ATOS 1-PAGE BRIEF OVERVIEW – 20 POINT BRIEF RATING GUIDES 27 Aug 08

The Psychotherapy Research Program at HMS

Leigh McCullough Ph.D., Director

 

AWARENESS OR INSIGHT INTO MALADAPTIVE PATTERNS OF THOUGHTS, FEELINGS, AND/OR BEHAVIORS

81-100-- Excellent recognition of problem patterns. Excellent links to past origin of behaviors. Excellent awareness/insight.

   61-80-- Good recognition of problem patterns. Some description of origins in past, linked to present. Good awareness/insight.

   41-60-- Moderately clear recognition.  On own describes occurrence of maladaptive patterns. No references to past. Moderate awareness/insight.

   21-40-- Low recognition. Can see problem pattern only when pointed out by therapist.  Little/no elaboration.  Minimal awareness/insight.

     1-20-- No recognition of maladaptive behavior patterns, or unsure when pointed out.  May mention anxiety without reference to pattern.  No awareness/insight or resists awareness/insight.

 

MOTIVATION TO GIVE UP MALADAPTIVE PATTERNS OF THOUGHTS, FEELINGS, AND/OR BEHAVIORS

81-100-- Excellent motivation to give up maladaptive patterns.  Very strong discomfort, sorrow, openness to change.  Litte/no resistance.

   61-80-- Strong motivation to give up maladaptive patterns.  Strong discomfort, sorrow, openness to change.  Low resistance.

   41-60-- Moderate motivation to give up maladaptive patterns.  Moderate discomfort, sorrow, openness to change.  Moderate resistance.

   21-40-- Low motivation to give up maladaptive patterns.  Low discomfort, sorrow, openness to change.  Much resistance.

     1-20-- No motivation to give up maladaptive patterns.  Ego-syntonic/desirable.  ÒThis is who I am.Ó  Almost total resistance.

 

DEGREE OF INTENSITY  OF AFFECTIVE AROUSAL (IN-SESSION EXPOSURE TO PHOBIC AFFECTS)

81-100-- Full experience of emotion, well-integrated.  Full grief, full openness/tenderness/trust, full justifiable outrage, full joy, etc.

   61-80-- Strong experience of emotion.  Strong affect quickly cut off or sustained but a little held back.

   41-60-- Moderate experience of emotion.  Some grief, some anger, some openness/tenderness/trust/care, etc.  Some holding back.

   21-40-- Low experience of emotion.  Beginning indications of grief, anger, openness/tenderness/trust/care/joy, etc.  Much holding back.

     1-20-- Little/no physiological experience of emotion in facial expression, verbal report, tone of voice, body movement. Flat, dull, bland presentation.

 

NEW LEARNING: ADAPTIVE EXPRESSION OF THOUGHTS, FEELINGS, WISHES, OR NEEDS

81-100-- Excellent expression of thoughts/feelings; sense of completeness, balance and excellent results.  Great relief and satisfaction experienced.

   61-80-- Good expression of thoughts/feelings; slight holding back.  Not all expressed, but good sense of relief in speaking up.  Good satisfaction.

   41-60-- Moderate expression of thoughts or feelings; moderate holding back, but  moderate effectiveness.  Moderate relief.  Moderate satisfaction.

   21-40-- Beginning attempt to express thoughts or feelings.  Much holding back. A little relief in expression.  A little satisfaction.

     1-20-- No expression of adaptive thoughts or feelings.  Total holding back.  No relief.  No satisfaction.  High end of this rating level: can begin to imagine expressing adaptive thoughts or feelings, wants and needs, but is as yet unable put it into action.

 

INHIBITORY FEELING: VERBAL OR NONVERBAL EVIDENCE OF THE OBSERVABLE PRESENCE OF ANXIETY, GUILT, SHAME, OR PAIN

81-100-- Extreme inhibitory affect: e.g., extreme shakiness, hesitancy, vigilance, trembling, anxiety or shame.  Extreme uneasiness.

   61-80-- High inhibitory affect: e.g., high levels of shakiness, hesitancy, vigilance, trembling, anxiety or shame.  Great uneasiness.

   41-60-- Moderate inhibitory affect: e.g., moderate shakiness, hesitancy, vigilance, trembling, anxiety or shame.  Moderate uneasiness.

   21-40-- Low inhibitory affect: e.g., low shakiness, hesitancy, vigilance, trembling, anxiety or shame.  Low level of uneasiness.

     1-20-- Little or no inhibitory affect. Little or no shakiness, guardedness, hesitancy, vigilance, trembling, anxiety, etc.  Comfortable, at ease.

 

IMPROVEMENT IN SELF-IMAGE

81-100-- Highly adaptive sense of self; compassionate and accepting of strengths and vulnerabilities.

   61-80-- Very adaptive sense of self; much compassion and acceptance, but some self-blame or shame present.

   41-60-- Moderately adaptive/maladaptive aspects of self-image in approximately equal amounts.

   21-40-- Very maladaptive sense of self, but a little compassion, and a little ability for acceptance.

     1-20-- Highly maladaptive sense of self; little or no compassion, awareness, or self acceptance—or excessive grandiosity.

 

IMPROVEMENT IN IMAGE OF OTHERS

81-100-- Highly adaptive sense of others.  Very much compassion/acceptance/trust in others; little or no idealization or devaluation.

   61-80-- Very adaptive sense of others.  Much compassion/acceptance/trust, but some devaluation or idealization.

   41-60-- Moderately adaptive as well as maladaptive aspects; moderate compassion/acceptance/trust, moderate devaluation/idealization.

   21-40-- Very maladaptive sense of others, but some compassion, empathy or ability for acceptance; much devaluation or idealization.

     1-20-- Highly maladaptive sense of others; Little or no compassion, empathy or acceptance.  Very much devaluation, idealization or splitting.

 

© 1997, 2003, 2008 Leigh McCullough                                                                                                                                        ATOS Brief Overview