1. Assessment- purpose, hx, interviewing

Question 1

Why should we assess and diagnose?

Answer 1

• To identify the problem
• To guide treatment (consistent interventions)
• To indicate prognosis
• To help the patient understand what is wrong
• To promote empathy towards the patient
• Useful for research.

Question 2

what is the general purpose of an assessment?

Answer 2

To use tools and skills to …

• learn about the client (generally and specifically)
• answer specific questions
• be able to predict future behavior and functioning
• be able to make reasonable recommendations to improve functioning

Question 3

Describe the six stages of assessment

Answer 3

1. Evaluate the referral question
2. Collect data - use multiple sources (interviews, obs, tests etc)
3. Interpret the data (develop hypotheses)
4. Describe a formulation
5. Make recommendations
6. Give feedback

Question 4

What are some biases common with poor clinical judgments?

Answer 4

1. Primacy effect; develop incorrect hypotheses based on first impression
2. Confirmatory bias; seeking information to confirm hypothesis not probing for disconfirmation
3. Halo effects; general impression then infer other seemingly related characteristics

Question 5

What are the five core areas of history taking?

Answer 5

1. Chief complaint - why are they seeking help?
2. History/severity of reported difficulty - duration, start, changed?
3. Past medical and psychiatric history
4. Perinatal/developmental history (probe for childhood)
5. social history (friends, hobbies, interests - probe for strengths)

Question 6

What is the most essential elements in gathering data in an assessment?

Answer 6

RAPPORT

Found to be the most robust predictor of positive therapeutic outcome (regardless of therapy used)

Question 7

What is the Therapeutic Model of Assessment (TMA)?

Answer 7

Possesses distinctive features of a traditional “information gathering” assessment .. BUT it expands the focus of assessment by integrating the following elements…

Responding to acute stressors that may have developed since last meeting (last time spoke about .. has this come up since we discussed?

Clarifying sources of distress and cyclical relational themes (when was the first/last time you remember feeling …)

Allowing the patient to initiate the discussion of salient issues

Facilitating client affect and experience (how do you feel right now)

Exploring uncomfortable feelings

Exploring in-session process and affect

Always share assessment results with clients

Question 8

What are the benefits of using a TMA approach?

Answer 8

Alliance developed during preliminary assessment using TMA found to be superior to traditional information gathering (IG) models

TMA clients less likely to terminate before formal treatment relative to those receiving IG assessments

Question 9

What are some essential interview techniques?

Answer 9

Open ended questions
Clarification
Confrontation
Active listening
Reflection
Summary Statements
Interpretations
Positive regard
Physically attending to client (posture, eye-contact, expression etc)

Question 10

What are the three channels of communication in an interview?

Answer 10

Verbal
Non-verbal
Countertransference.