Beck Ch 5

Question 1

What are 3 main ways you might miss a diagnosis?

Answer 1

1. you get incomplete information,
2. clients deliberately withhold information (e.g., substance use)
3. you erroneously attribute certain symptoms (e.g., social isolation) to a particular disorder (depression), when another disorder is also present (social phobia).

Question 2

What are the 6 main objectives of the evaluation session?

Answer 2

1. Collect information in order to form an initial cognitive conceptualization, diagnosis, and treatment plan
2. Determine if you are a good fit
3. Determine if adjunctive treatment (e.g., medication) might be indicated
4. Initiate a therapeutic alliance
5. Educate client about CBT
6. Set up an easy Action Plan

Question 3

How is many parts does the evaluation session consist of?

Answer 3

6

Question 4

How long does an evaluation session typically take?

Answer 4

1-2 or more hours

Question 5

What is Part 1 of the evaluation session?

Answer 5

Part 1: Starting the evaluation session

1. Before client comes to office, review records and forms they have completed
2. Greet client upon arrival
3. Determine if they want a loved one to attend all, part, or none of the evaluation session
4. SET THE AGENDA: start the session by introducing yourself and setting the agenda

Question 6

What is Part 2 of the evaluation session?

Answer 6

Conducting the assessment

1. Collecting info about different areas of client’s life and issues
2. Eliciting a description of a typical day
3. Responding to hopelessness and skepticism
4. Seek additional info (anything else important for me to know)
5. Involving a trusted person

Question 7

What is Part 3 of the evaluation session?

Answer 7

Relating your Diagnostic Impressions, setting Broad Goals, and relating your general Treatment Plan

Question 8

What is Part 4 of the evaluation session?

Answer 8

Setting the Action Plan: Laying out what the action plan is in writing, troubleshoot with client about how they will make sure they do the action plan (where, when, how)

Question 9

What is Part 5 of the evaluation session?

Answer 9

Establishing Expectations for treatment

Question 10

What is Part 6 of the evaluation session?

Answer 10

Summarizing and eliciting feedback

Question 11

Provide an example of an initial interaction with a client

Answer 11

This is our evaluation session. It’s not a therapy session, so we won’t work on any issues today. We’ll start doing that next time. (pause) Today, I need to ask you a lot of questions [providing a rationale] so I can make a diagnosis. Some of the questions will be relevant. Some won’t be, but I need to ask them so I can rule in the problems you have and rule out the problems you don’t have. [being collaborative] Is that okay?

I’ll probably need to interrupt you a few times, so I can get
the information I need. If it bothers you, would you let me know?

Before we begin, I’d like to tell you what to expect. This is what we call “setting the agenda,” and it’s something we do at every session. Today, I need to find out why you’re here, and I’ll ask you about the symptoms you’ve been having, how you’ve been functioning lately, and about your history. (pause) All right?

Second, I’m going to be asking you what’s going right with your life and when the best period of your life was. Then I’ll ask you to tell me anything else you think I should know. Does that sound okay?

Third, I’ll tell you what I think your diagnosis is, but I may need to look over your records and forms and my notes and talk to you more about it next week. Fourth, I’ll tell you what I think we should focus on in treatment. (pause) And along the way, I’ll be telling you more about CBT, and I’ll ask you how it all sounds. (pause) At the end, we’ll set some broad goals for how you’d like your life to be different. Then I’ll ask you whether you have any questions or concerns. Okay?

Question 12

What areas need to be included in the assessment?

Answer 12

Maybe remove? Too extensive? See Case Write up worksheet

Question 13

When asking a client to describe a typical day, what things should you look out for?

Answer 13

1. variations in their mood;
2. the degree to which they are interacting with family, friends, and people at work;
3. General level of functioning at home, work, and elsewhere;
4. How they’re spending their free time;
   activities that bring them a sense of pleasure, accomplishment, and/or connection;
5. self-care activities; and
6. activities they’re avoiding.

Question 14

What needs to be done between the evaluation session and the first therapy session?

Answer 14

1. Write an Evaluation Report and initial Treatment plan
2. Contact previous therapists or health professionals for any additional info (with consent, if not already done)
3. Contact any other relevant current professionals to coordinate care