Reach Intervention and Recovery Services

iWitness Report

What you write here will be kept strictly confidential and will be destroyed after our work together. The goal of these questions, after I've connected with all members of the intervention, is to create a comprehensive (complex and nuanced) profile of your Identified Loved One (ILO). Be blunt, be truthful, be emotional, be thoughtful.

Three questions that are especially important for you to fill out:

In "What have you seen?" be specific in describing the 'visual' of your ILO's behavior. ("I saw Julie sweating and trembling at our niece's commencement ceremony," or "I saw Jamie on the floor with all my pill bottles emptied out."
In "What do you fear?" describe what might happen to your ILO should he/she continue to use. ("I'm afraid that Jason will lose his job." "I am afraid he'll lose custody of his son." "I'm afraid that one day, I will walk into Tyler's room and find him dead.")
In "What are your hopes" tell me what it will look like when he/she says yes to treatment. ("I want to see my dad dance at his daughter's wedding." "I hope mom's liver damage get better.: "I hope she finds her soul mate.)

iWitness Report

The Privacy Rule protects all personally identifiable health information, known as protected health information (PHI), created or received by a covered entity. Personally identifiable health information is defined as information, including demographic information, that “relates to past, present, or future physical or mental health or condition of an individual, the provision of health care to an individual, or the past, present, or future payment for the provision of health care for the individual” that either identifies the individual or with respect to which there is a reasonable basis to believe the information can be used to identify the individual.” National Insitute of Health

(https://www.ncbi.nlm.nih.gov)

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