Reality Testing

Destroyed

Damaged

Distorted

Disturbed

Intact

Thought Processes

Incoherent, nonsensical

Tangential or pressured difficult to follow

Repetitive or rambling sometimes confusing

Abstractor circumstantial; something irrelevant

Mostly logical and relevant; some blockage

Logical, relevant, coherent

Thought Content

Extreme Disorganization Incoherent

Bizarre; somewhat disorganized

Bizarre but organized. Systematic deletions may be present

Distorted and difficult to modify; may be referential

Distortion Present but limited to particular situations. May be modified

Limited in transient distortions. Recognizable by client

Intact accurate and functional

Judgment

Extremely poor in all areas

Limited in many areas

Limited in particular areas

Judgment intact but not used

Judgment intact, used inconsistently

Judgment intact used inconsistently; aware of inconsistency present

Judgment intact used consistently

Capacity for Insight/Self-Observation

Extremely poor

Severely limited

Limited, Used with great difficulty

Mild to moderate but extreme resistance to use

Mild/moderate w/ resistance to use

Good w/ Extreme resistance to use

Good w/ Some resistance to use

Cognitive Rigidity Cognitive Flexibility

Rigid can think & conceptualize

only in narrow terms, in either/

or thinking

Flexible; thinks in manner

appropriate to situation; balanced

Too flexible; combines ways of
thinking in manner that is unhelpful.
E.g., combines logic and Intuition when only one is needed.

Sense of Mastery/Competence

Feels incompetent. Can accomplish little in world. Feels impotent. No sense

of control.

Beginning sense of competence. Can accomplish tasks with encouragement and support, but inconsistent

Mastery developed. Can accomplish tasks, but has not internalized sense of competence Or control

Mastery and competence are developed and internalized person has sense of developed experience/ basic trust in ability

Sense of mastery & competence complete. Person has confidence and trust in own abilities even under duress. Internalized sense of potency and control

Motivation

None

Little

Beginning

Inconsistent/motivated by extreme rewards

Motivation internalized/ need support

Motivation high/internalized