The “O” is the hardest part of SOAP notes. Here’s how one therapist tackles it
You can make writing the “objective” section of SOAP notes even easier.
Learn more about the ADNM-8 assessment and how you can incorporate it into your practice.
Adjustment disorder, or a mental or behavioral response to stressful events in a person’s life, is one common diagnosis therapists see in their practices. While context like your clients’ presentation and their report of what's going on in their lives may give you helpful clues, an assessment can help you determine whether adjustment disorder is the right diagnosis.
The ADNM-8 is an evidence-based questionnaire that can help you better understand how stress may be impacting your clients’ lives so you can develop a treatment plan that supports their mental health. As their symptoms change, you can re-issue the assessment and adjust your plan if necessary. Below, learn more about the ADNM-8 assessment and how you can incorporate it into your practice.
The ADNM-8 is a questionnaire that helps support a diagnosis of adjustment disorder. It asks participants to select from 18 potentially stressful events that may have happened to them in the last six months.
A second portion of the questionnaire asks participants to list the most stressful events from the items they selected. Finally, the last part of the questionnaire has participants choose from eight reactions these types of events can trigger in their everyday lives.
The ADNM-8 is a self-administered assessment, which means the client fills it out on their own. Then, a provider scores the assessment based on the client’s answers.
The ADNM-8 assessment includes the following scenarios and prompts clients to mark “yes” to the ones they have experienced in the last six months:
1. Divorce/separation
2. Family conflicts
3. Conflicts in working life
4. Conflicts with neighbors
5. Illness of a loved one
6. Death of a loved one
7. Adjustment due to retirement
8. Unemployment
9. Too much / too little work
10. Pressure to meet deadlines / time pressure
11. Moving to a new home
12. Financial problems
13. Own serious illness
14. Serious accident
15. Assault
16. Termination of an important leisure activity
17. Any other stressful event (please indicate)
18. Any other stressful event (please indicate)
Next, the assessment asks participants to list the items that have been most straining in their lives.
Lastly, the ADNM-8 asks participants to score how stressful events have impacted them over the last six months. Selections include:
1. I have to think about the stressful situation repeatedly.
2. I have to think about the stressful situation a lot and this is a great burden to me.
3. Since the stressful situation, I find it difficult to concentrate on certain things.
4. I constantly get memories of the stressful situation and can’t do anything to stop them.
5. My thoughts often revolve around anything related to the stressful situation.
6. Since the stressful situation, I do not like going to work or carrying out the necessary tasks in everyday life.
7. Since the stressful situation, I can no longer sleep properly.
8. Overall, the stressful situation affected me strongly in my personal relationships, my leisure activities, or other important areas of life.
The first part of the ADNM-8 simply asks clients to mark stressors in their lives. The highest possible score is 18.
Each measure on the third part of the ADNM-8 is assigned a certain number of points. The highest possible score is 32, indicating that stressors are significantly affecting a client’s life.
Never: 1
Rarely: 2
Sometimes: 3
Often: 4
In this scored section, questions 1, 2, 4, and 5 represent preoccupation with the stressor, while questions 3, 6, 7, and 8 represent failure to adapt to stress. This information gives useful context for not only if the client meets criteria for adjustment disorder, but also paints a more comprehensive picture of how the different criteria and symptoms are showing up.
While it’s often used as a tool for screening and diagnosing adjustment disorder in new clients, the ADNM-8 is also useful in reassessing clients so you can adjust their treatment plan as needed. For example, if you diagnosed a client with adjustment disorder six months ago, you can re-issue the ADNM-8 to determine the current severity of symptoms and adjust your treatment plan as needed.
You can make writing the “objective” section of SOAP notes even easier.
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