Lecture 2 - Assessment and Diagnosis

Question 1

Assessment of presenting problem (9 + intro)

Answer 1

Assessment of presenting problem: collaborative process, never know how much information you will get. No one way to conduct an assessment – “Do you want to tell me a bit about what has brought you in today?” Ongoing process – more information obtained over time.

• Presenting problem – description, onset, frequency/duration, severity, coping methods, history.
• Expectations and goals – working with them on what they want to work on. Functional goals.
• Cognitive/behavioural analysis – example of recent experience. Trigger, thoughts, feelings, sensations, behaviours, consequences.
• Alcohol, substance use, risk assessment – MOST IMPORTANT PART. Doesn’t matter if they are resistant, you need to conduct a risk assessment.
• Diagnostic screening – structured assessments. Ruling out other disorders.
• Developmental, medical, educational, and occupational history
• Psychosocial history – social support is essential. Emphasise and highlight protective factors.
• Family history of mental illness – understanding what has contributed. Normalising experiences.
• Sleep/diet/exercise/concentration/memory – sometimes they might not disclose severity. Need to get them to baseline levels to work with them.

Question 2

Case Formulation

Answer 2

• Predisposing – vulnerabilities that have led them developing their current problems.
• Precipitating – triggers for current problems. Proximal or distal.
• Presenting issues – summarise what they have brought in. Need to normalise diagnosis, can be stigmatising as well as normalising.
• Perpetuating – what is keeping you in this cycle, maintaining these feelings?
• Protective – resilience, social support, access to resources.

Question 3

Cognitive Model (4)