mission
Heather Adams ? Treatment Coordinator, Imago Residential Treatment Program
Hayden Aikers ? Personal Assistant to Governor Nixon
Virginia Bledsoe ? Circuit Court Judge
Jon Conklin ? Licensed Medical Social Worker
Stanley Friedman ? MD?Psychologist/Director, Imago Addiction Treatment Center
Eric Knight ? Department of Health and Human Services Case Manager
Roberto Mendez ? LICSW, Stacy’s Therapist
Stacy Nixon ? Governor’s Daughter
Thomas Nixon ? Governor
Abby Ormond ? Family Court Case Worker
Expository Text
After several days of treatment in the psychiatric unit, Stacy’s care providers think she is ready to be
discharged. A family meeting is set so that she and her family can discuss their concerns.
Collaborative discussion
Instructional Prompt
Click on all highlighted characters to hear their thoughts about Stacy’s upcoming discharge.
Dialogue 01: Dr. Friedman provides some context to begin the Nixon family
Dr. Stanley Friedman
Alright… it looks like we’re all here. Let’s get started. The purpose of this meeting is to talk about what to
expect when Stacy is discharged tomorrow and what kind of help you, Stacy, and your family might need
both in the short term and the long term.
Roberto Mendez
Stacy, what are your thoughts at this point?
Stacy Nixon
I’ll be honest… I feel really trapped. You all make these decisions for me and if I don’t agree to your plans,
I’m not making progress and I don’t get discharged.
Dr. Stanley Friedman
Don’t you think that’s a bit extreme?
Stacy Nixon
Of course. Stacy’s being extreme again.
Thomas Nixon
Do you really need to start this meeting by picking a fight with everyone?
Roberto Mendez
It’s okay, Thomas… Stacy may be feeling a lot of frustration and anger right now. This relapse was
unexpected and really shook her confidence. She thought her medications were doing the job and then
this happened.
Thomas Nixon
Stacy ? I really want to understand how you feel. What’s going on? You just clam up and I feel like the
only time I know what’s going on is when we have a family meeting like this.
You shut me out but then, when you’re in trouble, you expect me to move heaven and earth to help you.
It’s frustrating.
Dialogue 02: Stacy tries to explain some of the issues she faces with her bipolar
Stacy Nixon
I know it’s frustrating, Dad. It is for me, too. There’s no way I could ever make you understand what it’s
like to be me, to be in my head.
Thomas Nixon
Honey… that’s probably true, but you don’t know what you’re like when you go off your meds. It’s awful.
It’s like someone kidnapped my beautiful girl and left a… a… (embarrassed because he was thinking
“monster”) …I don’t know. Someone who isn’t you.
Stacy Nixon
[Shouting] I didn’t go off my meds this time!
Roberto Mendez
I know, Stacy. I don’t think anyone was saying you did.
Thomas Nixon
But it’s not like you never have.
Stacy Nixon
[Really dejected] No… it’s not.
Thomas Nixon
I’m just saying, Stacy. You do so well when you stay on your medication, but it just feels like sooner or
later, you’re going to decide to stop taking something and then it all falls apart again.
Roberto Mendez
Stacy, how do you feel when you hear your dad saying that?
Stacy Nixon
Like a complete failure. It’s like I have to accept being this zombie or I’m letting everyone else down. It
doesn’t matter that I can’t paint any more… and not just because of the tremors. I just don’t see the world
the same way.
It doesn’t look the same to me when I take all this stuff. I know it’s bad when I’m manic, but what I hear
from you all is that it’s better for me to be miserable than manic.
Thomas Nixon
Don’t you think that’s a little melodramatic?
Stacy Nixon
NO! I don’t… I think it’s how I feel.
Dialogue 03: Robert moves the conversation to discharge concerns.
Roberto Mendez
[Watch for examples of the hourglass model in Roberto’s facilitation of this discussion.]
I think we should talk about what happens after you’re discharged. How can we all contribute to a
successful recovery and transition back into your daily routines? The first thing to think about is living
Stacy Nixon
What’s to think about? I’m going home, right?
Roberto Mendez
To your apartment?
Thomas Nixon
No… home. To the family house in Lindner Hills.
Stacy Nixon
No… home. To my apartment.
Dr. Stanley Friedman
Thomas ? can you clarify what you were thinking?
Thomas Nixon
Stacy, I know you aren’t going to move in with Cynthia and me forever, but… well; the fact is that you are
still manic and we both know these episodes could go on for several weeks, if not longer.
In the past, the time after you’ve been hospitalized has been very difficult. It would be a lot easier for us to
help keep you out of trouble if you stayed with us.
Stacy Nixon
No. Absolutely not. I am going to my home.
Roberto Mendez
[Still gathering input from all stakeholders]
I’m not taking sides, but your father has a fair concern. Post-discharge has traditionally been a rocky time
for you. If you didn’t move in with your dad and his wife, what could you do instead?
Thomas Nixon
We go through this every time, Stacy… you get out of the hospital and stop taking your medications, you
don’t sleep, you don’t eat for days at a time.
Stacy Nixon
That’s happened once.
Roberto Mendez
Well, no. It may not have happened every time, but your father is right that it has been a pattern. I’m also
concerned about logistics. How will you get to your appointments?
Stacy Nixon
I’ll ride my bike.
Thomas Nixon
With two cracked ribs? Are you crazy?
Roberto Mendez
[Expanding the collaborative process]
I’d like to bring some other people into this discussion… Jon Conklin is one of the social workers here at
the hospital. I’d like to have him join us tomorrow so he can help coordinate some of these issues.
Stacy, you look really unhappy, but I think if we can get a better support network identified for you before
you’re discharged, you’ll have a more successful transition. Can I bring Jon into our discussion tomorrow?
Stacy Nixon
Sure… whatever.
Thomas Nixon
I understand you need to assert your independence, Stacy, but I have access to so many resources. It’s
very frustrating not to be able to use them. I mean… seriously, I have staff.
You don’t need to be biking all over town with a broken rib. My driver can take you wherever you need to
Roberto Mendez
Let’s go ahead and take a break ? stretch our legs, whatever ? and then talk a little more about all this.
Expository Text
A few weeks have passed since Stacy’s discharge and many of the concerns voiced by her father and her
treatment team have come to pass. This culminates with Stacy being picked up for driving under the
influence and with a revoked license. Fortunately, it was a single car accident and there were no injuries
or damage other than to the vehicle. Unfortunately, Stacy’s passengers were two underage college
students she’d only met that evening at a bar near the campus of Beck University.
This scene occurs several weeks later.
Gathering Information
Instructional Prompt
Click on all highlighted characters to hear what they have to say about Ms. Nixon’s situation.
Dialogue 04: Virginia Bledsoe, circuit court judge, explains the situation in very
blunt terms.
Judge Virginia Bledsoe
First of all, let me say that the only reason that I haven’t recused myself from this case is that I am
confident that it will not go to trial. None of us wants that.
Stacy, I’ve known you since you were a little girl, but if this goes to court, you will be facing serious jail
time. That no one was injured when you crashed that car is pure luck.
The fact that you were driving without a license, with minors in the vehicle, and under the influence tells
me that you are not making good decisions. Just the opposite in fact.
Stacy Nixon
Judge, I really appreciate all your help, but I actually wish we could go to trial. I’d really like to clear all this
up. I know I shouldn’t have been driving, but it was actually Erica and Troy who had been drinking.
That was the only reason I was driving… they were in worse shape than I was and I felt bad because I’d
been buying. I was actually shocked when I found out they were underage to be drinking in the first place.
I know I should probably…
Thomas Nixon
Stacy, that’s enough.
Virginia, we appreciate what you’ve done to help keep this a private matter.
Judge Virginia Bledsoe
Tom, I am not doing anything different than I would if we had no relationship. That’s what you need to
This is the bottom line ? Stacy needs to begin treatment for her drinking problem and, if she doesn’t
successfully complete an approved program, she will face prosecution.
This is Abby Ormond, she’s with the department of health and human services. Abby will work out a plan
to help Stacy, you, and Cynthia all navigate the treatment process and everything that goes along with it.
Abby Ormond
[Gathering information]
Hi, I’m pleased to meet you. I’m sure this is a stressful and confusing time, but we’re going to get through
it. I’ve reviewed the case file, but just to make sure I’m not making assumptions, Cynthia is Stacy’s
Stacy Nixon
Stepmother. She’s dad’s trophy wife. My real mother’s a drunk, too.
Thomas Nixon
Oh, for God’s sake, Stacy.
Judge Virginia Bledsoe
Tom… Stacy… this isn’t a counseling session. I’ll ask you both to keep it civil.
Abby Ormond
I’m sorry everyone. I’m not trying to reopen old wounds, but part of what I will be doing is coordinating
with everyone who is going to be helping with Stacy’s treatment and recovery.
It’s helpful if I know who will be visiting Stacy while she’s in the treatment facility or who will be involved in
family meetings and such.
Thomas Nixon
Visiting Stacy? I think your case file needs some work. Stacy is coming home with us. My wife is currently
on tour with the chamber orchestra, but she’s cutting that short and will be home by the end of the week.
Dialogue 05: Governor Nixon raises a strenuous objection to the idea that Stacy’s
treatment be an inpatient program.
Gathering information
Thomas Nixon
Virginia, I accept that you’re mandating that Stacy complete an alcohol treatment program, but that
doesn’t mean I agree it’s necessary. Quite frankly, the only reason I’m going along with the idea is
because you’ve made it clear that we don’t have a choice.
Abby Ormond
Are you saying that you don’t think Stacy has a dependency on alcohol?
Thomas Nixon
I think Stacy likes to drink too much. She has said herself, her mother had drinking problems also, though
my understanding is that Joanne hasn’t been drinking for the last couple of years.
Judge Virginia Bledsoe
Tom, I want to keep the line between our friendship and this situation very clear, but I am surprised that
you don’t see Stacy’s drinking as more than a problem. This is not the first time she has been charged
with a DUI.
Stacy Nixon
Gee… do you think the fact that my father is the governor has anything to do with that?
The police union distributes my picture to every cop out there just to make sure I am harassed every
chance they get. I know for a fact that they tell traffic officers to watch for me.
Thomas Nixon
I’m sorry, Virginia… Ms. Ormond… Stacy has bipolar disorder and unfortunately, we’re seeing that
paranoid grandiosity that comes out during her manic episodes.
Roberto Mendez
Stacy, we’ve discussed this issue before.
I know you don’t believe that you have any substance abuse issues, but you know that I’ve long thought
that a residential treatment program would help you not only with the drinking issues, but also with other
aspects of managing your condition.
I think this wake-up call could be a good thing for you.
Abby Ormond
From my review of your records, Stacy, I have to agree with Mr. Mendez. I think the residential program is
the best choice for a number of reasons. But, I would like to hear what your thoughts are on this, Stacy. I
want to know what you feel that you need.
Thomas Nixon
What Stacy needs is a safe and private environment where she can get the rest and support she needs to
get stabilized on her medications as quickly as possible.
Roberto Mendez
That is important, sir. You won’t get an argument from me on that. But I do think there are multiple issues
to be addressed and often, that’s better handled in a residential setting.
Obviously, the intake assessment will provide the final recommendations on the type of treatment, but I
fully expect that the report will recommend a residential program.
Judge Virginia Bledsoe
You all need to work this out. I am looking at two things ? successful completion of an approved alcohol
treatment program and adherence to the treatment plan that Ms. Ormond develops.
I’m not ready to mandate the specifics, but I do think that it’s in everyone’s best interest to take seriously
the recommendations being offered by Ms. Ormond and Mr. Mendez.
Dialogue 6: Abby explains her role in Stacy’s treatment.
Abby Ormond
[Communicating a course of action]
I think this is a good time to talk about what happens next ? what the expectations are and what my role
in this will be. I like to describe my role as being a snowplow.
We’re going to figure out a route to get you where you need to go, Stacy, and I’m going to be out front
trying to make sure the road is clear for you.
In more pragmatic terms what I’m going to be doing is helping put together a treatment plan that looks at
all the issues ? the treatment strategy, biomedical issues, psychological issues, support network,
logistics ? the whole ball of wax.
What I do is not counseling ? you have Mr. Mendez for that ? but rather looking at your situation
holistically and trying to find out where the pitfalls might be and what kind of support can help you avoid
Thomas Nixon
That’s all well and good, Ms. Ormond, but Stacy has been down this path before. Whether we like it or
not, she is a public figure just by virtue of being my daughter.
What we need is a plan that will keep her out of the public eye while she gets better. I don’t see how
residential treatment can accomplish that.
Roberto Mendez
Stacy, we haven’t heard much from you. What are your thoughts?
Stacy Nixon
What does it matter? I can see that everyone else has an opinion of what I need. It’s obvious that I’m just
going to have to follow your agenda whether I agree with that or not.
Thomas Nixon
Stacy, do you want to go into a residential treatment program or do you just want to come home with me
and Cynthia where you can work on getting better?
Stacy Nixon
None of the above?
Abby Ormond
While I agree that we need to decide what program is going to be the best fit, that decision won’t be made
this afternoon. I want to be sure that what I am hearing, though, is correct.
I am hearing that you are willing to begin treatment for alcohol dependence. Is that correct, Stacy?
Thomas Nixon
That’s correct.
Abby Ormond
Stacy? You’re actually the person who has to make this decision. The rest of us ? even the judge and
your father ? are only able to offer advice and opinions.
Whatever you choose may have certain consequences, but it is still your choice. Are you willing to begin
treatment for alcohol dependence?
Stacy Nixon
I don’t have an alcohol problem, but everyone else seems to think I do, so sure… yeah; I’m willing to go
through the program.
Expository Text
The next day finds Abby coordinating with various agencies and individuals and pulling together the
information and materials she will need to create a treatment plan as well as to manage other aspects of
Stacy’s case.
Creating a solution
Instructional Prompt
Click on all highlighted characters to hear how Abby is interacting with the various stakeholders and other
Dialogue 7: Abby answers a call from Dr. Stanley Friedman, director of the Imago
Addition Treatment Center.
Gathering information and creating a solution
Abby Ormond
Hello, Doctor Friedman, thanks for getting back to me.
Dr. Stanley Friedman
Not a problem. I understand you’re working with Stacy and the Governor?
Abby Ormond
Yes, I’ve been appointed by the court as Stacy’s advocate and case manager.
Dr. Stanley Friedman
Yes, I see from the paperwork you sent over that Stacy’s got some legal issues on top of everything else.
Abby Ormond
Yes, but I’ll be honest, I think this could be a good opportunity for her. I’m very glad that there’s space for
her in your residential program.
Dr. Stanley Friedman
Yes, she did get lucky on the timing.
Abby Ormond
One of my responsibilities is to ensure Stacy knows what is expected of her. She’s obviously been
hospitalized for her mental health issues, but she hasn’t been in an alcohol treatment program.
I know that her counselor has talked to her about your program, but I want to make sure that everyone
knows what is expected in terms of behavior once she is admitted.
Dr. Stanley Friedman
Absolutely. What I’d like to do is to have our treatment coordinator talk to you. She’s in an intake meeting
right now, but I can have her get back to you. Will you be available after lunch?
Abby Ormond
Sure. That would be excellent. Thanks.
Dr. Stanley Friedman
You’re welcome. Anything else?
Abby Ormond
Actually, yes… a couple of things. One is that for obvious reasons, Stacy and her father are both
concerned about confidentiality.
Dr. Stanley Friedman
Yes, and that’s a tricky issue. Obviously, anyone on staff is bound by legal and ethical standards ?
HIPAA and all that. There are a couple of things to consider, though. One is that the other group
members are not bound by our ethical codes or laws.
Obviously everyone signs paperwork stating basically that is what is shared within the group is supposed
to stay there, but… well, that doesn’t have a whole lot of teeth. Couple that with all the cell phones and
electronic devices ? it could get ugly.
The other issue is that people know what goes on at these facilities. If I see you going in the door of
Imago, well… people can guess why you might be there. They might guess incorrectly, but they can
guess nonetheless.
Abby Ormond
Those are really good points.
Dr. Stanley Friedman
Not trying to sound partial, but those are actually good reasons that she’s entering the program at Imago.
As far as the electronic devices ? we don’t allow them. Clients are not supposed to have them at all while
they are in the facility and certainly not in group.
Obviously, we’re not going to guarantee that s …
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