Chief Complaint and Free Speech

Question 1

What is “chief complaint”?

Answer 1

Client’s main reason to seek therapy.

Answer of the opening question.
Usually takes only a few seconds.

Question 2

What immediately follows the opening and chief complaint?

Answer 2

Free Speech

Question 3

What are the 2 interviewing styles that you can pump information?

Explain

Answer 3

1. Directive: Structure is given and client knows what we want to know.
2. Nondirective: Clinician absorbs passively.

Question 4

Which interviewing style should be used?

Answer 4

Both.

Question 5

What are the advantages and disadvantages of nondirective interview?

Answer 5

Advantages:
- Strong rapport.
- Reliable facts.

Disadvantages:
- Less information.

Question 6

Which interviewing style should be used more at the beginning of session and why?

Answer 6

Nondirective:
1. Strong relationship.
2. What is the uppermost problem.

Opening request for information should
clearly state what is expected.

Question 7

How should the clinician do the opening question?

Answer 7

• Being specific.
• Informs patient what information is needed.

Question 8

How should the clinician ask the client why did they come?

Answer 8

“What brings you here today?”

Doesn’t give anxiety, doesn’t imply that they need treatment.

Question 9

Can the diagnosis be done on the first session?

Answer 9

NEVER!

Question 10

What are the qualities of opening questions that affect the type of information gathered?

Answer 10

• Close-ended
• Open-ended

Question 11

What are the advantages of open-ended questions?

Answer 11

• Builds rapport.
• More time to observe.

Question 12

What are the functions of open-ended questions?

Answer 12

1. Request more information.
2. Move the story to the present.

Question 13

When are the close-ended questions needed?

Answer 13

When you need to obtain information in the least time.

Question 14

Why is the chief complaint important?

Answer 14

1. It’s the most important problem.
2. Flat denial (by contrast).

Question 15

What information does the denial give about the client?

Answer 15

1. Insight
2. Intelligence
3. Cooperation

SERIOUS PATHOLOGY OR RESISTANCE!!!

Question 16

Should be the chief complaint rephrased or should it be put as it is?

Answer 16

Write down in the client’s words.

Question 17

What is “free speech”?

Answer 17

• Clients express their thoughts without a direction.
• Minimum structured.

Ideally, 8-10 minutes in an hour-long session.

Question 18

Why is free speech recommended?

Answer 18

• Clinician is represented as they care.
• Client realizes they’ll be active in these sessions.
• Client can organize their thoughts.
• Client can explore other concerns.
• Client’s personality shows up (traits).
• Client’s mind can be observed better.

Client explores the reason why they are here.

Question 19

What should be done if a client isn’t able to give a satisfactory narration?

Low IQ, psychosis, etc.

Answer 19

Make the conversation much more structured.

Q-A

Question 20

What are the areas of clinical interest?

Answer 20

1. Social and personality problems.
2. Difficulty thinking (cognitive)
3. Excessive arousal, avoidance, anxiety
4. Mood disturbance (depression, mania)
5. Substance use
6. Physical complaints
7. Psychosis

People become mental health patients usually because of the 7 problems.

Question 21

Does free speech give enough information for a diagnosis?

Answer 21

No.

But you should make notes about anything that should be explored later.