Psychiatric interviewing

Question 1

4 tasks of the initial interview

Answer 1

Build a therapeutic alliance
Obtain the psychiatric database
Interview for diagnosis
Negotiate a treatment plan and communicate it to patient

Question 2

3 phases of the diagnostic interview

Answer 2

Opening phase (5-10min): why came?
Body of the interview (30-40 min): interview priorities
Closing phase (5-10 min): discussion of assessment, and effort to come to a negotiated agreement about treatment

Question 3

Essential concepts therapeutic alliance

Answer 3

Be warm, courteous and emotionally sensitive
Actively diffuse the strangeness of the clinical situation: greet pt naturally, get to know the pt as a person first, educate person about nature of the interview (time), address the pt’s projections
Give pt the opening word: shows interest, scout for clues about dx hypothesis
Gain pt’s trust by projecting confidence: ask good questions, dress, confident attitude, good feedback

Question 4

Rapport building techniques

Answer 4

Empathetic statements
Direct feeling questions
Reflective statements

Question 5

How to approach threatening topics

Answer 5

Normalization 
Sx expectation
Sx exageration
Decreasing guilt
Use familiar language

Question 6

Interviewing family members 3 goals

Answer 6

Let them know they’re not alone
Provide support and allow informants to vent
Instill hope for change

Question 7

Interviewing family questions

Answer 7

Open-ended: how do you think she's been doing lately 
causse? 
dx, explain 
better/ worse
typical day

Question 8

Mental staut evaluation

Answer 8

Appearance (height, build, hair , eyes, facial hair,tatoos, are, younger, hygiene)
Behaviour and attitude
Motor activity: bradykinesia, hyperkinesia, tocs, gait, pacing
Speech: rate, volume, latency of response, general quality
Affect and mood: stability, appropriateness, range, intensity
Thought process
Though content: SI, HI, delusions, obs, compulsions
Perceptual disturbances: hallu, ill, depress, deralisation
Cog examination: att, concentraion, memory, judgment, insight, awareness, orientation

Question 9

Parts of the psychiatric interview

Answer 9

Identifying data: name, age, sex, marital status, ethnicity, occupation, referral source
source and reliability
chief complain "" 
history of present illness 
past psychiatric history 
subside, abuse and addictions
past medical history
family history
dev and social history
review of systems (physical)
MSE
physical exam
formulation
trx planning

Question 10

Suicidal pts

Answer 10

prior history, family history, lethality, plan, prevented, psychotic